Lecture 18

1.
What are sytematic (predictable) variations that create differences in PKPD?
"Body size, disease, genotype"
2.
What are random (not predictable) variations that create differences in PKPD?
"Between subject variability, within subject variability"
3.
What is included in predicting clearance levels?= ="Allometry (body size), maturation"
4.
What people have low clearance?
"Heart failure patients, elderly"
5.
Who have an induction in enzymes causeing increase in clearance?
Smokers
6.
What are three dose determinations?
"Population (same dose for all), group, individual"
7.
What is the difference between group and individual dosing?
"Individual is based on response measurements (BP, conc, INR (coagulants)"
8.
Which drugs are hard to measure clinical dose?
"Anti-arrhythmics, anti-convulsants, anti-coagulants"
9.
Why else might TCI be used?
Unpredictable variability
10.
How is target concentation arrived at?
Choose target conc -> determine Vd and Cl -> calculate LD and MDR -> measure PD response -> revise target conc. or: measure PK conc -> revise Vd and Cl -> revise LD and MDR
11.
What type of drugs use PK to determine conc?= ="Aminoglycosides, digoxin"
12.
How to individualise V?
V equals V(pop) x (weight/weight std)
13.
How to individualise clearance?
Cl equals Cl(pop) x (weight/weight std)e3/4
14.
How to calculate LD?
TC x Vd
15.
How to calculate MDR?
TC x Cl
16.
Which drug needs 2 measurements of conc?
Gentamicin
17.
18.