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Pharmacodynamics-DPA
Duke PA pharmacodynamics
Question | Answer |
---|---|
What is EC? | Effective concentration - potency. |
What is EC50? | 50 |
What is efficacy? | Maximal effect of drug - ceiling effect |
What is ADR? | harm caused by drug @ normal dose w/ normal use |
What is ADE? | Injury resulting from use of drug |
What is the criteria for true ADR? | 1. Reasonable temporal sequence 2. Known response pattern 3. Improvement on dechallenge 4. Reappearance on rechallenge |
Definte cause-effect in ADR | meets criteria 1-4 |
Probable cause - effect in ADR | meets criteria 1,2,3 |
Possible cause - effect in ADR | 1,2 |
Conditional cause - effect in ADR | 1 |
Doubtful cause - effect in ADR | does not meet any criteria |
What are the four types of drug allergies? | 1. Immediate or Anaphylactic 2. Cytotoxic 3. Immune complex 4. Delayed-hypersensitivity |
What antibodies mediate type 1 allergy? | IgE |
What antibodies mediate type 2 allergy? | IgG and IgM - target cells in circulatory system |
What antibodies mediate type 3 allergies? | IgG - destructive inflammatory response |
What type of cells are activated in type 4 allergy? | Memory T-cells - active & produce inflammatory response |
Additive | 1+1 = 2 |
Syngergistic | 1+1=3 |
Potentiation | 0+1=2 |
Antagonism | 1+1=0 |
What 3 factors is pediatric dosing based on? | age, weight or surface area |
Body water in peds vs. adults | increased body water |
body fat in peds vs. adults | decreased body fat |
What happens to Vd in neonates for water soluble drugs? | Increased Vd |
What happens to Vd in neonates for lipid soluble drugs? | decreased Vd |
Drug biotransformation in neonates | Decreased for most drugs |
Drug biotransformation ages 1-5 | increases (can exceed adults) |
Drug biotransformation after puberty | declines to adult values |
At what age are Phase I reactions mature? | 6 months |
At what age are Phase II reactions mature? | a few years |
Neonatal kidney function | immature - increased t1/2 of various drugs |
gastric pH in elderly? | increased |
acid secretory capacity in elderly? | decreased |
GI blood flow in elderly? | decreased |
Total body water in elderly? | decreased |
Total body fat in elderly? | increased |
Lean mass in elderly? | decreased |
Vd in elderly for water soluble drugs? | decreased |
Vd in elderly for lipid soluble drugs? | increased |
Serum albumin in elderly? | decreased 15-20 |
Hepatic function inelderly? | declines |
Phase 1 in elderly? | decreased |
Phase II in elderly? | little change |
Renal function in elderly? | declines starting @ age 30 |
What is Beers' criteria? | criteria for determining potentially inappropriate medication use in adults 65 years and older |
GI motility in pregnancy? | reduced |
gastric pH in pregnancy? | increased |
maternal plasma volume in preg.? | increases 40-50 |
plasma albumin in pregnancy? | decreased |
renal blood flow & GFR in pregnancy? | increased |
What is a teratogen? | agent that can cause malformations of an embryo or fetus |
What is pregnancy category A? | well controlled studies - no fetal risks |
What is preg. Category B? | animal studies - no risk, no trials in women |
What is preg. Category C? | animal stuides adverse fetal effects, no trials in women |
What is preg. Category D? | Some fetal risk, benefits may outweigh risk, warn patient. |
What is preg. Category X? | fetal abnormalities - extreme risk, no benefit worth risk |