CONDITIONS THAT IMPACT PK/PD HIGH YIELD A Flashcards
drug response depends on?
host factors
environmental factors
genetics factors
variation in drug responsiveness examples?
hyporeactivity hyperreactivity idiosyncratic tolerance dependence tachyphylaxis
hyperreactivity shouldn’t be confused with…?
hypersensitivity
what are the different types of genetic variants?
single nucleotide polymorphism
indels
gene amplification
what are the two types of SNPs?
synonymous (no change of function (phenotype) results)
non synonymous (change in function may result)
what are the terms used to describe individuals with varying rates of metabolism?
poor metabolizer
intermediate metabolizer
extensive metabolizer
ultra-rapid metabolizer
name this type of metabolism?
two-nonfunctional alleles
poor metabolizer
name this type of metabolism?
one function, one non-functional allele
intermediate metabolizer
name this type of metabolism?
two functional alleles
extensive metabolizer
name this type of metabolism?
more than one increased functional allele
ultra-rapid metabolizer
what are the genetic variants affecting pharmacokinetics?
CYP2D6 CYP2C19 CYP2C9 UGT1A1 ABCB1
what are the exceptions of absorption in relating the PK in the elderly?
what is significant about calcium carbonate?
calcium carbonate vs citrate
cyanocobalamin
it reacts with hydrochloric acid to form soluble calcium chloride, which is absorbed in the proximal small bowel
benzodiazepines are metabolized by what phase?
phase 1
what are the considerations of PK in the elderly?
absorption
distribution
metabolism
elimination
what medications are sensitive in terms of PD in the elderly?
benzodiazepines
anticholinergics
opioids
beta blockers
what are the important attributes that affect placental transfer?
lipophilicity ionization molecular weight pH protein binding metabolism
what period is the greatest for being at risk for anatomical malformations when being exposed to teratogenesis?
organogenesis
what are the medications put in category X that can have an effect on drugs and pregnancy?
methotrexate
statins
phenytoin
warfarin
factors affecting teratogenicity?
ability of the drug to pass into fetal circulation like thiopental
intensity of exposure
duration of exposure
distribution in the fetal tissue
what information is provided in the new FDA pregnancy and lactation label?
fetal risk summary
clinical consideration
PK changes in infants/children considerations?
absorption at site of administration
GI function
distribution
metabolism
elimination
so we know that the Cockcroft Gault equation is used to estimate creatinine clearance…what makes this less accurate?
reduced muscle mass severely ill elderly weight extremes unstable renal function
the kidneys can also be responsible for the activation of this vitamin?
vitamin D activation
what is the purpose of hemodialysis?
determinant of drug removal
what is the equation used for the creatinine clearance in children?
Schwartz equation
what are the common causes of liver disease?
hepatitis B and C
alcohol
autoimmune
liver disease and effects on drugs?
drug accumulation
failure to form active/inactive metabolites
increased bioavailability
alterations in drug protein binding
the score obtained for drug dosing in cirrhosis
child Pugh score
what are the types of interaction of therapeutic action?
additive interaction
potentiation
synergistic antagonism
