Module 9 questions - Extreme volumes (Clinical challenge)
  1. Which are the most clinically important differences in calculated values between adults and foals.

    Cmax and Cmin are most important.

  2. What general recommendations can be made for the proper dose and interval of aminoglycosides given to neonatal foals?

    It is important to understand that the dose should be increased and the interval extended.

  3. Examine the plot of the plasma concentration profile for the foal after you make your final dose adjustment. The plasma concentrations are below MIC for typical sensitive organisms (2.0 - 3.0 μg/ml) for about 6 hours out of each dose interval. What could you do for this patient to provide continuous antimicrobial therapy without risking gentamicin intoxication? (It should be clear that changing doses and intervals of gentamicin will not work. You need to think outside the pharmacokinetic box.)

    Add a second drug with likely activity against the pathogen or suspected pathogen(s).