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Class of 2012 Abstract / Objectives: The primary objective of this study was to evaluate the appropriateness of when aminoglycoside serum concentrations are obtained and assess whether the timing and techniques used in obtaining aminoglycoside serum concentrations are appropriate. Additionally, pharmacists’ interpretation of aminoglycoside serum concentrations and the appropriateness of intervention in response to these results were assessed. Methods: This descriptive retrospective study to evaluate the appropriateness of aminoglycoside monitoring at an academic medical center has been approved by the Institutional Review Board. Patients over the age of 46 weeks gestational age admitted to an academic medical center between February 1, 2010 to February 1, 2011 who were prescribed intravenous aminoglycoside therapy were included in this study. Patients with therapy duration of less than 72 hours without at least one aminoglycoside level were excluded. The time of aminoglycoside concentrations in relation to time of aminoglycoside administration along with calculated pharmacokinetic parameters and therapy recommendations documented in clinical notes were also recorded. Appropriateness of aminoglycoside monitoring and documentation were determined by use of expert opinion and pharmacokinetic guidelines. Results: Timing of aminoglycoside serum concentrations and subsequent clinical assessments were evaluated in 103 subjects. The median (range) age was 28 (0.2 – 88) years. The initial aminoglycoside prescribed in 12%, 40%, and 48% of subjects was amikacin, gentamicin, and tobramycin, respectively. A total of 314 aminoglycoside concentrations were obtained: 41 amikacin, 129 gentamicin, and 144 tobramycin. At least one clinical pharmacokinetic assessment of aminoglycoside concentration(s) was written for 91 subjects (88%). The aminoglycoside indication, actual time of aminoglycoside dose administration, estimated renal function, and both goal peak/trough aminoglycoside concentrations were documented in at least one aminoglycoside clinical note for each of these 91 subjects at a rate of 95%, 80%, 89%, and 51%, respectively. Calculated peak, trough, estimated volume of distribution, and estimated half-life or ke were documented in 53 subjects. Conclusions: Aminoglycoside serum concentration monitoring can be used to maximize therapeutic outcomes while minimizing toxicity. However, errors in obtaining and evaluating serum drug levels can arise that may affect patient outcomes. For monitoring to be effective, the timing of serum concentration orders, the process of obtaining serum concentration samples, and the interpretation of data including pharmacokinetic calculations should be accurate.

Master of Science - Science / The analytical methods for speciation of manganese in three different types of matrices (water, milk and blood serum) was studied. Supported liquid membrane (SLM) extraction was optimized and successfully used for the extraction and preconcentration on Mn(II) from water, milk and blood serum. The extractant used was 15% (v/v) DEHPA with an organic membrane modifier, 10% (v/v) TOPO. All determinations of Mn(II) were carried out using Adsorptive Stripping Voltammetry. A SLM membrane probe was developed and used for the extraction of Mn(II) from smaller water, milk and blood serum samples. Membrane probe depth was optimized: probe depth - 2mm below donor solution. The membrane probe yielded higher extraction efficiencies compared to the flat spiral disk SLM unit. The Adsorptive Stripping Voltammetry method used for the determination of Mn(II) in water was optimized and used in other applications (determination of Mn(II) in aged and fractionated blood serum). The optimum conditions obtained: pH = 7.5-8.0, deposition potential = -(1.9V-2.0V), deposition time = 45-65s, equilibration time = 5s, stirring speed = 2000rpm, and no gelatin addition. The AdSV optimized parameters were then used for the analysis of Mn(II) in aged whole and fractionated blood serum. Size exclusion chromatography was used to obtain the blood serum fractions. It was determined that with aging, the concentration and thus extraction efficiency of free Mn(II) in blood serum matrix decreases. The spiked blood serum fractions were extracted and Mn(II) was determined with adequate reproducibility.

Thesis (Ph. D.)--Ohio State University, 2003. / Title from first page of PDF file. Document formatted into pages; contains xxiii, 325 p.; also contains graphics (some col.). Includes abstract and vita. Advisor: Gary E. Means, Dept. of Biochemistry. Includes bibliographical references (p. 206-225).

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There is no abstract available for this thesis. / Department of Family and Consumer Sciences