The original version was based on the following equation:
Mean Plasma Blood Glucose = (HbA1c * 35.6) - 77.3
eAG = (28.7 X A1C) – 46.7 [eAG
(estimated average glucose)]
Greater accuracy is expected with the updated equation... See quote
"RESULTS— Approximately 2,700 glucose values were obtained by each
subject during 3 months. Linear regression analysis between the A1C and
AG values provided the tightest correlations (AGmg/dl = 28.7
x A1C - 46.7, R2 = 0.84, P < 0.0001), allowing calculation of
an estimated average glucose (eAG) for A1C values. The linear regression
equations did not differ significantly across subgroups based on age,
sex, diabetes type, race/ethnicity, or smoking status."
July 14th, 2010
Minor updates have been completed for the IV Dilution database section
including the addition of colistin and ketorolac.
Here is a preview of the new Oncology dilution section..... It
will probably take another sixty days or so to wrap this section up.
All of the initial navigation and launch pages have been completed.
Renal dosing section: Several new updates should
be available later this month. A comprehensive list has already
been developed (new listings). Over 100 new agents may be added.
Based on feedback from several visitors, we will be creating a
benzodiazepine equivalence calculator. Also, a levothyroxine
dosing calculator. Release date: ~August 2010.
March 9th, 2010
Vancomycin - single level analysis.
Based on important feedback from Dr. MacKichan, subtle improvements were
made to this recently released program [Jan 2010]. After further
analysis it was determined that the recommended dose was being
calculated using the 'regimen' interval and not the 'calculated'
interval. This unintentional mix up in programmatic variable names did
not affect the final dosage analysis. The newly calculated recommended
dosage and interval data should now be much closer to the final regimen
Janis J. MacKichan, Pharm.D., FAPhA
Professor of Pharmacy Practice
Northeastern Ohio Universities
College of Pharmacy
Important update to the lean body weight equation. A pharmacist from
Nova Scotia had contacted one of the original authors of the LBW
Demirovic JA, Pai AB, Pai MP. Estimation of creatinine clearance in
morbidly obese patients. Am J Health Syst Pharm. 2009 Apr 1;66(7):642-8
Mary Doig, BSc (Pharm)
South Shore Regional Hospital
Bridgewater, Nova Scotia
Substituting the lean body weight into the Cockcroft and Gault equation
(Female patient): Manjunath (Amit) Pai, PharmD, BCPS:
"Most important point is to not multiply by 0.85 for female as the LBW
compensates for the weight differential between males and females. The
0.85 assumption was made up as no females were studied by Cockcroft and Gault."
MASSIVE update to the financial
calculator section .... There are now more than 40
calculators. Everything from asset allocation, retirement,
investing, mortgages, etc.
In the next couple of weeks, I will be adding several new financial
calculators including new investment tools, retirement calculators, as
well as a few other calculators.
Minor changes were made to our phenytoin
calculator based on comments from a VA (Veterans Administration)
pharmacist: Kelly Maxwell, Pharm.D.
The updated version now has a specific option for patient's with
profound renal insufficiency (CrCL<10 ml/min). The previous version
provided guidelines but did not actually calculate corrected phenytoin
levels for this type of patient. Additional dosing information can
be found here.....
Easy access to all major section menus -
New Page. This page
can also be accessed by clicking the main header (top) image on the
Laboratory values (tables): Added navigation buttons to the top of
each separate lab page. Also added a quick drop down menu to the Lab home page.
Robert F. Shaw, PharmD, MPH, BCPS, BCNSP
ICU Clinical Pharmacy Specialist
".....The hypertonic saline calculator still did not meet what I was
looking for, but I understand one calculator cannot fit every
need and the inherent risks and liability with administration of
If I had the "perfect" calculator... I would want fields for:
desired ending Na
choice of saline concentration 0.9% or 3%
This would provide how many ml of either 3% or 0.9% saline
required to change the sodium to the desired value. This could
further be defined if a meq/hr choice was provided of 0.5 meq/hr
or 1 to give a infusion rate...."
The Internal Medicine section has been completed:
Internal Med...... Also, the following additional updates have been completed:
Jessica Morehouse, Pharm.D.
"............ I needed to make a 12.5 % dextrose and 1/4 % NS 250
ml infusion out of a dextrose 70% bag and a bottle of concentrated NaCl
23.4%...." .."I think it would be extremely helpful if you
put in another calculator to calculate out a solution with one
base and 2 additives. I know I have run into this before, and it
would be great to have a verification of our math.."
(2) An option for the new serum creatinine IDMS method was added to
the CRCL Multi-calc.
This update was based on a request from:
Patricia Vetter, Pharm.D. - Central
Washington Hospital. "I want to know what
reference standard for SCr value you are using in the
multi-calculator. I am assuming you are using the more
traditional serum creatinine range and not the IDMS based range
for your calculator......" ".... I suggest you add
another option to the serum creatinine box, so one can enter
either SCr (traditional range) or SCr (IDMS)...."
Future updates in the coming months:
Expanded pediatric section and a complete review and update to the
infectious disease empiric dosing section.
In the next couple of weeks, a completely new
section will be added to help navigate the entire GlobalRPh website.
In many cases, typical users are not aware of or are unable to quickly
locate several valuable tables, calculators, or articles that be needed.
This new section will divide the website into the primary Internal Medicine
disciplines in order to improve the navigation of the site. Here
is an early glimpse.... click the thumbnail below for a larger view.....
Also, new programs are being created for the infectious disease section. Here is an early look at the
cephalosporin's dosing program, which is based primarily on package insert data.
It covers all of the IV cephalosporin's [ Microbiology, Indications, and
Dosing]. All antibiotics will eventually be covered.
Significant changes/updates to the current
Intravenous Dilution Guidelines have been completed. I was
especially interested in reviewing the latest stability data from the
various manufacturers. Occasionally new formulations or even new
studies have led to changes in the recommended storage requirements for
Currently, GlobalRPh is the 8th largest medical reference site on the
internet (MDConsult leads this group). One of the reasons this
site has grown so large is due to the tremendous support this site
receives from its visitors. I frequently receive emails from our
visitors with helpful insight and ideas for improving this site....
Examples include: 1) Simple message informing us of a missing
dilution standard for a new medication. 2) Summary of a recently
published study that may impact one of our current drug monographs. 3)
Ideas for new medical calculators. 4) Many others...
Several other sections of this website will be undergoing substantial
revisions. The infectious disease section in particular should be
completed by the end of this year.
New tools for the palm and pocket pc:
Actually, some of our latest work can be found on the
Check out the
Medtools section... GlobalRPh has been a long time contributor to
this section along with other outside developers. You will find some of
our popular tools as well as a few new ones. Looking for a medical
software suite?? Take a look at the
software solution page at Epocrates...