[醫如往常] Senior Clerkship Day 101: Lab Medicine: vWD; Von Willebrand disease; TDM OF Amikacin in NTM treatment

洪醫師

vWD; Von Willebrand disease

Female多 but not x-linked

Platelet GP1b alpha

Mucosal bleeding

Hypermennorrhea

Tooth bleeding

Tests

PFA 100

VWF Ag

VWF Ristocetin Cofactor activity assay

• Poor sensitivity

Factor VIII

Recombinant glycoprotein 1b fragments

Mutant gain of function glycoprotein 1b

Type

I 70-80% quantitative deficiency. (沒有一定標準)

Ii 20% dysfunction

Iii <5% absence

DDAVP 治療type I,  II

劉醫師

TDM OF Amikacin in NTM treatment

Treatment

Time kill curve

16MIC 效果才好

3mm fiber

至少五天

Ec80=3.2 Cmax/MIC

Neurotoxicity; ATN

Once daily

No more than 10 days

Bilateral ototocixity

180 days 50%

Monitor

Trough level測不到

要測peak後兩小時，跟random

Clinical 2-4 weeks

Shift to oral quinolone