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PK/PD Sparks Flashcards

1
Q

According to pharmacokinetics principle, What happened to the medication upon entering the body?

A
  • Absorption
  • Distribution
  • Metabolism
  • Excretion
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2
Q

What is absorption?

A

Ability of a drug to travel from the administration site to the bloodstream

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3
Q

what are the extra vascular sites that effect absorption? (Slide 5)

A
  • Intramuscular/SubQ
  • Inhaled
  • Intraventricular/intrathecal
  • Oral route
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4
Q

What are some of the advantages of IM/SubQ site administration (Slide 6)

A
  • Avoids first-pass metabolism, may have higher bioavailability than oral route
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5
Q

Slide 6
What are the listed disease state for PenG?

A
  • Syphilis infection
  • Strep infection-Single dose
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6
Q

Slide 6
What are the listed disease state for Rocephin

A
  • N. gonorrhea STI
  • Otitis Media
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7
Q

Slide 6
What are the listed disease states for Aminoglycosides?

A

Mycobacterium infections

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8
Q

Which drugs have increased Vd in the lungs?

A
  • Polymixin-Colistin
  • Monobactam/Aztreonam
  • ## Aminoglycosides-Tobramycin,Amikacin
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9
Q

Slide 7
What are some of the recommendations for Pt using ventilator with gram (-) ventilator-associated pneumonia (VAP)

A
  • Use systemic Therapy
  • Solution, Nebulizer device, mechanical vent settings, sedation, and other medications
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10
Q

What is the primary use if Intraventricular and intrathecal injection?

A
  • Primary use in CNS infections
  • It improves Vd crossing blood-brain barrier (BBB)
  • May minimize toxicity outside of CNS
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11
Q

What are some of the drugs that can be injected Intrathecally?

A
  • Aminoglycosides
  • Colistin
  • Daptomycin
  • Vancomycin
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12
Q

Gastric pH
. Absorption in the stomach favor ______ drugs
. Absorption in the small intestines favors _____ drugs

A

Acidic; Basic

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13
Q

Gi motility
What are potential effects of Delayed-gastric emptying?

A
  • Decrease the absorption of meds in small intestines
  • Increase the absorption of meds in stomach
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14
Q

Through oral route, which drug would have poor absorption (First pass)

A

B-Lactams

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15
Q

Which drugs have excellent Bioavailability through Oral route?

A
  • FQ
  • Metronidazole
  • Oxazolidinones
  • Doxycycline
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16
Q

What’s important to know to admin Ciprofloxacin along with nutrition?

A

Hold nutrition 1-2 hours before and after enteral nutrition administration (bioavailability may drop 40%)

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17
Q

What’s important to know to admin FQ and Tetracycline along with nutrition?

A

Give 4 hours before or after cation’s (Calcium, Magnesium, iron, aluminum)

18
Q

What is the concentration formula?

A

dose/Vd

19
Q

What are some of the factors that affect Drug distribution?

A
  • Tissue perfusion/permeability
  • Lipid solubility/ Molecular size/Protein binding
20
Q

What condition favors Distribution?

A
  • High lipophilicity
  • Low molecular weight
  • Unionized state
  • Low protein binding
21
Q

What are some steps you could take to increase the CNS penetration?

A
  • High doses
  • higher frequencies
  • Injecting intraventricular
22
Q

What to do when serum albumin is slower then 3.5?

A
  • Increase ECF/Increase Vd
  • Decreases Plasma on optic pressure
  • Increased proportion of unbound drug in plasma that can distribute in ECF
  • Ultimately increases renal clearance of antibiotics with renal excretion
23
Q

what would be the properties of a Hydrophilic drug be with general Pk

A
  • Low Vd
  • Low intracellular penetration
  • typically renal clearance
24
Q

what would be the properties of a Hydrophilic drug be with Critically ill pK?

A
  • Higher Vd
  • Clearence altered d/t changes in renal function
25
Q

what would be the properties of a Lipohilic drug be general Pk?

A
  • High Vd
  • Good intracellular penetration
  • Typically hepatic clearance
26
Q

what would be the properties of a Lipohilic drug be critically ill Pk?

A
  • Unchanged Vd
  • Clearance altered d/t changes in hepatic function
27
Q

What are 2 reactions that are primarily responsible for metabolism in the liver?

A
  • Phase 1 Oxidative metabolism (Requires oxygen; CYP isoenzymes)
  • Phase 2 glycosylation and glucoronidation
28
Q

What are the medications usually found in Extracellular space post admin?

A
  • B-Lactams (PCN, Cephlasporin, Carbapenems)
  • Daptomycin
  • AG
29
Q

What are the medications usually found in Total body water post admin?

A
  • Clindamycin
  • Linezolid
  • Metronidazole
  • Vancomycin
30
Q

What are the medications usually found Tissues post admin?

A
  • Colistin
  • FQ
  • Macrolides
    • Azithromycin
    • Calrithromycin
  • Tigecycline
31
Q

What agents are with significant hepatic/biliary clearance or sensitivity to decreased metabolism?

A
  • Amoxicilin,
  • Ceftriaxone
  • Clarithromycin
  • Clindamycin
  • Doxycycline
  • Metronidazole
  • Rifeampin
32
Q

What are some of the antibiotics known for cyp inhibitors?

A

Macrolides
Metronidazole
Bactrim

33
Q

What are some of the antibiotics known as CYP inducers

A

Rifamycins
Anti staphylococcus penicillins

34
Q

Which antibiotic may cause serotonin syndrome?

A

Oxazolidinones

35
Q

What are the antibiotics with highest risk of INR elevation with Warfarin (CYP2C9)

A
  • FQ
  • Bactrim
  • Metronidazole
  • Clarithromycin
36
Q

What are the antibiotics with highest risk of decreased INR and risk of thromboses with Warfarin (CYP2C9)

A
  • Rifampin
  • Anti-Staphylococcal Penicillin
37
Q

What antibiotics do not need renal adjustment?

A
  • Avelox (Moxifloxacin)
  • Rocephin (Ceftriaxone)
  • Rifampin
  • Azithromycin
  • Cleocin
  • Doxycycline
  • Nafcillin
  • Oxacillin
  • Linezolid
  • Tigecycline
38
Q

(T/F) most antimicrobial agents are time-dependent

A

True

39
Q

Time-dependent antimicrobials

A
  • B-Lactams
  • Linezolid
  • Tetracycline
  • Bactrim
40
Q

How to admin Cefepime for E.Coli?

A
  • 1gm q6hr
  • 1gm q4hr
  • 2pm q8hr
41
Q

How to admin Cefepime for K. Pneumoniae?

A
  • 1gm q6hr
  • 1gm q4hr
  • 2pm q8hr
42
Q
A

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