Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Clinical Chemistry > L.17 Immunoassay Applications > Flashcards

L.17 Immunoassay Applications Flashcards

1
Q

What is Therapeutic Drug Monitoring (TDM)?

A

The clinical practice of measuring specific drugs at designated intervals to maintain a constant concentration in a patient’s bloodstream

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

What is the primary goal of TDM?

A

To optimize individual dosage regimens

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

How is drug therapy usually monitored?

A

Clinically, by assessing if the patient is getting better

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

For which types of drugs is TDM commonly carried out?

A

Drugs with a narrow benefit-to-risk ratio and/or a narrow therapeutic range

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

What is the therapeutic window?

A

The range of drug concentrations in the blood that produces the desired effect without causing toxicity

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

Is the therapeutic window fixed?

A

No, it can change with time, age, disease state, etc.

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

When is TDM required? (1)

A

When dose regimen at start of therapy needs establishing/optimising

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

When is TDM required? (2)

A

In cases of polypharmacy (multiple drugs) due to drug-drug interactions

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

When is TDM required? (3)

A

In renal-/hepatic impairment due to altered pharmacokinetics

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

When is TDM required? (4)

A

When there is non-compliance, meaning the patient is not taking the drug as prescribed

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

When is TDM required? (5)

A

In cases of toxicity, especially when adverse drug reactions (ADRs) resemble the disease being treated

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

When is TDM required? (6)

A

When there is a narrow therapeutic range

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

When is TDM required? (7)

A

When the drug itself can alter hepatic or renal function (e.g. gentamicin)

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

What does ADME stand for in pharmacokinetics?

A

Absorption, Distribution, Metabolism, Excretion

ADME represents the four key processes that affect the pharmacokinetics of a drug.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Define absorption in the context of pharmacokinetics.

A

The process by which a drug enters the bloodstream.

Absorption is crucial for determining the onset of a drug’s effects.

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

What is distribution in pharmacokinetics?

A

The dissemination of substances throughout the fluids and tissues of the body.

Distribution is influenced by factors such as drug solubility and blood flow.

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

What factors affect the distribution of a drug?

A
  • Drug’s solubility
  • Binding to plasma proteins
  • Blood flow to tissues

These factors determine how well a drug spreads in the body.

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

Define metabolism in pharmacokinetics.

A

The process by which the body breaks down medication into active chemical substances.

Metabolism often occurs in the liver and affects drug efficacy.

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

What does excretion refer to in pharmacokinetics?

A

The process of eliminating drugs from the body (urine or feces).

Excretion is key for clearing drugs from the system and preventing toxicity.

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

What is TDM in pharmacokinetics?

A

Therapeutic Drug Monitoring.

TDM helps ensure drug levels remain within a therapeutic range.

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

What is peak concentration?

A

The highest concentration of a drug in the bloodstream after administration.

Monitoring peak concentration is important to avoid toxicity.

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

What is trough concentration?

A

The lowest concentration of a drug in the bloodstream before the next dose is administered.

Ensuring adequate trough concentration is vital for therapeutic effects.

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

What is Gentamicin?

A

An aminoglycoside antibiotic used to treat serious infections caused by Gram-negative bacteria.

Gentamicin is effective against specific bacterial infections.

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

Name two other aminoglycosides used in TDM.

A
  • Amikacin
  • Tobramycin

These antibiotics are monitored similarly to Gentamicin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the half-life of Gentamicin?
1-2 hours. ## Footnote The half-life can increase significantly in patients with renal impairment.
26
What is the effect of renal impairment on Gentamicin's half-life?
It can increase to over 100 hours. ## Footnote This necessitates careful monitoring to prevent toxicity.
27
What is meant by Gentamicin's narrow therapeutic range?
The range between effective and toxic drug levels is small. ## Footnote This requires precise dosing and monitoring.
28
What happens to tissue pools with prolonged use of Gentamicin?
They can become saturated. ## Footnote Saturation can lead to increased risk of toxicity.
29
What are two side effects of Gentamicin?
* Nephrotoxicity * Ototoxicity (hearing loss) ## Footnote Monitoring is essential to manage these potential side effects.
30
What is the primary use of Tacrolimus?
Graft rejection prophylaxis in organ transplant patients ## Footnote Tacrolimus is an immunosuppressant drug that inhibits T-lymphocyte activation.
31
What class of drug is Tacrolimus?
Immunosuppressant drug (calcineurin inhibitor) ## Footnote It inhibits T-lymphocyte activation.
32
What is a significant risk associated with Tacrolimus due to its pharmacokinetics?
Narrow therapeutic range ## Footnote This means small changes in drug levels can lead to adverse effects or reduced efficacy.
33
What can significantly impact graft survival in patients taking Tacrolimus?
Subtherapeutic levels ## Footnote Maintaining appropriate drug levels is crucial for graft survival.
34
What are the potential toxic effects of Tacrolimus?
Nephrotoxic, neurotoxic, and can cause hyperglycemia ## Footnote Hyperglycemia occurs due to inhibited insulin secretion.
35
What is the primary use of Lithium?
Treatment of depressive and bipolar disorder ## Footnote Lithium acts as a mood stabilizer.
36
What effect does Lithium have on mood episodes?
Reduces the severity and frequency of mania ## Footnote This is essential for managing bipolar disorder.
37
What is a notable characteristic of Lithium's pharmacokinetics?
Narrow therapeutic range ## Footnote This necessitates careful monitoring of drug levels.
38
Why is it important to measure Lithium levels?
To monitor toxicity and non-compliance ## Footnote Toxic effects can mimic disease symptoms.
39
What type of sample is required for measuring Lithium levels?
Serum sample, not plasma ## Footnote This distinction is important for accurate measurement.
40
What are some potential toxic effects of Lithium?
Nephrotoxic, thyroid dysfunction (hypothyroidism), and psychogenic polydipsia ## Footnote Monitoring is important to prevent these side effects.
41
What is the primary use of Digoxin?
Used for atrial fibrillation and atrial flutter ## Footnote It is a cardiac glycoside that helps regulate heart rhythm.
42
What is the therapeutic range for Digoxin?
1-2 /mug/L ## Footnote Levels below 1 /mug/L have very little effect.
43
What is a critical factor to consider when interpreting Digoxin levels?
Potassium levels ## Footnote Hypokalaemia potentiates the effect of digoxin.
44
What can occur at therapeutic Digoxin levels in the presence of hypokalaemia?
Toxicity ## Footnote This highlights the need for electrolyte monitoring.
45
What other electrolyte imbalances can potentiate Digoxin toxicity?
Calcium (hypocalcaemia) and magnesium (hypomagnesaemia) ## Footnote Monitoring these levels is essential for safe Digoxin use.
46
What is crucial to monitor in patients taking Digoxin?
Renal function (creatinine) ## Footnote Digoxin is renally excreted, making renal function monitoring vital.
47
What is toxicology?
The study of adverse effects of chemicals on living organisms.
48
What percentage of all emergency department visits does poisoning account for?
≈ 5-10%.
49
What are the types of poisoning?
* Accidental (e.g. children) * Intentional * Occupational (e.g. pesticides) * Environmental (e.g. heavy metals) * Homicidal.
50
List common poisons.
* Paracetamol (acetaminophen) * Salicylates (aspirin) * Alcohols (ethanol, methanol) * Opiates (morphine, codeine, heroin) * Benzodiazepines (diazepam, lorazepam).
51
What is the most widely abused drug in the world?
Ethanol (alcohol).
52
What type of drug is ethanol?
CNS depressant.
53
How is ethanol metabolised?
To acetaldehyde by alcohol dehydrogenase (ADH).
54
What bodily fluids can ethanol be measured in?
Blood or urine.
55
Why can't the venipuncture site be cleaned with alcohol?
Because it can interfere with testing.
56
How long is alcohol collected in the bladder before measurement?
8-12 hours.
57
What method is used to measure alcohol?
Spectrophotometry.
58
Fill in the blank: Toxicology studies the ________ effects of chemicals on living organisms.
[adverse]
59
What type of drug is Paracetamol?
Analgesic and antipyretic drug ## Footnote Paracetamol is used to relieve pain and reduce fever.
60
What is the consequence of a Paracetamol overdose?
Acute liver failure ## Footnote Overdose can lead to serious liver damage.
61
Why is TDM important in overdose cases of Paracetamol?
To determine the appropriate intervention and risk of hepatotoxicity ## Footnote Therapeutic Drug Monitoring (TDM) helps in managing overdoses.
62
What are the symptoms of a Paracetamol overdose?
Nausea, vomiting, abdominal pain, and confusion ## Footnote These symptoms can indicate severe toxicity.
63
What is the Rumack-Matthew nomogram used for?
To determine the risk of hepatotoxicity in Paracetamol overdose ## Footnote It helps assess the severity of the overdose.
64
How can Paracetamol levels be measured?
Spectrophotometer and immunoassay ## Footnote These methods are used for accurate measurement of drug levels.
65
What are tumour markers?
Substances produced by cancer cells or by the body in response to cancer ## Footnote They can indicate the presence of cancer but are not diagnostic.
66
Where can tumour markers be measured?
In blood or urine ## Footnote They are typically found in bodily fluids.
67
What types of substances can be considered tumour markers?
Proteins, hormones, enzymes, or other molecules ## Footnote These substances can vary widely in nature.
68
Are tumour markers specific to one type of cancer?
No, they are not specific to any one type of cancer ## Footnote Many can be elevated in non-cancerous conditions as well.
69
What is the role of tumour markers in cancer screening?
To identify individuals at high risk of developing cancer ## Footnote They must be elevated in early stages of cancer.
70
Give an example of a tumour marker used for screening.
Prostate-specific antigen (PSA) for prostate cancer ## Footnote PSA is commonly used to monitor prostate health.
71
What is the prognostic value of tumour markers?
To predict the likely course of the disease ## Footnote Elevated levels can indicate worse outcomes.
72
Provide an example of a tumour marker with prognostic value.
Carcinoembryonic antigen (CEA) in colorectal cancer ## Footnote Higher levels of CEA are associated with a worse prognosis.
73
What is the purpose of monitoring tumour markers?
To monitor the response to treatment ## Footnote They help assess the effectiveness of therapies.
74
Give an example of a tumour marker used for monitoring.
CA-125 for ovarian cancer ## Footnote It is used to track treatment response and disease progression.
75
What makes tumour markers cost-effective and non-invasive?
They can be measured through blood or urine tests ## Footnote This avoids the need for more invasive procedures.
76
What is the role of HER2 in predicting treatment response?
Used to predict the likely response to Herceptin in breast cancer ## Footnote HER2 status can guide targeted therapy decisions.
77
What is Carcinoembryonic Antigen (CEA) primarily used for?
Prognosis and monitoring of colorectal cancer ## Footnote CEA is not good for screening; the FIT/FOB test is used for that purpose.
78
Is Carcinoembryonic Antigen (CEA) specific to colorectal cancer?
No, it is also increased in other cancers such as breast, lung, and pancreatic cancer.
79
What is Carbohydrate Antigen 125 (CA-125) associated with?
Screening and monitoring of ovarian carcinoma ## Footnote Found on endothelial cells of fallopian tubes, endometrium, ovary, and mesothelium.
80
What percentage of patients with advanced ovarian cancer have elevated CA-125 levels?
90% of patients.
81
What is the CA-125 elevation percentage in women with stage 1 ovarian cancer?
50% of women.
82
In addition to ovarian cancer, CA-125 can be elevated in which conditions?
Pregnancy, endometriosis, and pelvic inflammatory disease.
83
What does Alpha-fetoprotein (AFP) indicate?
Used in screening and monitoring of hepatocellular carcinoma (HCC) ## Footnote Produced by the fetal liver and yolk sac.
84
Who should be screened for Alpha-fetoprotein (AFP) levels?
Patients at risk of HCC, such as those with chronic hepatitis B or C, cirrhosis, and haemochromatosis.
85
What percentage of non-squamous germ-cell tumors secrete AFP?
50-70% of tumors.
86
When is AFP physiologically elevated?
In pregnancy, neonates, and infants.
87
What is the primary use of Prostate-specific antigen (PSA)?
Screening and monitoring of prostate cancer.
88
Is PSA diagnostic for prostate cancer?
No, but it is very useful.
89
What type of enzyme is PSA?
A serine protease produced by the prostate gland.
90
How does PSA reference range change with age?
Increases with age.
91
In addition to prostate cancer, when else can PSA be elevated?
In benign prostatic hyperplasia (BPH) and prostatitis.
92
What does an elevation in PSA indicate regarding bone metastasis?
It is associated with an increased risk of bone metastasis.
93
What is the limit of quantification (LOQ) for older PSA assay methods?
0.1 /mug/L.
94
What is the limit of quantification (LOQ) for 3rd generation PSA assays?
0.01 /mug/L.
95
What advantage do 3rd generation PSA assays provide?
Cancer recurrence can be detected at lower levels.

Clinical Chemistry (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions