Pharm Review
AKA, STUFF I STOLE FROM DR. ABLES AND DR. OCHS YOU SHOULD KNOW
ALLISON SERDAH, PHARM.D., OMSI
>when acid goes above pka (more basic) going to be charged
>when base goes below pka (more acidic) going to be charged
Ion trapping?
• Low 𝑉𝑑 (4-8 L) mostly in blood
• Mid 𝑉𝑑 (12-14 L) mostly in extracellular
fluid
• High 𝑉𝑑 (> TBW) distributed in all
tissues
Whoo! 93 slides in 17! Next!
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Physical Actions
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Chemical Actions
cAMP, DAG, IP3
Signal convergence
What does this tell you about the safety or efficacy?
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Pharmacokinetic parameters may be altered by:
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Age
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Gender
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Weight
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Disease states (renal & hepatic disease, heart failure)
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Genetics (drug metabolism, CYP450)
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Transport proteins (P-gp)
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Interactions with other drugs/foods
Aminoglycoside antibiotics
STEP 1: 7 mg/kg dose every:
≥ 60 mL/min: q 24h
59 - 40 mL/min: q 36h
39 – 20 mL/min: q 48h
STEP 2: Measure C 6-14h after the infusion
STEP 3:
Vanco
General Ideas for DI
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St. John’s wort and OC’s don’t mix. Some ABX too!
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GFJ, Erythromycin, Clarithromycin, Cimetidine, “Azoles” inhibit 3A4
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Phenytoin, Rifampin Induce big time
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NSAIDS, ACEI’s change renal blood flow
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When in doubt, don’t take with dairy
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P-gp’s a jerk. Watch out with Dig.
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Know your low TI drugs!
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Dig, Lithium, Warfarin. Low bioavailability. Renal and hepatic dysfxn