Skip to 0 minutes and 11 secondsSo in addition to these specific aminoglycoside and the vancomycin I would like to take this opportunity to review some general principles regarding dosing in renal failure at least in a qualitative sense. So I have several questions to follow and we were to go through them each one and give some explanations as to why the choice is chosen that way. So these are the general questions whether they come from hypothetical talks or from real drugs. So we are going to discuss these questions in terms of a general principle. So here is question number one Drug A is primarily excreted unchanged in urine,
Skip to 1 minute and 15 secondsthe dosage regimen is usually necessary when the patient creatinine clearance is: and we have four choices here and as you look at C and the D 80 and 100 milliliters per minute. Now they are normal. So we really don't have to worry about them for the dosing regimen A, less than 10 milliliters per minutes Well then that's absolutely necessary to do the dosing adjustment. So the correct answer is B. less than 50 milliliters per minutes. In other words at about 50% of renal function normally we would just reduce the dose by 50% and then followed by TDM therapeutic drug monitoring So this is a general question number one.
General questions 1
Prof. Lee explains the first general question 1 : Drug A is primarily excreted unchanged in the urine, dosage adjustment is usually necessary when the patient’s creatinine clearance is_______mL/min.
When is dosage adjustment usually necessary? This is very easy to guess.
When a patient’s creatinine clearance is less than 50 milliliter per minute, which is about only 50% of normal renal function, we would reduce the dose by 50% in general.
Let’s move on to general question2.