During the first and second year, the ID Fellow will spend one day (60 minutes) per month 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 willprovide the Fellow with didactic lectures that focus on thepharmacokinetic and pharmacodynamic properties of antimicrobials.In addition, ID consult patients that required dosage modificationbased on PD and PK principles will be discussed. The focus of thesepresentations and discussions will on the practical application ofPK and PD theory to the hospitalized patient. The Fellow will gainexperience with PK and PD theory through the completion of practiceproblem 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
Mix of diseases: not applicable
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.
Pathological material: not applicable
Evaluation: Practice problem sets will be evaluated by the course instructor. Feedback will be provided to the Fellows upon completion of these problems sets.
- Curriculum - Infectious Disease Fellowship
- Clinical Microbiology/Immunology
- Outpatient Rotation
- Hospital Epidemiology Course
- Inpatient Rotation
- Research Year
- Elective Months
- Clinical Pharmacology