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Clinical problem-based questions and MCQs 13. A 34-year-old female patient suffering from vulvovaginitis is on oral fluconazole 100 mg, single-dose therapy. Such a dose results in a peak plasma concentration of 25 µg/mL. c. 50 L d. 4 L Calculate the apparent volume of distribution of fluconazole in this patient. a. 0.5 L b. 1 L ii. Define the volume of distribution. Why is it considered an apparent value? iii. Enumerate the factors affecting the volume of distribution of a drug. iv. Name some diseases that may alter the Va of drugs. 14. Identify the drug with the highest volume of distribution. 15. b. Tolbutamide d. Warfarin a. Aspirin c. Chloroquine In a pharmacokinetic study, the volume of distribution of digoxin is calculated to be 6 L/kg, which exceeds any physical volume. i. Explain the cause for such a high Vg. ii. Describe the clinical implications of high volume of distribution. 16. Dialysis is useful for drug with: a. High Va and high PPB b. High V and low PPB c. Low Va and high PPB d. Low V and low PPB 17. i. A drug that has high PPB will: 18. 19. tudin a. Have a very short-lived effect. b. Be filtered quickly by the glomerulus. c. Have lower chances of drug interactions. d. Have low volume of distribution. ii. Enumerate drugs that have an affinity for plasma albumin and a-acid glycoprotein. iii. What are the clinical implications of a high PPB? Thiopentone sodium is an ultra-short-acting barbiturate, used for the induction of anesthesia. The central action of thiopentone gets terminated within a few minutes due to redistribution. Describe the phenomenon of redistribution. ii. What happens if a drug showing redistribution is given repeatedly in quick succession? Redistribution is a characteristic of drugs that have: a. High lipid solubility b. High aqueous solubility c. High volume of distribution d. High plasma protein-binding

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