ICU SAQs · Infection / pharmacology
Once-daily gentamicin — dosing, monitoring, and the toxicities
A CICM SAQ on the gentamicin — the once-daily extended-interval dosing (the Cmax/MIC target, the Hartford nomogram), the renal monitoring, and the three toxicities (the nephro, the oto, the neuromuscular).
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Prompt
A 70-kg septic patient is started on the empirical once-daily gentamicin for the Gram-negative cover. Discuss the dosing, the monitoring, and the toxicity avoidance.
Question
A 70-kg septic patient is started on the empirical once-daily gentamicin for the Gram-negative cover. Discuss the dosing, the monitoring, and the toxicity avoidance.[1]
References6ShowHide
- [1]Nicolau DP, Freeman CD, Belliveau PP, et al. Experience with a once-daily aminoglycoside program administered to 2,184 adult patients. Antimicrobial agents and chemotherapy, 1995.PMID 7793867
- [2]Pechère JC, Dugal R, Pechère M Pharmacological considerations for the proper clinical use of aminoglycosides. Drugs, 2011.PMID 22085385
- [3]Barza M, Ioannidis JP, Cappelleri JC, Lau J Single or multiple daily doses of aminoglycosides: a meta-analysis. BMJ (Clinical research ed.), 1996.PMID 8611830
- [4]Lopez-Novoa JM, Quiros Y, Vicente L, et al. Aminoglycoside-induced nephrotoxicity. International journal of nephrology, 2011.PMID 25199523
- [5]Xie J, Talaska AE, Schacht J Aminoglycoside-induced ototoxicity. Clinical toxicology (Philadelphia, Pa.), 2011.PMID 17266591
- [6]Sheikh S, Alvi U, Soliven B, Rezania K Drugs That Induce or Cause Deterioration of Myasthenia Gravis: An Update. Journal of clinical medicine, 2021.PMID 33917535