Modules 1 & 2, Foundations

Question 1

What is pharmacokinetics?

Answer 1

What the body does to the drug

Question 2

What 4 processes does PK include?

Answer 2

absorption, distribution, excretion, metabolism

Question 3

The clinical goal of PK is to

Answer 3

maximize efficacy and minimize toxicities

Question 4

only the _____ drugs may distribute into the tissue and exert an effect

Answer 4

Unbound to albumin

Question 5

What disease states will result in unbound drug, increasing plasma levels?

Answer 5

liver disease, kidney disease, poor nutrition, ESRD

Question 6

What influences the reabsorption in the renal tubules, thereby affecting excretion?

Answer 6

the pH in the renal tubules

Question 7

What is bioavailability?

Answer 7

percentage of the drug that reaches systemic circulation

Question 8

what influences the onset of action of drugs?

Answer 8

the rate of absorption

Question 9

What does the cockcroft-gault equation measure?

Answer 9

serum creatinine in adult patients

Question 10

What is Vd?

Answer 10

volume of distribution; extent of drug distributed into the tissues

Question 11

What does a small Vd indicate?

Answer 11

a large amount of drug in the plasma

Question 12

What dose adjustment is needed for a large Vd?

Answer 12

A larger loading dose to overcome the large amount lost to the tissues

Question 13

What is the formula for elimintation?

Answer 13

K = CL/Vd

clearance divided by volume of distrubtion

Question 14

How are pharmacodynamics visually shown?

Answer 14

nonlinear dose response curve (Emax model)

Question 15

What is Emax?

Answer 15

Maximal effect the drug can achieve

Question 16

What is EC50?

Answer 16

potency, the smaller the EC50, the more potent the drug

Question 17

What antagonist cannot be overcome by increasing the dose?

Answer 17

Noncompetitive antagonist; lowers the Emax.

Question 18

What antagonist CAN be overcome by increasing the dose?

Answer 18

Competitive antagonists

Question 19

What effect does Phase I enzyme metabolizers have?

Answer 19

adverse drug reactions (60%)

Question 20

What effects does Phase II enzyme metabolizers have?

Answer 20

Drug toxicities

Question 21

What PD and PK changes are seen in pediatric patients

Answer 21

Decreased gastric pH & motility
Increased percentage of body water
Decreased albumin
decreased GFR (infants)

Question 22

What formula is used to calculate GFR in children under 12?

Answer 22

Schwartz equation

Question 23

What PK and PD changes are seen in pregnant patients?

Answer 23

Increased pH, decreased motility
Increased body water and fat
Increased drug clearance
GFR increases (up to 3x)

Question 24

What are the teratogenic medications?

Answer 24

ACEs, ARBs, Carbamazepine, Lithium, methotrexate, misoprostol, phenytoin, retinoids, statins, topiramate, valproic acid, warfarin

Question 25

What are the PK and PD changes seen in the elderly?

Answer 25

Increased pH, decreased motility
Decreased total body water, increased body fat
Decreased albumin
Decreased hepatic clearance 
Decreased GFR

Question 26

Which medications are commonly needed to be adjusted in CKD?

Answer 26

Opioids, anti-HTN, and ABXs

Question 27

Which renal formulas overestimate GFR in obese patients?

Answer 27

Cockcroft-Gault and MDRD.

CKD-EPI suggested for obese patients

Question 28

What is medication adherence?

Answer 28

Taking the medication correctly 80% of the time