Question 1

Asians from Eastern Asia are known to be fast acetylators. Fast acetylators:&#10;A) Require acetylization in order to metabolize drugs&#10;B) Are unable to tolerate higher doses of some drugs that require acetylization&#10;C) May have a toxic reaction to drugs that require acetylization&#10;D) Require higher doses of drugs metabolized by acetylization to achieve efficacy&#10;

Accepted Answer

Fast acetylators require higher doses of drugs metabolized by acetylization to achieve efficacy.

Question 2

Alterations in drug metabolism among Asians may lead to:&#10;A) Slower metabolism of antidepressants, requiring lower doses&#10;B) Faster metabolism of neuroleptics, requiring higher doses&#10;C) Altered metabolism of omeprazole, requiring higher doses&#10;D) Slower metabolism of alcohol, requiring higher doses&#10;

Accepted Answer

Asians have higher prevalence of genetic variants in CYP2D6 and CYP2C19 enzymes, which can result in slower metabolism of antidepressants and proton pump inhibitors, requiring lower doses for therapeutic effect.

(Note: Option B is incorrect as Asians have been found to have lower activity of CYP2D6, resulting in slower metabolism of some neuroleptics, not faster metabolism requiring higher doses. Option C is incorrect as Asians have faster metabolism of omeprazole, not altered metabolism requiring higher doses. Option D is incorrect as Asians have lower activity of alcohol dehydrogenase, resulting in slower metabolism of alcohol and requiring lower doses.)

Question 3

Ethnic differences have been found in drug:&#10;A) Absorption&#10;B) Hepatic metabolism&#10;C) Filtration at the glomerulus&#10;D) Passive tubular reabsorption&#10;

Accepted Answer

Ethnic differences have been found in hepatic metabolism of drugs. Some ethnic groups may have polymorphisms in liver enzymes that can affect the metabolism of certain drugs, leading to differences in drug efficacy and adverse effects.

A, C, and D are incorrect because there is limited evidence for ethnic differences in drug absorption, filtration at the glomerulus, or passive tubular reabsorption. While there may be individual variations, overall, these processes are not significantly affected by ethnicity.

Question 4

According to the National Standards of Culturally and Linguistically Appropriate Services, an interpreter for health care:&#10;A) May be a bilingual family member&#10;B) May be a bilingual nurse or other health-care provider&#10;C) Must be a professionally trained medical interpreter&#10;D) Must be an employee of the organization&#10;

Accepted Answer

The National Standards of Culturally and Linguistically Appropriate Services recommend that health care interpreters be professionally trained medical interpreters. This ensures that they have the necessary knowledge and skills to effectively facilitate communication between the provider and patient, as well as maintain confidentiality and impartiality. Using family members or other staff members may create conflicts of interest or result in inaccurate translations.

Question 5

Cultural factors that must be taken into account when prescribing include(s):&#10;A) Who the decision maker is in the family regarding health-care decisions&#10;B) The patient's view of health and illness&#10;C) Attitudes regarding the use of drugs to treat illness&#10;D) All of the above&#10;

Accepted Answer

All of the options listed are important cultural factors that must be taken into account when prescribing medication. The decision maker in the family may affect the patient's adherence to medication and treatment, the patient's view of health and illness may influence their perceptions about the effectiveness and necessity of medication, and attitudes towards drug use can impact the patient's willingness to take prescribed medication. Cultural sensitivity and understanding are critical in making appropriate and effective medication decisions.

Question 6

The National Standards of Culturally and Linguistically Appropriate Services are required to be implemented in all:&#10;A) Hospitals&#10;B) Clinics that serve the poor&#10;C) Organizations that receive federal funds&#10;D) Clinics that serve ethnic minorities&#10;

Accepted Answer

The National Standards of Culturally and Linguistically Appropriate Services are required to be implemented in all organizations that receive federal funds. This includes hospitals, clinics, and other healthcare organizations. It is not limited to clinics that serve the poor or ethnic minorities, although these may be included in the scope of the standards.

Question 7

Pharmacokinetics among Asians are universal to all the Asian ethnic groups.&#10;A) True&#10;B) False&#10;

Accepted Answer

Pharmacokinetics can vary among different ethnic groups, even within the same geographic region. While certain factors like body composition and genetics may play a role in pharmacokinetics, it would be inaccurate to assume that all Asians have universal pharmacokinetics.

Question 8

Hispanic native healers (curanderas):&#10;A) Are not heavily utilized by Hispanics who immigrate to the United States&#10;B) Use herbs and teas in their treatment of illness&#10;C) Provide unsafe advice to Hispanics and should not be trusted&#10;D) Need to be licensed in their home country in order to practice in the United States&#10;

Accepted Answer

Hispanic native healers (curanderas) do use herbs and teas in their treatment of illness. While there may be variations in their practices, calling them unsafe or suggesting that they should not be trusted is not accurate. Licensing requirements may vary by country, but it is not mentioned in the given question that being licensed in their home country is necessary to practice in the United States.

Question 9

According to the U.S. Office of Minority Health, poor health outcomes among African Americans are attributed to:&#10;A) The belief among African Americans that prayer is more powerful than drugs&#10;B) Poor compliance on the part of the African American patient&#10;C) The genetic predisposition for illness found among African Americans&#10;D) Discrimination, cultural barriers, and lack of access to health care&#10;

Accepted Answer

The U.S. Office of Minority Health attributes poor health outcomes among African Americans to discrimination, cultural barriers, and lack of access to health care. While beliefs and compliance may play a role in individual cases, these factors do not account for the overall disparities in health outcomes. The idea of a genetic predisposition for illness among African Americans is a controversial and debated topic in the medical community, with limited evidence to support it.

Question 10

The racial difference in drug pharmacokinetics seen in American Indian or Alaskan Natives are:&#10;A) Increased CYP 2D6 activity, leading to rapid metabolism of some drugs&#10;B) Largely unknown due to lack of studies of this population&#10;C) Rapid metabolism of alcohol, leading to increased tolerance&#10;D) Decreased elimination of opioids, leading to increased risk for addiction&#10;

Accepted Answer

According to the information provided, the racial difference in drug pharmacokinetics among American Indian or Alaskan Natives is largely unknown due to a lack of studies on this population. Therefore, option B is the best choice. The other options provided may be true for other racial or ethnic groups, but the question specifically asks about American Indian or Alaskan Natives.

Deck 7: Cultural and Ethnic Influences in Pharmacotherapeutics