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Kinetics, pharmacogenomics, stats and economics,

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vitohuxo's version from 2016-06-27 02:07

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Question Answer
kinetics=what human body does to a drug
dissolutionactive ingredient released from the dosage form.
destroyed in gut drugs primarily byhydrolysis
enteric coartedlimits drug degradation in stomach so that released in basic intestine...
micronized make smaller particles so more surface area to dissolve
noyes whitney equationrate of dissolution
only _________ drugs can enter into thebloodstreamdissolved
favors drug distributionhigh lipophilicity, low mw, unionized, low protein binding.
first order eliminationwhen a certain concentration of drug is removed per time
zero order eliminationwhen a constant amount (mg) of a drug is removed per time no matter how much is in the body
michaelis menton kinetics=begins as first order but at higher concentrations the rate of metabolism reaches maxiumum capacity.
kmconc at which the rate of metabolism is half of the maximal
saturable kinetics drugs=phentoin, theophylline, and voriconazole
gene=specific nucleotides code for a single protein
codeine genomicscyp2D6= can be ultra metabolizers, extensive, intermediate, or poor metbolizers into morphine.
carbamazepine genomicsHLA-B*1502= if present then the risk of a severe skin reaction increases from 1% to 5-10%
trastuzumab and genomicsif a breast cancer tumor overexpresses HER2, this medication will be efficacious. must be 2+ or 3+ to use drug
abacivir(ziagen) testinghla-b5701. if positive, do not use because of hypersensitivity reactions
plavix testingcyp29 *2 and *3 alleles - poor metabolizers will not be efficious these people
carbamazepine testingtest in asian patients for hla-b1502 allele= more chance hypersensitivity. do not use these people
cetuximab (erbitux) and panitumumab (vectibix) testingKRAS positive mutation on codon 12 or 13 do not use drug- not effective
afatinib (gilotrif), cetuximab (erbitux), erlotinib (tarceva), and panitumumab (vectibix) testingEGFR protein positive, can use these drugs
imatinib (gleevec) testingif positive, can use drug for CD117 for GI tumors
imatinib, dasantinib, nilotinib, ponatinib, bosutinib testingBCR-ABL positive to use drug- luekemia
maraviroc (selzentry) testingccr5 positive can use drug HIV
rituximab (rituxan) testingpositive can use drug for cancers B cell CD20 expression
allopurinol testing that should be consideredHLA-B *5801 = increased risk skin reactions in korean patients with sig renal impairment, or those han chinese or thai ancestry.
warfarin testing should be consideredcyp 2c9 and vkorc1- increased bleeding risk due to decreased function alleles
means used whendata not skewed, continous data
median used whendata skewed
guassian curvenormal distribution or bell shaped curve. mean, mode, and median would all have similiar values
standard deviation calculated by takingsquare root of the variance
null hypothesisstates no difference between the two groups
p-valueprobability the result was due to chance
95% CI does not include 0 or 1 for odds ratio, risk ratio, or hazard ratio then results aresig at the 0.05 level
type 1 error=null hypothesis is true that there is no difference, yet rejected in error
type 2 error=null hypothesis is false, yet accepted in error.
beta expressed aspower
statistical power isavoiding a type 2 error, probability that the test will reject the null when null false. as power increaes, chance make type 2 error occuring decreaes.
sensitivityproportion time a test is positive in patients who have the disease. percentage of true positive
specificityprop time a test is negative patients do not have the disease. true negative.
case control studcompare patients have disease versus do not. rare disease or outcomes good for....make an association.
cohort studystudy cohort of people over time and compared to group not exposed to intervention such as drug. may be prospective or retrospective.
cost minimization analysistwo or more interventions already demonstrated equivalency in outcome and costs of each are being compared. dollars cost and outcome equivalent
cost benefit analysiscomparing benefits and costs of an intervention in terms of monetary units.cost dollars and outcome is dollars
cost effective analysismain advantage is that outcomes easie to quantify. most common type seen. cost in dollars and outcome is natural units like mmhg blood pressure, life years gained, %at treatment goal
cost utility analysisdollar cost and quality adjusted life years outcome.
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