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43 Cards in this Set

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what type of drug is gentamycin?
How would change the patient's maintenance dose for gentamycin if the GFR were low?
decrease the dose, since gentamycin is cleared renally, since clearance is proportional to maintenance does.
Would you increase or lower the does of gentamycin in an obese patient?
Use IBW for dosing, since the drug is not lipophilic
Which has greater bioavailability, furosemide or propranolol orally?
Furosemide = 61%… propranolol = 21%
How is propranolol cleared?
gut flora
How does omeprazole interfere with itraconazole?
Itraconazole require a low pH to be absorbed, and omeprazole is a proton pump inhibitor
Is propofol lipophilic or hydrophilic?
why is the onset of anesthesia and awakening from propofol so fast?
Propofol is lipophilic and crosses the BBB readily, plus the brain has a high perfusion rate… fast awakening is due to redistribution due to propofol's lipophilicity
If propofol has such a long half-life, why does awakening happen so fast?
because of propofol's redistribution to other fatty tissue
How would you adjust propofol for obese patients?
you would use the actual weight because the drug is sequestered in body fat…
how is propofol metabolized?
by the liver
Which order of clearance is independent of concentration and thus clears as fx of time?
zero order: thus a specific amount of drug clears in a unit of time and does not vary with concentration
Which order of clearance changes as a function of drug concentration?
first order: thus the gradient of concentration vs time is not constant, it's proportional to the concentration and will thus decrease as concentration decreases…
What can be used to derive the K of a first order clearance?
the slope of the rate/concentration (y/x)
In which drug clearance rxn is the fraction of drug elimination constant?
first order: which is to say that a constant fraction is eliminated per unit time… thus the rate of elimination is proportional to to the amount of drug in the body
How are the majority of drugs eliminated… first or zero order?
first order
what is the Vd?
Vd is the amount of drug in the body divided by the concentration in the plasma
what is the Cl (clearance) of a drug?
Cl is the volume of plasma from which the drug is completely removed per unit time
what is the amount of eliminated drug proportional to?
the amount of drug eliminated is proportional to the concentration of drug in the body and its clearance
What is the fraction of the drug in the body eliminated per unit time determined by?
It is determined by the eliminatino constant: K(elim)
give the equation for Cl.
Cl=K(elim) x Vd
give the equation for the "rate of elimination":
rate of elimination= clearance x concentration in the blood
if the Vd is increased, what will happen to: rate of elimination, half-life, and clearance?
if Vd is increased, rate of elimination indirectly decreases since clearance decreases , half-life increases, clearance decreases.
give the equation for the rate of elimination:
rate of elimination = Cl x [plasma]
T/F Alcohol is a CNS depressant.
What is the mechanism by which Alcohol depresses the CNS?
Alcohol: Modifies the flux of Na through GABA channel --> potentiate inhibitory effects of GABA
What are the indications for alcohol?
Indications for Alcohol: methanol poisoning, inhibits ADH & oxytocin
What are the ADRs for Alcohol?
Alcohol ADRs: nausea, liver cirrhosis, coma
What are the indications Chloroquine?
Chloroquine indications: 4-aminoquioline used for treatment of malaria (although there is much resistance to it, and it's toxic), amebiasis and some chronic inflammatory diseases, rheumatoid arthritis, lupus
What is the Vd for chloroquine? BA? % bound to plasma? Half-life?
Chloroquine: Vd=13,000… BA=61%… Bound to plasma proteins = 61%… t-1/2=214 hrs
Which drugs tend to have a high Vd? Lipid soluble or insoluble?
Lipid soluble
Is Digoxin lipid soluble? Is the Vd of digoxin high or low?
Digoxin is lipid soluble… thus it has a high Vd of 500
Where does digoxin distribute to?
muscles (and fat)
What are the effects of digoxin?
Digoxin is a cardiac glycoside protype with + inotrope activity… it decreases AV conduction
What Digoxin's mechanism of action?
Digoxin inhibits Na/K ATPase
T/F Digoxin has a wide therapeutic index.
What is the half-life of Digoxin?
40 hrs… renal excretion
What are the indication for Digoxin? And what are the ADRs?
Digoxin: Indications: CHF, A-fib… ADRs: v-fib, heart rhythm problems, hyperkalemia, prolonged PR intervals, GI, eyes
What is the BA of Furosemide and Propranolol?
Oral BA: propranolol = 26%… Furosemide = 61%
What is Furosemide? What are its indications? Does it have wide or narrow therapeutic index?
Furosemide: (1) A loop diuretic… (2) Indications: edema secondary to CHF, cirrhosis, and renal disease, HTN, pulmonary edema… (3) Wide Therapeutic index
What is the mechanism of action for furosemide? And how greatly is it bound to plasma proteins?
Furosemide: (1) Mech of Action: inhibit Cl part of Na+/K+/2Cl- cotransport… (2) 95% plasma bound
What are the indications for Gentamycin? Contraindications? Mech of Action?
Gentamycin: indications: Gram +/-… (2) contraindication: anaerobes… (3) Mech of Action: inhibits bacterial protein synthesis…
Gentamycin is not lipophilic. Does it have a high or low Vd?
Gentamycin is not lipophilic, thus it has a low Vd