JNTU
JNTU Pharm. D V Year CLINICAL PHARMACOKINETICS AND PHARMACOTHERAPEUTIC DRUG MONITORING Previous Question Paper (July/August - 2021 - R08)
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Define clinical pharmacokinetics. What are its applications?
Answer
Clinical pharmacokinetics is the discipline that applies pharmacokinetic principles to the safe and effective therapeutic management of individual patients. It involves the study of the time course of drug absorption, distribution, metabolism, and excretion (ADME) to optimize drug therapy.
Its primary applications include:
- Designing individualized dosage regimens based on patient-specific parameters such as age, weight, renal function, and hepatic status.
- Monitoring plasma drug concentrations to adjust therapy for drugs with a narrow therapeutic index.
- Identifying and managing drug-drug interactions that may alter the pharmacokinetic profile.
- Adjusting therapy in patients with organ dysfunction to prevent toxicity or therapeutic failure.
- Evaluating the clinical significance of pharmacokinetic variability among different patient populations.
Describe drug dose. Differentiate loading dose and maintenance dose with equation to calculate the same.
Answer
A drug dose is the measured quantity of a therapeutic agent to be administered to a patient to achieve a desired pharmacological effect. It is determined by the drug's potency, the patient's physiological state, and the target concentration required for efficacy.
A loading dose is an initial higher dose of a drug that may be given at the beginning of a course of treatment to achieve the target therapeutic concentration rapidly. A maintenance dose is the smaller, repeated dose administered to maintain the drug concentration within the therapeutic range by replacing the amount of drug eliminated during the dosing interval.
The formulas for calculation are:
Half life of an antibiotic is 3 hours; apparent volume of distribution is 30% of body weight. What is the dose required for a 70 kg individual if steady state level of 2.5µg/ml. The drug is given as IV bolus 8 hourly.
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Write a note on factors influencing geriatric and pediatric dosage regimen.
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Describe in detail different pharmacokinetic drug interactions with suitable examples.
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Describe creatinine clearance. Enumerate various formulae for measuring creatinine clearance.
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What is the creatinine clearance of a 30year old female patient with a serum creatinine of 1mg/dl? The patient is 5ft in height and weigh 75kg.
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Discuss in detail the significance of genetic polymorphism on drug metabolism with suitable examples.
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Calculate creatinine clearance in an 65 year old male patient with 90kg body weight and serum creatinine concentration of 1.4mg/dl.
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Explain extracorporeal removal of drugs.
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Describe NONMEM method of analysis.
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Enumerate the influence of drug interaction on drug metabolism with respect to enzyme induction and enzyme inhibition.
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What are cytochrome P450 enzymes? Describe its significance in pharmacokinetics with suitable example.
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What are the effect of age and body weight in individualizing and optimizing dosage regimen?
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The elimination half-life of an antibiotic is 2hrs with an apparent volume of distribution equivalent to 25% of body weight. The usual therapeutic range for this antibiotic is between 5 and 15µg/ml. Adverse toxicity for this drug is often observed at serum concentration greater than 20µg/ml. Calculate a dosage regimen (multiple IV doses) that will just maintain the serum drug concentration between 5 and 15µg/ml.
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