Lec 13- Variability in Drug Response

Question 1

4 things to consider with drug therapy

Answer 1

efficacy, safety, tolerability, cost

Question 2

t/f: all individuals with a disease experience the same drug effects

Answer 2

false!

Question 3

what are some sources of interindividual variability in drug response

Answer 3

genetics, adherance, age, body comp, hormones, sex, diet, disease, lifestyle, drug ints, placebo, psychology

Question 4

neonates

Answer 4

birth to 4 weeks

Question 5

premature infants

Answer 5

< 37 weeks

Question 6

infants

Answer 6

1 mo to 2 yrs

Question 7

young children

Answer 7

2- 6 years

Question 8

older children

Answer 8

6-12 years

Question 9

adolescents

Answer 9

12-18 years

Question 10

older adults

Answer 10

older than 18

Question 11

describe absorption in neonates and infants (ph, emptying, transit)

Answer 11

higher gastic ph (will affect which drugs can cross barriers), longer emptying time, shorter intestinal transit (because they are smaller)

Question 12

vd in neonates is

Answer 12

increased (more fat)

Question 13

describe pp binding and clearance in neonates and infants

Answer 13

less pp binding, less drug stays in vessel, decreased clearance due to immature organ function

Question 14

how to dose by surface area vs by age (yOungs rule)

Answer 14

(1.5 X weight ) + 10 = % of adult dose

Age / Age + 12 = fraction of adult dose

Question 15

fat prop in older adults

Answer 15

increases

Question 16

t/f: older adults are less likely to experience adverse drug effects

Answer 16

false due to age, polypharmacy

Question 17

what happens to lipophillic drugs in older adults

Answer 17

increased amount goes to tissues

Question 18

what happens to transporters, blood flow, liver size, and phase 1 met in older adults

Answer 18

less albumin, but more glycoprotein, altering transport

decreased blood flow, decreased liver size, decreased phase 1 met (all by 30%)

Question 19

t/f: phase 2 met changes in older adults

Answer 19

false

Question 20

how is renal function in older adults impacted

Answer 20

decreased - less nephrons, less blood flow, decreased gfr

Question 21

how does vd change for older adults for lipid vs water soluble drugs

Answer 21

lipid = higher vd , water = lower vd

Question 22

how does half life change for older adults

Answer 22

higher

Question 23

relationship between creatinine and gfr

Answer 23

creat clearance roughly equal to gfr. pcreat inversely prop to gfr

Question 24

what does the cockroft gault eqn predict

Answer 24

creatinine clearance (therefore gfr)

Question 25

male cockroft gault eqn

Answer 25

1.2 (140-age)(weight) / serum creatinine

Question 26

female cockroft gault eqn

Answer 26

1.2(140-age)(weight)(0.85) / serum creatinine

Question 27

what is drug tolerance and physical dependence and how does it affect dosages

Answer 27

Tol: higher doses to get same effect

Dep: depend on drug to function normally