Glossary of 17. Therapeutic Drug Monitoring
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- What is pharmacology?
- The science of drugs - their origin, kinetics, influence, and therapeutic processes.
- What is pharmacokinetics?
- Study of the bodily absorption, distribution, metabolism, and excretion of drugs.
- What is pharmacodynamics?
- branch of pharmacology dealing with reactions betwn drugs and living systems
- What is toxicology?
- The study of poisons and their effect and the problems involved.
- List the 4 pharmacokinetic process related to change in [drug] with time.
- What 2 factors affect drug absorption?
- -Perfusion of the drug at its absorption site
-Polarity of the drug
- What 3 things related to drug polarity affect drug distrbn?
- -Additional compartments that the drug has to get to (CNS)
-How fat the patient is
- Drug distribution is dependent on what 2 things?
- What is the Vd?
- Volume of distribution; the vol required to contain a distributed dose
- What are 4 factors that can alter the Vd?
- What are the routes of drug elimination?
- -Liver - removes drug from circulation by chemical metabolism
-Renal - in urine
- What is a "Narrow Therapeutic Index"?
- Refers to when therapy drug levels are very close to toxic levels
- What is an example of a drug with a very low TI?
- What is the "first pass effect"?
- Refers to when a drug is significantly metabolized by the liver on its FIRST pass through it; means more has to be given to reach therapeutic levels.
- What could reduce first pass effect?
- Reduced hepatic blood flow in congestive heart failure - means that more drug will be given than thought.
- What is an example of a drug whose CLEARANCE is dose-dependent?
- What is the Half-life of a drug?
- -Affected by Vd and Clearance;
-Time it takes for a drug to reach steady state level.
- How does protein binding affect drug levels?
- -Pharmacologic effect of drug is intended for FREE drug.
-Measurement is of TOTAL drug
-Increased/Decreased Protein levels will alter the amt measured AND distributed.
- Give an example of drug interference:
- Quinidine reduces Digoxin clearance
- how many doses does it take to reach steady state drug concentration?
- What is therapeutic range based on?
- Graphing Drug concentration vs. Toxicity
- What is digibind?
- Anti-digoxin antibody
- What are the aminoglycosides?
- Amikacin, gentamicin, kanamycin, etc.
- What are the aminoglycosides prescribed for?
- gram negative aerobes
- How are aminoglycosides toxic?
- Nephrotoxic and ototoxic - they concentrate at the kidneys during clearance.
- What are the Anti-arrythmics?
- What is another name for Phenytoin?
- What are the anti-convulsants?
- 1. Phenytoin
2. Valproic acid
- What's another name for Carbamezapine?
- What is methotrexate?
- An anti-cancer drug
- What are the anti-depressants?
- What is Digoxin?
- A Cardiac glycoside used to increase cardiac output
- What is another name for digoxin?
- Digitoxin, Lanoxin
- What is Theophylline?
What is it prescribed for?
- -An Anti-asthmatic
-Prescribed for Bronchospasms and neonatal apnea
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