4 Pharmacokinetics/dynamics Flashcards

1
Q

Vd of a drug that is lipophilic v hydrophobic

A

Lipophilic= exceeds TBW >0.6L/kg. Hydrophilic= <0.6 L/kg

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2
Q

Clearance is directly related to 3

A

Bf to clearing organ, extraction ratio, drug dose

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3
Q

Clearance is inversely proportional to 2

A

Bf to clearing organ and drug conc in central compartment

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4
Q

When is steady state achieved

A

5 half times

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5
Q

Alpha phase

A

Central compartment (plasma) to peripheral (tissues).steep pt of slope, distribution,

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6
Q

Beta phase

A

Elimination from central compartment

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7
Q

Elim half life

A

Time for half of drug to be removed from body after IV injection

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8
Q

Elim half time

A

Time for half of drug to be removed from plasma during elim phase

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9
Q

Ionized: solubility, hepatic v renal elim, diff thru bbb/gi tract/placenta

A

Hydrophilic/lipophobic, renal elim, no diffusion

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10
Q

Non ionized: solubility, hepatic v renal elim, diffusion

A

Lipophilic/hydrophobic, more hepatic, diffusion across bbb/gi/placenta

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11
Q

How to tell if a drug is a weak acid

A

Usually w a positive ion like na, ca, or mg

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12
Q

How to tell if a drug is a weak base

A

Usually with a neg ion like cl or so4

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13
Q

When unionized fraction predominates

A

If molecule weak base and ph of sol > pka of drug. Or if its a weak acid and ph sol is

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14
Q

How to calc % change w drugs

A

(New value - old value) / old value. X 100

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15
Q

Albumin: carries ___ charge, binds ___ drugs mainly

A

Negative, acidic

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16
Q

A1 glycoprotein binds ___ drugs, beta globulin binds ___ drugs

A

Basic, basic

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17
Q

Conditions w dec albumin, effect

A

Decreased binding of acidic drugs: liver/renal disease, elderly, malnutrition, preg

18
Q

A1 glycoprotein effect when inc, cond, effect when dec, cond

A

Inc= more basic drug binding: stress, mi, pain, RA, elderly. Dec= less basic drug binding, preg and neonates

19
Q

Zero v first order kinetics

A

Zero= linear, constant amt per time. First order= log, constant fraction per time

20
Q

Drugs that follow zero order kinetics

A

Asa, phenytoin, alcohol, warfarin, heparin, theophylline

21
Q

Phase 1 reactions

A

Oxidation, reduction, hydrolysis

22
Q

Phase 2 rxn.

A

Conjugation, adding on a polar/h20 soluble substrate to molecule to allow it to be excreted

23
Q

Phase 3 metab

A

Elimination. ATP dep carrier proteins transport drugs across membranes in kidney, liver, and gi tract

24
Q

Drugs w low hepatic Er 7

A

Roc, valium, Ativan, methadone, tpl, theophylline, phenytoin

25
Drugs w intermediate hepatic Er
Versed, vec, alfent, methohexital
26
Drugs w high hepatic Er
Fent, sufent, morphine, demerol, narcan, ketamine, prop, lido, bup, metop/propranolol/Alpren, nifedipine, dilt, verap
27
CYP 3A4: drug substrates affected by it
Opioids (fent, methadone), benzos, locals
28
Cyp 3a4 inducers
Etoh, rifampin, barbs, tamoxifen, carbamazepine, john wort
29
Cyp 3a4 inhib
Grapefruit juice, cimetidine, emycin, antifungals, ssris
30
Cyp 2d6 substrates
Codeine to morphine, oxycodone, hydrocodone
31
Cyp 2d6 inducers and inhib
Induce: disulfiram. Inhib: isoniazid, ssris, quinidine
32
Dynamics v kinetics
Dynamics= effect site conc and clinical effect. Kinetics= drug dose and plasma conc
33
Pharmacobiophasics
Plasma conc and effect site conc
34
Dose response curve: x axis, y axis, slope
X= potency, y= efficacy, slope= receptors occupied to elicit a clinical effect
35
Synergism v potentiation
Syn= 1+1= 3. Potentiation= 0+1=3. Pot= has one drug that enhances another drug that would’ve had no effect on its own
36
How to calculate therapeutic index
LD50 / ED50
37
Chirality
Carbon bonded to 4 diff atoms. 2 enantiomers
38
Enantiomer
Chiral molecules that are mirror images
39
Site with lowest bioavailability
Intrathecal
40
Vessel rich: % co, % total body mass
75. 10