Deck 1: Principles of Pharmacology

Question 1

_______ refer(s) to specific molecular changes that occur when a drug binds to a particular target site or receptor, while _______ are the resulting widespread alterations in function.

A) Drug action; therapeutic effects
B) Side effects; drug effects
C) Therapeutic effects; side effects
D) Drug action; drug effects

Answer 1

D

Question 2

The specific molecular changes that occur when a drug binds to a particular target site or receptor are referred to as

A) drug effects.
B) drug action.
C) side effects.
D) placebo effects.

Answer 2

B

Question 3

Which of the following is not a possible explanation for placebo effects?

A) Pavlovian conditioning
B) Genetic variation
C) Drug competition
D) Expectation of outcome

Answer 3

C

Question 4

Which of the following scenarios illustrates the nocebo effect?

A) Participants are warned about potential negative side effects of a drug, and experience negative effects even though the actual drug that administered is completely inert.
B) Participants are warned about potential negative side effects of a drug but do not experience effects because the actual drug that was administered is completely inert.
C) Participants are not warned about potential negative side effects of a drug that can produce negative side effects, but do not experience the effects because they don't expect them.
D) Participants are not warned about potential negative side effects of a drug because they are being given an inert substance, but they do experience side effects due to the anxiety of not knowing.

Question 5

For some conditions, such as ADHD, medication is needed for only part of each day. In this case a _______ would be required, so as not to cause effects at unwanted times during the day.

A) small dose of a drug
B) drug with a short half-life
C) drug with a long half-life
D) drug given subcutaneously

Question 6

A patient is prescribed a drug with serious side effects. The doctor is concerned about toxicity so takes several blood samples after administering the drug to monitor it's levels or biological effect, which is also called a _______ for a toxic response.

A) drug-rate
B) setpoint
C) biolevel
D) biomarker

Question 7

After drug administration has occurred, the amount of drug in the blood that is free to bind at specific target sites is referred to as

A) the therapeutic dose.
B) first-pass effects.
C) bioavailability.
D) ED₅₀.

Question 8

Which factor does not affect the pharmacokinetics of a drug?

A) Route of administration
B) Lipid solubility
C) Depot binding
D) Drug action

Question 9

Ionization of a drug depends on the _______ of the solution and the _______ of the drug.

A) pH; pK_a
B) pK_a; pH
C) concentration; lipid solubility
D) pH; concentration

Question 10

The absorption of a drug depends on all of the following except

A) lipid solubility.
B) ionization.
C) body temperature.
D) the concentration of the drug.

Question 11

Drug metabolism mostly occurs in the _______ and usually makes a drug more _______ soluble.

A) kidneys; fat
B) liver; fat
C) liver; water
D) kidneys; water

Question 12

Which statement about drug clearance by first-order kinetics is false?

A) Molecules of a drug are cleared at a constant rate regardless of drug concentration.
B) Molecules of a drug are cleared at an exponential rate.
C) A constant fraction of the free drug in the blood is removed in each time interval.
D) Clearance of most drugs occurs in this manner.

Question 13

Drugs that are _______ should be avoided by women of childbearing age.

A) teratogenic
B) able to cross the placental barrier
C) psychoactive
D) highly lipid-soluble

Question 14

Agents that induce developmental abnormalities in a fetus are known as

A) psychoactive drugs.
B) illicit drugs.
C) teratogens.
D) placental drugs.

Question 15

Ethyl alcohol (ethanol) is an example of a drug that is eliminated

A) by first-order kinetics.
B) by zero-order kinetics.
C) by second-order kinetics.
D) at the point that six half-lives have passed.

Question 16

Biotransformation of drugs in the liver often occurs in two stages; phase I changes are _______ and include _______.

A) nonsynthetic; conjugation
B) synthetic; conjugation
C) nonsynthetic; oxidation
D) synthetic; oxidation

Question 17

Biotransformation of drugs can result in the formation of _______, which enter the circulation and cause _______.

A) inactive metabolites; sensitization
B) active metabolites; prolonged drug action
C) active metabolites; tolerance
D) enzymes; tolerance

Question 18

Which statement about water-soluble metabolites formed in the liver is false?

A) They may return to the circulation and act on target tissues.
B) They may be filtered out by the kidneys.
C) They may be excreted into bile.
D) They may be eliminated with the feces.

Question 19

Which statement about microsomal enzymes in the liver is false?

A) They are highly specific and act only on certain compounds.
B) They are located on the smooth endoplasmic reticulum.
C) The CYP450 family is one of the most important.
D) They can metabolize toxins and environmental pollutants as well as drugs.

Question 20

The liver and kidneys work together to _______ and _______ drugs, respectively.

A) metabolize; excrete
B) excrete; metabolize
C) bind; metabolize
D) absorb; excrete

Question 21

For drugs that have a narrow therapeutic window or potentially serious side effects, therapeutic drug monitoring uses _______ to determine the optimum dosage for a new patient.

A) body temperature
B) urine testing
C) brain scans
D) blood sampling

Question 22

First-pass metabolism occurs when drugs are taken

A) orally.
B) intravenously.
C) subcutaneously.
D) nasally.

Question 23

First-pass metabolism occurs with orally administered drugs because

A) their absorption is slowed by food.
B) drugs absorbed into the bloodstream from the stomach go to the liver on the way to general circulation.
C) drugs must first survive the acidic environment of the stomach.
D) salivary enzymes in the mouth begin the process of metabolism.

Question 24

Drugs administered _______ have the most rapid onset of action.

A) subcutaneously
B) intramuscularly
C) orally
D) intravenously

Question 25

Commonly used during childbirth, an epidural bypasses the _______ barrier. During this procedure, a catheter is placed in the epidural space just outside of the _______.

A) blood-brain; spinous process
B) blood-brain; dura mater
C) lipid; spinous process
D) lipid; dura mater

Question 26

Which type of drug administration would bypass the blood-brain barrier?

A) Sublingual administration, which involves placing the drug under the tongue.
B) Subcutaneous administration, in which case the drug is injected into a location just below the skin.
C) Intrathecal injection of anesthetic into the cerebrospinal fluid.
D) Transdermal administration with a skin patch that delivers the drug through the skin

Question 27

The area postrema is one area in the brain where the _______ is not complete.

A) cerebrospinal fluid
B) blood-brain barrier
C) choroid plexus
D) phospholipid membrane

Question 28

Toxic substances in the blood trigger a vomiting response by activating the

A) blood-brain barrier.
B) choroid plexus.
C) area postrema.
D) median eminence.

Question 29

Depot binding is said to occur when drugs

A) bind to their target sites.
B) bind to inactive sites.
C) compete for binding sites.
D) are excreted before binding.

Question 30

Which statement about depot binding is false?

A) It reduces the concentration of drug at its site of action.
B) It may delay the onset of drug action.
C) It may prolong drug action by disrupting normal metabolism.
D) It increases the concentration of drug at its site of action by releasing large quantities at once.

Question 31

Due to _______, antidepressants known as monoamine oxidase inhibitors (MAOIs) can cause cardiac arrhythmias and high blood pressure in patients that consume foods high in tyramine.

A) sensitization
B) tolerance
C) drug competition
D) enzyme inhibition

Question 32

While drugs can be excreted from the body by several routes, the most important route of elimination is through the

A) breath.
B) sweat.
C) feces.
D) urine.

Question 33

While pharmacokinetics describes how the body deals with drugs, _______ describes how drug molecules interact with their targets.

A) drug effects
B) pharmacodynamics
C) antagonist actions
D) agonist actions

Question 34

In order for a drug to have an effect, it must first bind to a

A) ligand.
B) depot site.
C) receptor.
D) neurotransmitter.

Question 35

Most drugs and neurotransmitters act upon

A) intracellular receptors.
B) membrane-bound receptors.
C) protein synthesis.
D) second messengers.

Question 36

While most _______ receptors are membrane-bound on the cell surface, many _______ receptors are intracellular.

A) drug; neurotransmitter
B) hormone; drug
C) neurotransmitter; hormone
D) agonist; antagonist

Question 37

Ligands that have no effect on a receptor after binding are called

A) antagonists.
B) agonists.
C) neurotransmitters.
D) null ligands.

Question 38

The baseline receptor function, which occurs when neurotransmitter receptors are active even without a neurotransmitter or drug agonist, is called

A) constitutive activity.
B) the steady state.
C) maximal efficacy.
D) up-regulation.

Question 39

Both agonists and antagonists have _______ but only agonists have appreciable _______.

A) interactions; affinity
B) affinity; bioavailability
C) efficacy; affinity
D) affinity; efficacy

Question 40

In the dose-response curve, a decrease in potency is indicated by a shift

A) to the left.
B) to the right.
C) upward.
D) downward.

Question 41

A dose-response curve shows that noncompetitive antagonists alter both the _______ and the _______ of the agonist, while competitive antagonists alter only the _______.

A) potency; efficacy; potency
B) bioavailability; metabolism; bioavailability
C) efficacy; potency; efficacy
D) depot binding; metabolism; metabolism

Question 42

Which of the following describes the interaction of two drugs when the combined drug effects are greater than would be predicted from that combination?

A) Addictive effects
B) Physiological antagonism
C) Potentiation
D) Tolerance

Question 43

The _______ index is a measure of drug safety and is calculated by comparing the dose of a drug that produces a particular drug-induced toxic effect in 50% of a given population with the dose of the drug that produces a particular therapeutic effect.

A) therapeutic
B) dose
C) optimal
D) absolute

Question 44

Repeated use of many psychoactive drugs can cause _______, which can speed up the rate of biotransformation of these drugs as well as others.

A) drug competition
B) enzyme inhibition
C) enzyme induction
D) tolerance

Question 45

After chronic use, the need to administer more of a drug to achieve the same drug effect is known as

A) sensitization.
B) antagonism.
C) potentiation.
D) tolerance.

Question 46

Which factor does not cause tolerance?

A) Conditioning
B) Increased activity of liver enzymes
C) Down-regulation of receptors
D) Decreased kidney function

Question 47

Sensitization is most often seen with which class of drugs?

A) Barbiturates
B) Psychomotor stimulants
C) Opiates
D) Hallucinogens

Question 48

_______ tolerance occurs as a result of cellular adaptation to the presence of a specific drug.

A) Cross
B) Drug disposition
C) Pharmacodynamic
D) Behavioral

Question 49

A pharmacoepigenetic approach to drug response

A) takes into account only those factors that are related to behavioral factors.
B) takes into account factors that can alter gene function that the result of environmental and behavioral factors.
C) involves testing drugs among individuals with different blood types.
D) involves testing drugs at different levels over a set period of time to find the appropriate dose.

Question 50

Which of the following is not a goal of pharmacogenetics?

A) Assessing addiction potential
B) Selecting the best drug for a given individual
C) Predicting therapeutic outcome
D) Minimizing serious toxic reactions

Question 51

Write a coherent and informative paragraph using the following terms: nonspecific drug effects, double-blind experiment, placebo, subject expectation.

Question 52

List the factors that can influence biotransformation, and briefly explain how they can lead to individual differences in drug response.

Question 53

List and briefly describe the five major factors that determine the pharmacokinetics of drug action.

Question 54

Describe the recent method of drug administration that has been used to treat individuals with opioid addiction. What is the mechanism of action of this treatment that appears to make it successful?

Question 55

People with alcohol addiction have been known to self-administer alcohol rectally instead of orally. What are the dangers this practice?

Question 56

Explain why absorption of aspirin is slower from the intestine than from the stomach.

Question 57

Define and explain receptor up-regulation and down-regulation.

Question 58

Draw the dose-response curves for two drugs with the same efficacy, given that Drug A is ten times as potent as Drug

Question 59

Compare and contrast competitive and noncompetitive antagonists.

Question 60

Define the therapeutic index and describe how it is calculated and why it is important.

Question 61

Describe briefly the four types of tolerance.

Question 62

What is state-dependent learning? Why does it occur?

Question 63

Explain how pharmacogenetic approaches could lead to better pharmacological treatment.