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Bactrim dosing abscess is not feasible at this time because of a very limited number dosing sites and the limited number of sites that have been found. However, Bactrim dosing for intubation and decontamination may be practical in a few years when we have a wider range of sites available to use for the treatment of dosing errors. We found that the dosing of Bactrim for intubation was highly dependent upon the site, site-specific parameters of dosing and the presence or absence of Bactrim dosing error. Our experience has demonstrated that in most cases, Bactrim dosing errors are not attributable to patient error per se, rather to an interaction between patient, site, and device. While the exact dosing error is generally unknown, several important factors must be considered ( ). Table 1 Site Parameter 1.5 mL of Bactrim 2 1.8 saline (1 mL of is sufficient for every 2 doses; a 4 mL syringe is sufficient volume) 3 Bactrim 5 1.2 mL of 3 saline 6 3.2 mL of Bactrim and 0.5 g magnesium chloride. A 3 g-equivalent volume generic pharmacy uk of sodium chloride has proven more consistent and efficacious than magnesium chloride; 2 g-equivalent volume of sodium chloride is not suitable to use owing its rapid onset and short-lasting action. 7 1 mL of saline 9 0.4 sodium chloride 1.0 mL of saline Bactrim has been shown to rapidly diffuse through the tracheal tube, whereas sodium chloride appears to have a slower distribution. 10 0.1 mL of saline 11 0.2 sodium chloride mL of saline Bactrim does not exhibit a significant absorption of water, thus its volume is less than that required for effective dosing. A 2-mL-equivalent volume of 1% dextrose is recommended. 12 3 g of salt tablets 12 mL saline A single Bactrim dose is intended to achieve rapid dosing for multiple sites. However, in many cases multiple Bactrim sites are also effective for each dose and patient on the same dosing schedule. Thus, more than one Bactrim dose may be recommended. In the presence of other agents, it seems advisable to avoid a continuous flow of water when delivering Bactrim for intubation in patients with renal failure. Bactrim has been shown in experimental animal studies to inhibit the synthesis of cyclosporine. There is no conclusive evidence, however, that oral cyclosporine therapy would result in decreased Bactrim concentration. Because Bactrim can also cross the epithelial layer, it is also unlikely that dosing error will result in increased concentration at the site of dosing error. Bactrim does not exhibit a significant pharmacokinetic or pharmacodynamic interaction with several other drugs. Bactrim should generally not be used in patients with cardiovascular disease. Because of Bactrim's toxicity with respect to concomitant therapy cyclosporine, it should be avoided in patients with congestive heart failure and in those without normal renal function who are concurrently receiving cyclosporine. In summary, because Bactrim dosing errors can affect and therefore result in increased volume of medication, Bactrim should generally not be utilized when dosing for intubation or decontamination patients with impaired renal function. Instead, it should be used to maintain therapeutic pressure on the distal end of bronchial trachea, where the largest volume of medication can be safely delivered. Determination of the total dose intubation fluid The total effective dose for intubation fluid is determined by determining the volume of a intubation fluid that contains certain amount of Bactrim and the presence or absence of a dosing error. The total effective dose (TE) for intubation fluid may easily be calculated using the following formula, given concentration and specific volume of medication per unit syringe volume. Calculating the TE (mL/S) is as follows: The following is an equation to calculate the TE