快樂小藥師 Im pharmacist nichts glücklich

 

肌肉注射：

腎功能正常者：2.5-5mg/kg/day，分成2-4次

以注射用滅菌水或生理食鹽水2mL稀釋，濃度為33.4mg/mL

體重50 kg的病患，給藥劑量為：125~250mg/day（31.25~62.5mg bid），等於0.5~1vial q12h

靜脈注射：

一次為半日劑量，給藥時間要超過5分鐘，每12小時一次。

Dosage Adjustment During Dialysis

Continuous Venovenous Hemodiafiltration

1)  When colistin methanesulfonate (CMS) 150 milligrams every 48 hours was administered intravenously to a 53-year-old woman (total body weight, 100 kilograms (kg); ideal body weight, 61 kg) with bowel perforation leading to multiple organ failure which required continuous venovenous hemodiafiltration (CVVHDF), the maximum plasma concentration of CMS and colistin was less than 16 x MIC and less than 2 x MIC against Pseudomonas aeruginosa, respectively, and the plasma concentrations of CMS and colistin fell below their respective MICs approximately 4 hours after CMS administration and remained so for most of the 48-hour dosing interval. The authors suggest a more modest dosage adjustment for CMS in patients requiring CVVHDF, such as 2 to 3 milligrams/kilogram (mg/kg) every 12 hours, rather than the regimen used in this case (2.46 mg/kg of ideal body weight every 24 hours) (Li et al, 2005).

 特別注意的是，如果洗腎患者，洗腎前已經給藥，需要再洗腎後補打一劑，否則可以選擇在洗腎後給藥

臨床Colistin吸入給藥劑量調整

吸入給藥盡量不要超過3天，不過臨床上建議可以延長到1 個禮拜。

配製：先以Dis. water 泡製成2mL，吸入給藥時再用NS調整為4～6mL

Colistin 66.8mg吸入給藥時劑量調整

如果復發，則改為160mg q8h（就是1vial q8h）