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7364 Critical Care Block 1 > PK/PD > Flashcards

PK/PD Flashcards

1
Q

3 drugs that kill by Peak:MIC?

FAM

Hollie’s FAM is the PEAK of crazy

A

F - fluoroquinolones
A - aminoglycosides
M - metronidazole

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2
Q

2 drugs that kill by time:MIC?

BO

Some people have BO all the TIME

A

B - beta-lactams

O - oxazilidinones

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3
Q

3 rugs that kill by AUC:MIC?

VTM

Get money from the ATM with an upside down A so your stuff doesn’t get AUCtioned off

A

V - vancomycin
T - tetracyclines
M - macrolides

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4
Q

4 bacteriostatic drugs?

CMTL

CMT’s Love to cause static

A

C - clindamycin
M - macrolides
T - tetracyclines
L - linezolid

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5
Q

Clindamycin is __

a. bactericidal
b. bacteriostatic

A

b. bacteriostatic

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6
Q

Linezolid is __

a. bactericidal
b. bacteriostatic

A

b. bacteriostatic

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7
Q

Macrolides are __

a. bactericidal
b. bacteriostatic

A

b. bacteriostatic

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8
Q

Tetracyclines are __

a. bactericidal
b. bacteriostatic

A

bacteriostatic

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9
Q

Which drug is slowly bactericidal?

A

vancomycin

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10
Q

Aminoglycosides are __

a. bactericidal
b. bacteriostatic

A

a. bactericidal

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11
Q

Beta lactams are __

a. bactericidal
b. bacteriostatic

A

a. bactericidal

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12
Q

Daptomycin is __

a. bactericidal
b. bacteriostatic

A

a. bactericidal

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13
Q

fluoroquinolones are __

a. bactericidal
b. bacteriostatic

A

a. bactericidal

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14
Q

Metronidazole is __

a. bactericidal
b. bacteriostatic

A

a. bactericidal

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15
Q

3 ADME issues for the critically ill (hypercatabolic)?

A
  • often poor oral absorption
  • large Vd
  • faster or slower excretion
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16
Q

Why is Vd increased in crucially ill pts?

A

increased capillary permeability > fluid leaks into interstitial space (third spacing)

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17
Q

Concentration __ drugs are more impacted by large Vd of critically ill pts

a. hydrophilic
b. lipophilic

A

a. hydrophilic

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18
Q

Why is CrCl not always reliable for critically ill patients?

A
  • renal perfusion decreased
  • augmented renal clearance

dose adjustments are often required

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19
Q

Renal clearance is unreliable in critically ill, but a significant portion do have __ renal clearance

a. increased
b. decreased

A

a. increased

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20
Q

Volume status does not effect CrCl calculation

a. true
b. false

A

b. false

21
Q

Ke is the fraction of specific drug removed per unit time assuming what?

A

blood flow rate to the kidneys is stable

22
Q

PK equations do not work if you cannot assume stable clearance

a. true
b. false

A

a. true

23
Q

What is the main drug parameter that determines time to steady state?

A

half life

24
Q

2 independent factors for PK/PD?

A

Cl

Vd

25
Q

An increase in CrCl causes __ in Ke*Vd

a. an increase
b. a decrease

A

a. an increase

26
Q

An increase in CrCl causes a(n) __ in drug clearance and a(n)__ in half life

a. increase, increase
b. decrease, increase
c. increase, decrease
d. decrease, decrease

A

c. increase, decrease

27
Q

What is the formula for AUC?

AUC =

A

dose/clearance

28
Q

Loading doses do not effect the time to steady state.

a. true
b. false

A

a. true

29
Q

Loading doses decrease the time to therapeutic levels

a. true
b. false

A

a. true

30
Q

5 main pt factors that change drug clearance?

A
  • age
  • volume status
  • concomitant nephtrotoxic meds
  • muscle wasting
  • critical illness
31
Q

The minimum time to wait to get a vanc level after HD is __ hours

A

6

32
Q

Which type of CRRT does not need dose adjustments?

A

SCUF

33
Q

Vanc loading dose range?

A

25-30mg/kg

34
Q

Vanc dosing is based on __

a. TBW
b. AjBW
c. IBW

A

a. TBW

35
Q

The maintenance vanc dose is __ mg/kg

A

15-20

36
Q

Bayesian modeling does not always hold true in the ICU

a. true
b. false

A

a. true

37
Q

What is the AUC goal for vanc definitive dosing?

A

400-600

38
Q

Aminoglycosides are dosed on __

a. IBW
b. TBW
c. AdjBW

A

a. IBW

39
Q

Which type of aminoglycoside dosing is adjusted by nomogram?

A

definitive extended interval

40
Q

CrCl < __mL/min OR changing renal fxn OR HD are exclusions for aminoglycoside extended interval dosing

A

20

41
Q

Synergy dosing is preferred for aminoglycoside extended interval dosing

a. true
b. false

A

b. false

synergy dosing is an EXCLUSION for EI dosing

42
Q

What kind of dosing should be used for AKI with vanc?

A

pulse dosing

43
Q

Vanc AKI is defined as SCr increase of >= __ mg/L or UOP decrease of __ %

A

0.3, 50

44
Q

Does pulse dosing impact loading dose?

A

no

45
Q

Vanc pulse dosing is preferred when drug clearance is unpredictable.

a. true
b. false

A

a. true

46
Q

Two main disadvantages of continuous infusions for time dependent antimicrobials?

A
  • stability

- line occupation

47
Q

Aminoglycosides should be dosed > __ to __ times the MIC for extended interval dosing

A

8, 10

concentration dependent

48
Q

What class of antibiotics should be dosed at the higher end of ranges to overcome altered PK?

A

beta lactams

7364 Critical Care Block 1 (11 decks)

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