Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PK > Final Exam > Flashcards

Final Exam Flashcards

1
Q

Gent and tobra dose

A

7 mg/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Amikacin dose

A

15 mg/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When to draw AG peak

A

0.25 - 1 hour after 1 hour infusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When to draw AG trough

A

30 minutes or less before the next dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When to draw random AG

A

If drawn after 1st dose, should be at least one 1/2 life from the peak concentration
If drawing after dialysis, wait at least 2 hours for redistribution to take place before drawing a concentration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When to draw Vanc peak

A

At least 1-2 hours after the end of infusion

Avoids distributional phase which may result in erroneous calculations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When to draw Vanc trough

A

Less than 1 hour before next dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When to draw Vanc random

A

At least one anticipated t1/2 from previous level obtained

To ensure accuracy in calculating elimination rate constant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What causes AG-induced nephrotoxicity

A

When the trough is too high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When does AG-induced nephrotoxicity occur

A

w/in 4-5 days

High risk associated w/long duration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Is AG-induced nephrotoxicity reversible?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

AG-induced RF

A

other disease states, age, other nephrotoxic drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What happens to the urine production in AG-induced nephrotoxicity?

A

Non-oliguric

Will still be producing urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What factors increase AG Vd

A 
Ascites/pancreatitis
Cancer
CF
Intensive caare
Post-op/mechanical ventilation
Post partum
Surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What factors increase AG CL?

A

Burns
CF
Fever
HD/PD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What factors decrease AG half-life?

A

Burns
CF
HD/PD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is oral vanc used for

A

Pseudomembraneous colitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Are IM vanc injections considered?

A

No d/t severe pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Vanc distribution

A

Widely into body tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What type of compartment model is used for Vanc?

A

1, 2 is most realistic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Vanc metabolism

A

Little to none

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Vanc IV excretion

A

80-100% recovered in urine in first 24 hours in normal adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Vanc in HD/PD

A

minimally removed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Vanc pts with increased clearance

A

Obese
Pediatrics
Burn pts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

CAPD

A

Peritoneal dialysis
Moves along a fluid gradient
Less efficient than HD
Drugs can be added to PD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

GFR in pts on CAPD

A

10-20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

CAVH/CVVH

A

continuous renal replacement

Removes larger molecules than any other types of dialysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

GFR in pts on CAVH/CVVH

A

30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Concentration dependent abx

A

Amount of microbial killing depends on the max concentration of drug above the MIC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Concentration dependent abx PK/PD parameters

A

Peak MIC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Concentration dependent abx examples

A

AGs
FQs
Daptomycin
Metronidazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Time dependent abx

A

Amount of microbial killing depends on the time the drug stays above the MIC

33
Q

Time dependent abx PK/PD parameters

A

T > MIC

34
Q

Time dependent abx examples

A 
Beta-lactams
Macrolides
Clindamycin
Vanc
Linezolid
35
Q

Post-abx effect

A

Continued expression of bacterial growth after a short exposure to abx agents

36
Q

Drugs that increase risk of nephrotoxicity w/CSA/TAC

A

AGs
Amphotericin B
Vanc
NSAIDs

37
Q

Enzyme inducers and immunosuppressants

A

Prospectively increase CSA/TAC/EVR daily dose by 25%

Monitor CSA/TAC/EVR trough levels 4-7 days after initiation

38
Q

Conversion of PO TAC to IV TAC

A

IC TAC is 1/3 dose of PO dose

39
Q

Harvoni and Epclusa are not recommended with

A

Amiodarone
Rifampin, St. John’s wort
Carbamazepine, phenytoin, phenobarb, oxcarbazepine
Rosuvastatin (Harvoni only)

40
Q

Viekiera is C/I with

A

Carbamazepine, phenytoin, phenobarb
Rifampin, St John’s wort
Lovastatin, simvastatin
Sildenafil

41
Q

Zepatier is C/I with

A

Carbamazepine, Phenytoin
Rifampin
St. John’s wort
CsA

42
Q

Zepatier is not recommended with

A

3A4 inducers: nafcillin

3A4 inhibitors: ketoconazole, cobi

43
Q

EFV/NVP + rifampin PK result and recommendation

A

decreased EFV/NVP

Increase EFV dose

44
Q

EFV/NVP + statins PK result and recommendation

A

Decreased statins

Monitor cholesterol closely

45
Q

RPV + PPIs PK result and recommendation

A

Decreased RPV

Avoid PPIs

46
Q

ETV + unboosted PIs PK results

A

decreased PIs

47
Q

ETV + warfarin PK result and recommendation

A

Increased warfarin

Monitor INR carefully

48
Q

PI + rifampin PK result

A

Decreased PI, increased rifampin

49
Q

PI + St John’s Wort Pk result

A

Decreased PI

50
Q

PI + (midaz/triaz)/ergot/statin/pimozide

A

Increased second drug

51
Q

PI contraindicated with

A 
Rifampin
Midaz/triaz
Lova/simva
ergot
St John Wort
Pimozide
52
Q

ATV + PPI PK result and recommendation

A

Decreased ATV
Max omep 20 mg/day
Always boost

53
Q

PI + amiodarone PK result and recommendation

A

Increase amiodarone
Avoid if possible
TDM

54
Q

PI + trazodone PK result and recommendation

A

Increased trazodone

Use lowest dose

55
Q

PI + immunosuppressants PK result and recommendation

A

Increased immunosuppressants

TDM

56
Q

PI + statins PK result and recommendation

A

Increased statins

Prava/atorv preferred

57
Q

PIs + fluticasone

A

Increased fluticasone

Use alternative inhaled/nasal glucocorticoid

58
Q

RAL + rifampin PK result and recommendation

A

Decreased RAL

Double RAL dose

59
Q

RAL + phenytoin/phenobarb PK result and recommendation

A

Potential decreased RAL

Use caution

60
Q

DTG + dofetilide PK result and recommendation

A

Increased dofetilide

C/I

61
Q

DTG + rifampin

A

decreased DTG

Increase DTG

62
Q

DTG + cations

A

Decreased DTG

Take DTG 2hrs before or 6 hours after cations

63
Q

Amiodarone level

A

0.5-2 mg/ml

Peak level at 3-7 hours

64
Q

Amiodarone MOA

A

Class III antiarrhythmic

Has properties of all classes

65
Q

Amiodarone absorption

A

Very slow

50-70%

66
Q

Amiodarone distribution

A

Mainly to lipophilic tissues

Tissue concentration 10-400x higher

67
Q

Amiodarone compartment model

A

2

68
Q

Amiodarone major metabolism site

A

Liver

3A4

69
Q

Amiodarone active metabolite

A

Desmthylamiodarone

70
Q

Amiodarone DDI by cyp enzymes

A 
Warfarin - decrease dose by 25%
Digoxin - decrease dose by 50%
HMG-CoA reductase inhibitors
Phenytoin - increase phenytoin by 50%
Grapefruit juice may increase oral absorption - separate by 2 hours
71
Q

Amiodarone DDI by AV node conduction

A

NDH CCB
BB
Dig

72
Q

Amiodarone elimination

A

Biliary

73
Q

Adjustment of theophylline dosing based on ss concentration

A

For every 1 mg/kg of theophylline, blood concentrations will rise 2 mg/L

74
Q

Factors affecting drug absorption in the elderly

A 
CV
CNS
Renal
GU
Endocrine
GI
Musculoskeletal
Immunology/hematology
75
Q

Absorption changes associated with aging

A

Intestinal permeability
Gastric acid secretion
GI motility
Transdermal/IM

76
Q

Distribution changes associated with aging

A

Protein binding

Body fat and body water

77
Q

Metabolism changes associated with aging

A

40% reduction of blood flow to the liver and reduction in liver mass
Phase 1 metabolism reduction

78
Q

Elimination changes associated with aging

A

Kidney mass decreases

Physiologic changes

79
Q

The aged kidney has…

A

Decreased ability to maximally concentrate or dilute urine
Decreased response to inadequate dietary daily
Impaired handling of potassium

PK (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions