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25 Cards in this Set
- Front
- Back
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metabolite of meperidine
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normeperidine
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metabolite of allopurinol
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oxypurinol
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metabolite of procainamide
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n-acetyl procainamide (NAPA)
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metabolite of sodium nitroprusside
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thiocyanate
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metabolite of morphine
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morphine-3-glucuronide
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Stage 1 Kidney Damage
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kidney damage with normal or increased GFR (>90 ml/min)
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Stage 2 Kidney Damage
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kidney damage with mild decrease in GFR (60-89 ml/min)
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Stage 3 Kidney Damage
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kidney damage with moderate decrease in GFR (30-59 ml/min)
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Stage 4 Kidney Damage
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kidney damage with sever decrease in GFR (15-29 ml/min)
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Stage 5 Kidney Damage
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kidney failure (GFR < 15 ml/min)
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What does BUN stand for?
How is urea produced? What is the normal BUN range? What is BUN influenced by? |
--Blood Urea Nitrogen
--product of protein metabolism --8-20 mg/dL --can be influenced by diet, drugs, fluid status of patient |
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What is the normal range for Scr?
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0.8-1.2
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What does a BUN/CLcr of >20 indicate?
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dehydration or hypovolemia
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Give two examples of situations in which there will be saturable kinetics:
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--limited area of gut that can absorb drug
--competition for transporters |
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Is albumin more prone to bind to acidic or basic drugs?
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acidic
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Is a1-acid glycoprotein more likely to bind to acidic or basic drugs?
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basic
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What drug follows saturable kinetics at normal doses?
What drugs follow saturable kinetics at toxic doses? |
--phenytoin
--alcohol, aspirin, theophylline |
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Name two drugs that exhibit concentration dependent protein binding with albumin:
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--valproate
--aspirin (high, usually toxic doses) |
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Name three drugs that exhibit concentration dependent protein binding with a1-acid glycoprotein:
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--lidocaine
--disopryamide --meperidine |
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What is the equation for rate of drug loss with saturable elimination?
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Rate = VmaxCss / (Km + Css)
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Km
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concentration at total drug establishing half of Vmax
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What is the effect of high phenytoin doses on the amount of time it takes to reach steady state and the amount of time needed to return from toxic concentrations to acceptable concentrations?
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High phenytoin doses increase the half-life of phenytoin, therefore increasing the amount of time it takes to reach steady state and return to an acceptable concentration.
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Explain the effect of polymorphic enzyme differences on Km:
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the enzyme that binds phenytoin is common across almost the entire population; difference between people is the number of enzymes
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Does dosing of phenytoin change with changes in fu?
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Nope. Total concentration may appear low, but free concentration should be right.
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What value is typically used for Km?
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4 mg/L
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