Nicholson et al developed a simple score as an alternative to the equation for predicting the dose of digozin required by a patient. The authors are from The Middlesex Hospital Medical School, University of Manchester, and Tameside General Hospital in England.
Parameters:
(1) inpatient vs outpatient
(2) body weight in kilograms
(3) serum creatinine in µmol/L
(4) mobility
(5) gender
(6) age
(7) heart rhythm
(8) diuretic treatment
|
Parameter |
Finding |
Points |
|
inpatient vs outpatient |
inpatient |
0 |
|
|
outpatient |
17 |
|
weight |
< 55 kg |
0 |
|
|
55 to 64.9 kg |
5 |
|
|
65 to 74.9 kg |
10 |
|
|
>= 75 kg |
15 |
|
serum creatinine |
< 70 µmol/L |
33 |
|
|
70 to 99 µmol/L |
11 |
|
|
100 to 199 µmol/L |
4 |
|
|
>= 200 µmol/L |
0 |
|
mobility |
chronically home or chair bound |
0 |
|
|
other |
12 |
|
gender |
female |
0 |
|
|
male |
7 |
|
age in years |
< 70 years |
8 |
|
|
>= 70 years |
0 |
|
heart rhythm |
normal sinus rhythm |
4 |
|
|
other |
0 |
|
diuretic treatment |
none |
4 |
|
|
prescribed |
0 |
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 100
• The higher the score the higher the daily maintenance dose.
|
Total Score |
Daily Dose in mg |
Tablets |
|
0 to 13 |
0.062 |
1 x 0.0625 |
|
14 to 24 |
0.09375 |
1x 0.0625 mg day 1, 2x 0.0625 mg day 2 |
|
25 to 37 |
0.125 |
1 x 0.125 mg |
|
38 to 49 |
0.1875 |
3 x 0.0625 mg |
|
50 to 61 |
0.250 |
1 x 0.25 mg |
|
62 to 73 |
0.375 |
3 x 0.125 mg |
|
74 to 85 |
0.500 |
2 x 0.25 mg |
|
86 to 100 |
0.750 |
3 x 0.25 mg |
Performance:
• Serup et al found that the simple method tended to underdose inpatients and recommended modifying the score to take this into account.
• Since serum level monitoring is readily available the score should be used as a starting point.
Specialty: Toxicology, Emergency Medicine, Critical Care, Cardiology
