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Related Concept Videos

Dosage Regimen: Individualization01:24

Dosage Regimen: Individualization

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Individualization in dosing regimens is the customization of medication doses for individual patients. Its necessity arises from the goal of maximizing therapeutic benefits while minimizing risks. This approach is pivotal because human responses to drugs can vary widely; what is effective for one person may be inadequate or excessive for another. Interpatient (intersubject) variability refers to differences in drug responses between individuals, while intrapatient (intrasubject) variability...
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Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
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A drug dosage regimen describes the specific instructions and schedule for administering a drug to a patient. It considers factors such as drug dosage, frequency, route of administration, and duration of treatment. Designing an appropriate dosage regimen for a patient aims to achieve a target drug concentration at the site of action.
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A rational dosage regimen considers a drug's pharmacokinetics, including its absorption, distribution, metabolism, and elimination from the body. By understanding these factors, the appropriate dosage can be determined, and the dosing schedule can be designed to achieve and maintain the desired therapeutic effect while minimizing adverse effects.
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Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant01:25

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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...
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Dosage Regimen: Multiple Oral Dosage01:25

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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...
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Related Experiment Video

Updated: Apr 28, 2026

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Cotrimoxazole - optimal dosing in the critically ill.

Glen R Brown1

  • 1Pharmacy Department, St. Paul's Hospital, 1081 Burrard St, Vancouver, BC V6Z 1Y6, Canada.

Annals of Intensive Care
|June 10, 2014
PubMed
Summary

Determining the optimal cotrimoxazole dosage for critically ill patients is challenging due to unclear regimens and limited therapeutic drug monitoring. This study provides recommendations for empiric dosing based on pharmacokinetics and pathogen susceptibility.

Keywords:
CotrimoxazolePharmacodynamicsPharmacokineticsSulfamethoxazoleTrimethoprim

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Area of Science:

  • Pharmacology
  • Critical Care Medicine
  • Infectious Diseases

Background:

  • The optimal dosage regimen for cotrimoxazole in life-threatening infections in critically ill patients remains unclear.
  • Therapeutic drug monitoring for cotrimoxazole is not widely available, complicating dosing decisions.
  • Clinicians rely on pharmacokinetic and pharmacodynamic data to guide dosing for specific pathogens.

Purpose of the Study:

  • To provide evidence-based recommendations for cotrimoxazole dosing in critically ill patients.
  • To address the lack of clear dosage guidelines for this patient population.
  • To optimize infection eradication by utilizing pharmacokinetic principles.

Main Methods:

  • Review of pharmacokinetic and pharmacodynamic data for trimethoprim and sulfamethoxazole.
  • Consideration of minimum inhibitory concentrations (MICs) for target pathogens.
  • Adjustment of dosing regimens based on organ clearance impairment in critically ill patients.

Main Results:

  • Established empiric dosing regimens for cotrimoxazole in critically ill patients.
  • Demonstrated the utility of pharmacokinetic data and MICs in guiding dosing.
  • Provided a framework for individualized dosing strategies.

Conclusions:

  • Clinicians can utilize pharmacokinetic and MIC data to establish effective cotrimoxazole dosing regimens.
  • The proposed dosing strategies aim to improve treatment outcomes in critically ill patients.
  • Further research may refine these recommendations for specific pathogens and patient subgroups.