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
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
