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Critically Ill Exam 2 > PKPD > Flashcards

PKPD Flashcards

1
Q

Male patients with what urine CrCl are considered to be in augmented renal clearance?

A

> 130

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2
Q

Female patients with what urine CrCl are considered to be in augmented renal clearance?

A

> 120

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3
Q

What are some consequences of ARC in regards to treatment?

A
  1. Sub therapeutic concentrations
  2. Treatment failures
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4
Q

What can decreased perfusion/blood flow decrease?

A

Absorption via any non IV route

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5
Q

True or False: clearance is used to determine loading doses not Vd

A

False

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6
Q

An increase in fluid volume can cause a ______ in Vd

A

Increase

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7
Q

An increase in capillary permeability leads to a _____ in Vd

A

Increase

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8
Q

________ drugs tend to have a wider distribution and tend to stay within the intravascular space

A

Lipophilic

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9
Q

What is the normal range of albumin?

A

3.5-5 g/dL

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10
Q

What is hypoalbuminemia typically referred to as?

A

<2.5 g/dL

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11
Q

What is the total level range for phenytoin?

A

10-20 mg/L

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12
Q

What is the free range for phenytoin?

A

1-2 mg/L

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13
Q

What is x in the phenytoin equations for patients with hypoalbuminemia?

A

0.2

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14
Q

What is x in the phenytoin equations for patients with hypoalbuminemia and ESRD or HD dependent?

A

0.1

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15
Q

What level should you always use if you have it?

A

Free level

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16
Q

What is the valproic acid total range?

A

50-100 mcg/mL

17
Q

What is the valproic acid free range?

A

6-22 mcg/mL

18
Q

Hypoalbuminemia with antibiotics has a potential for causing what?

A

Underdosing

19
Q

Why are loading doses usually given?

A

To rapidly achieve therapeutic concentrations

20
Q

To optimize concentration dependent antibiotics, what should be maximized?

A

Peak:MIC ratio

21
Q

To optimize time dependent antibiotics, what should be maximized?

A

t>MIC

22
Q

Highly _______ drugs and highly ______ drugs tend to become sequestered within the ECMO circuit

A

Protein bound; lipophilic

23
Q

The ECMO circuit leads to ______ systemic concentrations

A

Lower

24
Q

What are the 3 most lipophilic analgesics/sedatives that may require higher dosing due to the ECMO circuit?

A
  1. Fentanyl
  2. Midazolam
  3. Propofol
25
Q

What are the 4 most lipophilic antibiotics that may require higher dosing due to the ECMO circuit?

A
  1. Fluoroquinolones
  2. Zosyn
  3. Ceftriaxone
  4. Vancomycin
26
Q

What should patients on ECMO have?

A

Anticoagulation

27
Q

ECMO patients need more or regular DVT prophylaxis?

A

More (full anticoagulantion)

28
Q

The duration of action of single or isolated IV doses in critically ill patients is more a function of _____ than _______

A

Distribution; Clearance

Critically Ill Exam 2 (7 decks)

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