Pharmacokinetics question

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jard

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Today my pharmacology professor wanted us to solve some MCQs on pharmacokinetics (propably he copied them from the Kaplan Qbank or Qbook) and I'm a little bit confused about two of them so I would like to read your opinion about them.

1) It was about a 70 year old man that is a smoker and comes in the ER with bronchospasm due to an asthma attack. His Sat is 80%. There was also an FEV1 value which I cannot remember now 🙁. We were going to administer cortisol to the patient and the question was about which way of administration we are going to choose in order to achieve the highest possible absorption.

The possible answers were:
a) IV
b) Oral Administration
c) Sublingual
d) Inhalation
e) Rectal

I chose answer C but he told us that the correct answer is D.

I remember from the Kaplan videos that you can achieve the maximum absorption through inhalation but I cannot understand how this is true in this specific case that the patient cannot breath.

2) There was also another question that required the Schild equation in order to be solved. I managed to solve this question but is it possible that there will be something like this on the actual USMLE exam? There is no mention about this equation on Kaplan lecture notes, Harvey or Katzung review. I found a paragraph about it in the big Katzung book which I use as a reference.

Thanks!
 
In the first question, it's not as if there's a complete lack of lung function. Even if there were, you could push drug in with positive pressure (just a pump bag even) and still get a huge capillary bed exposure to drug. Provided you get the drug in, the target site also happens to be the lungs, making that an even faster delivery.
 
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