Drug Monitoring
Drug Monitoring Guidelines for Home IV Therapy
Patients with cystic fibrosis (CF) may receive home IV therapy to treat pulmonary exacerbations. Below are suggested monitoring parameters for home IV.
Antibiotic | Possible adverse drug reaction | Suggested monitoring parameter |
---|---|---|
Penicillins Eg. Cloxacillin |
GI intolerance Rash Phlebitis Interstitial nephritis (rare) Leukopenia (rare) |
ONCE weekly:
|
Anti-pseudomonal penicillins Eg. piperacillin/tazobactam |
GI intolerance Rash Phlebitis Interstitial nephritis (rare) Leukopenia (rare) |
ONCE weekly: CBC, diff |
Cephalosporins Eg. Ceftazidime |
GI intolerance Rash Leukopenia (rare) |
ONCE weekly: CBC, diff |
Carbapenems Eg. Meropenem |
GI intolerance Rash Phlebitis Interstitial nephritis (rare) Leukopenia (rare) |
ONCE weekly: CBC, diff |
Aminoglycosides Eg. Amikacin, tobramycin |
Nephrotoxicity Ototoxicity Vestibular toxicity |
TWICE weekly:
Pre/post dose level with third dose, then if therapeutic pre dose level ONCE weekly* Consider audiometry |
Aztreonam |
GI intolerance Rash Leukopenia Elevated AST/ALT |
ONCE weekly:
|
Colistimethate |
Nephrotoxicity Neurotoxicity (eg. Peripheral neuropathies) |
TWICE weekly:
|
Vancomycin |
Redman’s syndrome Phlebitis Nephrotoxicity (rare) Leukopenia (rare) |
ONCE weekly:
|
*Levels: | Peak (mg/L) | Trough (mg/L) |
---|---|---|
Amikacin | 25-30 | < 10 |
Tobramycin once daily | 20-30 | < 1 |
Tobramycin conventional | 10-12 | < 2 |
Vancomycin | n/a | 15-20 |