Pharmacokinetics Flashcards
What is dosing schedule for carbimazole
OD (half life: 6 hours)
PK of Levothyroxine
Route
Bioavailablity
Oral and empty stomach
Bioavailiblity: 80%
PK of T3/Leothyronine
Route:
Bioavailablity:
Route:Oral/IV
Bioavailablity:100%
PK of Alpha glucosidase inhibitors
Route
Frequency
How to take
Metabolism
Absorption
Specific
Oral
TDS
First bite of meal
Adjuvant to diet
Metabolism
Acarbose: intestinal bacteria metabolism (colon)
Miglitol and Voglibose:
Both no metabolites
Absorption
Miglitol: Well-absorption
PK of GLP 1 analogues
Route
Specfic frequency
Route: S/C
Exenatide: BD
Lixisenatide: OD
PK of gliptins
Route
Elimination
M/I
Metabolism
D/I
Route: Oral
Elimination
Renal
Alo, Sita, Saxa
M/I dose adjusment in Renal dysfunction
Entero-Hepatic
Lina
Metabolism
CYP450 3A4
Inducers:Rifampicin
Inhibitors: Ketoconazole, Diltiazem
Pramlinitide
Route
Duration of Action
Syringe
Why?
Subcutaneous
2-3 hours
Different syringe than INSULIN
If same: reduce INSULIN by 50%
(Increased risk of hypoglycemia)
PK of Shortest and Fastest acting Insulin: Afrezza
Route:
Catridge:
When:
Inhalational
Colour coded
Blue: 4 units
Green: 8 units
Yellow: 12 units
Before meal
PK of short but fast acting Insulin:
Lispro
Glulisine
Aspart
Effect time:
When:
Route:
15 minute
15-20 minutes before or after a meal
IV
PK of Short but slow acting insulin: Regular insulin
Effect time:
Route:
When:
45 minutes to 1 hour
S/C
30 minutes to 1 hour before meal
PK of intermediate acting insulin: Neutral Protamine Hagedorn
Lente Insulin
Route:
S/C
PK of long acting Insulin:
Detemir
Glargine
Degludec
Why long-acting?
Route:
Which is longest acting?
Saturated fatty acid-> ^^ PPB
Acidic pH form crystals or precipitate which break downs slowly
Hexadecanoic acid which form hexamers with tissue and slowly release as monomers
S/C
Degludec
Which insulin the site of injection doesn’t affect absorption rate
Glargine
When to use this route of insulin adminstartion ?
(5) hospital settings
Subcutaneous: for ease and convinence for patients
Syringes pumps and pens
I/V: in hospital settings in emergency treatement requiring close monitoring of blood glucose levels such as in
Diabetic Ketoacidosis
Hyperosmolar hyperglycemic state
Severe hyperkalemia
Beta-blocker toxicity
Calcium-channel blocker toxicity
Site of insulin S/C to not be used jn abdomen
Peri umblical region
Method to mix insulin injection
Mixed in different syringes
In one syringe (only a insulin): first load regular and then load NPH
(As it might contaminate regular vial and confuse with NPH)
Continuous subcutaneous infusion for regular insulin
Storage of open vial and new vial
Opened vial: store in fridge up to 1 month (do not store in freezer).
New vial: store in a cool dark place till expiry. 28 days
2-8 degree celsius refrigerator middle shelf
PK of insulin releasing OHA
Specific
1st generation feature
Route
Action
Excretion
SU:
Tolubtamide: Zero order
Low potency
Oral
Longer acting and more insulin release
Urine and Faeces
Glinides:
Oral
Shorter acting and less insulin release
Bile
SGLT2 Inhibitors
Route
Dosage schedule
FDC
Oral
OD morning before first meal
With metformin or DPP4 inhibitors
Growth Hormone/IGF-1
Route
1/2 life
PK
Route: IM OR SC
HALF life: 25min : short
IGF-1:20hrs: long (1PPB)
Somatostatin Analogues
PK
1/2 life feature:
Route:
Frequency:
Specific
Long
Depot formulations
Once a month
IV for acute variceal bleeding
Gonadotropins
1-route:
- Duration
- dose
subcutaneous/IM
5-12 days. hMG
Subsquently : HCG->Ovulation
75-15O IU
Psyllium
Psyllium can reduce the absorption of other oral drugs and administration of other agents should be separated from psyllium by at least 2 hours.
Bisacodyl form
Suppositories and enteric coated tablets
Mineral Oil: why Rectal adminstration?
Mineral oil usage should probably be limited to rectal administra- tion because of the risk of aspiration pneumonia
