Vancomycin Adult Dosing and Monitoring

2012 ◽  
Author(s):  
John W. Wilson ◽  
Lynn L. Estes
Keyword(s):  
Health Care ◽  
Body Weight ◽  
Renal Replacement Therapy ◽  
Serum Levels ◽  
Loading Dose ◽  
Actual Body Weight ◽  
Serious Infections ◽  
The One ◽  
Monitoring Protocols ◽  
Health Care Associated Pneumonia

(Note: Several vancomycin dosing and monitoring protocols exist; this is the one used at Mayo Clinic.)•Loading dose: Consider 20–30 mg/kg, especially in critically ill patients with serious infections such as meningitis, health care–associated pneumonia, or endocarditis.•Maintenance dose: Give 15–20 mg/kg based on actual body weight for most patients (20 mg/kg is reasonable when aiming for a trough range of 15–20 mcg/mL). Adjust based on serum levels. See also the following sections on hemodialysis and continuous renal replacement therapy....

scholarly journals Multicenter Population Pharmacokinetic Study of Colistimethate Sodium and Colistin Dosed as in Normal Renal Function in Patients on Continuous Renal Replacement Therapy

2018 ◽  
Vol 63 (2) ◽  
pp. e01957-18 ◽  
Author(s):  
Anne B. Leuppi-Taegtmeyer ◽  
Laurent Decosterd ◽  
Michael Osthoff ◽  
Nicolas J. Mueller ◽  
Thierry Buclin ◽  
...  
Keyword(s):  
Renal Function ◽  
Body Weight ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Normal Renal Function ◽  
Maintenance Dose ◽  
Population Pharmacokinetic ◽  
Loading Dose ◽  
Optimal Dosing ◽  
Colistimethate Sodium

ABSTRACT Intravenous colistimethate sodium (CMS) is used to treat infections with multiresistant Gram-negative bacteria. Optimal dosing in patients undergoing continuous renal replacement therapy (CRRT) is unclear. In a prospective study, we determined CMS and colistin pharmacokinetics in 10 critically ill patients requiring CRRT (8 underwent continuous venovenous hemodialysis [CVVHD]; median blood flow, 100 ml/min). Intensive sampling was performed on treatment days 1, 3, and 5 after an intravenous CMS loading dose of 9 million international units (MU) (6 MU if body weight was <60 kg) with a consecutive 3-MU (respectively, 2 MU) maintenance dose at 8 h. CMS and colistin concentrations were determined by liquid chromatography with mass spectroscopy. A model-based population pharmacokinetic analysis incorporating CRRT settings was applied to the observations. Sequential model building indicated a monocompartmental distribution for both CMS and colistin, with interindividual variability in both volume and clearance. Hematocrit was shown to affect the efficacy of drug transfer across the filter. CRRT clearance accounted for, on average, 41% of total CMS and 28% of total colistin clearance, confirming enhanced elimination of colistin compared to normal renal function. Target colistin steady-state trough concentrations of at least 2.5 mg/liter were achieved in all patients receiving 3 MU at 8 h. In conclusion, a loading dose of 9 MU followed after 8 h by a maintenance dose of 3 MU every 8 h independent of body weight is expected to achieve therapeutic colistin concentrations in patients undergoing CVVHD using low blood flows. Colistin therapeutic drug monitoring might help to further ensure optimal dosing in individual patients. (This study has been registered at ClinicalTrials.gov under identifier NCT02081560.)

scholarly journals What is the Best Predictor of Phenobarbital Pharmacokinetics to Use for Initial Dosing in Neonates?

Pharmaceutics ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 301
Author(s):  
Martin Šíma ◽  
Danica Michaličková ◽  
Ondřej Slanař
Keyword(s):  
Body Weight ◽  
The Other ◽  
Loading Dose ◽  
Actual Body Weight ◽  
First Line ◽  
Drug Dosing ◽  
Drug Levels ◽  
Upper Limit ◽  
Initial Drug ◽  
First Line Treatment

Phenobarbital is a first-line treatment of various seizure types in newborns. Dosage individualization maximizing the proportion of patients with drug levels in therapeutic range or sufficient treatment response is still challenging. The aim of this review was to summarize the available evidence on phenobarbital pharmacokinetics in neonates and to identify its possible covariates suitable for individualization of initial drug dosing. Several covariates have been considered: body weight and height, body surface area, gestational and postnatal age, laboratory parameters of renal and hepatic functions, asphyxia, therapeutic hypothermia, extracorporeal membrane oxygenation (ECMO), drug interactions, and genetic polymorphisms. The most frequently studied and well-founded covariate for the estimation of phenobarbital dosing is actual body weight. Loading dose of 15–20 mg/kg followed by a maintenance dose of 3–5 mg/kg/day seems to be accurate. However, the evidence for the other covariates with respect to dosing individualization is not sufficient. Doses at the lower limit of suggested range should be preferred in patients with severe asphyxia, while the upper limit of the range should be targeted in neonates receiving ECMO support.

Nucleolar Segregation and Chronic Methanol Intoxication

1969 ◽  
Vol 27 ◽  
pp. 360-361
Author(s):  
Julio H. Garcia ◽  
Janice P. Van Zandt
Keyword(s):  
Body Weight ◽  
Methyl Alcohol ◽  
Rhesus Monkeys ◽  
Repeated Administration ◽  
Serum Levels ◽  
Methanol Intoxication ◽  
Intragastric Tube ◽  
Nucleolar Segregation

Repeated administration of methyl alcohol to Rhesus monkeys (Maccaca mulata) by intragastric tube resulted in ultrastructural abnormalities of hepatocytes, which persisted in one animal twelve weeks after discontinuation of the methyl alcohol regime. With dosages ranging between 3.0 to 6.0 gms. of methanol per kg. of body weight, the serum levels attained within a few hours averaged approximately 475 mg. per cent.

The influence of gender, age, smoking habit and body weight on serum levels of antiepileptic drugs under naturalistic conditions

2013 ◽  
Vol 46 (06) ◽  
Author(s):  
S Unterecker ◽  
L Samanski ◽  
M Fischer ◽  
J Deckert ◽  
B Pfuhlmann
Keyword(s):  
Body Weight ◽  
Antiepileptic Drugs ◽  
Smoking Habit ◽  
Serum Levels

Assessment of motor activity of knowledge workers (on the example of employees of social service centers)

2020 ◽  
Vol 60 (11) ◽  
pp. 727-729
Author(s):  
Nadezhda S. Belyakova ◽  
Artyom K. Sergeev
Keyword(s):  
Body Weight ◽  
Motor Activity ◽  
Social Service ◽  
Preventive Measures ◽  
Knowledge Workers ◽  
Actual Body Weight ◽  
Service Center ◽  
Work Shift ◽  
Working Day ◽  
The Ideal

Introduction. The work of many employees in the service sector is associated with a constant stay in a forced working position sitting at the computer for up to 60-80% of the time of the entire work shift, which leads to fatigue. The rate of fatigue depends on the specifics of work: it is much more likely to occur when working with monotony, muscle tension. An important role in the appearance of fatigue is also played by the attitude of a person to the work performed. The aim of study is to study the motor activity of knowledge workers in social service centers for the development of preventive measures aimed at reducing hypokinesia and hypodynamia during the work shift. Materials and methods. The following methods were used in the study: questionnaire and working day timing, calculation methods to determine whether the actual body weight corresponds to the ideal one using the Broka’s index and the Ketle’s index. The study involved employees of the integrated social service center "Raduga" in Bugulma. Results. An assessment of the motor activity of employees of the social service center of the population was made, and it was concluded that the problem of hypokinesia and hypodynamia is relevant and significant for employees of social service centers of the population both in their daily activities and during the work shift. Most of the employees showed an increase in actual body weight compared to the ideal one, which is to some extent due to hypokinesia and hypodynamia both during the working day and at home. Conclusions. Preventive measures aimed at compliance with the principles of rational nutrition and a healthy lifestyle, work and rest regimes, high-quality preliminary and periodic medical examinations are proposed.

Health-Care Associated Pneumonia (HCAP): Identification of Low and High-Risk Patients

2015 ◽  
Vol 11 (3) ◽  
pp. 241-246 ◽  
Author(s):  
John Abisheganaden ◽  
Yew Ding ◽  
Wai Chong ◽  
Bee Heng ◽  
Akash Verma ◽  
...  
Keyword(s):  
Health Care ◽  
High Risk ◽  
High Risk Patients ◽  
Risk Patients ◽  
Health Care Associated Pneumonia
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