What is the best method of monitoring therapeutic blood levels of vancomycin during therapy?
By assessing the temperature every 4 hours
By repeating a culture and sensitivity test on day 3
By obtaining drug peak and trough levels
By assessing for breathlessness
The Correct Answer is C
A. By assessing the temperature every 4 hours:
Monitoring temperature every 4 hours is a common practice in hospitalized patients to detect fever, which could indicate an infection or an inflammatory response. However, this method does not directly assess the therapeutic blood levels of vancomycin. Fever alone does not provide specific information about the effectiveness or concentration of the antibiotic in the bloodstream.
B. By repeating a culture and sensitivity test on day 3:
Culture and sensitivity tests involve taking a sample from the patient (such as blood, urine, or sputum) and growing the microorganisms in a laboratory to identify the causative organism and determine its susceptibility to antibiotics. While this test is essential for identifying the appropriate antibiotic therapy initially, repeating it on day 3 does not directly monitor therapeutic blood levels of vancomycin. It also doesn't provide real-time information about the concentration of vancomycin in the bloodstream.
C. By obtaining drug peak and trough levels:
This choice involves measuring the highest (peak) and lowest (trough) concentrations of vancomycin in the bloodstream. Peak levels are typically measured about 1 hour after the completion of a vancomycin infusion, while trough levels are measured just before the next dose is administered. These measurements allow healthcare providers to ensure that the drug concentration remains within the therapeutic range to effectively treat the infection while minimizing the risk of toxicity.
D. By assessing for breathlessness:
Assessing for breathlessness is important for monitoring respiratory status, particularly in patients receiving vancomycin, as rare side effects like red-man syndrome or anaphylaxis can cause respiratory distress. However, this method does not directly monitor therapeutic blood levels of vancomycin.
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Related Questions
Correct Answer is D
Explanation
A. Doxycycline:
Doxycycline is a tetracycline antibiotic that is effective against anthrax. It is commonly used for post-exposure prophylaxis and treatment of anthrax infections.
B. Penicillin:
Penicillin is not typically the first-line antibiotic for treating anthrax. While some strains of Bacillus anthracis may be susceptible to penicillin, other antibiotics like doxycycline or ciprofloxacin are preferred due to their broader spectrum of activity and better penetration into tissues.
C. Oxytetracycline (Terramycin):
Oxytetracycline is another tetracycline antibiotic similar to doxycycline. Like doxycycline, oxytetracycline is effective against anthrax and can be used for post-exposure prophylaxis and treatment of anthrax infections.
D. Ciprofloxacin:
Ciprofloxacin is a fluoroquinolone antibiotic that is effective against anthrax. It is commonly used as an alternative to doxycycline for post-exposure prophylaxis and treatment of anthrax infections, particularly for individuals who cannot tolerate tetracyclines.
Correct Answer is A
Explanation
A. Keep the serum drug level within the therapeutic margin:
This is the correct goal of monitoring peak and trough levels during antibacterial therapy. The therapeutic margin refers to the range of drug concentrations in the bloodstream that achieves optimal therapeutic effects while avoiding toxicity. By monitoring peak and trough levels, healthcare providers can adjust the dosing regimen to maintain drug levels within this therapeutic margin.
B. Increase the therapeutic effect of the drug by gradually decreasing the drug dose:
This statement is incorrect. Monitoring peak and trough levels is not about increasing the therapeutic effect of the drug by gradually decreasing the drug dose. Instead, it's about ensuring that the drug levels are maintained within the appropriate therapeutic range to achieve optimal efficacy without causing adverse effects.
C. Provide maximum physical comfort to the patient:
Monitoring peak and trough levels is not primarily aimed at providing physical comfort to the patient. While optimizing drug therapy can contribute to improved clinical outcomes and patient well-being, the goal of monitoring these levels is specifically related to achieving therapeutic drug concentrations.
D. Treat the main disorder with no psychological distress to the patient:
This statement is unrelated to the goal of monitoring peak and trough levels during antibacterial therapy. While psychological distress may be a consideration in patient care, the primary goal of monitoring drug levels is to ensure therapeutic efficacy and safety.
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