Factors Modifying Drug Action

Question 1

What is Cockcroft and Gault formula?

Answer 1

It is used for creatinine clearance and to estimate GFR

Question 2

What are the elements of Cockroft and Gault formula?

Answer 2

Age
Sex(multiply w 0.85 for females/for muscle mass)
Serum creatinine
Body weight

Question 3

What are the consequences that CGF misleading ?

Answer 3

Old people
Thin people
malnutrition

Question 4

Meperidine and it’s metabolite normeperidine is an example for ____

Answer 4

Drug metabolites can accumulate w/impaired renal function and can be toxic.

Question 5

Phenobarbital is an example for ___

Answer 5

Weak acid drug which excretin increases in alkaline urine

Question 6

Do we have a hepatic function evaluation test like GFR for kidney?

Answer 6

No we don’t.We can use ASL ALT but these values don’ correlate with drug modification all the time.

Question 7

If there is a hepatic cirrhosis or any dysfunction of liver which kind of drugs will be effected?

Answer 7

Oral administered(ones that have first pass clearence).Their clearance will decrease and concentration will increase.

Question 8

What will be the result of hypoalbuminemia for plasma protein bound drugs?

Answer 8

Their free unbound concentrations=active will increase.

Question 9

Why do we evaluate drugs in adults rather than children and old people?

Answer 9

Because variability of pharmacokinetics is likely to be greatest at the times of physiologicial changes.

Question 10

How is the drug disposition in children?

Answer 10

Not linearly w/either body weight or surface and tehere are no broadly applicable formulas for converting drug doses used in adults.

Question 11

Which drug metabolizing enzymes are expressed first in neonates?they dont have much as adults

Answer 11

CYP2E1&CYP2D6 in first day
CYP3A4&CYP2C in first week
CYP2A1 NOT EXPRESSED FOR A MONTH

Question 12

Which drug shouldn’t we use for neonates bcs of the inability of glucuronidation?

Answer 12

Chloramphenicol/causes gray baby syndrome

Question 13

How is the renal elimination of drugs in neonates?

Answer 13

Decreased in newborn way lesser in premature

Question 14

What is glucuronidation?

Answer 14

It is a phase 2 biotransformation and glucuronide is used as a conjugation molecule

Question 15

Pharmacokinetics in elderly?

Answer 15

CYP activities is reduced but conjugation activities are similar.

Question 16

What is polymorphism?

Answer 16

Allelic variation with a frequency of more than >%1

Question 17

Does polymorphism affect pharmacodynamics and kinetics?

Answer 17

yes.

Question 18

What is compliance?

Answer 18

Patient taking the drugs accoring to prescribed dose regimen like the doctor said.

Question 19

What is placebo?

Answer 19

İnert material used in clinical drug trials which effect patient psychologically and therefore physiologically patient thinks its a good effecting drug but it aint anything actually

Question 20

What is nocebo?

Answer 20

Opposite of placebo

Question 21

When do we consider fatless body weight

total body weight?

Answer 21

polar drugs

lipid soluble drugs in order

Question 22

What is the difference of parenteral administration of drug than oral one?

Answer 22

higher concentration
Faster effect
More side effects

Question 23

What is the difference between IV BOLUS, ORAL DRUGS,IV INFUSION?

Answer 23

The least concentration will be w/oral taking
In iv bolus you will take a high amount in less time and there will be a really high dose for few minutes than it will distribute quickly
In iv infusion distiribution eş zamanlı olur alım ile çünkğ mesela serumu 1 saate ayarlarsın ve net sonuçta aslında dengeye ulaşınca plazmada en yüksek olacağı durum ilacın ıv infusion ama asla iv bolus kadar yüksek olamaz.

Question 24

Chronopharmacology?

Answer 24

Study of interactions of biologc rhytms w/medications

Question 25

Desensitization=tachyplaxis?

Answer 25

Developed tolerance within minutes.

Question 26

What are the physiologic responses happinin in pregnancy?

Answer 26

Decreased albumin
İncreased C.O
İncreased blood flow,GFR,renal elimination of drug