pharm calc

Worth up to 30 points added to your lowest exam score (with grades capped at 105 with the addition of bonus points). These points cannot be split between exams. This bonus assignment integrates creatinine clearance calculations, body weight selection (ABW vs IBW vs AdjBW), renal dose adjustment, and pharmacogenetic modifications into a single patient-specific case.

You will:

• Calculate creatinine clearance using CockcroftGault with ABW, IBW, and AdjBW
• Determine the appropriate dosing weight
• Perform mg/kg-based dosing
• Apply genotype-based dose adjustments
• Apply renal adjustments when indicated
• Write a complete prescription

Your case is individualized based on your last name and student ID. All calculations must be shown (in a word doc/pdf using the equation function, written out on an iPad/touchscreen, or handwritten on paper & clearly scanned so I can see it). Additionally, you will be required to upload a brief (2-3 minute) video explanation of your reasoning in laymen’s terms (ie: easy to understand language). Please do not just read off the answers in your video – use this video as an opportunity to explain your patient and case, and why their dose requires adjustment.

STEPS:

STEP 1: Download the INSTRUCTIONS document to see which patient, drug, and metabolizer status you are assigned.

STEP 2: Download the TEMPLATE document and fill in the information you were assigned – many of these answers will not require calculations.

STEP 3: Calculate the CrCL using all bodyweight types, and decide which bodyweight is the most appropriate. Justify this answer.

STEP 4: Calculate the “healthy patient” dose before and after renal adjustment (if necessary) – write out the script for this patient.

STEP 5: Calculate the “extreme metabolizer” dose before and after renal adjustment (if necessary) – write out the script for this patient.

STEP 6: Answer Clinical Rationale questions

STEP 7: Record a brief video explanation of your patient, and upload this and other respective documents (filled in template, calculations) to Canvas.

OPTIONAL: EVIDENCE ADD-ON FOR (UP TO) 15 ADDITIONAL BONUS POINTS:

To earn up to 15 additional bonus points, submit a 1-page evidence brief showing how pharmacogenetic-guided therapy for your assigned druggene pair could improve patient safety. Your brief must use CPIC as the anchor source and include at least 1 additional primary source (clinical trial, cohort study, meta-analysis, or implementation study).

Please provide specific, research-based evidence on the drug you were assigned and how genotype informed-dosing may reduce patient adverse events. If evidence does not support improved safety for patients, explain why.

This should be your own writing – submission of AI writing of this brief will result in 0 additional bonus points.

Your 1-page brief must include:

• Your druggene pair + phenotype (Poor vs Ultra-rapid); what level of evidence of interaction (A, B, C, D, etc.)
• The CPIC recommendation (12 sentences) + recommendation strength (e.g., strong/moderate/optional)
• One key piece of evidence (from a primary source) supporting safety benefit – include the outcome, direction of effect, and population
• A mechanism-to-outcome link (23 sentences): explain why genotype changes exposure and how that leads to the safety outcome or safety proxy outcome
• One figure/table screenshot from CPIC (or PharmGKB/ClinPGx CPIC annotation) with the relevant row highlighted (you may paste it into the document – this will not count towards the page count)
• Maximum line spacing of 1.5