The timing of gentamicin administration affects the concentration-time profile in patients using hemodialysis. The timing of gentamicin administration.

Slides:

Advertisements

Similar presentations

First, zero, pseudo-zero order elimination Clearance

Advertisements

Pharmacokinetics Questions

Intravenous Infusion Previous rates of administration were instantaneous IV bolus and first order absorption. As a rate (mg/hr) a first order rate constantly.

Multiple dosing: intravenous bolus administration

Continuous intravenous infusion (one-compartment model)

Lecture 2 Clearance, maintenance dose and AUC

Use of antibacterial agents in renal failure R2 박준민.

Allie punke pharmcokinetics Allie punke

The aminoglycoside antibiotics

Pharmacokinetics Tutoring

Among Medicare beneficiaries >65 years old with a index hospitalization at the time of dialysis initiation, use of post-acute SNF care was common. Among.

Suggested approach to patients with dabigatran-associated bleeding

Positive interactions between the basic and translational research, clinical research, patient care, and training components of an academic dialysis access.

Pharmacokinetic–Pharmacodynamic Modeling of Opioids

Probability of cumulative incidence of ESRD, disease-related death, or death from other cause for the entire cohort. Probability of cumulative incidence.

Adjusted rate ratios of hospital days and admissions for blacks and Hispanics compared with whites by age group. Adjusted rate ratios of hospital days.

Plasma concentration–time profile, relative bioavailability and pharmacokinetic (PK) parameters of 4 mg TAK-228 in the single-agent QD PK run-in period,

Drug Dosing Considerations in Alternative Hemodialysis

Gentamicin pharmacokinetics during slow daily home hemodialysis

Parathyroid hormone (PTH) levels by Dialysis Outcomes and Practice Patterns Study (DOPPS) phase and selected patient characteristics. Parathyroid hormone.

Patient disposition. Patient disposition. AE, adverse event. *One patient died during the follow-up period. ^Four of the 12 discontinuations of treatment.

PTA for AUC/MIC ratio ≥800 for each 48-hour AUC: AUC0 to 48 (A), AUC48 to 96 (B), and AUC96 to 144 (C). PTA for AUC/MIC ratio ≥800 for each 48-hour AUC:

The Basics of Intravenous Fluid Administration

Scatterplots showing the association between the three peritoneal equilibration test (PET) parameters. Scatterplots showing the association between the.

Volume 55, Issue 5, Pages (May 1999)

Leo F. Buckley et al. JCHF 2016;4:1-8

Drug levels during the course of a dosing interval.

(A) Mean (SD) serum continuous erythropoietin receptor activator (C. E

REFERENCE: APPLIED CLINICAL Slideshow by: lecturer HADEEL DELMAN

Mean and median systolic and diastolic BPs after dialysis were unchanged over time and similar between epoetin alfa-epbx and epoetin alfa. Mean and median.

Lifestyle intervention was associated with improved cardiorespiratory fitness. Lifestyle intervention was associated with improved cardiorespiratory fitness.

Intrapatient variability in cyclosporine blood levels in renal transplant patients. Intrapatient variability in cyclosporine blood levels in renal transplant.

More women are affected than men in X-linked Alport syndrome.

Ionized-to-total magnesium (Mg) and calcium (Ca) ratios are lower in patients on hemodialysis than those in patients not on dialysis. Ionized-to-total.

Ratio of actual to expected rise in sodium as calculated using the Adrogué-Madias formula. Ratio of actual to expected rise in sodium as calculated using.

Mean plasma concentrations of ampicillin/sulbactam in plasma of critically ill patients with AKI undergoing extended dialysis (duration depicted by box.

Dialyzer clearance of ampicillin/sulbactam in plasma of critically ill patients with AKI undergoing extended dialysis. Dialyzer clearance of ampicillin/sulbactam.

Ca2+ infusion rates during all three protocol versions.

PTH response to the predialysis serum calcium concentration in hemodialysis patients with severe (A), moderate (B), and mild (C) hyperparathyroidism. PTH.

Changes in total drug clearance with declining kidney function relates to the extent of drug clearance by the kidney. Changes in total drug clearance with.

Many anticancer drugs are dosed according to body surface area (BSA), but they are dose adjusted according to measures of absolute kidney function (i.e.,

Area under the curve (AUC)–targeted dosing of carboplatin using either the Cockcroft–Gault formula or the Chronic Kidney Disease Epidemiology Collaboration.

A loading dose decreases the time to achieve the target concentration.

Rates of plasma sodium concentration increase before and after DDAVP administration. Rates of plasma sodium concentration increase before and after DDAVP.

Effects of DDAVP administration on PNa kinetics and urine composition and output. Effects of DDAVP administration on PNa kinetics and urine composition.

Serum bicarbonate increased by ≥3, ≥4, and ≥5 mEq/L in 52%, 39%, and 22% of patients, respectively, in the combined TRC101 dose group compared with 6%,

Distribution of vascular access type (2002–2011) among countries with stable or decreasing catheter burden over time. Distribution of vascular access type.

The same daily dose of metformin administered as different dosage regimens has differing effects on the concentration–time profile in a patient with CKD.

Mortality caused by cardiovascular disease (A) and sepsis (B) of patients with end-stage renal disease (ESRD) treated by dialysis compared with the general.

Cumulative mortality risk in patients with 48-h blood urea nitrogen (BUN) levels of ≥8 mg/dl or

We identified 200 Android and 178 iOS apps using 4 search terms and narrowed this to 12 Android apps, 11 iOS apps, and 5 dual-platform apps after applying.

Comparison of Medicare reimbursement to a nephrology practice on an annual per-patient basis for care of a patient on dialysis (at two different frequencies.

Among three residual kidney function (RKF) indices, only residual urine volume (UV) indicated an independent prognostic value in patients with UV≥0.1 or.

Gentamicin plasma and peritoneal dialysate concentrations in peritoneal dialysis patients with peritonitis. Gentamicin plasma and peritoneal dialysate.

Distribution of percent consistent facility aspirin use.

Changes in 44-hour interdialytic systolic BP as a function of change in echocardiographic volume parameter. Changes in 44-hour interdialytic systolic BP.

The Centers for Medicare and Medicaid Services (CMS) and the Kidney Care Quality Alliance (KCQA) ultrafiltration (UF) rate measure specifications and selection.

New dialysis starts in the United States by year in patients with and without diagnosis of diabetes. New dialysis starts in the United States by year in.

Dialysis limitations. Dialysis limitations. (A) Recent data from observational studies and randomized, clinical trials indicate significant limitations.

Renal replacement therapy using an in-line hemofilter during extracorporeal membrane oxygenation (ECMO). Renal replacement therapy using an in-line hemofilter.

Effect of IS on proliferation, senescence, and the production of NO and ROS from endothelial cells. Effect of IS on proliferation, senescence, and the.

As the patient nears the end of life (dashed arrow), there is an increasing focus on symptom control and patient goals of care and a shift in the approach.

Dose adjustments in patients with CKD are based on the change in the concentration-time profile for the drug of interest. Dose adjustments in patients.

Plasma concentration-time profile after oral administration of a single dose. Plasma concentration-time profile after oral administration of a single dose.

A change in either volume of distribution or clearance has differing effects on the concentration-time profile. A change in either volume of distribution.

Temporal distribution (from time 0 to 720 min after drug administration) of mean dosage-adjusted mycophenolic acid (MPA) concentrations at month 6 after.

Survival among hemodialysis patients by geographic region in DOPPS 3 (2005–2008), with and without adjustments for patient mix differences. Survival among.

Mean number of dialysis sessions per patient for which intradialytic hypotension–related nursing interventions were required during the first 2 wk and.

Peritonitis treatment algorithm.

Distribution of facility mean treatment time, by DOPPS region and phase. Distribution of facility mean treatment time, by DOPPS region and phase. Restricted.

Presentation transcript:

The timing of gentamicin administration affects the concentration-time profile in patients using hemodialysis. The timing of gentamicin administration affects the concentration-time profile in patients using hemodialysis. Simulation on the basis of a 30-minute intravenous infusion of 200 or 80 mg gentamicin, using median values from Sowinski et al. (43) including Vd of 13.5 L, endogenous elimination t1/2 of 39.4 hours, and elimination t1/2 during hemodialysis (HDx) of 1.6 hours. Administration prehemodialysis maximizes the Cmax:MIC ratio (ratio of Cmax to the minimum inhibitory concentration of the bacteria; see part 1 [2]) and decreases the overall exposure. This demonstrates that a large dose can be administered immediately predialysis to take advantage of the concentration-dependent killing and postantibiotic effect of this antibiotic class. This maximizes the antibiotic concentration–time profile and drug effect, and the clearance achieved by dialysis allows for the aminoglycoside to be rapidly cleared to a less toxic concentration. Other antibiotics that also have a concentration-dependent killing and therefore may also benefit from a large dose immediately before dialysis are daptomycin (44) and the fluoroquinolones (45,46). Darren M. Roberts et al. CJASN 2018;13:1254-1263 ©2018 by American Society of Nephrology