During the first and second year, the ID Fellow will spend at least one hour per month of dedicated teaching time with the infectious disease pharmacist.
Goal: To provide the Fellow with the skills and knowledge that are necessary to integrate pharmacokinetic (PK) and pharmacodynamic (PD) principles to design, monitor, and adjust drug dosing regimens for hospitalized patients
Objectives: The Fellow should be able to:
- Perform basic PK calculations and demonstrate an understanding of the clinical significance of the various PK parameters.
- Demonstrate the ability to utilize PK data, in conjunction with available clinical information and scientific literature, to design and monitor individualized drug dosage regimens such as aminoglycosides, vancomycin, and other antimicrobials.
- Discuss the pharmacodynamics of aminoglycosides, vancomycin, and other antimicrobial classes.
- Integrate the knowledge of pharmacokinetic and pharmacodynamic theory and principles in a useful and clinically relevant manner with the patient's overall medical management
Teaching methods: The ID pharmacist will provide the Fellow with didactic lectures that focus on the pharmacokinetic and pharmacodynamic properties of antimicrobials. In addition, ID consult patients that required dosage modification based on PD and PK principles will be discussed. The focus of these presentations and discussions will on the practical application of PK and PD theory to the hospitalized patient. The Fellow will gain experience with PK and PD theory through the completion of practice problem sets.
Teaching topics: The following topics will be taught during the rotation:
- Introduction to pharmacokinetic principles
- Volume of distribution & clearance
- Elimination rate constant & half-life
- Drug accumulation and steady-state
- Clinically useful equations
- Aminoglycosides and vancomycin
- Pharmacokinetic and dynamic properties
- Empiric dosing strategies
- Dosage modification based on serum drug concentrations
- Pharmacodynamics of beta-Iactams and other antimicrobials
- Antimicrobial dosage in special populations
- Renal disease
- Obesity
- Pediatrics
Patient characteristics and types of clinical encounters,procedures, and services: not applicable
Reading list: The Fellow will be provided with readings from the primary literature as well as from selected pharmacokinetic textbooks.
Evaluation: Practice problem sets will be evaluated by the course instructor. Feedback will be provided to the Fellows upon completion of these problems sets.
