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BCPS study guide

Pharmacokinetics - equations and therapeutic ranges mostly

goal range for flucytosine 50-100 mcg/ml
goal range for digoxin 0.8-2.0 mcg/L [typically 1.2 is the upper limit]
goal range for valproic acid 50-100 mg/L
Formula for loading dose [Peak] * Vd / bioavailability
formula for the elimination rate constant or slope [ln (y1)- ln (y2)] / x1-x2
formula for volume of distribution dose/change in concentration = bioavailability * dose / peak conc (bolus) = rate of infusion / k* Css
formula for peak concentration peak conc = concentration / e^kt t=time from peak for concentration.
formula for bioavailability F= [DOSEiv * AUCpo] / [DOSEpo * AUCiv]
relationship between the elimination constant k, VD and clearance Cl=k*VD
formula for half life t1/2=0.693/k
in what way do isozymes affect fluconazole at doses above 400 mg/day you get 3A4 inhibition but lower doses only have 2C9
Cockcroft -Gault formula for CrCl CrCl=[(140-age)*TBW]/Scr*72 Women get 80% of total AdjBW if BMI >25 actualBW if BMI <18.5 all others use IBW
formula for IBW men=50+2.3 for each inch over 5 ft women 45.5 +2.3 for each inch over 5 ft
what population is the schwartz eqn designed for peds
what GFR equations work for pts with renal dysfunction MDRD and CKDepi. MDRD is limited to pts with CrCl < 60 only.
drugs that compete with creatinine for secretion in pts resulting in false elevations in Creatinine clearance trimethoprim, cimetidine, fibric acid derivatives OTHER than gemfibrozil, dronedarone
what does the hill eqn measure relationship btn drug response and concentration
hysteresis conc late after dose has diff effect than early with same conc
causes of counterclockwise hysteresis loop delayed equilibrium between plasma and site of action, active metabolite, sensitization, Ex: digoxin
causes of clockwise hysteresis loop tolerance, formation of inhibitory metabolite, faster equilibrium between arterial blood supply and site of action than venous and site of action. Ex: cocaine and pseudoephedrine
goal ranges, free and total for phenytoin free=1-2 total=10-20
calculation for phenytoin adjustment in changing albumin Cp=[Cp' / (0.9*Alb/4.4)]+1
calculation for phenytoin adjustment in CKD AND changing albumin Cp=Cp' / [(0.48*0.9*Alb/4.4)+1]
calculation for phenytoin adjustment in CKD Cp=Cp'/0.5
what is the effect on digoxin in pts with renal insufficiency Vd decreases. need to decrease BOTH loading dose and maintenance dose. typically loading doses ok to keep same but not in this case due to lower VD for digoxin.
therapeutic range for aminoglycosides peak 4-10, trough <2 amikacin 20-30 trough amikacin <10
phenobarbital therapeutic range 15-40 mg/L
therapeutic range for lithium 0.3-1.3 mmol/L
therapeutic range for carbamazepine 4-12 mg/L
therapeutic range for cyclosporine 100-250 mcg/L
theophylline therapeutic range 10-20 mg/L
concentration or time dependent killing for aminoglycosides concentration
concentration or time dependent killing for vancomycin time dependent though some concentration dependence as well
Created by: mjuhlin



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