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Related Concept Videos

Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations01:15

Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations

Gentamicin, an aminoglycoside antibiotic, is commonly administered via intermittent intravenous infusion to treat severe infections. An intermittent one-hour infusion of gentamicin, administered at eight-hour intervals, allows for precise control of plasma drug concentrations, minimizing toxicity while ensuring therapeutic efficacy. Pharmacokinetic principles govern the dynamics of plasma concentrations and can be mathematically described using specific equations.The plasma drug concentration...
Drug Accumulation During Multiple Dosing: Intermittent IV Infusions01:24

Drug Accumulation During Multiple Dosing: Intermittent IV Infusions

Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
Determination of Multiple Dosing Parameters: Loading and Maintenance Doses01:25

Determination of Multiple Dosing Parameters: Loading and Maintenance Doses

A loading dose is an essential pharmacological strategy to rapidly achieve the target plasma drug concentration necessary for an immediate therapeutic effect. This approach is especially critical for drugs characterized by slow absorption or extended half-lives, where delaying therapeutic plasma levels could compromise treatment outcomes. By administering a loading dose, clinicians ensure a prompt onset of drug action, even for agents with complex pharmacokinetic profiles.Achieving steady-state...
Dosage Regimen: Multiple Oral Dosage01:25

Dosage Regimen: Multiple Oral Dosage

Understanding how a drug's concentration fluctuates within the body over time is crucial in pharmacokinetics, particularly with multiple oral doses. A graphical representation of multiple oral dosages provides insight into these dynamics. Typical accumulation curves of a drug's concentration in the body reveal a sawtooth pattern, indicating periodic peaks and troughs correlating with each dose administration and the drug's subsequent elimination.The plasma concentration at any time during an...
Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant01:25

Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant

In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...

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Updated: Jun 2, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
11:17

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

Antibiotic dosing in multiple organ dysfunction syndrome.

Marta Ulldemolins1, Jason A Roberts2, Jeffrey Lipman3

  • 1Burns, Trauma and Critical Care Research Centre, The University of Queensland, Brisbane, QLD, Australia; Critical Care Department, Vall d'Hebron University Hospital, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica En Red de Enfermedades Respiratorias (CIBERES), Barcelona, Spain.

Chest
|May 5, 2011
PubMed
Summary
This summary is machine-generated.

Optimizing antibiotic dosing for critically ill patients with multiple organ dysfunction syndrome (MODS) is crucial. Initial "front-loaded" doses should counter increased drug distribution, followed by maintenance doses adjusted for altered drug clearance.

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Area of Science:

  • Pharmacology
  • Critical Care Medicine
  • Infectious Diseases

Background:

  • Antibiotic therapy is vital for septic shock, but optimal dosing in critically ill patients with multiple organ dysfunction syndrome (MODS) is under-researched.
  • MODS alters patient physiology, significantly impacting drug pharmacokinetics (PK) and pharmacodynamics (PD), necessitating tailored dosing strategies.

Purpose of the Study:

  • To review PK/PD variations in critically ill patients with MODS.
  • To provide evidence-based antibiotic dosing recommendations for this patient population.

Main Methods:

  • Literature review focusing on disease-driven changes in PK/PD parameters.
  • Analysis of how MODS affects drug volume of distribution and clearance.
  • Synthesis of findings to formulate dosing guidelines.

Main Results:

  • Drug volume of distribution and clearance are significantly altered in MODS.
  • Increased volume of distribution can lead to subtherapeutic drug concentrations early in treatment.
  • Decreased drug clearance is common, increasing the risk of toxicity.

Conclusions:

  • Initial high-dose (front-loaded) antibiotic therapy is recommended to overcome increased volume of distribution in the first 24 hours.
  • Subsequent maintenance dosing requires careful adjustment based on drug clearance and the severity of organ dysfunction to ensure efficacy and prevent toxicity.