General questions 5-6: Digoxin and Normeperidine
In this step, Prof. Lee discusses two general questions.
The fifth one is about the volume of distribution of digoxin. In renal failure, the tissue uptake of the digoxin by the cardiac muscle is reduced, resulting in the decrease of the volume of distribution.
Therefore, D is the correct answer.
Besides, the sixth one is about the metabolite of meperidine. However, it is obvious that normeperidine is an active metabolite; therefore, meperidine is actually a poor drug. Consequently, normeperidine is the moiety to accumulate.
Also, he provides some pharmacokinetics information on digoxin and meperidine, which is helpful for us to solve the questions.
Pharmacokinetics: Drug Dosing in Renal Disease
Pharmacokinetics: Drug Dosing in Renal Disease
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