Deck 2: Review of Basic Principles of Pharmacology

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Question
Drugs administered via IV:

A)Need to be lipid soluble in order to be easily absorbed
B)Begin distribution into the body immediately
C)Are easily absorbed if they are nonionized
D)May use pinocytosis to be absorbed
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Question
Steady state is:

A)The point on the drug concentration curve when absorption exceeds excretion
B)When the amount of drug in the body remains constant
C)When the amount of drug in the body stays below the minimum toxic concentration
D)All of the above
Question
The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the:

A)Minimum adverse effect level
B)Peak of action
C)Onset of action
D)Therapeutic range
Question
When a medication is added to a regimen for a synergistic effect, the combined effect of the drugs is:

A)The sum of the effects of each drug individually
B)Greater than the sum of the effects of each drug individually
C)Less than the effect of each drug individually
D)Not predictable, as it varies with each individual
Question
Azithromycin dosing requires that the first day's dosage is twice that of the other 4 days of the prescription. This is considered a loading dose. A loading dose:

A)Rapidly achieves drug levels in the therapeutic range
B)Requires four to five half-lives to attain
C)Is influenced by renal function
D)Is directly related to the drug circulating to the target tissues
Question
A laboratory result indicates that the peak level for a drug is above the minimum toxic concentration. This means that the:

A)Concentration will produce therapeutic effects
B)Concentration will produce an adverse response
C)Time between doses must be shortened
D)Duration of action of the drug is too long
Question
Drugs that have a significant first-pass effect:

A)Must be given by the enteral (oral) route only
B)Bypass the hepatic circulation
C)Are rapidly metabolized by the liver and may have little, if any, desired action
D)Are converted by the liver to more active and fat-soluble forms
Question
Drugs that are receptor agonists may demonstrate what property?

A)Irreversible binding to the drug receptor site
B)Up-regulation with chronic use
C)Desensitization or down-regulation with continuous use
D)Inverse relationship between drug concentration and drug action
Question
Drugs are metabolized mainly by the liver via phase I or phase II reactions. The purpose of both of these types of reactions is to:

A)Inactivate prodrugs before they can be activated by target tissues
B)Change the drugs so they can cross plasma membranes
C)Change drug molecules to a form that an excretory organ can excrete
D)Make these drugs more ionized and polar to facilitate excretion
Question
Drugs that are receptor antagonists, such as beta blockers, may cause:

A)Down-regulation of the drug receptor
B)An exaggerated response if abruptly discontinued
C)Partial blockade of the effects of agonist drugs
D)An exaggerated response to competitive drug agonists
Question
A patient's nutritional intake and laboratory results reflect hypoalbuminemia. This is critical to prescribing because:

A)Distribution of drugs to target tissue may be affected.
B)The solubility of the drug will not match the site of absorption.
C)There will be less free drug available to generate an effect.
D)Drugs bound to albumin are readily excreted by the kidneys.
Question
Phenytoin requires that a trough level be drawn. Peak and trough levels are done:

A)When the drug has a wide therapeutic range
B)When the drug will be administered for a short time only
C)When there is a high correlation between the dose and saturation of receptor sites
D)To determine if a drug is in the therapeutic range
Question
Which of the following statements about bioavailability is true?

A)Bioavailability issues are especially important for drugs with narrow therapeutic ranges or sustained-release mechanisms.
B)All brands of a drug have the same bioavailability.
C)Drugs that are administered more than once a day have greater bioavailability than drugs given once daily.
D)Combining an active drug with an inert substance does not affect bioavailability.
Question
Medroxyprogesterone (Depo-Provera) is prescribed intramuscularly (IM) to create a storage reservoir of the drug. Storage reservoirs:

A)Assure that the drug will reach its intended target tissue
B)Are the reason for giving loading doses
C)Increase the length of time a drug is available and active
D)Are most common in collagen tissues
Question
Which of the following statements about the major distribution barriers (blood-brain or fetal-placental) is true?

A)Water soluble and ionized drugs cross these barriers rapidly.
B)The blood-brain barrier slows the passage of many drugs into and out of brain cells.
C)The fetal-placental barrier protects the fetus from drugs taken by the mother.
D)Lipid-soluble drugs do not pass these barriers and are safe for pregnant women.
Question
The nurse practitioner (NP) chooses to give cephalexin every 8 hours based on knowledge of the drug's:

A)Propensity to go to the target receptor
B)Biological half-life
C)Pharmacodynamics
D)Safety and side effects
Question
All drugs continue to act in the body until they are changed or excreted. The ability of the body to excrete drugs via the renal system would be increased by:

A)Reduced circulation and perfusion of the kidney
B)Chronic renal disease
C)Competition for a transport site by another drug
D)Unbinding a nonvolatile drug from plasma proteins
Question
Once they have been metabolized by the liver, the metabolites may be:

A)More active than the parent drug
B)Less active than the parent drug
C)Totally "deactivated" so they are excreted without any effect
D)All of the above
Question
Factors that affect gastric drug absorption include:

A)Liver enzyme activity
B)Protein-binding properties of the drug molecule
C)Lipid solubility of the drug
D)Ability to chew and swallow
Question
The route of excretion of a volatile drug will likely be the:

A)Kidneys
B)Lungs
C)Bile and feces
D)Skin
Question
Instructions to a client regarding self-administration of oral enteric-coated tablets should include which of the following statements?

A)"Avoid any other oral medicines while taking this drug."
B)"If swallowing this tablet is difficult, dissolve it in 3 ounces of orange juice."
C)"The tablet may be crushed if you have any difficulty taking it."
D)"To achieve best effect, take the tablet with at least 8 ounces of fluid."
Question
An agonist activates a receptor and stimulates a response. When given frequently over time, the body may:

A)Up-regulate the total number of receptors
B)Block the receptor with a partial agonist
C)Alter the drug's metabolism
D)Down-regulate the numbers of that specific receptor
Question
Two different pain medications are given together for pain relief. The drug-drug interaction is:

A)Synergistic
B)Antagonistic
C)Potentiative
D)Additive
Question
The major reason for not crushing a sustained-release capsule is that, if crushed, the coated beads of the drugs could possibly:

A)Disintegrate
B)Become toxic
C)Not be absorbed properly
D)Deteriorate
Question
The time required for the amount of drug in the body to decrease by 50% is called:

A)Steady state
B)Half-life
C)Phase II metabolism
D)Reduced bioavailability time
Question
Drugs that use CYP 3A4 isoenzymes for metabolism may:

A)Induce the metabolism of another drug
B)Inhibit the metabolism of another drug
C)Both 1 and 2
D)Neither 1 nor 2
Question
Actions taken to reduce drug-drug interaction problems include all of the following EXCEPT:

A)Reducing the dosage of one of the drugs
B)Scheduling their administration at different times
C)Prescribing a third drug to counteract the adverse reaction of the combination
D)Reducing the dosage of both drugs
Question
Drug antagonism is best defined as an effect of a drug that:

A)Leads to major physiological and psychological dependence
B)Is modified by the concurrent administration of another drug
C)Cannot be metabolized before another dose is administered
D)Leads to a decreased physiological response when combined with another drug
Question
Which of the following variables is a factor in drug absorption?

A)The smaller the surface area for absorption, the more rapidly the drug is absorbed.
B)A rich blood supply to the area of absorption leads to better absorption.
C)The less soluble the drug, the more easily it is absorbed.
D)Ionized drugs are easily absorbed across the cell membrane.
Question
Which of the following substances is the most likely to be absorbed in the intestines rather than in the stomach?

A)Sodium bicarbonate
B)Ascorbic acid
C)Salicylic acid
D)Glucose
Question
An advantage of prescribing a sublingual medication is that the medication is:

A)Absorbed rapidly
B)Excreted rapidly
C)Metabolized minimally
D)Distributed equally
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Deck 2: Review of Basic Principles of Pharmacology
1
Drugs administered via IV:

A)Need to be lipid soluble in order to be easily absorbed
B)Begin distribution into the body immediately
C)Are easily absorbed if they are nonionized
D)May use pinocytosis to be absorbed
Begin distribution into the body immediately
2
Steady state is:

A)The point on the drug concentration curve when absorption exceeds excretion
B)When the amount of drug in the body remains constant
C)When the amount of drug in the body stays below the minimum toxic concentration
D)All of the above
When the amount of drug in the body remains constant
3
The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the:

A)Minimum adverse effect level
B)Peak of action
C)Onset of action
D)Therapeutic range
Onset of action
4
When a medication is added to a regimen for a synergistic effect, the combined effect of the drugs is:

A)The sum of the effects of each drug individually
B)Greater than the sum of the effects of each drug individually
C)Less than the effect of each drug individually
D)Not predictable, as it varies with each individual
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Unlock for access to all 31 flashcards in this deck.
Unlock Deck
k this deck
5
Azithromycin dosing requires that the first day's dosage is twice that of the other 4 days of the prescription. This is considered a loading dose. A loading dose:

A)Rapidly achieves drug levels in the therapeutic range
B)Requires four to five half-lives to attain
C)Is influenced by renal function
D)Is directly related to the drug circulating to the target tissues
Unlock Deck
Unlock for access to all 31 flashcards in this deck.
Unlock Deck
k this deck
6
A laboratory result indicates that the peak level for a drug is above the minimum toxic concentration. This means that the:

A)Concentration will produce therapeutic effects
B)Concentration will produce an adverse response
C)Time between doses must be shortened
D)Duration of action of the drug is too long
Unlock Deck
Unlock for access to all 31 flashcards in this deck.
Unlock Deck
k this deck
7
Drugs that have a significant first-pass effect:

A)Must be given by the enteral (oral) route only
B)Bypass the hepatic circulation
C)Are rapidly metabolized by the liver and may have little, if any, desired action
D)Are converted by the liver to more active and fat-soluble forms
Unlock Deck
Unlock for access to all 31 flashcards in this deck.
Unlock Deck
k this deck
8
Drugs that are receptor agonists may demonstrate what property?

A)Irreversible binding to the drug receptor site
B)Up-regulation with chronic use
C)Desensitization or down-regulation with continuous use
D)Inverse relationship between drug concentration and drug action
Unlock Deck
Unlock for access to all 31 flashcards in this deck.
Unlock Deck
k this deck
9
Drugs are metabolized mainly by the liver via phase I or phase II reactions. The purpose of both of these types of reactions is to:

A)Inactivate prodrugs before they can be activated by target tissues
B)Change the drugs so they can cross plasma membranes
C)Change drug molecules to a form that an excretory organ can excrete
D)Make these drugs more ionized and polar to facilitate excretion
Unlock Deck
Unlock for access to all 31 flashcards in this deck.
Unlock Deck
k this deck
10
Drugs that are receptor antagonists, such as beta blockers, may cause:

A)Down-regulation of the drug receptor
B)An exaggerated response if abruptly discontinued
C)Partial blockade of the effects of agonist drugs
D)An exaggerated response to competitive drug agonists
Unlock Deck
Unlock for access to all 31 flashcards in this deck.
Unlock Deck
k this deck
11
A patient's nutritional intake and laboratory results reflect hypoalbuminemia. This is critical to prescribing because:

A)Distribution of drugs to target tissue may be affected.
B)The solubility of the drug will not match the site of absorption.
C)There will be less free drug available to generate an effect.
D)Drugs bound to albumin are readily excreted by the kidneys.
Unlock Deck
Unlock for access to all 31 flashcards in this deck.
Unlock Deck
k this deck
12
Phenytoin requires that a trough level be drawn. Peak and trough levels are done:

A)When the drug has a wide therapeutic range
B)When the drug will be administered for a short time only
C)When there is a high correlation between the dose and saturation of receptor sites
D)To determine if a drug is in the therapeutic range
Unlock Deck
Unlock for access to all 31 flashcards in this deck.
Unlock Deck
k this deck
13
Which of the following statements about bioavailability is true?

A)Bioavailability issues are especially important for drugs with narrow therapeutic ranges or sustained-release mechanisms.
B)All brands of a drug have the same bioavailability.
C)Drugs that are administered more than once a day have greater bioavailability than drugs given once daily.
D)Combining an active drug with an inert substance does not affect bioavailability.
Unlock Deck
Unlock for access to all 31 flashcards in this deck.
Unlock Deck
k this deck
14
Medroxyprogesterone (Depo-Provera) is prescribed intramuscularly (IM) to create a storage reservoir of the drug. Storage reservoirs:

A)Assure that the drug will reach its intended target tissue
B)Are the reason for giving loading doses
C)Increase the length of time a drug is available and active
D)Are most common in collagen tissues
Unlock Deck
Unlock for access to all 31 flashcards in this deck.
Unlock Deck
k this deck
15
Which of the following statements about the major distribution barriers (blood-brain or fetal-placental) is true?

A)Water soluble and ionized drugs cross these barriers rapidly.
B)The blood-brain barrier slows the passage of many drugs into and out of brain cells.
C)The fetal-placental barrier protects the fetus from drugs taken by the mother.
D)Lipid-soluble drugs do not pass these barriers and are safe for pregnant women.
Unlock Deck
Unlock for access to all 31 flashcards in this deck.
Unlock Deck
k this deck
16
The nurse practitioner (NP) chooses to give cephalexin every 8 hours based on knowledge of the drug's:

A)Propensity to go to the target receptor
B)Biological half-life
C)Pharmacodynamics
D)Safety and side effects
Unlock Deck
Unlock for access to all 31 flashcards in this deck.
Unlock Deck
k this deck
17
All drugs continue to act in the body until they are changed or excreted. The ability of the body to excrete drugs via the renal system would be increased by:

A)Reduced circulation and perfusion of the kidney
B)Chronic renal disease
C)Competition for a transport site by another drug
D)Unbinding a nonvolatile drug from plasma proteins
Unlock Deck
Unlock for access to all 31 flashcards in this deck.
Unlock Deck
k this deck
18
Once they have been metabolized by the liver, the metabolites may be:

A)More active than the parent drug
B)Less active than the parent drug
C)Totally "deactivated" so they are excreted without any effect
D)All of the above
Unlock Deck
Unlock for access to all 31 flashcards in this deck.
Unlock Deck
k this deck
19
Factors that affect gastric drug absorption include:

A)Liver enzyme activity
B)Protein-binding properties of the drug molecule
C)Lipid solubility of the drug
D)Ability to chew and swallow
Unlock Deck
Unlock for access to all 31 flashcards in this deck.
Unlock Deck
k this deck
20
The route of excretion of a volatile drug will likely be the:

A)Kidneys
B)Lungs
C)Bile and feces
D)Skin
Unlock Deck
Unlock for access to all 31 flashcards in this deck.
Unlock Deck
k this deck
21
Instructions to a client regarding self-administration of oral enteric-coated tablets should include which of the following statements?

A)"Avoid any other oral medicines while taking this drug."
B)"If swallowing this tablet is difficult, dissolve it in 3 ounces of orange juice."
C)"The tablet may be crushed if you have any difficulty taking it."
D)"To achieve best effect, take the tablet with at least 8 ounces of fluid."
Unlock Deck
Unlock for access to all 31 flashcards in this deck.
Unlock Deck
k this deck
22
An agonist activates a receptor and stimulates a response. When given frequently over time, the body may:

A)Up-regulate the total number of receptors
B)Block the receptor with a partial agonist
C)Alter the drug's metabolism
D)Down-regulate the numbers of that specific receptor
Unlock Deck
Unlock for access to all 31 flashcards in this deck.
Unlock Deck
k this deck
23
Two different pain medications are given together for pain relief. The drug-drug interaction is:

A)Synergistic
B)Antagonistic
C)Potentiative
D)Additive
Unlock Deck
Unlock for access to all 31 flashcards in this deck.
Unlock Deck
k this deck
24
The major reason for not crushing a sustained-release capsule is that, if crushed, the coated beads of the drugs could possibly:

A)Disintegrate
B)Become toxic
C)Not be absorbed properly
D)Deteriorate
Unlock Deck
Unlock for access to all 31 flashcards in this deck.
Unlock Deck
k this deck
25
The time required for the amount of drug in the body to decrease by 50% is called:

A)Steady state
B)Half-life
C)Phase II metabolism
D)Reduced bioavailability time
Unlock Deck
Unlock for access to all 31 flashcards in this deck.
Unlock Deck
k this deck
26
Drugs that use CYP 3A4 isoenzymes for metabolism may:

A)Induce the metabolism of another drug
B)Inhibit the metabolism of another drug
C)Both 1 and 2
D)Neither 1 nor 2
Unlock Deck
Unlock for access to all 31 flashcards in this deck.
Unlock Deck
k this deck
27
Actions taken to reduce drug-drug interaction problems include all of the following EXCEPT:

A)Reducing the dosage of one of the drugs
B)Scheduling their administration at different times
C)Prescribing a third drug to counteract the adverse reaction of the combination
D)Reducing the dosage of both drugs
Unlock Deck
Unlock for access to all 31 flashcards in this deck.
Unlock Deck
k this deck
28
Drug antagonism is best defined as an effect of a drug that:

A)Leads to major physiological and psychological dependence
B)Is modified by the concurrent administration of another drug
C)Cannot be metabolized before another dose is administered
D)Leads to a decreased physiological response when combined with another drug
Unlock Deck
Unlock for access to all 31 flashcards in this deck.
Unlock Deck
k this deck
29
Which of the following variables is a factor in drug absorption?

A)The smaller the surface area for absorption, the more rapidly the drug is absorbed.
B)A rich blood supply to the area of absorption leads to better absorption.
C)The less soluble the drug, the more easily it is absorbed.
D)Ionized drugs are easily absorbed across the cell membrane.
Unlock Deck
Unlock for access to all 31 flashcards in this deck.
Unlock Deck
k this deck
30
Which of the following substances is the most likely to be absorbed in the intestines rather than in the stomach?

A)Sodium bicarbonate
B)Ascorbic acid
C)Salicylic acid
D)Glucose
Unlock Deck
Unlock for access to all 31 flashcards in this deck.
Unlock Deck
k this deck
31
An advantage of prescribing a sublingual medication is that the medication is:

A)Absorbed rapidly
B)Excreted rapidly
C)Metabolized minimally
D)Distributed equally
Unlock Deck
Unlock for access to all 31 flashcards in this deck.
Unlock Deck
k this deck
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Unlock Deck
Unlock for access to all 31 flashcards in this deck.