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PT 1 > L4 Clinical Pharmacokinetics > Flashcards

L4 Clinical Pharmacokinetics Flashcards

1
Q

What is an undesirable experience associated with the use of a medical product in a patient?

A

Adverse drug event (ADE)

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2
Q

What are three common types of drugs associated with ADEs?

A
  1. Pain medications
  2. Anticoagulant/anti-platelet agents
  3. Oncology drugs
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3
Q

True or false - all ADE are allergies.

A

False - all allergies are an ADE, but not all ADE are allergies.

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4
Q

Where do dosing standards come from?

A

Population pharmacokinetics

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5
Q

What describes how the drug gets into the body from the site of administration?

A

Absorption

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6
Q

What is the fraction of administered drug that reaches systemic circulation unchanged?

A

Bioavailability

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7
Q

The area of the body and perfusion affects ___.

A

Distribution (will the drug reach its target?)

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8
Q

What are some physiologic barriers to distribution?

A
  1. Protein binding (albumin)
  2. BBB
  3. Eye
  4. Bone
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9
Q

Calcium is often measured based on albumin levels, as ___% of calcium is bound to albumin. If albumin is low, what can happen?

A

80; the calcium level can appear falsely low

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10
Q

How do you correct the calcium level for low albumin?

A

= measured calcium + 0.8(4 - albumin)

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11
Q

What describes how a medication is broken down to less active, more water soluble by-products?

A

Metabolism

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12
Q

What is the primary site of metabolism?

A

Liver

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13
Q

Describe Phase I metabolism broadly.

A

Involves reduction, oxidation, and hydrolysis with CYP450 systems

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14
Q

Describe Phase II metabolism broadly.

A

Involves GAS (glucuronidation, acetylation, sulfation)

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15
Q

Elimination directly affects ___.

A

Half life

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16
Q

Most drugs undergo ___ elimination.

A

Renal

17
Q

What is normal creatinine clearance?

A

70-100 mL/min

18
Q

True or false - you must also adjust for fecal/biliary elimination.

A

False - these are less common.

19
Q

What are four broad factors that affect elimination?

A
  1. Age
  2. Disease states (renal failure)
  3. Hemodialysis/hemofiltration
  4. Medication
20
Q

True or false - renal function decreases with age.

A

True

21
Q

True or false - creatinine levels increase with age and creatinine clearance decreases.

A

True (muscle breaks down)

22
Q

What are some pharmacokinetic variations in neonates?

A
  1. Immature skin leads to increased skin hydration and increased absorption of topical products
  2. Increased ECF leads to increased volume of distribution of water-soluble drugs
  3. Metabolic pathways mature at different times
  4. Immature kidney function
23
Q

What are some pharmacokinetic variations in people who are elderly?

A
  1. Skin thinning leads to increased absorption of topical products
  2. Increased adipose tissue leads to increased volume of distribution of fat soluble drugs
  3. Decreased ECF leads to decreased volume of distribution of fat soluble drugs
  4. Decreased GFR
24
Q

Dose adjustments are most accurate when made at ___.

A

Steady state

25
Q

What are the 4 types of drug interactions?

A
  1. Drug-drug
  2. Drug-nutrient
  3. Drug-disease state
  4. Level of drug action or organ system
26
Q

What are two types of drug interactions that affect absorption?

A
  1. Chelation

2. Changes in stomach pH

27
Q

What are three types of drug interactions that affect distribution?

A
  1. Competition for binding sites
  2. Changes in protein binding due to disease states
  3. Changes in ECF or adipose tissue
28
Q

What are two types of drug interactions that affect metabolism?

A
  1. Induction of CYP450 (increase metabolism)

2. Inhibition of CYP450 (decrease metabolism)

29
Q

What are two types of drug interactions that affect elimination?

A
  1. Competition for elimination pathways

2. Decreased or increased elimination

PT 1 (34 decks)

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