Reflection – Pharmacokinetics

For the past week, Dr. Ensom went over pharmacokinetics for vancomycin, aminoglycosides, phenytoin and digoxin, as well as, gave us a brief overview of other drugs that have TDM. On our last day, we also had clinical pharmacists share real-life cases and how to apply pharmacokinetics in real life. The sessions were incredibly useful, especially since I didn’t take the pharmacokinetics electives. During my general medicine rotation, I hope to get more experience with interpreting levels, applying my pharmacokinetic knowledge and writing concise and comprehensive chart-notes/documentations.

Some things I took away from the sessions:

  • For future chart notes on TDM, I will document if possible on: individual pharmacokinetic parameters, population estimates (if clinically useful)
    – check if this is the first or follow-up note
    – write chart notes in bullet points
    – check infusion times, timing of level relative to dose, previous doses and their timing
    – keep in mind that my audience is the health care team and other pharmacists
  • Patient can only be toxic if they are alive!
  • Population estimates are like clothes off the clothing rack. Whenever possible, want to get individual PK parameters
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2 thoughts on “Reflection – Pharmacokinetics

  1. when doing tDM, try to avoid calling them “levels”; rather they are serum drug concentrations (or to be more precise, serum vancomycin concentration or example). i liked your trouble shooting (wrong drug given? wrong lab sample? wrong sampling, eg wrong arm, wrong patient; wrong timing, eg. drew trough during infusion; final question: how is the patient doing?

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