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MLT Toxicology

What is the purpose for drug monitoring? ID non-compliance; Ascertain effectiveness of dosage; verify therapeutic range; Maximize therapeutic benefit and minimize adverse toxic reaction
The body sees drugs, etc as______. foreign material/toxins
List the four general processes of metabolism. Absorption; Distribution; Metabolism; Excretion
What are the 3 routes toxins/drugs are absorbed? orally; rectally; parenterally (IV, IM)
What is a metabolite? By product of metabolism or digestion
Which stage in the process of metabolism must the drug traverse the membrane when it reaches the tissue site? Distribution
How does the body interpret drugs? Foreign material
How are soluble and insoluble drugs excreted from the body? Soluble drugs are excreted through the kidneys, and insoluble drugs must first be converted to soluble by the liver before it can be excreted by the kidneys.
Why do neonates have little capacity to eliminate drugs? immature liver and kidneys
For children the dose is____the adult dose. 2x; due to very active drug disposition (metabolism)
In the elderly drug disposition is________. Decreased
Elderly have decreased drug disposition due to: dec albumin 9carrier protein); dec metabolic rate; effects of disease
How does pregnancy affect drug disposition? Hormonal chnages; Increased fluid volume
How does disease affect drug disposition? hepatic function; cardiac capacity; renal function
What is the admin data needed for drug testing? PT name, SSN, DOB, sex; date and time of colection; date/time of last dose; amt of last dose; name of drug; PT diagnosis;
Which is most important of the admin data? Time
What are the sample requirements in drug testing? Non hemolyzed serum/ plasma
What guidelines should you consider on collection? trough, peak
prior to dose, drug concentration lowest level trough
60 min after dose highest level of concentration peak
How do you store drugs? Centrifuge samples; seperate serum/plasma from cells ASAP; most drugs/metabolites stable several days @ RT
Detects wide variety of drugs? TLC
Better ID of drugs than TLC? GC
Further specificity & extreme sensativity. MS
Measure drugs simultaneously (slow) HPLC
Which methodology uses carrier gas to seperate compounds? Gas Chromatography
Which methodology id the method of choice? EIA--uses enzyme
Effcective smooth muscle relaxant theophylline
Helps to treat asthma & copd theophylline
Stimulates CNS, inc resp rate principle of theophylline
10-20 ug Therapeutic range (theophylline)
70% absorbed orally Digoxin
Improves cardiac contractions in CHF Digoxin
Reported in ng/ml Digoxin
Timing for Digoxin Collect 8 hrs after dose
Corrects ventricular arrythmias associated with MI, cardiac surgery, and digitalis intoxication Lidocaine
Not given orally lidocaine
Toxic > 6.0 ug/ml Lidocaine
Treatment and therapy for febrile seizures and neonatal seizures phenobarbital
Primary drug in tx of absence (Petit-mal) and myoclonic seizures Valporic Acid
Name 2 anti-eppileptics phenobarbital;valproic acid
Multirpose antibiotic Chloramphenicol
Used to treat certain Rickettsial Infxns Chloramphenicol
Given to penicillin allergic PTs w/ bacterial meningitis Chloramphenicol
Prevents cell wall synthesis Vancomycin
Used aganinst S. Epi and S. Aureus Vancomycin
Anibiotic against GPC/GPR Vancomycin
Measure amt of NADH Ethanol
Reactive Enzyme Assay Methodology Ethanol
Salicylate is also known as... Aspirin
Created by: Nsikanete