Aminoglycosides TDM

Question 1

Extended Dosing

Answer 1

• Less toxic
• Concentration dependent killing
• Cost savings
• Has some contraindications

Question 2

Conventional Dosing

Answer 2

• Used when extended is contraindicated
• Synergy dosing

Question 3

Synergy Dosing

Answer 3

Aminoglycosides + Beta Lactams for Aerobic Gram Negative

Aminoglycosides + Vancomycin for Gram Positive

Question 4

Extended Dosing
- Contraindications

Answer 4

1. Dialysis
2. Aminoglycosides being used for synergy (better to use conventional dosing)
3. Abnormal clearance (Burns > 20% BSA)
4. Endocarditis
5. Surgical Prophylaxis

Question 5

Extended Interval Dosing Questions

Answer 5

1. Calculate IBW (If ABW is lower then use that)
2. Calculate Creatinine Clearance to obtain dosing interval
3. Calculate Starting Dose (5-7 mg/kg or 7 mg/kg for severe infections)

Question 6

Extended Interval Dosing
- Monitor

Answer 6

Monitor for resolution of symptoms

Monitor for toxicity: Ototoxicity and Renal

Question 7

How long to administer IV line

Answer 7

Extended = 1 hour
Conventional = 30 mins