Knowledge
"What does the body do to the drug?"
What is pharmokinetic.
What medication is Aya on to treat her pneumonia?
What is Clarithromycin (CLA) Brand name Biaxin, a macrolide antibiotic similar to erythromycin and azithromycin, binds to the 50S ribosomal subunit resulting in inhibiting protein synthesis.
What lab values do we look at when assessing a patient for rhabdomyolysis?
What is Creatine Kinase (CK), Aspartate transaminase (AST), Alanine transaminase (ALT), Creatine (Cr).
What risk factors does Aya present for Rhabdomylosis?
Aya has functional decline, weakness, advanced age as well as terrible muscle pain.
What are the early clinical manifestations of rhabdomyolysis?
Early signs include unexplained fatigue or muscle weakness, pain in joints or muscles, dark urine/pigmenturiaand an increase in CK level.
What alternative medication should Aya be on to control her lipid and cholesterol levels
What is Rosuvastatin, Fluvastatin or Pravastatin.
What is pigmenturia and why would a patient with rhabdomyolysis be experiencing pigmenturia?
What is reddish brown urine.
Rhabdomyolysis manifests as skeletal muscle tissue damage. As a result, many cellular proteins (myoglobin) and electrolytes are released into the blood. Can lead to acute kidney injury, abnormal liver function. Electrolyte and cardiac imbalances are expected as well.
What would happen to the Clarithromycin if Aya continued to take Simvastatin?
As simvastatin is metabolized by CYP 450 3A4, concomitant use of Clarithromycin increases the blood level of simvastatin and the risk of myotoxicity.
What happens to Simvastatin during absorption (pharmokinetics)
Simvastatin is lipophilic and rapidly absorbed; low bioavailability due to first bypass effect; it’s bioavailability is dependent on CYP3A4, therefore, inhibition of the isoenzyme has a larger effect on exposure