Unit 4 Pharmacology: Pharmacokinetics Continued Flashcards
what does an extraction ratio of 1 mean
that 100% of the drug delivered to the clearing organ is removed
what is considered a high hepatic extraction ratio
> 0.7
drugs that have low hepatic extraction ratios
rocuronium
diazepam
lorazepam
thiopental
theophylline
phenytoin
drugs that have intermediate hepatic extraction ratios
midazolam
vecuronium
alfentanil
methohexital
drugs that high have hepatic extraction ratios
fentanyl
sufentanil
morphine
meperidine
naloxone
ketamine
propofol
lidocaine
bupivicaine
metoprolol
propanolol
alprenolol
nifedipine
diltiazem
verapamil
how must you adjust PO dose to compensate for first pass
increase PO dose
describe a characteristic most drugs that undergo enterohepatic circulation have in common
tend to have a long duration of effect (diazepam, warfarin)
examples of enzyme inducers
tobacco smoke
barbiturates
ethanol
phenytoin
rifampin
carpamazepine
examples of enzyme inhibitors
grapefruit juice
cimetidine
omeprazole
isoniazid
SSRI’s
erythromycin
ketoconazole
which opioids utilize the CYP3A4 pathway
fentanyl
alfentanil
sufentanil
methadone
which opioids utilize the CYP3A4 pathway
midazolam
diazepam
which LA’s utilize the CYP3A4 pathway
lidocaine
bupivicaine
ropivicaine
which drugs utilize the CYP2D6 pathway
codeine
oxycodone
hydrocodone
which drug utilizes the CYP1A2 pathway
theophylline
role of organic anion and cation transporters in proximal renal tubules (OAT and CAT’s)
actively secrete organic acids and bases into the urine
OAT’s (organic anion transporters) meds include
furosemide, thiazide diuretics, PCN
OCT’s (organic cation transporters) meds include
morphine, meperidine, dopamine
what does urine pH determine
whether drugs get excreted into the urine or reabsorbed into the peritubular capillaries
what does acidic urine favor (2 things)
reabsorption of acidic drugs
excretion of basic drugs
(AAA= acidic drugs better absorbed in acidic medium)
what does basic urine favor (2 things)
reabsorption of basic dugs
excretion of acidic drugs
(BBB basic drugs better absorbed in basic medium)
if we alkalinize the urine, we help to eliminate what kind of drugs
acidic
if we acidify the urine, we help to eliminate what kind of drugs
basic
what are the 4 key metabolic pathways in the plasma
pseudocholinesterase
nonspecific esterases
alkaline phosphatase
hofmann elimination (pH and temp)
which drugs utilize pseudocholinesterase for metabolism
succinylcholine
mivacurium
ester local anesthetics (have an i)
which drugs utilize nonspecific esterases
remifentanil
remimazolam
esmolol (RBC esterases)
etomidate
atracuium
clevidipine
which drugs utiliz ealkaline phosphatase
fospropofol (a pro dug converted to propofol)
which drugs utilize hofmann elimination
cisatracurium
atracurium
