Pharmacokinetics of aminoglycosides in patients with chronic spinal cord injury
Bibliographic record
Abstract
PURPOSE: The pharmacokinetics of amino-glycosides in patients with chronic spinal cord injury (SCI) is reviewed. SUMMARY: SCI is associated with many physiological changes that can affect disposition of drugs such as aminoglycosides; therefore, dosing of aminoglycosides in this population can be challenging. In general, volume of distribution is significantly higher in the SCI population compared with the non-SCI population; however, clearance and half-life may be larger or no different. When gentamicin is administered intramuscularly, there is no difference in bioavailability when the dose is administered below the level of the injury but absorption appears to be slower in patients with SCI compared with the non-SCI population. Several methods of laboratory assessment of renal function, such as serum creatinine (SCr), 24-hour urine creatinine clearance (CL(cr)), and cystatin C, have advantages and limitations associated with their use in the SCI population. The majority of evidence suggests that SCr and various estimation equations are not accurate methods for assessing renal function in this population. Although measured CL(cr) by 24-hour urine collection is not dependent on muscle mass, wide intrapatient variability in CL(cr) results is still observed. Cystatin C may be a good option in this population; however, its use is limited by its availability. CONCLUSION: Determining appropriate aminoglycoside dosage in patients with SCI is challenging because such patients exhibit physiological changes that lead to their having different aminoglycoside pharmacokinetic values than the general population. Monitoring of aminoglycoside concentrations and calculation of patient-specific pharmacokinetic values can help guide dosage in this patient population.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.006 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".