Pharm

Question 1

Constant amount of drug is eliminated at any given time. Which elimination order?

Answer 1

Zero order kinetics

Half life depends on dose
Larger doses decreased slower

Question 2

Constant percentage of drug is eliminated over time. Which kinetics?

Answer 2

First order (most drugs)

Halflife is constant

Large amount of drug is removed in first interval

Question 3

Volume of distribution

Answer 3

Vd (L/kg)=Total amount of drug (mg/kg)/plasma [drug] mg/L

Question 4

Cmax

Answer 4

Maximum [drug] at end infusion

Question 5

Half-life

Answer 5

T1/2 (hr)=0.693 *Vd/CL

Question 6

Drug clearance

Answer 6

CL (L/hr*kg)=dose/interval/average steady state of drug

Question 7

How best is drug efficacy predicted for aminoglycosides (ie gentamicin) as it relates to drug concentrations?

Answer 7

Cmax>MIC ratio

Question 8

Beta lactams and cephalosporins need which PD targets?

Answer 8

Time [drug]> MIC within dosing interval that predicts effectiveness

Question 9

Vancomycin treatment target is based on which PD parameters?

Answer 9

AUC>MIC for dosing effectiveness

Question 10

What 3 biochemical factors of a drug will improve absorption?

Answer 10

Molecular weight (smaller better absorbed)
Lipid solubility (lipid soluble better)
Degree of ionization (non-ionized better)

Question 11

Premature neonates have a _____ volume of distribution and ______ clearance compared to full term infants

Answer 11

Higher Vd

Slower clearance

Question 12

High protein binding leads to _______ Vd

Answer 12

Decreased

Question 13

Neonates have _____ protein binding ability

Answer 13

Decreased protein binding ability because tod decreased total protein, albumin and glycoprotein

Question 14

Name cytochrome P450 inducers

Answer 14

Dexamethasone
Phenobarbital
Phenytoin
Rifampin

Question 15

Name cytochrome P450 inhibitors that are involved in Phase 1 reactions (drug modifications)?

Answer 15

Cimetidine
Chloramphenicol 
Erythromycin 
Fluconazole
Infomethacin
Méthadone 
Omeprazole
Ranitidine

Question 16

Name modifications of drug in phase I reactions

Answer 16

Oxidation, reduction, hydrolysis or methylation

75% drugs are modified this way

Question 17

Name examples of Phase 1 reactions

Answer 17

Oxidation
Reduction
Hydrolysis
De methylation

Question 18

What is the most important enzyme system in phase I reactions?

Answer 18

Cytochrome p450 system

Microsomal enzymes that transfer electrons from NADPH to cytochrome p450

Question 19

What is the most common phase II reaction ?

Answer 19

Glucuronidation

Question 20

Excrete a constant amount of drug per unit time. What order kinetics?

Answer 20

Zero order kinetics

Ie aspirin, chloramphenicol, ethanol, diazepam

Question 21

Half life is independent on drug dosage. Which drug kinetics?

Answer 21

First order kinetics

Excrete a certain percentage of drug per unit time

Rate of drug elimination is directly proportional to serum drug concentration

Question 22

Describe the four phases of clinics trials

Answer 22

Phase I - intervention tested on a small cohort to: (1) evaluate safety; (2) establish a safe range
for dosing; and (3) document side effects

Phase II - intervention tested on a larger cohort to: (1) determine effectiveness and (2) evaluate
safety

Phase III- intervention in an even larger cohort to: (1) confirm effectiveness; (2) document
side effects; (3) compare effectiveness against other treatment modalities for the same
condition; and (4) continued safety profiling

Phase IV - tests the intervention after it has been released to the public (“post-marketing”) to
continue to establish and document: (1) benefits and effectiveness; (2) risks and side effects;
and (3) appropriate use and indications

Question 23

What compartment model do aminoglycosides and vancomycin follow?

Answer 23

Gentamicin follows one compartment model (rapidly equilibrates and 1st order kinetics)
Linear slope

Vancomycin follows two compartments model (slow équilibration with tissues)
Distribution phase and élimination phase

Question 24

Antenatal Corticosteroids cross placenta to fetus by which type of transport?

Answer 24

Facilitated