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13 Cards in this Set
- Front
- Back
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Why is studying variation in individual drug response important?
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Because not everyone reacts to the same drug dose as based on mean values.
Some require a bit less while others require a bit more while others do not respond at all. It is based on a mean response, not applicable to every individual. |
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What are the four areas that can lead to individual variation?
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1) Compliance: Did the patient take the drug as prescribed?
2) Absorption: Was the drug absorbed by the body and did it enter the systemic circulation? 3) Pharmacokinetic Variation: Was the drug delivered to where it needed to go and reach the target site of action? 4) Pharmacodynamic Variation: Did the tissues respond to the drug as they needed to? |
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Where do you see compliance the highest? And the lowest?
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Compliance is the highest for short-term preventative medicine, if disease is perceived to be serious and if good relations with physician.
It is the lowest for long-term preventative medicine, if disease is: - symptom free or - if complicated drug schedule, like taking with food or - several times throughout the day (shorter half-lives) if the drugs produce undesirable side-effects |
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What does compliance refer to?
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When a patient does not take a dose at the right amount or time as indicated by the physician. So drug can't affect appropriate effect.
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How can a doctor check for compliance?
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Asking patients to keep drug diaries, do blood tests, do interviews, check how many pills they have every time they come in for a check-up.
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Does age affect compliance?
Does mental health also affect compliance? |
Yes, elderly people have more complicated health concerns that can require more than one drug, and therefore, have a complex drug regime.
They can forget because of memory loss. Yes, mental health affects compliance. A person with schizophrenia can forget to take a drug due to their condition. So the responsibility is assigned to a family member. |
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Do demographic factors or the type of disease have anything to do with compliance?
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Not really. Age, sex, socio-economic status do not impact compliance and neither does the type of disease.
It's only those diseases that are long-term (e.g. hypertension) or chronic or require more than one drug and elderly that can forget to take drugs. |
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What are some things that pharmaceutical companies do to increase compliance?
What is the disadvantage of that? |
They can package drugs for patients with more than one illness in one packet. Makes it easier to take.
However, less flexibility in personalizing and adjusting the dosages for each drug. |
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What would have greater bioavailability: a syrup/solution or a pill?
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Most likely a solution/syrup.
A lot of pills have packers/fillers which can affect how quickly they dissolve and release the drug. If they do not dissolve fast enough, then the drug can go out through the feces. |
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How does body composition affect drug pharmacokinetics?
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It affects drug distribution. A obese person may need a larger dose of lipid-soluble drug as compared to that of a lean person, but may have a prolonged storage time.
An obese person may need the same amount of water-soluble drug as a lean person. It is important drugs as given on a mg/kg basis where appropriate to achieve same concentration levels in blood. |
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Is penicillin usually allowed to cross the blood-brain barrier? So does it affect its distribution?
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No.
But it can during disease such as meningitis. So disease affects its distribution. |
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What are the two ways for calculating dosages in children?
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Young's rule and the body surface area method. Drug doses are really calculated to body surface area, not so much to mg per kg. But for adults it doesn't matter too much. For kid's, it is quite impactful.
The younger the child, the better the surface area method. Young's rule: Age / Age + 12 (Fraction of adult dose) Surface area rule: 1.5 x body weight kg + 10 (Percent of adult dose) |
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What are some factors that contribute to how a target tissue responds to a drug?
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Genetics
Diseases Previous drug use history that can cause tolerance, cross-tolerance (alcoholics/ethanol can make it hard for people to respond to anesthesia) Current adverse drug responses |
