Pharmokinetics in curriculum

[sbomb]

Hi,

Can anyone give me a brief outline of main topics your learn in your pharmacokinetics classes? And possibly suggest the textbook that you guys are using. I'm asking one of my profs to write a rec letter for me to pharm school (the class I took has pharmacokinetics but is taught from an tissue engineering perspective with differential equations and such). I'd just like to know how relevant what you guys learn is to what I learned. Thanks

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[genesis09]

In PK, you learn about how long drugs stay in the body, various dosing theory, nonlinear kinetics, drug departments, little about PD, drug metabolism, clearance, etc. We did not use a text. Also, no calculus was required just algebra.

 

[dgroulx]

We used two books, one for each semester. I preferred the second book, which was by Winter and called Basic Clinical Pharmacokinetics. It's a worthwhile book to own and has specifics for all the narrow therapeutic index drugs.

 

[ZpackSux]

Pharmacokinetics is nothing more than a study of bucket with a hole.

You figure out the size of the bucket otherwise known as the volume of distribution.. ex Vd(vanc) = 0.76L/Kg

Then you figure out the size of the hole..otherwise known as the Clearance..or Ke..

T1/2 o = 0.693/ke

ke = ln(cmax-cmin)/dt

cmax = dose/vd

So you dump some drugs into the bucket.. because you know the size of the bucket by calculating the Vd, you can calculate the extrapolated cmax... then you can calculate the size of the hole by crcl.....

Of course... non-linear kinetics like michelis-menten... Phenytoin enzyme saturation kinetics is slightly more involved... but good god, who orders "phenytoin per pharmacy????"

 

[sbomb]

...seems quite similar to what I learned actually...although I'm curious to know when pharmacists actually use this knowledge in a clinical or retail setting...I haven't seen a pharmacist use michaelis-menton or solve a diff. equation yet. Industrial pharmacy maybe.

 

[ZpackSux]

...seems quite similar to what I learned actually...although I'm curious to know when pharmacists actually use this knowledge in a clinical or retail setting...I haven't seen a pharmacist use michaelis-menton or solve a diff. equation yet. Industrial pharmacy maybe.

We do kinetics daily.... but we never ever do non-linear kinetics.

 

[genesis09]

In clerkship, you are required to do some kinetics calculations. Kinetics is certainly used regularly.

 

[sdn1977]

Agreed - kinetics are done daily & usually by programs built into the computer system.

However, there are exceptions, I feel, in which you need to understand the math (calculus) involved when the program spits out a dose or predicted drug level which doesn't make any clinical sense. That is the difference in understanding the math behind the kinetics & just running the programs.

I personally have seen 3 acute renal failures due to gentamicin doses which were recommended by pharmacist secondary to a computer calculation, but when looked at from a clinical perspective...the dose should never have been recommeded (not the pharmacy's finest hour!).

So...you can't take just what the computer or formula says, plug in the numbers without understanding the values in context of the patient.

I actually have used non-linear kinetics to help physicians in the ICU understand why the drugs they have used in the OR or during the perioperative period have not performed in the manner expected.....Not your normal function of a pharmacist, certainly....but interesting.

As for books....well...we didn't have books...Winter was still doing research at UCSF & hadn't written the book when I was there. But....he was a great teacher & made us learn, relearn & learn again!!! But...I'm sure there are many, many books out there including his.