Assignment Cases Details and Student List
Semester: Spring 2016-17
Name of the Course: Clinical Pharmacokinetics Code: PHCY350 Faculty Name: Dr. Sabin Thomas
Sl.No. / Section / Student ID / Name / Assignment Case No. & Details1. / 1 / 09433663 / MUNTAHA SALIM HAMED ALROOTLY / Case-1
Dosage regimen calculation of Quinidine in ventricular tachycardia patient.
2. / 1 / 13091214 / DIYANA ABDULAH KHLFAN AL-GHUZAILI
3. / 2 / 03456751 / HAMIDA RASHID NASIB AL RAWAHI
4. / 2 / 06664946 / ASHGAN SALIM AIL AL ARAIMI
5. / 1 / 13943773 / MAHA SAID GHALIB ALMUKHAINI / Case-2
Dosage regimen calculation of Quinidine for tachycardia in liver cirrhosis patient.
6. / 1 / 24541167 / NOOF ALI SALIM AL SHEKAILI
7. / 2 / 04706649 / ZUWEINA KHAMIS SALEH AL ADHABARI
8. / 2 / 05398732 / BASMA MUBARAK HAMED AL BIMANI
9. / 1 / 12432488 / MARYAM YAQOOB MUSABAH AL BUSAIDI / Case-3
Dosage regimen calculation of Quinidine for atrial tachycardia in heart failure patient.
10. / 1 / 03806482 / RISA SAIF ABDULLAH AL REESI
11. / 2 / 07243788 / AL SHAIMA AHMED SAIF AL MAMARI
12. / 2 / 12864829 / KAWTHAR SAID SALIM ALHASHEMI
13. / 1 / 72062739 / SHAHAD AHMED HASSAN AL-ABIDI / Case-4
Dosage regimen calculation of oral carbamazepine for tonic-clonic seizures.
14. / 1 / 92828153 / ALI HAIDER ISMAEL AL MULA ALI
15. / 2 / 10451424 / HANAN HAMOOD SAIF AL-SABQI
16. / 2 / 11986981 / SULTAN HAMOOD MOHAMMED AL HASHMI
17. / 1 / 05721481 / RAHAB AHMED HARIB AL BALUSHI / Case-5
Dosage regimen calculation of oral carbamazepine for simple partial seizures.
18. / 1 / 15174987 / SALMA SALIM ABDULLAH AL SAEGHI
19. / 2 / 12035788 / ABDULAZIZ SAID HAMED AL BADI
20. / 2 / 12299332 / AHMED BAKHIT OBAID AL SAADI
21. / 1 / 64706524 / ALAA ELSAYED HASSAN ELSAYED / Case-6
Dosage regimen calculation of valproic acid for tonic-clonic seizures.
22. / 1 / 12808311 / SAMIYA AWADH MATTAR AL ABRI
23. / 2 / 14643904 / HANADI SAID KHALFAN AL SAADI
24. / 2 / 11812179 / MARWAH QASIM MOHAMMED AL-QASIMI
25. / 1 / 05389328 / FATEMA AHMED HASSAN AL MAMARI / Case-7
Estimate creatinine clearance and tobramycin elimination rate. Gentamycin dose calculations.
26. / 1 / 07217484 / ATKA ABDULLAH IBRAHIM AL HAMED
27. / 2 / 13687754 / SUHAILA HUMAID RASHID AL ABRI
28. / 2 / 13912814 / DALAL MUDHAFFAR MOHAMMED AL ABRI
29. / 1 / 10649273 / SALMA HAMED MOHAMMED AL MARHOUBI / Case-8
Estimate creatinine clearance. Tobramycin dose calculation in intra-abdominal infection.
30. / 1 / 11886913 / MARYAM NASSER RASHID ALMASHRAFI
31. / 2 / 14674985 / ZAINAB ABDULLAH HAMOOD AL TOBI
32. / 2 / 09881959 / BUSHRA NASSER FADHIL AL BURTAMANI
33. / 1 / 03540048 / SARA HUMAID MUSABAH AL KALBANI / Case-9
Estimate digoxin clearance in sever heart failure. Theophylline clearance in COPD patient.
34. / 1 / 13617056 / GHALIYA ABDULLAH MOHAMMED AL KASBI
35. / 2 / 14950943 / SALMA ABDALLAH HARIB AL BALUSHI
36. / 2 / 18279255 / MARYAM HAMED SAID AL SHABIBI
Sl.No. / Section / Student ID / Name / Assignment Case No. & Details
37. / 1 / 13715874 / NURA SULAIMAN SAIF AL HADHRAMI / Case-10
Dosage regimen calculation of Theophylline in heart transplant patient.
38. / 1 / 20219825 / KHALOUD SAID ALI AL MASHAYKHI
39. / 2 / 20281517 / ROUQAYA SALMAN SALIM AL FUDHAILI
40. / 2 / 5778279 / AISHA MAHMOUD MOHAMMED AL KINDI
41. / 1 / 79298649 / BATOUL ABDUL RAZAQ ALLAHAM / Case-11
Dosage regimen calculation of Cyclosporine for tachycardia in liver cirrhosis patient.
42. / 1 / 08890364 / KAWTHAR MUSALLAM SALIM AL WAHAIBI
43. / 2 / 63866325 / HAGER MOHAMMED ZAKI ABU ELEZZ
44. / 2 / 68335905 / DIMA RAID FAKHRI AL NAJJAR
45. / 1 / 82137232 / Esraa MAHDI MOOSA DIYAB / Case-12
Dosage regimen calculation of Cyclosporine for hematopoietic stem cell transplantation patient.
46. / 1 / 70425553 / AMIRA RAMADHAN ELSAYED MOHAMMED
47. / 2 / 68390704 / ITHAR SABRI HUSSEIN MAKHIMAR
48. / 2 / 77770142 / AMNA IRFAN BAQER AL HELLI
49. / 3 / 05756269 / RUQAIYA AHMED ALI AL BALUSHI / Case-13
Dosage regimen calculation of Vancomycin in MRSA pneumonia.
Instructions to be followed while preparing the clinical case:
1. Refer to the case given below and follow the page numbers in the text book given.
2. Prepare the slides for presentation and present in groups in the respective lab section according to Eduwave during the next Lab sessions.
3. Submit a printed document of the same case individually solved by each student on or before 11th May.
Clinical Pharmacokinetics
Assignment Cases
Spring Semester 2016-17
Case-1 (Page 470-473)· VC is a 67-year-old, 72-kg (6 ft 1 in) male with ventricular tachycardia who requires therapy with oral quinidine. He has normal liver function and does not have heart failure. Suggest an initial extended-release quinidine gluconate dosage regimen designed to achieve a steady-state quinidine concentration equal to 3 μg/mL.
· Patient VC was prescribed oral quinidine gluconate 648 mg every 12 hours. The current steady-state quinidine concentration equals 2.5 μg/mL. Compute a new quinidine gluconate dose that will provide a steady-state concentration of 4 μg/mL.
Case-2 (Page 471-475)
· EM is a 56-year-old, 81-kg (5 ft 9 in) male with ventricular tachycardia who requires therapy with oral quinidine. He has liver cirrhosis (Child-Pugh score = 10) and does not have heart failure. Suggest an initial quinidine gluconate extended-release tablet dosage regimen designed to achieve a steady-state quinidine concentration equal to 2 μg/mL.
· Patient EM was prescribed oral quinidine gluconate extended release tablets 648 mg every 8 hours. The current steady-state quinidine concentration equals 5.1 μg/mL, and the patient is experiencing symptoms that could be adverse effects related to quinidine therapy. Compute a new quinidine gluconate dose that will provide a steady-state concentration of 3 μg/mL.
Case-3 (Page 471-477)
· OF is a 71-year-old, 60-kg (5 ft 2 in) female with paroxysmal atrial tachycardia who requires therapy with oral quinidine. She has severe heart failure (NYHA CHF class IV) and normal liver function. Suggest an initial quinidine sulfate extended-release dosage regimen designed to achieve a steady-state quinidine concentration equal to 4 μg/mL.
· Patient OF was prescribed quinidine sulfate extended-release tablets 600 mg orally every 12 hours. A steady-state quinidine serum concentration was obtained and equaled 6.7 μg/mL. Compute a new quinidine sulfate dose that will provide a steady-state concentration of 4 μg/mL.
Case-4 (Page 558-559)
· TY is a 47-year-old, 85-kg (6 ft 1 in) male with tonic-clonic seizures who requires therapy with oral carbamazepine. He has normal liver function. Suggest an initial carbamazepine dosage regimen designed to achieve a steady-state carbamazepine concentration equal to 6–8 μg/mL.
· Patient TY was prescribed 400 mg every 12 hours of sustained release carbamazepine tablets for 1 month after dosage titration, and the steady-state carbamazepine total concentration equals 4.5 μg/mL. The patient is assessed to be compliant with his dosage regimen. Suggest a carbamazepine dosage regimen designed to achieve a steady-state carbamazepine concentration within the middle portion of the therapeutic range.
Case-5 (Page 558-560)
· IU is a 9-year-old, 35-kg female with simple partial seizures who requires therapy with oral carbamazepine. She has normal liver function. Suggest an initial carbamazepine dosage regimen designed to achieve a steady-state carbamazepine concentration equal to 6–8 μg/mL.
· Patient IU was prescribed 150 mg three times daily (450 mg/d) of carbamazepine suspension for 1 month after dosage titration, and the steady-state carbamazepine total concentration equals 4.9 μg/mL. The patient is assessed to be compliant with her dosage regimen. Suggest a carbamazepine dosage regimen designed to achieve a steady-state carbamazepine concentration within the middle of the therapeutic range.
Case-6 (Page 585-588)
· CD is a 42-year-old, 85-kg (6 ft 1 in) male with tonic-clonic seizures who requires therapy with oral valproic acid. He has normal liver function. Suggest an initial valproic acid dosage regimen designed to achieve a steady-state valproic acid concentration equal to 50 μg/mL.
· Patient CD was prescribed 750 mg every 12 hours of enteric coated divalproex sodium tablets for 1 month, and the steady-state valproic acid total concentration equals 40 μg/mL. The patient is assessed to be compliant with his dosage regimen. Suggest a valproic acid dosage regimen designed to achieve a steadystate valproic acid concentration of 75 μg/mL.
Case-7 (Page 87-89) & (Page 136-137)
· A 70-year-old, 80-kg, 5-ft 11-in tall male with a Pseudomonas aeruginosa infection needs to have an initial tobramycin dose computed. In order to do this, an estimated creatinine clearance must be calculated. The patient’s current serum creatinine equals 2.5 mg/dL and is stable. Compute this patient’s estimated creatinine clearance and estimated tobramycin elimination rate constant and half-life [assume tobramycin elimination rate constant is ke (in h−1) = 0.00293 (CrCl in mL/min) + 0.014].
· QZ is a 50-year-old, 70-kg (5 ft 10 in) male with gram-negative pneumonia. His current serum creatinine is 0.9 mg/dL, and it has been stable over the last 3 days since admission. A gentamicin dose of 550 mg every 24 hours was prescribed and expected to achieve steady-state peak and trough concentrations equal to 30 μg/mL and <1 μg/mL, respectively. After the third dose, steady-state peak and trough concentrations were measured and were 37 μg/mL and 1 μg/mL, respectively. Calculate a new gentamicin dose that would provide a steady-state peak of 30 μg/mL and a steady-state trough <1μg/mL.
1. Estimate creatinine clearance.
2. Estimate elimination rate constant (ke) and half-life (t1/2).
3. Compute new dose to achieve desired serum concentration.
4. Check steady-state trough concentration for new dosage regimen.
Case-8 (Page 88-90) & (Page 135-136)
· A 66-year-old, 120-kg, 5-ft 2-in tall female has a serum creatinine equal to 3.1 mg/dL. Compute an estimated creatinine clearance for this patient.
· ZW is a 35-year-old, 150-kg (5 ft 5 in) female with an intra-abdominal infection. Her current serum creatinine is 1.1 mg/dL and is stable. A tobramycin dose of 165 mg every 8 hours was prescribed and expected to achieve steady-state peak and trough concentrations equal to 6 μg/mL and 0.5 μg/mL, respectively. After the fifth dose, steady-state peak and trough concentrations were measured and were 4 μg/mL and <0.5 μg/mL (e.g., below assay limits), respectively. Calculate a new tobramycin dose that would provide a steady-state peak of 6 μg/mL.
1. Estimate creatinine clearance.
2. Estimate elimination rate constant (ke) and half-life (t1/2).
3. Compute new dose to achieve desired serum concentration.
4. Check steady-state trough concentration for new dosage regimen.
Case-9 (Page 88-90)
· A 59-year-old, 140-kg, 5-ft 8-in tall male with severe heart failure has a serum creatinine equal to 2.4 mg/dL. Compute an estimated creatinine clearance, digoxin clearance, and digoxin volume of distribution for this patient. Assume estimated digoxin clearance in severe heart failure: Cl (in mL/min) = 1.303 (CrCl in mL/min) + 20; estimated digoxin volume of distribution: V (in L) = 226 + [(298 ⋅ CrCl)/ (29.1 + CrCl)].
· A 62-year-old, 65-kg male with hepatic cirrhosis (total bilirubin = 2.6 mg/dL, serum albumin = 2.5 mg/dL, prothrombin time prolonged over normal by 8 seconds, slight amount of ascitic fluid, no hepatic encephalopathy) and severe chronic obstructive pulmonary disease needs to have an initial theophylline dose computed. The patient is not a tobacco smoker and does not have heart failure. Compute the patient’s Child- Pugh score, estimated theophylline clearance, and theophylline dose to achieve a steady-state concentration equal to 10 mg/L.
Case-10 (Page 758) (Page 765)
· OI is a 60-year-old, 85-kg (6 ft 1 in) male with emphysema who requires therapy with oral theophylline. He has liver cirrhosis (Child-Pugh score = 11) and normal cardiac function. Suggest an initial theophylline dosage regimen designed to achieve a steady-state theophylline concentration equal to 10 μg/mL.
· OI is a 60-year-old, 85-kg (6 ft 1 in) male with emphysema who is receiving 200 mg every 12 hours of an oral theophylline sustained-release tablet. He has liver cirrhosis (Child-Pugh score = 11) and normal cardiac function. The current steady state theophylline concentration equals 15 μg/mL, and he is experiencing some minor caffeine-type adverse effects (insomnia, jitteriness, nausea). Compute a theophylline dose that will provide a steady-state concentration of 10 μg/mL.
Case-11 (Page 668-671)
· VI is a 37-year-old, 85-kg (6 ft 1 in) male heart transplant patient who requires therapy with oral cyclosporine. He has normal liver function. Suggest an initial dosage regimen designed to achieve a steady-state cyclosporine concentration equal to 300 ng/mL.
· Patient VI was prescribed 400 mg every 12 hours of cyclosporine capsules for 4 days, and the steady-state cyclosporine concentration equals 426 ng/mL. The patient is assessed to be compliant with his dosage regimen. Suggest a cyclosporine dosage regimen designed to achieve a steady-state cyclosporine concentration of 300 ng/mL.
Case-12 (Page 669-673)
· AS is a 9-year-old, 35-kg female (4 ft 6 in) hematopoietic stem cell transplantation patient who requires therapy with oral cyclosporine. She has normal liver function. Suggest an initial cyclosporine dosage regimen designed to achieve a steady-state cyclosporine concentration equal to 250 ng/mL.
· Patient AS was prescribed 150 mg every 12 hours of cyclosporine solution for 3 days, and the steady-state cyclosporine concentration equals 173 ng/mL. The patient is assessed to be compliant with her dosage regimen. Suggest an oral cyclosporine dosage regimen designed to achieve a steady-state cyclosporine concentration equal to 250 ng/mL.
Case-13 (Page 233)
· JM is a 50-year-old, 70-kg (5 ft 10 in) male with a methicillin-resistant S. aureus (MRSA) pneumonia. His current serum creatinine is 0.9 mg/dL, and it has been stable over the last 5 days since admission. A vancomycin dose of 1000 mg every 12 hours was prescribed and expected to achieve steady-state peak and trough concentrations equal to 35 μg/mL and 15 μg/mL, respectively. After the third dose, steady-state peak and trough concentrations were measured and equaled 22 μg/mL and 10 μg/mL, respectively. Calculate a new vancomycin dose that would provide a steady-state trough of 15 μg/mL.
1. Estimate creatinine clearance.
2. Estimate elimination rate constant (ke) and half-life (t1/2).
3. Compute new dose to achieve desired serum concentration.
4. Check steady-state peak concentration for new dosage regimen.