Lecture: Therapeutic Drug Monitoring

Question 1

Individualized system of administration and management of drug therapy; deals with the measurement of drug concentrations during therapy with pharmaceutical agents

Answer 1

Therapeutic Drug Monitoring

Question 2

Rate of administration is equal to the rates of metabolism and excretion

Answer 2

Steady-state Drug Level

Question 3

Drug concentration in the blood can be sub-therapeutic, therapeutic, or toxic

Answer 3

Therapeutic Range

Question 4

Mathematical interpretation of drug disposition over time to determine proper dosing amounts of therapeutic drug

Answer 4

Pharmacokinetics

Question 5

Describes absorption, distribution & elimination of drugs

Answer 5

First-Order Kinetics

Question 6

Describe the rate of change of drug concentration that is independent of the concentration of the drug

Answer 6

Zero-Order Kinetics

Question 7

Whole blood is collected when determining presence of _ and _

Answer 7

Cyclosporine
Tacrolimus

Question 8

Lowest level of drug in the blood

Answer 8

Trough Concentration

Question 9

For initial investigation of therapeutic drug toxicity (exceeds upper therapeutic limit)

Answer 9

Peak Concentration

Question 10

Antibody specific to a particular drug

Answer 10

Immunoassay

Question 11

Best specimen for chromatography

Answer 11

Urine

Question 12

Type of chromatography based on how far drugs travel and separate (stained)

Answer 12

Thin-layer Chromatography

Question 13

Type of chromatography that depends on type of column used, solvent, detector systems; used to determine tricycline depressants and metabolites

Answer 13

High-Performance Liquid Chromatography

Question 14

Gold standard in chromatography is used for volatile drugs

Answer 14

Gas Chromatography-Mass Spectrometry

Question 15

Classification of Drugs

Answer 15

Cardioactive
Antibiotics
Antiepileptics
Psychoactive
Bronchodilator
Immunosuppressive
Antineoplastic
Anti-inflammatory (Analgesics)
Neuroepileptics

Question 16

Rapid sodium channel blockers are what class of cardioactive drugs?

Answer 16

Class I

Question 17

Quinidine, procainamide, lidocaine belongs to what class of cardioactive drugs?

Answer 17

Class I

Question 18

Beta receptor blockers are what class of cardioactive drugs?

Answer 18

Class II

Question 19

Propranolol belongs to what class of cardioactive drugs?

Answer 19

Class II

Question 20

K+ channel blockers are what class of cardioactive drugs?

Answer 20

Class III

Question 21

Amiodarone belongs to what class of cardioactive drugs?

Answer 21

Class III

Question 22

Calcium channel blockers are what class of cardioactive drugs?

Answer 22

Class IV

Question 23

Verapamil belongs to what class of cardioactive drugs?

Answer 23

Class IV

Question 24

Cardiac glycoside for treatment of atrial arrhythmia and CHF; inhibits Na-K-ATPase

Answer 24

Digoxin

Question 25

Local anesthetic that corrects ventricular arrhythmia

Answer 25

Lidocaine

Question 26

Another name for lidocaine

Answer 26

Xylocaine

Question 27

Metabolite of lidocaine

Answer 27

Monoethylglycinexylidide

Question 28

Naturally occurring drug for arrhythmia

Answer 28

Quinidine

Question 29

Substitute for quinidine; for arrhythmia

Answer 29

Disopyramide

Question 30

For ventricular arrhythmia that has toxic effects such as reversible lupus-like syndrome, nephrotic syndrome, urticarial

Answer 30

Procainamide

Question 31

Other name for Procainamide

Answer 31

Pronestyl

Question 32

What type of quinidine peaks 2 hours after oral dose?

Answer 32

Quinidine sulfate

Question 33

What type of quinidine peaks 4 hours after oral dose?

Answer 33

Quinidine gluconate

Question 34

Metabolite of procainamide

Answer 34

N-acetyl-procainamide

Question 35

Beta-receptor-blocking drug; suppresses conversion of T4 to T3

Answer 35

Propranolol

Question 36

Blocks K+ channels in cardiac muscle; contains iodine

Answer 36

Amiodarone

Question 37

Other name for amiodarone

Answer 37

Cordarone

Question 38

Treatment for angina, hypertension, supraventricular dysfunction

Answer 38

Verapamil

Question 39

Antibiotics

Answer 39

Aminoglycosides Vancomycin Chloramphenicol

Question 40

Types of aminoglycosides

Answer 40

Gentamicin, tobramycin, amikacin, kanamycin, neomycin, streptomycin

Question 41

Disopyramide can induce dry mouth and constipation, these effects are called?

Answer 41

Anticholinergic Effects

Question 42

Aminoglycoside toxicity can result to?

Answer 42

Hearing loss

Question 43

Gram-positive cocci and bacilli are susceptible to?

Answer 43

Vancomycin

Question 44

Vancomycin toxicity can result to?

Answer 44

Red Man Syndrome Nephrotoxicity Ototoxicity

Question 45

Protein synthesis inhibitor; works on gram-negative bacteria

Answer 45

Chloramphenicol

Question 46

Chloramphenicol toxicity can result to?

Answer 46

Blood dyscrasia (Aplastic anemia) Cytoplasmic vacuolation

Question 47

Antiepileptics

Answer 47

Phenobarbital Phenytoin Valproic Acid Carbamazepine Ethosuximide Gabapentin Topiramate, Lamotrigine

Question 48

Long-acting barbiturate; controls the grand mal tonic-clonic seizure & focal seizure

Answer 48

Phenobarbital

Question 49

Phenobarbital toxicity can result to?

Answer 49

Nystagmus, stupor, ataxia, respiratory depression

Question 50

For tonic-clonic, simple-partial seizure; short-term prophylactic agent; not for petit mal and atomic seizures

Answer 50

Phenytoin

Question 51

Phenytoin decreases _ and _ influx

Answer 51

Calcium Sodium

Question 52

Phenytoin toxicity can result to?

Answer 52

Teratogenic (cleft lip and palate)

Question 53

Used for petit mal, atomic seizure, grand mal

Answer 53

Valproic Acid

Question 54

Other name for valproic acid

Answer 54

Depakene

Question 55

Valproic Acid toxicity can result to?

Answer 55

Pancreatitis

Question 56

Tricyclic compound related to imipramine; used for grand mal seizures

Answer 56

Carbamazepine

Question 57

Other name for Carbamazepine

Answer 57

Tegretol

Question 58

Drug of choice for petit mal seizures

Answer 58

Ethosuximide

Question 59

Other name for Ethosuximide

Answer 59

Zarontin

Question 60

Carbamazepine toxicity can result to?

Answer 60

Hematologic dyscrasias, ataxia

Question 61

Ethosuximide toxicity can result to?

Answer 61

GI disturbances, ataxia, SLE, aplastic anemia, pancytopenia

Question 62

Chemically similar to a neurotransmitter gamma aminobutyric acid; for partial seizures

Answer 62

Gabapentin

Question 63

Other name for Gabapentin

Answer 63

Neurontin

Question 64

Gabapentin is chemically similar to?

Answer 64

Gamma aminobutyric acid (GABA)

Question 65

Adjunct drugs for partial seizure

Answer 65

Topiramate, Lamotrigine, Felbamate

Question 66

Other name for Lamotrigine

Answer 66

Lamictal

Question 67

Blocks dopamine and serotonin; for Schizophrenia; difficult to monitor

Answer 67

Neuroepileptics

Question 68

Neuroepileptics

Answer 68

Phenothiazines Butyrophenones Risperdal Olanzapine Quetiapine Aripiprazole

Question 69

Example of Butyrophenones

Answer 69

Haloperidol

Question 70

Example of Phenothiazines

Answer 70

Chlorpromazine

Question 71

Psychoactive drugs

Answer 71

Lithium Tricylic Antidepressants Fluoxetine

Question 72

Drug of choice for Chronic cluster headache; inhibits iodine uptake; for manic-depressive illness

Answer 72

Lithium

Question 73

Used for depression and insomnia

Answer 73

Tricylic Antidepressants

Question 74

Major metabolite of TCAs

Answer 74

Desipramine

Question 75

Examples of TCAs

Answer 75

Imipramine, amitriptyline, doxepin, nortriptyline, trazadone

Question 76

Blocks re-uptake of serotonin; for Obsessive-compulsive disorders

Answer 76

Fluoxetine

Question 77

Other name for fluoxetine

Answer 77

Prozac

Question 78

Relaxes the bronchial smooth muscles; asthma, COPD

Answer 78

Theophylline

Question 79

Immunosuppressive Drugs

Answer 79

Cyclosporine Tacrolimus Rapamycin Mycophenolate Mofetil Leflunomide

Question 80

Blocks production of IL-2; prevents allogenic organ transplant rejection and GVHD

Answer 80

Cyclosporine

Question 81

Macrolide antibiotic; 100X more powerful than cyclosporine

Answer 81

Tacrolimus

Question 82

Other name for Tacrolimus

Answer 82

Prograf

Question 83

This immunosuppressive drug has these side effects - lipid abnormalities, thrombocytopenia

Answer 83

Rapamycin

Question 84

Other name for Rapamycin

Answer 84

Sirolimus

Question 85

Used for renal allograft rejection

Answer 85

Mycophenolate Mofetil

Question 86

Inhibits lymphocyte proliferation; treatment for Rheumatoid arthritis

Answer 86

Leflunomide

Question 87

Anti-neoplastic and immunosuppressive agent; inhibits DNA synthesis

Answer 87

Methorexate

Question 88

Antidote for Methorexate

Answer 88

Leucovorin

Question 89

Used for leukemias and lymphomas before BM transplantation

Answer 89

Busulfan

Question 90

Busulfan toxicity can result to?

Answer 90

Hepatic occlusive diseases

Question 91

Direct stimulator of respiratory system and inhibitor of Kreb’s cycle

Answer 91

Salicylate

Question 92

Other name for Salicylate

Answer 92

Aspirin

Question 93

Anti-Platelet property of Salicylate

Answer 93

Cyclooxygenase inhibitor

Question 94

Common cause of fatal drug poisoning

Answer 94

Acute aspirin intoxication

Question 95

Salicylate toxicity can result to?

Answer 95

Reye’s Syndrome

Question 96

Method used for determining salicylate?

Answer 96

Trinder’s assay

Question 97

Inhibits prostaglandin metabolism

Answer 97

Acetaminophen

Question 98

Other name for Acetaminophen

Answer 98

Tylenol

Question 99

Lower toxicity than salicylates and acetaminophen

Answer 99

Ibuprofen

Question 100

Anti-inflammatory Drugs are also known as?

Answer 100

Analgesics