pharm

[passexam]

if a pt. has high metabolism how do you alters doses...is loading doses same and increasing maintence dose...or is it opposite of that

[md90]

Originally Posted by passexam

if a pt. has high metabolism how do you alters doses...is loading doses same and increasing maintence dose...or is it opposite of that

First, you would not want to give a loading dose unless you want to achieve a steady state of a drug in the plasma quickly, then give a maintenance dose to keep that steady state. Therefore I don't see a reason in giving a patient a loading dose b/c s/he has a high metabolic rate.

Second, the liver is the major site of metabolism;

Third, most drugs are eliminated by biotransformation and/or excretion into the urine or bile;

Fourth, there are two types of kinetics of metabolism:
1. first order: metabolic transformation is done by enzymes.. and the rate of metabolism is directly proportional to the concentration of the free drug.
2. zero-order: enzyme is overwhelmed by a higher free-drug concentration, and the rate of metabolism is constant over time;

Therefore, I believe that the answer would be to increase the dosage... in which the metabolism is zero-order kinetics so that it is constant and independent of the drug dose...

I know that this is long-winded answer... that I'm not very sure of... but I think as I write.... pharmacology is NOT my strongest subjects; Any other thoughts from others???? Thank you for the question...

[wcb22]

loading dose dosen't change, increase maintenance dose.

[md90]

thank you wcb22...