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12 Cards in this Set
- Front
- Back
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what are the kinetics of vancomycin
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2-3 compartment model
40-50% protein binding excreted primarily unchanged via GFR(Renal) |
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what are the dynamics of vancomycin
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>4-5xMIC = no greater killing
time dependent killing AUC/MIC 400 optimal variable PAE |
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since vancomycin is time dependent killing what do we try to achieve
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we try to achieve a concentration 4-5XMIC throughout infusion
AUC/MIC of 400 is difficult to achieve |
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what are the toxicities with Vancomycin
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infusion related reactions
red man or red neck syndrome blood dyscrasias (neutropenia, thrombocytopenia, eosinophilia) ototoxicity nephrotoxicity (main concern) |
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how are normal pts dosed
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nomogram
or 15-20 mg/kg q 8-12 hrs AUC/MIC 400 |
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what is the issue with AUC/MIC 400 goal
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as MIC increases it gets harder to achieve AUC/MIC ratio of 400
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how do you dose in pts with renal impairments
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calculate creatinine clearence
(140-age)/SCr use Creatinine clearance estimate for nomogram |
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what are the two nomograms
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detroit or lake
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detroit monogram
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weight vs CLcr
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lake monogram
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Clcr vs dosing interval
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what are the trough concentrations for MIC <1 bugs
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10-20 mg/L for MIC <1 bugs
15-20 mg/L for severe infections (EX: pneumonia) |
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how are obese pts dosed
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based on total body weight
30mg/kg/d |
