PharmacoKinetics

Question 1

Vanc Nephro increases in?

Answer 1

Advanced age
Prolong therapy >3 wk
Troughs >20
Nephrotoxins
-Monitor closely

Question 2

Weight based doses use what weight?

Answer 2

Actual Body Weight

Question 3

Renal function determines what?

Answer 3

Frequency

Question 4

Loading doses are required in what pts?

Answer 4

Illness second line to MRSA
Endocarditis
Febrile neutropenia
Meningitis
OM
Pnemonia
Sepsis/Shock

F POEMS

Question 5

Vanc loading dose

Answer 5

25-30 mg/kg IV x 1

MAX 2000

Question 6

Vanc Maintenance Dose

Answer 6

15-20 mg/kg/dose Q8-12H

MAX 2000

Question 7

Vanc Infusion rate

Answer 7

1 gram per hour

Question 8

Vanc Target Trough and Who

Answer 8

15-20mg/L

Bacteremia, meningitis, pneumo, SSTI, endocarditis, OM

Question 9

Vanc Target Rare Trough and Who

Answer 9

10-15 mg/L

UTI, mild SSTI

Question 10

Vanc AUC/MIC target

Answer 10

> 400

Question 11

Trough is lower than target

Answer 11

Efficacy is decreasing

Dose more freq

Question 12

If trough is higher than target

Answer 12

Efficacy is too much

Dose less freq & possible decrease

Question 13

Vanc Toxicity

Answer 13

Redman’s
Nephro
Oto

Question 14

Genta/Tobra Traditional Dose

Answer 14

1-2.5 mg/kg/dose

Question 15

Amikacin Traditional Dose

Answer 15

5-7.5 mg/kg/dose

Question 16

AG Frequency based on CrCl

Answer 16

> 60 Q8
40-59 Q12
20-39 Q24
<20 monitor

Question 17

AG Peak measures

Trough measures

Answer 17

Peak = efficacy
Trough = toxicity

Question 18

Gent/Tobra Peaks for:
Life threatening
Serious 
UTI
Endocarditis

Answer 18

8-10
6-8
4-6
3-4

Question 19

Amikacin Peaks for:
Life threatening
Serious 
UTI
Endocarditis

Answer 19

25-35
20-25
15-20
—

Question 20

Gent/Tobra Trough

Answer 20

0.5-2

Target: 1

Question 21

Amikacin Trough

Answer 21

<8

Target 4

Question 22

Measuring

Answer 22

Trough 30 minutes before 4th dose

Peak 30 minutes after 30 minutes infusion of 4th dose

Question 23

Low/High Peak and Trough

Answer 23

Proportionally increase/decrease

Question 24

AG Large dose, Less freq strategy?

Answer 24

Concentration dependent

Post-antibiotic effect

Question 25

Gent/Tobra Extended Spectrum Dose

Answer 25

5-7 mg/kg/dose

Question 26

Extended Spectrum Freq

Answer 26

> 60 Q24
40-59 Q36
30-39 Q48

Question 27

Hartford

Answer 27

Gent/Tobra 7 mg/kg
Level around 10 hrs
See if interval needs to change

Question 28

Urban and Craig

Answer 28

Gent/Tobra 5 mg/kg
Level around 10 hrs
See if interval needs to change

Question 29

Exclusion Criteria for Extended Interval Dosing

Answer 29

Impaired renal
Cirrhosis
CF
Prego
Burns >20% of BSA