Size and Age Adjustments

True or false: obesity increases the organs’ functional size

false

Excess weight generates (increase/decrease) in metabolism

increase

Use real weight if the total body weight (>/<) the IBW times 1.2

<

Use ABD if TBW (>/<) the IBW times 1.2

>

The volume of distribution varies with what factors?

• unbound fraction of the drug in plasma

• the size of the person

What happens to distribution if the drug is hydrophilic?

volume will change according to the ABW relationship

What happens to distribution if the drug is lipophilic?

obese subject will show a higher volume of distribution per kg at steady state

True or false: infants <6-12 months does NOT have fully functional organs regarding drug elimination

true

True or false: children have larger eliminating organs per weight than adults

true

Describe the liver function in 1-18 year olds

• excess liver function

• The liver is disproportionately large relative to total body weight

1kg equals _____lbs

2.2

1 inch = ______ cm

2.54

Describe the PK changes in elderly

• less ability to take up drugs

• lower concentrations of enzymes and transporters (intrinsic clearance)

• increase in bioavailability

• decrease clearance

• decreased hepatic blood flow

True or false: personalized measurements are often need in elderly populations

true

Do patients who are muscle wasting or are emaciated have (higher/lower) Scr?

lower

Body builders and athletes tend to have (higher/lower) Scr?

higher