一般临床药物代谢动力学回顾2(1).pptVIP

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一般临床药物代谢动力学回顾2(1).ppt

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General Clinical PharmacokineticsReview 2 University of Florida Working Professional Doctor of Pharmacy Program Christine Crain,Pharm.D., BCPS Clinical Question? Answer to Clinical Question Drug Elimination Hepatic Clearance Hepatic Clearance Hepatic Clearance Hepatic Clearance Intrinsic Clearance Clinical Question? Clinical Question? Answer to Clinical Question Half-Life Steady State Steady State Clinical Question? Answer to Clinical Question Clinical Question? Answer to Clinical Question Clinical Question? Answer to Clinical Question Elimination Rate Constant (ke) First-Order Elimination Elimination Rate Constant Elimination Rate Constant Clinical Question? First Order Elimination Answer to Clinical Question Relationship Between Drug Elimination and Half-life Answer to Clinical Question Clinical Question? First-Order Equation Answer to Clinical Question Maintenance Dose Equation Relationship Between Clearance, Vd and Half-life LD vs MD Equations Clinical Question? Answer to Clinical Question Answer to Clinical Question Renal Elimination Creatinine Clearance Estimated Elimination Rate Constant for Aminoglycosides Clinical Question? Answer to Clinical Question Answer to Clinical Question Desired Trough = 0.5 mcg/ml Est. ke = 0.0024 (CrCl) + 0.01 Est CrCl = 48 ml/min (x 0.85 for female) = 40.8 ml/mn (Please use 48 ml/min as the CrCl for this question since the author neglected to multiply by 0.85 for female and the calculations continue on using 48 ml/min.) Est ke = 0.0024 (48) + 0.01 = 0.125 Answer to Clinical Question Answer to Clinical Question Sampling Considerations in Therapeutic Drug Monitoring Ct = Co x e -ke t The half-life of digoxin is approximately 40 hours. ke = 0.693 t 1/2 = 0.0173 /hr Ct = Co x e -ke t 1 = 5 x e - .0173 t t = 93 hours ko = Css x CLs MD = Css x CLs CL = ke x Vd MD = Css x ke x Vd CL = 0.693 t 1/2 Vd LD = Cp x Vd MD = Css x ke x Vd A 50 year old man is to be started on a maintenance dose o