PKPD Flashcards
Male patients with what urine CrCl are considered to be in augmented renal clearance?
> 130
Female patients with what urine CrCl are considered to be in augmented renal clearance?
> 120
What are some consequences of ARC in regards to treatment?
- Sub therapeutic concentrations
- Treatment failures
What can decreased perfusion/blood flow decrease?
Absorption via any non IV route
True or False: clearance is used to determine loading doses not Vd
False
An increase in fluid volume can cause a ______ in Vd
Increase
An increase in capillary permeability leads to a _____ in Vd
Increase
________ drugs tend to have a wider distribution and tend to stay within the intravascular space
Lipophilic
What is the normal range of albumin?
3.5-5 g/dL
What is hypoalbuminemia typically referred to as?
<2.5 g/dL
What is the total level range for phenytoin?
10-20 mg/L
What is the free range for phenytoin?
1-2 mg/L
What is x in the phenytoin equations for patients with hypoalbuminemia?
0.2
What is x in the phenytoin equations for patients with hypoalbuminemia and ESRD or HD dependent?
0.1
What level should you always use if you have it?
Free level
What is the valproic acid total range?
50-100 mcg/mL
What is the valproic acid free range?
6-22 mcg/mL
Hypoalbuminemia with antibiotics has a potential for causing what?
Underdosing
Why are loading doses usually given?
To rapidly achieve therapeutic concentrations
To optimize concentration dependent antibiotics, what should be maximized?
Peak:MIC ratio
To optimize time dependent antibiotics, what should be maximized?
t>MIC
Highly _______ drugs and highly ______ drugs tend to become sequestered within the ECMO circuit
Protein bound; lipophilic
The ECMO circuit leads to ______ systemic concentrations
Lower
What are the 3 most lipophilic analgesics/sedatives that may require higher dosing due to the ECMO circuit?
- Fentanyl
- Midazolam
- Propofol
