Kinetics Exam #3 Aminoglycosides

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mp
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247102
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Kinetics Exam #3 Aminoglycosides
Updated:
2013-11-15 18:39:08
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Kinetics Exam Aminoglycosides
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Kinetics Exam #3 Aminoglycosides
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  1. Volume of distribution eqn (non-obese pts)
    0.25 L/kg (use IBW)
  2. Volume of distribution eqn (obese pts = >30% above IBW)
    0.25 L/kg (IBW) + 0.1(TBW-IBW)
  3. Cmax for Life Threatening infections (meningitis, bacteremia, PNA)
    • 8-10 mcg/mL
    • 25-40 mcg/mL
  4. Cmax for serious infections (pyelo, abdominal, peritonitis)
    • 6-8 mcg/mL
    • 20-25 mcg/mL
  5. Cmax for UTIs
    • 4-6 mcg/mL
    • 15-20 mcg/mL
  6. Goal troughs
    • G/T < 2 mcg/mL
    • A < 8 mcg/mL
  7. Dosing Interval for CrCl >= 60 mL/min
    Every 8 hours
  8. Dosing Interval for CrCl 40-59 mL/min
    Every 12 hours
  9. Dosing Interval for CrCl 20-39 mL/min
    Every 24 hours
  10. Dosing Interval for CrCl < 20 mL/min
    Give a loading dose then monitor levels
  11. Dosing Interval for HD
    give dose after HD if concentration is less than 2 mcg/mL
  12. Dosing Interval for CRRT/CVVHD
    Every 24-48 hours
  13. If an elevated peak what to do
    reduce the dose (only for conventional dosing)
  14. IF an elevated trough what to do
    extend the interval (only for conventional dosing)
  15. When to draw a steady state level
    After 3rd dose (only for conventional dosing)
  16. HD Dosing
    • 1-2 mg/kg
    • Same wt used as for conventional dosing (Actual, IBW, ABW)
    • Only dose if level after HD is <2 mcg/mL
  17. Once daily dosing for G/T and A
    • 5-7 mg/kg q 24 hrs
    • 15-20 mg/kg q 24 hrs
    • Use actual wt unless obese then use adjusted
  18. Goal Peak for once daily dosing
    • Use Cmax:MIC ratio (10:1)
    • G/T: 20-30 mcg/mL
    • A: 60-70 mcg/mL
  19. When to repeat a level for once daily dosing
    • SCr increases by > 0.5 mg/dL or 50% from baseline
    • Patient fluid status significantly changes
    • Monitor every 5 days
  20. Exclusion Criteria for once daily dosing
    • Acute Spinal Cord injury
    • Ascites
    • Burns over 20% BSA
    • CrCl < 30 mL/min or on HD
    • Endocarditis
    • Febrile neutropenia
    • Menigitis
    • Pediatrics
    • Pregnancy
  21. AG PK in gram-positive infections
    • Conventional dosing
    • Goal peak: 3-5 mcg/mL
    • Goal trough: <2 mcg/mL

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