PHA Third Exam. Fall On my honor, I have neither given nor received unauthorized aid in doing this assignment.

Transcription

1 Nm: UFI: PHA 527 hird Exm Fll 203 On my honor, I hv nihr givn nor rcivd unuhorizd id in doing his ssignmn. Nm Qusion/Poins S I 25 S II 25 S III 25 S IV 20 S V 20 S VI 5 S VII 0 ol 40

2 Nm: Qusion S I (25 poins) UFI:. Pls slc h ORRE nswr(s) for mulipl dos, shor-rm inrvnous infusion scnrio from h choics givn blow. (5 poins) ) h shorr drug s hlf-lif, h lrgr h flucuion 2) h fsr drug is clrd, h smllr h flucuion 3) For givn dosing inrvl (u), h slowr h drug dos is infusd, h lowr h p plsm concnrion 4) h lrgr h dos for dfind dosing inrvl, h highr h p concnrions will b 5) For givn dos, h longr h dosing inrvl, h smllr h flucuion. A., 3, 4 B., 2, 3, 4. 2, 3, 4, 5. All of h bov E. Non of h bov 2. A 500mg dos of drug Z is givn vry 2 hours s n inrvnous bolus injcion unil sdy-s lvls r rchd. A sdy-s, h AU for on dosing inrvl is 36 mg/l*h. Wh is h vrg concnrion for h dosing inrvl? (5 poins) A. 2.ug/mL B. 3ug/mL. 3.5ug/mL. 4.ug/mL E. Non of h bov 3. A pin ws givn 00mg of gnmicin vi consn r infusion ovr hour vry 8 hours. His p plsm concnrion sdy-s ws drmind o b 9mg/L. Wh will his plsm concnrion b 4 hours fr h sr of h ls infusion givn h drug s hlf-lif of 5 hours? (5 poins) A. 3.93mg/L B. 4.32mg/L. 5.93mg/L. 6.72mg/L E. 7.4mg/L 2

3 Nm: UFI: 4. A 30-yr-old ml (7g) is dmid o h hospil for colcomy. H dvlops pos-opriv wound infcion nd is pu on vncomycin. Pls ssum for your clculions h vncomycin is solly limind vi h idnys (filrion only) nd h h volum of disribuion is 0.8L/g. Furhr ssum h vncomycin is 35% plsm proin bound nd h h pin s glomrulr filrion r is 9mL/min. Pls compu n ppropri dosing inrvl o chiv sdy-s p nd rough concnrions of 25mg/L nd 0mg/L, rspcivly, following -hour infusion. (0 poins) A. Evry 4 hours B. Evry 6 hours. Evry 8 hours. Evry 2 hours E. Evry 24 hours 3

4 Nm: Qusion S II (25 poins) UFI: onsidr h following quion: You join nw compny nd your suprvisor lls you o wor on nw drug bou which you now only h following informion: i is givn s shor-rm infusion ( hour) vry 8 hours nd is hlf-lif is 7 hours. On h bubbl sh mr A for ru or B for fls. 5. F Flucuion will b 2 6. F hr is insufficin informion o compu h volum of disribuion 7. F rug inpu ino h sysmic circulion is in his cs chrcrizd by firs ordr procss 8. F Hlf of h dminisrd dos is limind during ch dosing inrvl sdy-s 9. F If quls Ƭ minus, h rough concnrion will b hlf of h h p concnrion 4

5 Nm: Qusion S III (25 poins) UFI: 0. Pls slc h corrc nswr rgrding wo-comprmn body modl from h choics givn blow. (0 poins) ) Mcro consns cn b usd o chrcriz h concnrion-im profil 2) h concnrion-im profil of wo-comprmn modl is rprsnd by bixponnil curv 3) B is h rminl liminion hlf-lif 4) h mhod of rsiduls (fhring) cn b usd o compu h r consn of drug disribuion ino priphrl issus 5) Xp ypiclly rprsns h moun of drug in h cnrl comprmn following prnrl drug dminisrion A. 2, 4 B., 2, 4. 2, 3, 4, 5., 2, 3, 4 E. Non of h bov. A 65-g pin is srd on coninuous inrvnous consn r infusion of hophyllin 40mg/h. His rspciv sdy-s concnrions r drmind o b 0mg/L. If you ssum h hophyllin disribuion volum o b 40L, wh would b h pin s plsm concnrions 0 hours fr h coninuous infusion is soppd (pls ssum h sdy-s hd bn rchd prviously for your compuions)? (0 poins) A. 2.5mg/L B. 2.9mg/L. 3.7mg/L. 4.8mg/L E. Non of h bov 5

6 Nm: UFI: 2. Wh impc will dcrs in plsm proin binding hv for high-xrcion drug h is solly clrd vi Phs I nd II nzyms in h livr following inrvnous dminisrion? Pls slc h corrc nswr. (5 poins) A. An incrs in hpic clrnc B. An incrs in glomrulr filrion r. An incrs in fr vrg sdy-s concnrions. An incrs in ol sdy-s concnrions E. Non of h bov 6

7 Nm: Qusion S IV (20 poins) UFI: Pls indic whhr h following smns for n orl dosing rgimn r ru (A) or Fls (B). 3. F hr is only drug bsorpion unil p plsm concnrions r rchd 4. F h rminl slop of h concnrion im profil is lwys rflciv of h liminion r consn 5. F If wo formulions of h sm drug r sd nd produc A hs grr bsorpion r hn produc B, produc A will longr im o rch p concnrions (mx) 6. F h im i s o rch p plsm concnrions (mx) is indpndn of h dos nd h orl biovilbiliy 7

8 Nm: Qusion S V (20 poins) UFI: Lisd in h bl r wo propris of cidic drug molculs: RUG h frcion unionizd ph=7.4 nd h priion cofficin of h unionizd form. h biliy o b civly pumpd in (+++) or pumpd ou (---) of h brin by xrmly civ rnsporrs. No civiy o rnsporrs (000) Frcion Unionizd ph=7.4 Priion officin of Unionizd form Molculr Wigh (lon) rnsporr civiy Slc h corrc rn ordr of up r wih which drugs -5 will nr brin issu. A. slowr hn 2 slowr hn 3 slowr hn 4 slowr hn 5 B. 2 slowr hn 4 slowr hn 3 slowr hn 5 slowr hn. slowr hn 4 slowr hn 3 slowr hn 5 slowr hn 2. 2 slowr hn 5 slowr hn slowr hn 3 slowr hn 4 E. Non of h bov 8

9 Nm: Qusion S VI (5 poins) UFI: A drug (lipophilic, unionizd, low molculr wigh) is showing in vrg pronouncd binding o plsm proins of 99%. Bwn-subjc vribiliy of proin binding is pronouncd. I is givn s i.v. bolus injcion. wo pins rciv his injcion. Pin hs much srongr plsm proin binding for h drug (99.995%) hn h scond pin (99.99%). his is h only physiologicl diffrnc bwn h wo pins. 8. Pls indic whhr pin will hv lrgr ( ), smllr ( ) idnicl ( ) vlu hn pin 2 for (5 poins): ol iniil ol plsm drug concnrion ( o ), f u f u V d A. 0, f u f u, V d B. 0, f u f u, V d. 0, f u f u, V d. 0, f u f u, V d E. Non of bov combinions. 9

10 Nm: Qusion s VII (0 poins) UFI: A hydrophilic drug (no n cid, no bs) is clrd hrough rnl nd hpic clrnc (l rn =32.5 ml/min; l o = 40.5 ml/min). Assum GFR of 30 ml/min, Urin flow of.5 ml/min; livr blood flow of 80 L/h(,333 ml/min). 9. F fu of his drug is F l in is.9 L/h 0

11 Symbols Usful Phrmcoinic Equions = dos = dosing inrvl L = clrnc Vd = volum of disribuion = liminion r consn = bsorpion r consn F = frcion bsorbd (biovilbiliy) K 0 = infusion r = durion of infusion = plsm concnrion Gnrl Eliminion r consn ln L Vd 2 ln ln Hlf-lif Vd ln( 2) / L Inrvnous bolus rough (mulipl dos) 0 min Avrg concnrion (sdy s) pss L Orl dminisrion Plsm concnrion (singl dos) F Vd im of mximum concnrion (singl dos) ln mx Plsm concnrion (mulipl dos) F Vd Iniil concnrion 0 Vd Plsm concnrion (singl dos) 0 Plsm concnrion (mulipl dos) 0 P (mulipl dos) 0 mx im of mximum concnrion (mulipl dos) ln mx Avrg concnrion (sdy s) F L lrnc os F l AU l V d Equions/Usful_phrmcoinic_qu_527

12 onsn r infusion Plsm concnrion (during infusion) 0 L Plsm concnrion (sdy s) 0 L lculd clrnc (hiou quion) 2 2 Vd 0 2 L Shor-rm infusion P (singl dos) mx( ) L rough (singl dos) min( ) mx( ) P (mulipl dos) mx L rough (mulipl dos) lculd p mx mx wih mx * = msurd p, msurd im * fr h nd of h infusion lculd rough min min wih min * = msurd rough, msurd im * bfor h sr of h nx infusion lculd volum of disribuion Vd [ mx ( min )] lculd rcommndd dosing inrvl ln mx( dsird ) min( dsird ) lculd rcommndd dos V mx( dsird ) wo-omprmn-body Modl min mx lculd liminion r consn mx ln min wih * mx = msurd p nd * min = msurd rough, msurd ovr h im inrvl b Equions/Usful_phrmcoinic_qu_527 2 AU / b / Vd Vd Vc r rinin lrnc L L cr cr ss ( 40 g) wigh ( ml) 72 p cr ( 40 g) wigh ( fml) 85 p cr Wih wigh in g, g in yrs, crinin plsm conc. in mg/dl nd L cr in ml/min

13 K for minoglycosids K = (rL) Mbolic nd Rnl lrnc E H = lin fub Q l fu H in b l H = E Q = H H QH lin fub Q l fu H in b F H = Q H Q H l in fu b l rn = RBFE = GFR in in ou l rn = l rn = l rn = r of xcrion plsm concnrion R of scrion - R of rbsorpion fu GFR Plsm concnrion Urin flow urin concnrion Plsm concnrion Idl Body Wigh Ml IBW = 50 g g for ch inch ovr 5f in high Fml IBW = 45.5 g g for ch inch ovr 5f in high Obs ABW = IBW + 0.4*(BW-IBW) Volum of isribuion V V P V V P lrnc l os AU l V d V V K P fu fu Equions/Usful_phrmcoinic_qu_527 3

14 For On omprmn Body Modl If h dosing involvs h us of I.V. bolus dminisrion: For singl I.V. bolus dminisrion: 0 V 0 For mulipl I.V. bolus dminisrion: n n( ) V p: = 0; sdy s n rough: = mx ss V ( ) min ss mx ss If h dosing involvs h us of I.V. infusion: For singl shor-rm I.V. infusion: Sinc = for mx mx min V mx ( ) For mulipl shor-rm I.V. infusion sdy s: mx V min mx ( ) Ls modifid 200 :\urrn \ph527_os_op_i\quions\ quions.doc

15 Ls modifid 200 :\urrn \ph527_os_op_i\quions\ quions.doc If h dosing involvs I.V. infusion (mor quions): V (mos gnrl q.) during infusion = so, V (during infusion) sdy s, -, 0 so, L V V pss 0 0 (sdy s) rmmbring 0 nd V L If h dosing involvs orl dminisrion: For singl orl dos: V F ln mx For mulipl orl doss: V F ln mx