Determination of Dosing Weight on Aminoglycosides

Aminoglycosides계 약물의 투약 체중 결정

Ascertainment of accurate pharmacokinetic parameters for aminoglycoside dosing remains critical, as the serum drug concentration relates directly to both the therapeutic response and toxic effect. In the initial dosing of aminoglycosides, the volume of distribution is especially important because the dosage is calculated by multiplying the volume of distribution by the desired serum concentration. Aminoglycosides distribute into mainly the extracellular fluid and it has been reported that the volume of distribution is 0.25 L/kg. Penetration of polar aminoglycosides into adipose tissue occurs to some extent, but varies according to the degree of obesity. Therefore, dosages may be overestimated or underestimated according to the type of the dosing weight in overweight or underweight patients. Prior investigations have suggested various dosing weights which are multiplied by the popular volume of distribution to calculate the total volume of distribution. Based on other investigations, we calculated a new dosing weight which was applicable to all patients regardless of obesity in order to use the popular volume of distribution. We estimated IBW+$0.414^{\ast}$(TBW-IBW) as a new dosing weight with the SAS program. A new dosing weight is similar to those of other studies which examined in morbidly obese patients. Consequently we suggests that the dosing weight reported in morbidly obese patients can be extended to a broader patients population. But we found that the volume of distribution per kilogram from our patients was significantly larger than that for foreign patients(0.343L/kg vs 0.25 L/kg)(Kor. J. Clin. Pharm. 1999; 9(1): 15-18)