Tdm Complete Exam Questions With 100% Guaranteed Answers

TDM - correct answers analysis of circulating drugs to ensure maximum therapeutic benefit and minimal toxicity Pharmakinetics - correct answers measurement of drug concentration over time. Influences by absorbption, biotransformation, distribution, elimination Bioavalability - correct answers amount of drug in circulation half life - correct answers time required for drug concentration to be decreased by one half therapeautic range - correct answers concentration between minimum effective and minimum toxic levels kinetic homogeneity - correct answers concentration between minimum is proportional to the concentration of drug at receptor sites steady state - correct answers amount administered= amount eliminated trough levels - correct answers lowest level during cycle, immediately before next dose and provides most consistent results peak levels - correct answers after dose (time varies with mode of administration) free drugs - correct answers binds to drug receptors on/in target cells. Pharmacology active form. bound drugs - correct answers mainly carried by albumin. Changes in serum albumin levels can effect bound and free drug levels (decreased albumin - decreased bound= increased free) 4 factors involving pharmokinetics - correct answers 1)Absorption: process by which drug proceeds from site of administration to blood circulation. Depends on mode of administration 2) Biotransformation (first pass effect): drugs circulating through liver are subjected to uptake and modification eg: activation, inactivation, and excretion, released unmodified 3)Distribution: amount of drug distributed through the tissues and length of time it remains there. Depends on: carrier protein binding, solubility, elimination by liver and kidneys 4)elimination: speed at which drug is inactivated and excreted from the body by the liver or kidneys reaction stages in liver - correct answers 1st stage: chemical modification of reactive groups. Usually enzyme mediated (render active/inactive) 2nd: conversion to more water soluble forms. Usually conjugation with another chemical group First order kinetics - correct answers linear relationship, blood concentration rises and falls in direct proportional to the dose Zero order kinetics - correct answers non-linear near top of their therapeutic range. Small increase in dosage may result in greatly elevated blood level with possible toxic effects eg: phenytoin, salicylates, ethanol and theophylline when to use TDM - correct answers -wide variation in response to drug among individuals -zero order kinetics apply -low therapeutic index -narrow therapeutic range -signs of toxicity difficult to recognize clinically -disease/physiological factors present which may affect drug pharmakinetics -patient non-compliance -drug interaction -usual dose does not give expected therapeutic effects Lab methods for TDM - correct answers -immunoassays most commonly used eg: fluorescene polatization immunoassay (FPIA): flurophore absorbs plane-polarized light it becomes energized and enters on excited state. Patients sample/drug and fluorescin labelled tracer absorbs and emits plane polarized light in proportion to size of molecule. When tracer is bound, rotates slower and has incrased polarization reading. Therefore, amount of drug in sample is inversely proportional to the polarization reading