Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated administration.
Advantages of intermittent infusion: This method is particularly beneficial for drugs that are poorly tolerated when given as a rapid IV bolus. By delivering the drug more gradually, intermittent infusion minimizes the likelihood of toxicity or side effects. For example, aminoglycosides such as gentamicin require high peak plasma concentrations to achieve antimicrobial efficacy while maintaining low trough levels to prevent nephrotoxicity and ototoxicity. Intermittent IV infusion achieves this balance more effectively than a single bolus or continuous infusion.
Intermittent IV infusion provides a flexible and effective strategy for delivering medications that require specific pharmacokinetic and pharmacodynamic considerations. It optimizes therapeutic outcomes while reducing the risks of toxicity and side effects.
In intermittent IV infusion, drugs are administered in short infusions followed by elimination periods. Unlike continuous infusion, this produces peaks and troughs that avoid prolonged high concentrations and reduce adverse effects.
Drug concentrations may not reach steady-state levels within a single infusion cycle, but this can occur with repeated dosing.
Most drugs are better tolerated with slow infusion than a single IV bolus dose.
One example is aminoglycosides, such as gentamicin, which require high peak concentrations for efficacy and low trough levels to minimize toxicity.
The continuous IV infusion equation can be modified to calculate the drug concentration during intermittent IV infusion. Here, R represents the rate of infusion, D denotes the dose size, and tinf is the infusion period.
After the infusion ends, the first-order elimination equation calculates the post-IV infusion concentration. Here, Cstop represents the drug concentration when the infusion stops, and t indicates the time elapsed since the infusion was stopped.
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