ID I: Aminoglycosides Flashcards Preview

NAPLEX 21 > ID I: Aminoglycosides > Flashcards

Flashcards in ID I: Aminoglycosides Deck (19)
Loading flashcards...
1
Q

aminoglycosides coverage

A

gram negative (including pseudomonas)

2
Q

Which AGs are used for synergy when treating gram positive bacteria (such as enterococcal endocarditis)??

A

gentamicin and streptomycin

in combination with a beta lactam or vancomycin

3
Q

What are the two dosing strategies?

A

traditional and extended interval

4
Q

When you use the lower doses more frequently (Q8H if renal function is normal is which dosing pattern

A

traditional

5
Q

When you use higher doses to attain higher peaks less frequently once daily if renal function is normal

A

extended interval

6
Q

With which dosing strategy is there less accumulation of drug?

A

extended; it has been shown to decrease nephrotoxicity and decrease cost

*not clinically superior though

7
Q

Your patient is underweight (less than ideal weight), what weight do you use for AG?

A

TOTAL BODY WEIGHT!

8
Q

If your patient is not obese or underweight, what body weight do you use?

A

IBW or TBW

9
Q

If your patient is obese what bodyweight do you use?

A

ADJUSTED!!! (think 0.4)

10
Q

What is the dosing for gentamicin and tobramycin for traditional dosing IV

A

1-2.5mcg/kg/dose

lower doses = gram positive
higher doses = gram negative

11
Q

When creatine clearance in your patient is >60, what is the interval?

A

Q8H

40-60 = Q12
20-40 = Q24
12
Q

Your patient is receiving extended interval IV dosing for gentamicin/tobramycin… what’s the equation?

A

4-7mch/kg/dose (commonly 7!)

13
Q

What are the boxed warnings for AG?

A

nephrotoxicity, ototoxicity

avoid use with other neurotoxic drugs (ampho B, cisplatin, polymyxins, cyclosporin, loops, INSAIDs, contrast dye, tacrolimus, vancomycin) / nephrotoxic drugs

neuromuscular blockade

14
Q

Your patient is receiving traditional dosing, when do you draw a trough?

A

right before the FOURTH dose (30 mins before)

15
Q

Your patient is receiving traditional dosing, when do you draw a peak?

A

30 minutes AFTER the fourth dose

16
Q

Your patient is receiving extended dosing, when do you draw a trough?

A

You don’t - draw a random level after the first dose per the timing on the Hartford nomogram

17
Q

What is the goal trough for tobramycin?

A

<2mcg/mL

peak = 5-10mcg

18
Q

What is the goal trough for gentamicin when treating gram negative infections?

A

<2mcg/mL

peak = 5-10mcg

19
Q

What is the goal trough for gentamicin when treating gram positive infections (synergy!)

A

<1mcg/mL

peak = 3-4mcg