CC2 TDM PT 1

• Antibiotics and anti-depressants have a narrow therapeutic index or marked pharmacokinetic
• Most drugs have a half-life independent of the dose
• Purpose of TDM

  Ensure that a given drug dosage produces:

  Maximal therapeutic benefit

  Minimal toxic adverse effects
• Therapeutic range


  The line between overdose and underdose
• Common indicators for TDM

  • Provides a basis for establishing optimal dosage
  • The consequence of overdosing and underdosing
  • There is a small difference between a therapeutic and a toxic dose
• Poor relationship between dose of the drug and circulating concentration
• Lower circulating drug concentration may be due to

  • Pregnancy
  • Inflammation
• What type of drug interaction must decrease the dose?

  Synergism
• Ex. Taking Drug A together with Drug B will make Drug B more powerful compared to Drug A

  What type of drug interaction?

  Antagonistic
• Mechanisms by which drugs exert their effects

  Pharmacodynamics
• Study of the action of the drugs on living organisms.

  Pharmacodynamics
• Study of how the body deals with pharmacologic compounds

  Pharmacokinetics
• What the body does to the drug once it is taken

  Pharmacokinetics
• Biologic fate of drugs

  Pharmacokinetics
• Organs responsible for elimination of drugs?

  Liver and kidneys
• Kidney and liver is part of the first order kinetics
• Rate of change of concentration of a drug is dependent on the drug concentration - FIRST ORDER KINETICS
• There is stronger rate of elimination in first order kinetics is due to

  Increased drug concentration
• Constant amount of drug is eliminated per unit of time

  Zero Order Kinetics
• Zero order kinetics depends on the ability of the liver to metabolize the drug
• Rate of decrease is different from one another

  First order kinetics
• No matter how many drug concentrations = same rate of elimination

  Zero Order kinetics
• What is direct and fastest route of administration?

  Intravenous
• Slowest route of administration?

  Intramuscular
• Pharamacological parameter which means release of the drug

  Liberation
• Absorption is the transport of the drug from the site of the administration to the blood.
• delivery of the drug to tissue

  Distribution
• Metabolism refers to the process of chemical modification of drugs
• The amount of drug that reaches the target organ is known as bioavailability
• Process by which the drug molecule is taken up into systemic circulation

  Absorption
• Majority of absorption occurs at?

  GIT
• Most drugs are absorbed by passive diffusion
• absorbed in the intestine are weak bases
• weak bases are absorbed in the intestine
• Rapidly absorbed drug

  Liquid solutions
• Where are weak acids absorbed?

  Stomach
• Drug metabolism occurs before the drug enters the systemic circulation is known as

  First Pass Metabolism
• Where does First Pass Metabolism occur?

  Liver
• There is decreased bioavailability in First Pass Metabolism
• 100% bioavailability

  Bypass First-Pass Metabolism