Unit 4 Pharmacology: Pharmacokinetics Continued

Question 1

what does an extraction ratio of 1 mean

Answer 1

that 100% of the drug delivered to the clearing organ is removed

Question 2

what is considered a high hepatic extraction ratio

Answer 2

> 0.7

Question 3

drugs that have low hepatic extraction ratios

Answer 3

rocuronium
diazepam
lorazepam
thiopental
theophylline
phenytoin

Question 4

drugs that have intermediate hepatic extraction ratios

Answer 4

midazolam
vecuronium
alfentanil
methohexital

Question 5

drugs that high have hepatic extraction ratios

Answer 5

fentanyl
sufentanil
morphine
meperidine
naloxone
ketamine
propofol
lidocaine
bupivicaine
metoprolol
propanolol
alprenolol
nifedipine
diltiazem
verapamil

Question 6

how must you adjust PO dose to compensate for first pass

Answer 6

increase PO dose

Question 7

describe a characteristic most drugs that undergo enterohepatic circulation have in common

Answer 7

tend to have a long duration of effect (diazepam, warfarin)

Question 8

examples of enzyme inducers

Answer 8

tobacco smoke
barbiturates
ethanol
phenytoin
rifampin
carpamazepine

Question 9

examples of enzyme inhibitors

Answer 9

grapefruit juice
cimetidine
omeprazole
isoniazid
SSRI’s
erythromycin
ketoconazole

Question 10

which opioids utilize the CYP3A4 pathway

Answer 10

fentanyl
alfentanil
sufentanil
methadone

Question 11

which opioids utilize the CYP3A4 pathway

Answer 11

midazolam
diazepam

Question 12

which LA’s utilize the CYP3A4 pathway

Answer 12

lidocaine
bupivicaine
ropivicaine

Question 13

which drugs utilize the CYP2D6 pathway

Answer 13

codeine
oxycodone
hydrocodone

Question 14

which drug utilizes the CYP1A2 pathway

Answer 14

theophylline

Question 15

role of organic anion and cation transporters in proximal renal tubules (OAT and CAT’s)

Answer 15

actively secrete organic acids and bases into the urine

Question 16

OAT’s (organic anion transporters) meds include

Answer 16

furosemide, thiazide diuretics, PCN

Question 17

OCT’s (organic cation transporters) meds include

Answer 17

morphine, meperidine, dopamine

Question 18

what does urine pH determine

Answer 18

whether drugs get excreted into the urine or reabsorbed into the peritubular capillaries

Question 19

what does acidic urine favor (2 things)

Answer 19

reabsorption of acidic drugs
excretion of basic drugs
(AAA= acidic drugs better absorbed in acidic medium)

Question 20

what does basic urine favor (2 things)

Answer 20

reabsorption of basic dugs
excretion of acidic drugs
(BBB basic drugs better absorbed in basic medium)

Question 21

if we alkalinize the urine, we help to eliminate what kind of drugs

Answer 21

acidic

Question 22

if we acidify the urine, we help to eliminate what kind of drugs

Answer 22

basic

Question 23

what are the 4 key metabolic pathways in the plasma

Answer 23

pseudocholinesterase
nonspecific esterases
alkaline phosphatase
hofmann elimination (pH and temp)

Question 24

which drugs utilize pseudocholinesterase for metabolism

Answer 24

succinylcholine
mivacurium
ester local anesthetics (have an i)

Question 25

which drugs utilize nonspecific esterases

Answer 25

remifentanil
remimazolam
esmolol (RBC esterases)
etomidate
atracuium
clevidipine

Question 26

which drugs utiliz ealkaline phosphatase

Answer 26

fospropofol (a pro dug converted to propofol)

Question 27

which drugs utilize hofmann elimination

Answer 27

cisatracurium
atracurium