Practice exercise (made-up values, not clinical guidance). A patient who weighs 88 kg needs a loading dose of gentamicin to reach a level of 6 mg/L straight away. The volume of distribution is 0.25 L/kg. Find the loading dose LD in mg.
Practice exercise (made-up values, not clinical guidance). Just after an IV dose, the tobramycin level is 6 mg/L. The half-life is 2 h, and the drug is eliminated by first-order kinetics. What is the level C 4 h later?
Practice exercise (made-up values, not clinical guidance). A patient receives an IV bolus of 170 mg of tobramycin. The level back-extrapolated to time zero is 8 mg/L and the half-life is 2 h. Find the clearance CL in L/h.
Practice exercise (made-up values, not clinical guidance). A patient receives an IV bolus of 140 mg of tobramycin. The level back-extrapolated to time zero is 6 mg/L and the half-life is 3 h. Find the clearance CL in L/h.
Practice exercise (made-up values, not clinical guidance). A 100 kg patient has a phenytoin level of 4.5 mg/L; the target is 15 mg/L. The drug is given intravenously as phenytoin sodium (S = 0.92), and the volume of distribution is 0.7 L/kg. What extra loading dose LD raises the level to the target?
Practice exercise (made-up values, not clinical guidance). A 61-year-old man weighs 95 kg and has a serum creatinine of 2.9 mg/dL (256 µmol/L). Estimate the creatinine clearance with Cockcroft–Gault: CrCl (mL/min) = (140 − age) × weight (kg)/(72 × SCr in mg/dL), × 0.85 for women. The usual gentamicin dose is 120 mg every 8 h for a creatinine clearance of 120 mL/min. Keeping the interval, the dose is reduced in proportion to the creatinine clearance. Find the adjusted dose D. Round to the nearest whole number.
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