Study Set Content:
FACTORS AFFECTING PROTEIN BINDING INCLUDE THE
FOLLOWING:
Albumin concentration:
Alpha 1 -acid glycoprotein concentration:
Capacity-limited protein binding:
Binding to red blood cells
are
extensively bound to plasma albumin.
phenytoin, salicylates, and disopyramide
Albumin levels are low in
many disease states, resulting in
lower total drug concentrations.
It is increased in acute
inflammatory disorders and causes major changes in total plasma
concentration of these drugs even though drug elimination is
unchanged.
Quinidine, lidocaine, and propranolol.
The binding of drugs to plasma proteins is capacity-limited.
Therapeutic concentrations of s(blank) show
concentration-dependent protein binding.
alicylates and prednisolone
bind extensively
inside red blood cells.
as cyclosporine and tacrolimus
An accurate (blank) is essential if one is to
obtain maximum value from a drug concentration
measurement.
dosing history
In fact, if the dosing history is unknown or
incomplete, a drug concentration measurement
loses all
predictive value
Absorption usually occurs during the first (blank)
after a drug dose and varies according to food
intake, posture, and activity.
2 hours
It is important to avoid drawing (blank) until absorption
is complete
blood
Attempts to measure peak concentrations early after
oral dosing are usually (blank)and
compromise the validity of the measurement,
because one cannot be certain that absorption is
complete
unsuccessful
Some drugs such as (blank) take several
hours to distribute to tissues.
digoxin and lithium
samples should be taken at least 6 hours
after the last dose and lithium just before the next
dose (usually 24 hours after the last dose).
Digoxin
distribute quite rapidly, but it is still
prudent to wait 1 hour after giving the dose before
taking a sample.
Aminoglycosides
Volume of distribution is commonly calculated for a
particular patient using
body weight
If a patient is obese, drugs that do not readily
penetrate fat (eg, gentamicin and digoxin) should
have their volumes calculated from
fat-free mass
(WT)
Total body weight
(HTM) is in meters.
Height
Patients with (blank)
offer a larger volume of distribution to the
aminoglycoside antibiotics (eg, gentamicin) than is
predicted by body weight.
edema, ascites, or pleural effusions
Drugs cleared by the renal route often require
adjustment of clearance in proportion to
renal function
