Distribution

Question 1

Body Fluid Compartments:

Total body water = __% of body weight

Answer 1

60

Question 2

Body Fluid Compartments:

Intracellular fluid = __% of body weight

Answer 2

40

Question 3

Body Fluid Compartments:

Extracellular fluid = ___% of body weight

Answer 3

20

Question 4

Body Fluid Compartments:

Plasma fluid = ___% of body weight

Answer 4

4

Question 5

Body Fluid Compartments:

Blood volume = ___% of body weight

Answer 5

7

Question 6

The body fluid compartments % are based on if the drug gets into the RBC.
If it doesn’t get into the RBC then use ____% instead of 60% for total body water

Answer 6

57

Question 7

Go over the questions on page 1

Answer 7

okay jose

Question 8

Following absorption the pattern of drug distribution is governed by the rate of _____ ______ (______) to each tissue and the affinity of the drug to accumulate in the tissue.

Answer 8

blood flow (perfusion)

Question 9

Tissues that receive the _____ blood flow will rapidly equilibrate with the drug, whereas tissues that are poorly perfused with equilibrate _____ with the drug.

Answer 9

highest

slower

Question 10

Blood flow is an important factor in determining the ____ ______ of drugs.

Answer 10

initial distribution

Question 11

Explain how you can have 0% blood concentration level of a drug but still get a therapeutic effect.

Answer 11

• Organ can take the drug in but won’t kick it out

- Drug will accumulate solely in the organ (not the blood) and elicit the drug response.

Question 12

Drug accumulation into tissues is dependent upon what 2 things?

Answer 12

1) blood flow

2) tissue affinity for the drug

Question 13

Tissue concentration of drugs with ____ tissue affinity will equilibrate rapidly with the plasma drug concentration and decline rapidly as the drug is eliminated from plasma.

Answer 13

low

Question 14

Conversely, drugs with high tissue affinity tend to _____ or _____ in the tissue.

Answer 14

accumulate or concentrate

Question 15

Highly ____ drugs are extracted by poorly perfused organs (ex. fat) hence drug accumulation is slow.

Answer 15

lipophilic

Question 16

Removal from fat tissue for lipophilic drugs is also extremely ____.

Answer 16

slow

Question 17

List some tissues that are highly perfused

Answer 17

adrenals
kidneys
thyroid
liver
portal-drained viscera
heart (basal)
brain

Question 18

List some tissues that are poorly perfused

Answer 18

skin
muscle (basal)
connective tissue
fat

Question 19

What is the formula for Vd (volume of distribution)

Answer 19

Volume (L) = Amount of drug added (mg)/ Drug conc (mg/L)

Question 20

What is the lowest apparent Vd of a 70 kg healthy male?

Answer 20

2.8 L (plasma volume)

Question 21

understand case on slide 6

Answer 21

if i must

Question 22

Drug bound to protein cannot ____ the cell

Answer 22

enter

Question 23

Lipophilic drug must be ______ to enter the cell and cross the membrane.

Answer 23

unbound

Question 24

What are the 2 proteins we are concerned about?

Answer 24

Albumin - acidic drugs

AAG (alpha 1 acid glycoprotein) - basic drugs

Question 25

Understand how they got the answers on slide 7

Answer 25

omfg

Question 26

Why does albumin concentration go down when you have a burn?

Answer 26

• When you have a burn, you lose skin
• Fluid comes out of burn
• Albumin is in the fluid (you are losing lots of albumin with burns)

Question 27

Why does albumin concentration go down in renal failure?

Answer 27

-In renal failure, the kidney becomes leaky and you get leakage of these proteins and you pee out the proteins. Hence, albumin levels are reduced

Question 28

Why does albumin level decrease in cirrhosis?

Answer 28

-Albumin is made in the liver so when the liver is failing, albumin is not being made.

Question 29

With conditions: renal failure, chirrosis, burns, and pregnancy - Albumin levels _____

Answer 29

decrease

*see page 8

Question 30

With conditions: renal failure, burns, stress/trauma, obesity, and MI - AAG (alpha 1 acid glycoprotein) levels ____

Answer 30

increase

*see page 8

Question 31

For _____ protein bound drugs, a 5% change in protein binding is a lot.

Answer 31

highly

Question 32

For _____ protein bound drugs, a 5% change in protein binding is not a lot.

Answer 32

intermediately

Question 33

As we increase protein binding, we increase ______

Answer 33

half-life