E01_07 Prescribing: Hepatic/Renal Diseases Flashcards
2017_Hepatic/Renal
Clearance of isoniazid is increased if:
A. Urine is alkaline
B. Urine is acidic
C. pH is not a factor
A. Urine is alkaline
2017_Hepatic/Renal
In the presence of hepatic insufficiency, the loading dose of an IV administered and hepatically cleared drug needs to be:
A. Increased
B. Decreased
C. Same
C. Same
2017_Hepatic/Renal
In the presence of hepatic insufficiency, the loading dose of an orally administered and hepatically cleared drug needs to be:
A. Increased
B. Decreased
C. Same
B. Decreased
2017_Hepatic/Renal
In the presence of decreased protein binding, the maintenance dose of a high extraction ratio and hepatically cleared drug needs to be:
A. Increased
B. Decreased
C. Same
C. Same
2017_Hepatic/Renal
For a renal high extraction ratio drug, we expect a:
A. Higher bioavailability
B. Lower bioavailability
C. This extraction has no effect on bioavailability
C. This extraction has no effect on bioavailability
2017_Hepatic/Renal
Which two constitute the dual elimination pathway of phenytoin:
A. CYP2C9 and CYP2C19
2018_Hepatic/Renal
In liver disease, which isozyme is last to decrease?
A. 2D6
B. 3A4
C. 2C19
D. 2C9
A. CYP2D6
2C19 is the first to decline
2C19 -> 1A2 -> 3A -> 2D6
2018_Hepatic/Renal
If there are no studies done and the patient is Child Pugh class A (mild), how much of the dose will you give?
A. 75% maintenance dose
B. 50% maintenance dose
C. 25% maintenance dose
B. 50% maintenance dose
A – 50% of normal dose
B – 25%
C – use drugs with clinical safety data
2018_Hepatic/Renal
Warfarin is metabolized by CYP3A and then ketoconazole (a CYP3A inhibitor) was given. What is likely to happen?
A. Increased risk of bleeding
B. Decreased risk of bleeding
C. No effect
A. Increased risk of bleeding
2018_Hepatic/Renal
If the protein binding of a drug is decreased, what happens to the loading dose?
a Increased
b Decreased
c No change
?
2016_Hepatic/Renal
True or False. In cirrhotic patients, BA of drugs with high extraction ratio is mor affected than low extraction ratio drugs.
True
2016_Hepatic/Renal
If with hepatic derrangement, only systemic clearance is affected.
True
2016_Hepatic/Renal
True or False. In patients with hepatic derangement, decrease in function of CYP3A is faster than CYP2D6.
True.
2D6 is last