Module 4 questions - Altered volume of distribution (General principles)
  1. Estimate a dose of gentamicin that would produce a Cmax in foals similar to that of adults dosed at 9.0 mg/kg. Assume a 24 hour dosing interval. (The number need not be exact. You may use the Excel worksheet for this purpose if you wish)

    A dose of approximately 19.5 is required to reach the same Cmax in foals.

  2. Any potential for drug accumulation with repeated doses is reduced directly by:

    Increasing the dose interval. Accumulation occurs because a fraction of the dose (any dose) is left at the end of a dose interval. Changing the dose dose not change WHETHER accumulation occurs.

  3. Defend this statement: "Dosing a foal as if it were an adult creates the risk of producing gentamicin toxicity without efficacy."

    The higher volume of distribution reduces initial and peak concentrations (which would decrease efficacy) but causes accumulation and high Cmin concentrations to occur (which can lead to toxicity).