A 43 year old man with a 7 year history of chronic renal disease - ProProfs Discuss
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A 43-year-old man with a 7-year history of chronic renal disease comes to the emergency department with a 5-day history of productive cough and shortness of breath. On physical examination, he is found to have rales in the middle lobe of his right lung. An x-ray film of the chest shows consolidation in the same area, and he is started on levofl oxacin. Which of the following indicates how the dosing of the levofloxacin would be different in this patient as compared to an otherwise healthy patient?



A. Higher loading dose, higher maintenance dose
B. Higher loading dose, same maintenance dose
C. Lower loading dose, lower maintenance dose
D. Lower loading dose, same maintenance dose
E. Same loading dose, higher maintenance dose
F. Same loading dose, lower maintenance dose
G. Same loading dose, same maintenance dose
Asked by Halbert, Last updated: Dec 05, 2017

This question is part of

Step 1 First Aid Pharmacology

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1 Answer

John Smith

John Smith

Answered on Sep 09, 2016

Same loading dose, lower maintenance dose-the correct answer is f. the most important concept in this answer is that the loading dose is independent of renal or liver disease; the loading dose has more to do with volume of distribution, since excretion and metabolism have not yet occurred. the maintenance dose will be lower, since this patient has a history of renal disease and levofloxacin is excreted in the urine.answer a is incorrect. a higher loading dose is unnecessary and may lead to elevated drug levels, which can cause elongated qt intervals. a higher maintenance dose would also lead to elevated drug levels.answer b is incorrect. a higher loading dose is unnecessary and may lead to elevated drug levels, which can cause elongated qt intervals. keeping the maintenance dose the same may also lead to elevated drug levels.answer c is incorrect. a lower loading dose would lead to subtherapeutic drug levels; however, adjusting for the compromised renal excretion and lowering the maintenance dose would be appropriate.answer d is incorrect. a lower loading dose would lead to subtherapeutic drug levels; keeping the maintenance dose the same may also lead to elevated drug levels.answer e is incorrect. keeping the same loading dose is the correct choice; however, a higher maintenance dose would lead to elevated drug levels.answer g is incorrect. keeping the same loading dose is the correct choice; however, keeping the maintenance dose the same may also lead to elevated drug levels.
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