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Quick pearl to determine how long to load/clear medications


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I don't remember where I read this last week (may have been in my monthly abstracts) but I thought that this was a neat pearl.  To determine how long it takes for a med to be loaded into the system, and also how long until it clears your system, utilize the "Rule of 5" (not to be confused with the "Rules of 2" for RAD).  Take your medication half-life and multiple x5.  This will tell you when you medication in time is loaded.  Same rule for when medication clears your system after completing final dosing.  Example:  Eliquis has a half-life of 12 hours.  12x5=60 hrs.  Pt. is anti-coagulated in almost  2 1/2 days.

 

Others may have already been aware of this pearl but it was news to me.  Back to our regularly scheduled programming...

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Good rule of thumb.

 

When considering clearance also bear in mind to take in a patient's renal and/or hepatic function, volume of distribution and whether the drug has active metabolites (some of my ICU patients will stay sedated for weeks after a versed gtt or a patient who is ESRD will remain therapeutic on vanc until their next HD session vs a normal steady state after 4-5 doses in a patient with normal renal function).

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