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22 Cards in this Set

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Volume of Distribution
Vd = total amount of drug in the body/drug blood concentration
Ideal Body Weight (IBW) for a female with a medium body build
100 lbs for 1st 5 ft, plus 5 lbs for each additional inch
Ideal Body Weight (IBW) for a female with a small body build
Calculate IBW, then subtract 10%
Ideal Body Weight (IBW) for a female with a large body build
Calculate IBW, then add 10%
Ideal Body Weight (IBW) for a male with a medium body build
100 lbs for 1st 5 ft, plus 6 lbs for each additional inch
Ideal Body Weight (IBW) for a male with a small body build
Calculate IBW, then subtract 10%
Ideal Body Weight (IBW) for a male with a large body build
Calculate IBW, then add 10%
If the pt's total body weight (TBW) is less than their Ideal Body Weight (IBW), should you go with the TBW or the IBW?
Go with the TBW
What is the Cockroft-Gault equation?
Creatinine Clearance = (140 - age) x Ideal Body Weight/72 x Serum Creatinine
How do you modify the Cockroft-Gault equation for females?
Multiply the CLcr you get by 0.85
TRUE or FALSE: Some elderly pts w/serum creatinine values in the high-normal range will have almost normal renal fxn.
TRUE
TRUE or FALSE: the Cockroft-Gault equation will still work for pts with unstable renal fxn
FALSE
TRUE or FALSE: If the pt has a normal serum creatinine, they have normal renal fxn.
FALSE
You give a pt drug X. You take a blood level and decide to double the dose to get the pt into the therapeutic range. Two days later, the pt is lethargic. What happened?
Possibly didn't wait long enough to take blood level, so pt wasn't in steady state when you decided to up the dose.
Why do you need to be aware of 2 compartment kinetics?
If you take a blood level too early, you may inappropriately decrease the dosage (digoxin's 2nd, slower elimination phase most closely mimics the concentration in the heart)
Name four common causes of misleading drug concentrations.
1)dose not given at correct time
2)drug concentration is ordered at correct time, but sample is collected early or late (but marked as collected at correct time)
3)failure to recognize a drug interaction affecting drug pharmacokinetics
4)non-compliance by pt
t1/2=
.693/k
CL=
Vd x k
Dosing rate=
CL x Css
Maintenance dose=
dosing rate x dosing interval
loading dose=
Vd x TC
dose=
change in C x Vd / F

F = bioavailability