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43 Cards in this Set
- Front
- Back
- 3rd side (hint)
what type of drug is gentamycin?
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antibiotic
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How would change the patient's maintenance dose for gentamycin if the GFR were low?
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decrease the dose, since gentamycin is cleared renally, since clearance is proportional to maintenance does.
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Would you increase or lower the does of gentamycin in an obese patient?
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Use IBW for dosing, since the drug is not lipophilic
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Which has greater bioavailability, furosemide or propranolol orally?
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Furosemide = 61%… propranolol = 21%
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How is propranolol cleared?
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gut flora
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How does omeprazole interfere with itraconazole?
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Itraconazole require a low pH to be absorbed, and omeprazole is a proton pump inhibitor
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Is propofol lipophilic or hydrophilic?
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lipophilic
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why is the onset of anesthesia and awakening from propofol so fast?
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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
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If propofol has such a long half-life, why does awakening happen so fast?
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because of propofol's redistribution to other fatty tissue
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How would you adjust propofol for obese patients?
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you would use the actual weight because the drug is sequestered in body fat…
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how is propofol metabolized?
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by the liver
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Which order of clearance is independent of concentration and thus clears as fx of time?
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zero order: thus a specific amount of drug clears in a unit of time and does not vary with concentration
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Which order of clearance changes as a function of drug concentration?
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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…
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What can be used to derive the K of a first order clearance?
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the slope of the rate/concentration (y/x)
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In which drug clearance rxn is the fraction of drug elimination constant?
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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
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How are the majority of drugs eliminated… first or zero order?
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first order
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what is the Vd?
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Vd is the amount of drug in the body divided by the concentration in the plasma
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what is the Cl (clearance) of a drug?
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Cl is the volume of plasma from which the drug is completely removed per unit time
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what is the amount of eliminated drug proportional to?
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the amount of drug eliminated is proportional to the concentration of drug in the body and its clearance
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None
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What is the fraction of the drug in the body eliminated per unit time determined by?
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It is determined by the eliminatino constant: K(elim)
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give the equation for Cl.
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Cl=K(elim) x Vd
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give the equation for the "rate of elimination":
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rate of elimination= clearance x concentration in the blood
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if the Vd is increased, what will happen to: rate of elimination, half-life, and clearance?
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if Vd is increased, rate of elimination indirectly decreases since clearance decreases , half-life increases, clearance decreases.
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None
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give the equation for the rate of elimination:
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rate of elimination = Cl x [plasma]
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T/F Alcohol is a CNS depressant.
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TRUE
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What is the mechanism by which Alcohol depresses the CNS?
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Alcohol: Modifies the flux of Na through GABA channel --> potentiate inhibitory effects of GABA
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What are the indications for alcohol?
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Indications for Alcohol: methanol poisoning, inhibits ADH & oxytocin
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What are the ADRs for Alcohol?
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Alcohol ADRs: nausea, liver cirrhosis, coma
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What are the indications Chloroquine?
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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
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What is the Vd for chloroquine? BA? % bound to plasma? Half-life?
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Chloroquine: Vd=13,000… BA=61%… Bound to plasma proteins = 61%… t-1/2=214 hrs
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Which drugs tend to have a high Vd? Lipid soluble or insoluble?
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Lipid soluble
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Is Digoxin lipid soluble? Is the Vd of digoxin high or low?
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Digoxin is lipid soluble… thus it has a high Vd of 500
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Where does digoxin distribute to?
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muscles (and fat)
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What are the effects of digoxin?
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Digoxin is a cardiac glycoside protype with + inotrope activity… it decreases AV conduction
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What Digoxin's mechanism of action?
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Digoxin inhibits Na/K ATPase
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T/F Digoxin has a wide therapeutic index.
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FALSE
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What is the half-life of Digoxin?
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40 hrs… renal excretion
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What are the indication for Digoxin? And what are the ADRs?
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Digoxin: Indications: CHF, A-fib… ADRs: v-fib, heart rhythm problems, hyperkalemia, prolonged PR intervals, GI, eyes
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What is the BA of Furosemide and Propranolol?
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Oral BA: propranolol = 26%… Furosemide = 61%
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What is Furosemide? What are its indications? Does it have wide or narrow therapeutic index?
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Furosemide: (1) A loop diuretic… (2) Indications: edema secondary to CHF, cirrhosis, and renal disease, HTN, pulmonary edema… (3) Wide Therapeutic index
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What is the mechanism of action for furosemide? And how greatly is it bound to plasma proteins?
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Furosemide: (1) Mech of Action: inhibit Cl part of Na+/K+/2Cl- cotransport… (2) 95% plasma bound
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What are the indications for Gentamycin? Contraindications? Mech of Action?
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Gentamycin: indications: Gram +/-… (2) contraindication: anaerobes… (3) Mech of Action: inhibits bacterial protein synthesis…
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Gentamycin is not lipophilic. Does it have a high or low Vd?
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Gentamycin is not lipophilic, thus it has a low Vd
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None
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