JAWAHARLAL NEHRU TECHNOLOGICAL UNIVERSITY HYDERABAD
JAWAHARLAL NEHRU TECHNOLOGICAL UNIVERSITY HYDERABAD Pharm. D V Year CLINICAL PHARMACOKINETICS AND PHARMACOTHERAPEUTIC DRUG MONITORING Previous Question Paper (June/July – 2022 - R08)
Answer any five questions. All questions carry equal marks.
Main
Define loading dose and maintenance dose. Give equations to calculate the same.
Answer
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 plasma concentration rapidly. It is calculated using the formula:
Where Cp is the target plasma concentration, Vd is the volume of distribution, and F is the bioavailability.
A maintenance dose is the amount of drug administered at regular intervals to maintain the steady-state plasma concentration within the therapeutic window. It is calculated using the formula:
Where Css is the steady-state concentration, Cl is the total body clearance, τ is the dosing interval, and F is the bioavailability.
Define pharmacokinetics. Name and define three pharmacokinetic parameters that describe a typical plasma level time curve.
Answer
Pharmacokinetics is the study of the time course of drug absorption, distribution, metabolism, and excretion (ADME) in the body. Three key parameters describing a plasma level-time curve include:
- Area Under the Curve (AUC): Represents the total integrated exposure of the drug in the plasma over time, reflecting the extent of drug absorption.
- Peak Plasma Concentration (Cmax): The maximum concentration of the drug observed in the plasma after administration, indicating the intensity of the drug effect.
- Time to Peak (Tmax): The time required to reach the Cmax, which serves as an indicator of the rate of drug absorption.
Add a note on BEER’s criteria for drugs to be used in geriatric patients.
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The elimination half-life of an antibiotic is 3 hrs with an apparent volume of distribution equivalent to 20% of bodyweight. The usual therapeutic range of this antibiotic is between 5-15 μg/ml. Calculate the dose and dosing interval that will just maintain the therapeutic concentration.
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Explain the effect of inhibition of biliary excretion of drugs and list out the drug interactions which influence the biliary excretion.
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Discuss drug interactions related to protein binding and metabolism.
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Explain the reasons for monitoring drug levels.
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Describe the protocol for TDM of a drug.
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Describe the methods of measurement of GFR and their significance.
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An adult male patient (52 years old, 75 kg) whose serum creatinine is 2.4 mg/dL is to be given gentamicin sulphate. The usual dose of gentamicin in adult patients with normal renal function is 1 mg/kg every 8 hours by multiple IV bolus injections. Calculate the appropriate dosage regimen of gentamicin sulfate for this patient.
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List the methods used for the population pharmacokinetic model evaluation.
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What do you understand by Goodness of Fit plot?
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Describe the genetic polymorphism in CYP2D6 and 2C9 isozymes.
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With suitable examples, enumerate drug dosing in genetic dependent fast acetylators.
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Discuss the effect of Hepatic disease on pharmacokinetics.
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Give a note on extracorporeal removal of drugs.
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