Factors Modifying Drug Action Flashcards
What is Cockcroft and Gault formula?
It is used for creatinine clearance and to estimate GFR
What are the elements of Cockroft and Gault formula?
Age
Sex(multiply w 0.85 for females/for muscle mass)
Serum creatinine
Body weight
What are the consequences that CGF misleading ?
Old people
Thin people
malnutrition
Meperidine and it’s metabolite normeperidine is an example for ____
Drug metabolites can accumulate w/impaired renal function and can be toxic.
Phenobarbital is an example for ___
Weak acid drug which excretin increases in alkaline urine
Do we have a hepatic function evaluation test like GFR for kidney?
No we don’t.We can use ASL ALT but these values don’ correlate with drug modification all the time.
If there is a hepatic cirrhosis or any dysfunction of liver which kind of drugs will be effected?
Oral administered(ones that have first pass clearence).Their clearance will decrease and concentration will increase.
What will be the result of hypoalbuminemia for plasma protein bound drugs?
Their free unbound concentrations=active will increase.
Why do we evaluate drugs in adults rather than children and old people?
Because variability of pharmacokinetics is likely to be greatest at the times of physiologicial changes.
How is the drug disposition in children?
Not linearly w/either body weight or surface and tehere are no broadly applicable formulas for converting drug doses used in adults.
Which drug metabolizing enzymes are expressed first in neonates?they dont have much as adults
CYP2E1&CYP2D6 in first day
CYP3A4&CYP2C in first week
CYP2A1 NOT EXPRESSED FOR A MONTH
Which drug shouldn’t we use for neonates bcs of the inability of glucuronidation?
Chloramphenicol/causes gray baby syndrome
How is the renal elimination of drugs in neonates?
Decreased in newborn way lesser in premature
What is glucuronidation?
It is a phase 2 biotransformation and glucuronide is used as a conjugation molecule
Pharmacokinetics in elderly?
CYP activities is reduced but conjugation activities are similar.
What is polymorphism?
Allelic variation with a frequency of more than >%1
Does polymorphism affect pharmacodynamics and kinetics?
yes.
What is compliance?
Patient taking the drugs accoring to prescribed dose regimen like the doctor said.
What is placebo?
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
What is nocebo?
Opposite of placebo
When do we consider fatless body weight
total body weight?
polar drugs
lipid soluble drugs in order
What is the difference of parenteral administration of drug than oral one?
higher concentration
Faster effect
More side effects
What is the difference between IV BOLUS, ORAL DRUGS,IV INFUSION?
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.
Chronopharmacology?
Study of interactions of biologc rhytms w/medications
Desensitization=tachyplaxis?
Developed tolerance within minutes.
What are the physiologic responses happinin in pregnancy?
Decreased albumin
İncreased C.O
İncreased blood flow,GFR,renal elimination of drug
