100-question Exam which will assess your knowledge on the Learning Resources from Weeks 1-6. • Time limit of 2 hours. • Multiple choice or multiple selection. Pharmacodynamics: how the drug effects the body Pharmacokinetics: how the body effects the drug ❒ Understand the implications of changing renal function on creatinine & drug dosing. Kidney/Renal functions : • Filters blood = Remove Waste, Toxins, and Extra Fluid from the body • Returns needed substances to the blood – & the remainder becomes urine • Removes acid produced by cells of the body to maintain balanced water, salts; minerals • Makes hormones that control BP, make RBCs; keeps bones strong Creatinine: Measures kidney function - byproduct of muscle metabolism (creatinine phosphate) Normal Serum Creatinine levels: 0.6-1.3 mg/dL - healthy kidney (Easily filters & excretes creatinine) More Reliable than BUN. Creatinine is Not Absorbed by the kidneys. Rises indicate renal damage or failure = Kidney is unable to properly filter & excrete waste (creatinine) = Lab Value rises in the serum. Creatinine = Kidney Function = Requires a decreased dose of medication or different dosing schedule = Renal Dosing ❒ What is the impact of the following on drug levels and dosing: ➢ Cirrhosis: a disease in which normal liver cells are replaced by scar tissue. As liver cells die, the organ makes less of the proteins that regulate fluid retention & blood clotting and the liver loses its ability to metabolize the pigment bilirubin. Liver/Hepatic functions : • Produces proteins that help clot blood • Removes / neutralizes poisons, drugs and alcohol • Manufactures bile that helps the body absorb fats & cholesterol • Helps maintain normal blood sugar levels • Regulates hormones With Cirrhosis - the liver fails to detoxify the blood & it becomes less able to metabolize medications, which magnifies their effects. Eventually toxins build up in the brain & can produce: