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CC2 lab finals > TDM > Flashcards

TDM Flashcards

1
Q

TDM ensures that a given drug dosage produce —

A
  • maximal therapeutic effect
  • minimal toxic adverse effects
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2
Q

TDM involves the — (3)

A
  • analysis
  • assessment
  • evaluation of circulating concentrations of drugs in serum, plasma, or whole blood
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3
Q

main highway in the body in order for one product or drug to proceed from point A to point B

A

circulation

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4
Q

TDM is a — procedure performed for?

A

quantitative procedure
performed for DRUGS WITH A NARROW THERAPEUTIC INDEX

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5
Q

only — can interact with the site of action and result in a biological response

A

free fraction of the drugs

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6
Q

drugs that are able to travel to the site where it is needed

when it is needed and when its concentration is elevated?

A

“free drug”
drugs that are circulating freely in the blood

elevated concentration is considered as TOXIC

it is able to do more harm than good such as destroying the environment of the target site

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7
Q

those drugs that are bound to — should be unbound first

A

carrier proteins

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8
Q

enumerate the causes of drug toxicity

A
  • elevated concentrations of free drug
  • abnormal response to drug after administration
  • presence of active metabolites
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9
Q

enumerate the factor of TDM (6)

A
  • route of administration
  • rate of absorption
  • protein binding
  • drug administration
  • drug distribution
  • drug elimination
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10
Q

enumerate the therapeutic failure (5)

A
  1. non-compliance
  2. sub-therapeutic dose
  3. bioavailability
  4. malabsorption
  5. drug interaction
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11
Q

enumerate the types of assays required (3)

A
  • total drug
  • free drug
  • metabolites
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12
Q

true or false

in TDM, we usually check for metabolites and the total drug while free drug is tested seldomly.

A

FALSE!
we usually check for total drug and free drug

metabolites are usually check in toxicology.

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13
Q

common specimen of metabolites

A

urine

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14
Q

enumerate the routes of administration for drugs

what is the most common method?

A
  • INJECTION (intravenous, intramuscular, subcutaneous, epidermal)
  • INHALED
  • ABSORBED IN THE SKIN
  • RECTAL (suppository)
  • ORAL

ORAL ADMINISTRATION

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15
Q

intravenous is with — bioavailability

what is the bioavailable fraction?

A

100% bioavailability

1.0 bioavailable fraction

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16
Q

for intravenous, drugs is administered directly in circulation and it will not pass the?

A

GIT and liver

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17
Q

bioavailability of oral administration

A

0.7

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18
Q

if oral administration, drug travels —

(enumerate the whole journey hahaha)

A
  1. mouth
  2. GIT
  3. liver
  4. circulation
  5. target site

not the complete drug will reach to the target organ since it has already processed first in the liver.

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19
Q

the distribution is through?

A

blood flow via capillary permerability

20
Q

location/s where the drugs are effective

it can either be?

A

BODY TISSUES
not generally in the blood

binding to proteins or free fractions

21
Q

differentiate the distribution for binding to proteins or free fractions

A

binding to proteins: still need to undergo a process of unbinding
free fractions: can immediately reach the target site

22
Q

this will matter in some drug distribution

A
  • lipid solubility of the drug
  • pH gradient
23
Q

the drugs can be broken down into metabolites, such as —

A
  • water soluble
  • pharmacologically active or inactive
  • easily excreted
24
Q

absorption is via?

also, absorption can depend on?

A

passive diffusion or active transport

formulation of drug

25
Q

a pill requires — while liquids are —

A

pill requires dissolution
liquids are rapidly absorbed

26
Q

indications and counterindications that we need to observe (5)

A
  • intestine motility
  • pH
  • inflammation
  • food, age, pregnancy
  • concurrent pathologic conditions
27
Q

for eliminations, the route of drug is via?

but most commonly, elimination is through?

A

hepatic metabolism or renal filtrations

renal filtration

28
Q

other modes of elimination (enumerate)

skin is done through?

A
  • skin
  • lungs
  • breast
  • saliva
29
Q
  • skin is done through?
  • breast is through?
A

skin = sweating
breat = breastmilk

30
Q

the rate at which a particular drug is cleared from the cirulation is dependent not only on the type of drug itself, but?

A

also on a patient’s capacity to metabolize and excrete it

31
Q

refers to the time required to reduce the blood level drug concentration to half after equilibrium is obtained.

A

steady state

32
Q

what is the most important factor to consider in specimen collection?

A

timing

33
Q

trough is?
peak is?

A

trough is 30 mins BEFORE the next dose

peak is 1 hr AFTER administration

34
Q

true or false.

there are some drugs that we can check randomly

A

TRUE

35
Q

specimen of choice

anticoagulants that can interfere in analysis.

A

WHOLE BLOOD
but serum and plasma can still be used.

EDTA, citrate, oxalate

36
Q
  • if serum will be used, what should be noted/avoided?
  • if plasma?

for yellow top, what should be avoided?

A
  • if serum, avoid the GEL
  • if plasma, use heparinized samples

THIXOTROPIC GEL is not allowed.

37
Q

the measurement of serum concentration should be done only?

A

after steady state has been achieved

38
Q

true or false

URINE cannot be used for testing TDM.

A

FALSE.
URINE can still be used but only rare

39
Q

enumerate the methods of TDM

A
  • enzyme multiplied immunoassay technique
  • enzyme link immunosorbent assay
  • radioimmunoassay
  • high performance liquid chromatography
  • fluorescence polarization immunoassay
40
Q

true or false

the amount of enzyme activity is inversely proportional to the amount of drugs present in the sample.

A

FALSE
directly proportional

41
Q

this method has moderate sensitivity, automated, and has rapid turn-around time

A

enzyme link immunosorbent assay

42
Q

this method has high sesnitibity but long turnaround time.

what is the disadvantage of this method?

A

radioimmunoassay

poses health risk due to radiation involved in the process.

43
Q

this is with highest sensitivity, least expensive, but long turnaround time. the measurement depends on the type of column used, the solvent and detector systems.

A

high performance liquid chromatography

44
Q

this method is automated, with rapid turn-around time and moderate sensitivity.

A

fluorescence polarization immunoassay

45
Q

which method has highest sensitivity?

A

high performance liquid chromatography

46
Q

which method has rapid turn-around time?

A

fluoresence polarization immunoassay

CC2 lab finals (2 decks)

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