Biliary and Pancreatic Pharmacology Flashcards Preview

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Flashcards in Biliary and Pancreatic Pharmacology Deck (17)
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1
Q

How does hepatic dz affect PK

A

Peak drug conc and duration can inc

Levels of drug with narrow therapeutic index can exceed toxic levels

Reduced effectiveness of prodrugs

2
Q

PLasma protein biding

A

Chronic hep dec bdining of both acidic and basic drugs

3
Q

Bioavail

A

Chronic will inc the bioavailability of many drugs by slowing metabolism and blood flow

4
Q

Why is damage to liver diff to predict for drug dosing

A

Different P450 enzymes are affected

5
Q

Diff drugs

A

Highly extracted drugs are so rapidly metabolized that much of drug disappears in single pass

Rate depends on hepatic blood flow which is dec by hep

6
Q

Adjusting drug dose

A

Lower peak and higher trouh

Easier to do for high therapeutic index

Accounts for dc metabolism

7
Q

Adjusting interval

A

Peak conc is same but the interval is longer

Easier if high therapeutic index

8
Q

3 types of drug-induced liver toxicity

A

Dose-dep
Idiosyncratic
Allergy

9
Q

Elevations in blood of liver enzymes

A

Statins

ABs

10
Q

Hepatitis

A
Acetominophen
Phenytoin
Isoniazid
Diclofenac
AMox
11
Q

Cholestasis

A
Erythro
Bactrim
Amp
Rifam
Estrogen
Anabolic roids
Naproxen
Haloperi
12
Q

Fatty liver

A
Methotrex
Giseo
Tamox
Steroids
Valpro
Amiodaron
13
Q

Cirrhosis

A

Metho
Amioda
Methyldopa

14
Q

Tx of drug-induced liver injury

A

N-acetylcysteine for acetominophen

L-carnitine for valproic

GCs if due to HS

Antihistamine for itching

Bile acid sequestrats for cholestatic

15
Q

Bile acid sequestrants

A

Dec enterohepatic recirculation

16
Q

Ursediol

A

For primary biliary cholangitis

Releases bile from liveri nto smal intestine

17
Q

Pancrelipase

A

Enzyme mixture that imrpoves digestion

Useful for chornic panc, CF< and other conditions

Mix of amylase, lipase and protease

Most of side effects are in GI tract