in 1997 .
Written in English
Toronto, Sunnybrook Health Science Centre
|The Physical Object|
|Pagination||52 leaves :|
|Number of Pages||52|
variability in estimated pharmacokinetic parameters of aminoglycosides with once-daily dosing and other studies have reported that in some patients, nomograms often do not accurately predict the correct dose or dosing interval. Therefore, selective pharmacokinetic monitoring may be required. 1. In elderly and patients with renal impairment consider increasing interval to every 12 hours Peaks are not routinely recommended, but if taken, target peak should be mcg/mL Routinely recommended: Target trough Once peak in therapeutic range it is not necessary to continue monitoring peaks. To evaluate the accuracy of four once-daily aminoglycoside dosing nomograms in producing the desired gentamicin peak concentration (Cmax) target of . • Monitor kidney function (BUN/SCr at least 2 – 3 times/week, UOP daily) • Serum concentrations should be monitored in all patients receiving aminoglycosides for a duration of therapy projected to exceed 48 hours • Peak and trough concentrations should be monitored in patients receiving Traditional Dosing of Aminoglycosides.
Br Med J ; 2. Hatala R, Dinh T, Cook DJ. Once-daily aminoglycoside dosing in immunocompetent adults: a meta-analysis. Ann Intern Med ; 3. Munckhof WJ, Grayson ML, Turnidge JD. A meta-analysis of studies on the safety and efficacy of aminoglycosides given either once daily or as divided doses. Results from the once daily administration trials appear to support this. Various methods of monitoring and dose adjustment have been proposed. The most common is to measure a hour trough concentration and to adjust the dose to maintain the trough concentration below a . Below is the Hartford nomogram for once daily administration of gentamicin or tobramycin. 7 mg/kg ODA for gentamicin and tobramycin Per Hartford, you first determine the dosing weight, which is either total body weight or adjusted (for obesity). The Hartford Nomogram method utilizes high-dose, once daily dosing to optimize the peak/MIC ratio in most clinical situations by administering a dose of 7mg/kg of either gentamicin or tobramycin. The Urban & Craig Nomogram is another method of extended-interval therapy utilizing 5 mg/kg of gentamicin or tobramycin in patients without renal.
Commonly used nomograms include the Hartford nomogram and Urban and Craig nomogram. The Hartford nomogram is designed for a gentamicin dose of 7 mg/kg body weight. To use this nomogram, measure serum gentamicin concentration hours after the first dose. The result can be plotted in the nomogram (figure ⇓) to predict the timing of the next. Validation of the Hartford Nomogram in Trauma Surgery Patients. to write an e-book on this topic. Once-daily aminoglycoside dosing using the four nomograms resulted in inaccurate dosing. Nicolau DP, Freeman CD, Belliveau PP, Nightingale CH, Ross JW, Quintiliani R. Experience with a once-daily aminoglycoside program administered to 2, adult patients. Antimicrob Agents Chemo ;29; Blouin RA, et al. Tobramycin pharmacokinetics in morbidly obese patients. Extended-interval (Once daily) aminoglycoside dosing 8 Aminoglycoside pharmacokinetic calculations 10 Aminoglycoside dosing in patients with cystic fibrosis 12 Vancomycin overview and pharmacokinetic calculations 15 This is especially true for elderly patients, malnourished patients, and spinal cord injury patients. These populations have.