Applied Pharmacokinetics (TSU)

Digoxin reversal agent is what

DigiFab

what is DigiFab indicated for

life threatening situations or large acute ingestion

higher affinity to digoxin than the Na+/K+ ATPase digoxin receptor site

• irreversibly binds to digoxin

true

digoxin levels cannot be measured for week after digifab administration

true

use is limited or restricted based on cost and indicated

DigiFab

in what drug we should monitor for resolution of arrhythmia and GI adverse effects

DigiFib

DigiFab IV administration

• onset of action 20 mins

• maximal response average 90 mins

true

DigiFab dose is based on whether digoxin dose is known and timing of toxicity

• acute unknown dose

• acute known dose

• chronic unknown dose

• chronic known dose

true

indication: treatment of ventricular arrhythmia is what drug

lidocaine

what class is lidocaine

Class IB antiarrythmic

what is the administration for lidocaine

IV injection

Usual dosing of lidocaine is what

bolus 1 to 1.5mg/kg followed by continous infusion of 1 to 4mg/min

what is the toxic concentration for seizures that have been seen

>9mg/L

Vd for Lidocaine decrease with

CHF

severe trauma and critically ill

Vd for lidocaine increased with

chronic liver disease

-high first pass effect

<5% renal clearance; no adjustment for renal disease

F=0.4

usual clearance= 10mL/kg/min

CHF/ cirrhosis clearance = 6mL/kg/min

clearance of lidocaine

4 to 8 hours after beginning of therapy

levels can be useful in patients in whom minor CNS effects are difficult or impossible to assess

lidocaine time to sample

which of the following factors are likely to affect lidocaine pharmacokinetics

• heart failure

• critical illness

• renal dysfunction

• liver dysfunction

a,b,d

Which statement regarding lidocaine pharmacokinetics is most accurate?

A.Lidocaine levels should be drawn 12 hours after last dose

B.Seizures are usually seen if levels are > 20 mg/L

C.Lidocaine follows a 2-compartment model after an IV bolus

D. Therapeutic levels are between 5-10 mg/L

C

Determine if the following statements regarding digoxin pharmacokinetics are true or false.

A.A pt’screatinine clearance can affect digoxin levels

B.Toxic effects are more likely at levels > 1 mcg/L

C.Amiodarone and diltiazem can increase clearance of digoxin

D.Heart failure patients have increased clearance of digoxin

true

false

false

false