Module 10 questions - Organ failure (Clinical challenge)
  1. Describe the concentration profile for simulation #2 (3.3 mg/kg q8H in terms of efficacy and toxicity).

    Efficacy is likely unaltered (could actually be slightly more active). The dosage regimen is likely to produce toxicity based on elevated Cmin

  2. Describe the concentration profile for simulation #3 (after you enter the reduced dose) in terms of efficacy and toxicity.

    Much higher Cmax concentrations likely produce a greater killing action on the bacteria with each dose. The dosage will remain efficacious if the interval is not to long (which might allow the bacteria to gain the "upper hand").

  3. Describe the concentration profile for simulation #4 (after you enter the extended interval) interms of efficacy and toxicity.

    Much higher Cmax concentrations likely produce a greater killing action on the bacteria with each dose. Accumulation is still occuring which is likely to cause toxicity. A 24 hour dose interval appears to be too short.

  4. In terms of its pharmacokinetic profile, how is a renal failure patient different from the neonatal patient that you studied in exercise IIe?

    Peak concentrations are MUCH higher in a renal failure patient for a given mg/kg dosage. Renal failure dose not make the volume of distribution larger. Prolonged elimination still occurs.