GI mc3

Question 1

lithium is the treatment of choice in

Answer 1

acute mania and in prophylaxis of manic depression

Question 2

lithium and toxicity outcome

Answer 2

producing dose-dependent and dose-independent side effects

Question 3

how is lithium distributed

Answer 3

unevenly, -0.7L/kg volume distribution

Question 4

Volume distribution

Answer 4

the theoretical volume that would be necessary to contain the total amount of an administered drug at the same concentration that is observed in the blood plasma.

Question 5

lithium distribution model

Answer 5

two-compartment model

Question 6

lithium distriibution time

Answer 6

8 hours

Question 7

lithiu half life

Answer 7

20-24 hours

Question 8

how long does it take lithium to reach a steady state

Answer 8

5-6 days

Question 9

how many half lives does it take lithium to reach steady state

Answer 9

5

Question 10

digoxin half life

Answer 10

36

Question 11

digoxin reaches steady state in how many days

Answer 11

5-7

Question 12

why do a loading dose

Answer 12

steady state plasma concentration must be reached more rapidly

Question 13

how do you do a loading dose

Answer 13

big dose on the innitiation of treatment

Question 14

Volume of distribution of digoxin =

Answer 14

7.3 L/kg

Question 15

what does Volume of distribution of digoxin suggest

Answer 15

widely distributed outside the water compartment and is also protein bound or distributed by some other tissue type

Question 16

what places does digoxin have a high affinity for

Answer 16

skeletal and cardiac muscles, intestines and kidneys

Question 17

what should digoxin dosing be based on

Answer 17

estimated lean body mass

Question 18

where are lipid soluble drugs stored

Answer 18

fat

Question 19

which drugs have a high volume of distribution

Answer 19

drugs that accumulate in organs either by active transport or by specific binding to tissue molecules

Question 20

what drugs is bone a resevoir for

Answer 20

tetracycline and heavy metals

Question 21

where is digoxin excreted

Answer 21

Most digoxin is eliminated unchanged by the kidneys

Question 22

patients w renal impairment and digoxin vod

Answer 22

vod reduced

Question 23

what mediates tubular digoxin secretion

Answer 23

p-glycoprotein

Question 24

what can inhibit p-glycoprotein

Answer 24

spironolactone, quinidine, verapamil and amiodarone

Question 25

renal failure affect on clearance of digoxin

Answer 25

decreases

Question 26

where can digoxin be metabolised

Answer 26

tiny bit in the liver

8% undergoes an enterohepatic cycle.

Question 27

is dogoxin absorbed in the gut

Answer 27

ye but poorly

Question 28

oral bioavailability of digoxin level

Answer 28

high

Question 29

Bioavailability

Answer 29

fraction of a dose of drug that is absorbed from its site of administration and reaches in an unchanged from the systemic circulation.

Question 30

what happens to digoxin in the gut

Answer 30

metabolised

Question 31

how is digoxin metablised in the gut

Answer 31

hydrolysed by acid in stomach

bacteria in the intestines

Question 32

what does the bioavailability of a drug depend on

Answer 32

absorption across the intestinal wall.
Decomposition of the drug in the lumen.
pH and perfusion of the small intestine.
Surface and time available for absorption.
Competing reactions in the lumen (for example of the drug with food).
Hepatic first-pass effect.

Question 33

whats more bioavailable liquid digoxin or tablet

Answer 33

liquid