7290446
Description
Flashcards by Katie Scanlon, updated more than 1 year ago
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Created by Katie Scanlon
over 7 years ago
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| Question | Answer |
| Volume of Distribution Vd | Vd= Amt of drug/ desired plasma concen |
| Vd Lipo/hydro PHILIC | Vd TBW > 0.6 L/kg or > 42 L = LIPOPHILIC Vd TBW < 0.6 L/kg or < 42 L = HYDROPHILIC |
| Loading dose calc | Loading dose= Vd x Desired Plasma Conce Bioavailability (1) |
| Clearance: Directly vs Inversely | Directly: Blood flow to organ Extraction ratio Drug dose Inversely: Half-life Drug concen in central compartment |
| Elimination Half-Life | Half life Drug Elim% Drug Remaining% 0 - 0 - 100 1 - 50 - 50 2 - 75 - 25 3 - 87.5 - 12.5 4 - 93.75 - 6.25 5 - 96.875 - 3.125 |
| Half life vs Half time | Half life: time it takes for 50% of the drug to be removed from the BODY Half time: time it takes for 50% of the drug to be removed from the PLASMA |
| Like Dissolves Like | Drug: Solution Acid: Basic sol = Highly ionized Acid: Acidic sol = Unionized Base: Acidic = Highly ionized Base: Basic = Unionized |
| Ion Trapping | Maternal Alkalosis & fetal acidosis ^Union fraction of locals crosses placenta Fetal acidosis - protonates the LA+ "trapping" the LA in the fetus |
| Plasma Protein Binding | Drug storage in the blood Albumin: negative charge; acidic >basic Alpha-1 acid glycoprotein: basic drugs Beta-globulin: binds basic drugs |
| Plasma Concen: Albumin & Alpha-1 acid glycoprotein | Decreased Albumin: Liver/renal dz, Age, malnutrition, prego a-1 acid glycoprotein: Neonates, prego Increased a-1 acid glycoprotein: Sx stress, MI, pain, RA, Age |
| Plasma Protein Binding & Vd | Vd is INVERSELY r/t plasma protein binding Highly protein bound drugs slower metabolism and elimination |
| Metabolism Phases (3) | 1- Oxidation: + O2 - reduction: + e- - hydrolysis: + H2O 2 - Conjugation (H2O soluble, inactive) 3 - Elimination (kidney, liver, GI) |
| Perfusion dependent vs Capacity dependent | Perfusion dependent: Fenta, lido, Prop Capacity dependent: Diazepam & Roc |
| Extraction Ratio formula | Extraction Ratio = Arterial - Venous concen Arterial concen |
| ER > 0.7 ER < 0.3 | Flow limited elimination ER > 0.7 blood flow Capacity limited elimination ER < 0.3 enzyme induction |
| LOW ER Drugs | Roc Benzo's (most) Methadone Thiopental Theophylline Phenytoin |
| P450 Enzymes: Inducers vs Inhibitors | Induce: Tobacco, Barbs, Phenytoin, ethanol, Rifampin, carbamazepine Inhibitor: grapefruit, SSRIs, cimetidine, omperazole, isoniazid, erythromyocin, -azole |
| Other enzymes | CYP 3A4: Opioids Benzos LA's CYP 2D6: Codeine, oxy-hydrocodone CYP 1A2: Theophylline |
| Polarity & Elimination | Hydrophilic drugs - excreted unchanged Lipophilic drugs - biotransformation to ^H2O solubility |
| Transport drugs to urine: | 1- Glomerular filtration: non-protein bound drugs & free fraction are filtered 2 - Organic Anion/Cation transporters: OAT-anion: furosemide, thiazide, PCN OCT-cation: morphine, meperidine, dopa |
| Urine pH Reabsorption & Excretion | Acidic Urine: AAA Reabsorption of acidic Excretion of basic Basic Urine: BBB Reabsorption of acidic Excretion of basic |
| Metabolism in the Plasma | |
| Difference between: Kinetics Biophasics Dynamics | |
| Dose Response Curve: Efficacy & Potency | |
| Dose Response Curve: Affinity for receptor | |
| Agonists Partial Agonists Antagonists Inverse Agonists (graph) | |
| Drugs administered together | Addition: 1+ 1 = 2 Synergism: 1 + 1 = 3 Potentiation: 1 + 0 = 3 Antagonism = 1 + 1 = 0 |
| Therapeutic Index | Measure of drug safety TI = Lethal dose50/Effective dose50 |
| ED 50 | Effective dose 50 = dose that produces expected clinical response in 50% of pop. POTENCY |
| LD 50 | Lethal dose 50 = dose that produces death in 50% of pop. |
| Chirality | Molecule with 3D asymmetry 1chiral carbon = 2 enantiomers |
| Enantiomerism | Molecules that are Mirror images & can't be superimposed Dextrorotary clockwise: R (rectus) d or + Levorotary counterclock: S (sinister) l or - |
| Enantiomerism in Anesthesia | Ketamine & Thiopental Methohexital Iso & Des Mepivacaine, Prilo, Bupi, CisAtra Morphine & Methadone Ibuprofen & Toradol (* Bupi & Cardiac toxicity: R > S) |
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