Term
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Definition
| Time course of A, D, M, E |
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Term
| Clinical Pharmacokinetics |
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Definition
| Application of PK principles to safe and effective therapeutic management of drugs in an individual patient |
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Term
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Definition
Study of biological effects resulting from the interaction between drugs and biological systems
(relationship between drug concentration and response) |
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Term
| Goals of Pharmacokinetic Monitoring |
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Definition
1) Optimize drug therapy for individual patients
2) Use PK and pharmacodynamic principles to guide drug therapy
- decrease toxicity w/o also decreasing efficacy
- increase efficacy w/o increasing toxicity |
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Term
| Clinical Pharmacokinetic Principles |
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Definition
- Kinetic homogeneity (predictable relationship btwn plasma drug concentration and concentration at the site of action/receptor site
- these principles often ASSUME that plasma concentration is directly related to tissue concentration |
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Term
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Definition
- Drug concentration range in which the probability of clinical response is high and probability of unacceptable toxicity is low
- Plasma concentration range that is safe and effective in treating specific diseases (desired effect seen within this range, subtherapeutic, supratherapeutic)
- Predicting response to drug (PK and Phamacologic response characteristics) |
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Term
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Definition
Selectivity of the drug in producing the desired vs. adverse effects
- Mean Effective Dose (ED50): dose required to produce an effect in 50% of population. OR the dose that produces 50% of the maximum effect
- Median Lethal Dose (LD50): median lethal dose (animal studies)
TI= LD50/ED50 |
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Term
| Clinical Therapeutic Index |
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Definition
| Drug dose/concentration required to produce toxic effects compared to concentration required to produce desired effects |
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Term
| Factors affecting response |
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Definition
1) concentration of drug at receptor site
2) other factors
3) interpatient variation in drug effect |
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Term
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Definition
Doses that maximize drug effects and minimize adverse effects
-Adverse effects usually occur at doses greater than the minimally effective dose and increase in frequency and/or severity with increasing doses
-treat with dose that provides the greatest effect with the fewest adverse effects |
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Term
| Min and Max Effective Dose |
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Definition
Min Effective Dose: dose that produces some detectable effect
Max Effective Dose: dose beyond which there is no additional effect |
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Term
| Area Under the Curve (AUC) |
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Definition
| an estimate of the range of concentrations over which a drug is effective |
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Term
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Definition
Potency= amount of drug needed to achieve desired effect
Tolerance= effectiveness of drug decreases with continued use
PK: increased drug metabolism --> decreased drug concentration
PD: receptor downregulation --> same concentration of drug results in reduced effect |
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Term
| Therapeutic Drug Monitoring |
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Definition
| the use of assay procedures for determination of drug concentrations in plasma (interpretation and application to develop safe and effective drug regimens) |
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Term
| Therapeutic Drug Monitoring: ADVANTAGES |
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Definition
1) more rapid achievement of therapeutic drug concentration
2) maximize therapeutic benefits
3) minimize toxicity |
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Term
| Therapeutuc Drug Monitoring: When to use and when not to use |
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Definition
Use when:
-good correlation btwn pharmacological response and plasma concentration
-wide intersubject variation in plasma concentration
-narrow therapeutic index
-no simple means to measure response
Don't use when:
-no well defined plasma conc range
-cannot account for metabolites
-toxic effects occur at low and high concentrations
-no significant consequences associated with high or low concentrations |
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Term
| Things to consider when interpreting TDM Drug Data |
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Definition
Patient Factors:
-interpatient variability of ADME
-Presence of diseases/physiological states that alter ADME
-Drug interactions
Other things to consider:
-kinetic homogeneity
-serum drug concentration vs. concentration at site of action (better correlation btwn serum conc and drug effects than dose and drug effects)
-dosage adjustments should be made based on pharmacological response and patient factors
-dosage adjustments should NOT be based solely on drug concentrations (treat the patient, not the lab value!)
-pharmacokinetic properties of drug in THIS patient (at SS? reasons for altered PK and ADME (dz state, drug interaction, nonadherence, draw time, etc) |
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