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