ID-Aminoglycosides

Question 1

What does AGs cover?

Answer 1

Gram - Pseudomonas
Syndergy with Gram + for Staph and enterococcus (use lower dose AG)

Question 2

What type of PK does AGs follow?

Answer 2

Concentration dependent

Question 3

What is the traditional dosing for AGs

Answer 3

1-2.5 mg/kg IV Q8H

Question 4

What is the extended interval dosing for AG

Answer 4

4-7 mg/kg Q24H

Question 5

What is monitored during traditional dosing for AG?

Answer 5

• trough 30 mins before the 4th dose
  -peak 30 mins after the infusion of the 4th dose

Question 6

what is monitored during extended interval dosing using the 7mg/kg

Answer 6

random level is drawn 6-14 hours after the infusion and plotted on the hartford nomogram.

Question 7

what are the peak and trough levels for Gentamicin and tobramycin

Answer 7

Trough <2 mcg/mL
Peak 5-10 mcg/mL

Question 8

What toxicities do AGs carry?

Answer 8

Ototoxic
nephrotoxic
neurotoxic (NMB)

Question 9

what nephrotoxic drugs must be avoided with AGs

Answer 9

1. NSAIDs
2. Loop diuretics
3. Cisplatin
4. Tacrolimus and cyclosporine
5. Amphotericin B
6. Polymyxins
7. Vancomycin
8. Radiocontrast dye

Question 10

what weight must be used in AGs dosing?

Answer 10

1. if underweight (TBW< IBW) –> use TBW
2. If Obese –> use adjusted BW

** Adj BW formula IBW + 0.4 (TBW-IBW)