Deck 1: Understanding Pharmacokinetics and Drug Administration

Question 1

Pharmacokinetics is:

A) The study of how drugs reach their target in the body and how the levels of a drug in the blood are affected by various factors
B) The study of how drugs can be designed using molecular modelling based on a drug's pharmacophore.
C) The study of how a drug interacts with its target binding site at the molecular level
D) The study of which functional groups are important in binding a drug to its target binding site and the identification of a pharmacophore.

Answer 1

The study of how drugs reach their target in the body and how the levels of a drug in the blood are affected by various factors

Question 2

Which of the following is the most correct sentence concerning intravenous administration of drugs?

A) Gives predictable blood levels
B) None undergoes first pass metabolism
C) All of it undergoes first pass metabolism
D) A and B
E) A, B, and C

Answer 2

A and B

Question 3

Some drugs have a low oral bioavailability due to extensive metabolism in the GI tract or liver. Which dosage form can be used to best avoid this complication?

A) Controlled release tablet
B) Enteric coated tablet
C) Soft capsule
D) Sublingual

Answer 3

Sublingual

Question 4

Concerning the enteral route of administration, the correct sentence is:

A) The bioavailability here is excellent as compared to parenteral route
B) Has faster onset of action as compared to parenteral route
C) Could be used by either conscious or unconscious patients
D) None of the above

Question 5

Which of the following preparations will give sustained drug delivery with prolonged duration of action?

A) Sugar coated tablet
B) Aqueous prepared IM injection
C) Transdermal patches
D) Sublingual tablet

Question 6

For a drug with a narrow therapeutic index, the plasma concentration required for therapeutic effects is near the concentration that produces toxic effects, and such a drug require routine plasma monitoring.

Question 7

All of the following statements are true about intranasal route of administration EXCEPT:

A) It is only used for administration of drugs used in respiratory conditions.
B) It has a rapid onset of action.
C) It possesses good compliance among patients
D) Few systemic side effects

Question 8

Variation in cytochrome P450 enzyme profile between individuals can explain individual variation in drug susceptibility.

Question 9

If the plasma concentration of a drug declines with "first-order kinetics," this means that:

A) There is only one metabolizing enzyme for drug disposition
B) The half-life is the same regardless of the plasma concentration
C) The drug is largely metabolized in the liver after oral administration and has low bioavailability
D) All of them

Question 10

In relation to the therapeutic window of a drug, which of the following sentences is true:

A) Drugs with wide therapeutic range are not potent enough compared with narrow therapeutic range.
B) A drug must exceed the maximum effective dose in order to be therapeutically active.
C) Drugs with plasma concentration below the minimum effective concentration show no therapeutic effect.
D) It is a range of concentration that determines both the safety and efficacy of drugs.

Question 11

Which of the following statements is the closest description of Phase! metabolism?

A) Reactions which add an endogenous polar molecule to a functional group already present on a drug or one of its metabolites.
B) Reactions which occur in the blood supply.
C) Reactions which add a polar functional group to a drug
D) Reactions which occur in the gut wall.

Question 12

The term of pharmacokinetics includes all of the following EXCEPT?

A) Clinical response to a drug ie; toxicity & efficacy
B) Drug concentration at site of action
C) Dose of drug administered

Question 13

The volume of distribution (Va) for a drug highly bound to plasma protein as compared to others would be?

A) High
B) Low
C) Unchanged
D) Cannot be determined, it's an apparent parameter

Question 14

Factors associated with drug absorption that can result in incomplete absorption

A) Drug metabolism by gastrointestinal flora
B) Drug instability in gastric acid
C) Presence of food in the GI tract
D) A and B
E) A B, and C

Question 15

Patient's age may affect a drug elimination

Question 16

Warfarin is metabolized by CYP450, and rifampicin is CYP450 inducer. Administration of warfarin and rifampicin together will

A) Rifampicin will decrease therapeutic effectiveness of warfarin
B) Rifampicin will increase the side effect of warfarin
C) Rifampicin of no effect on therapeutic effect of warfarin
D) Both A and B

Question 17

Dose adjustment is needed in the following situation EXCEPT

A) Elderly and newborn patients
B) Patients with renal and hepatic problems.
C) Patients with lung diseases
D) Patient with heart failure

Question 18

A type of absorption is called () Appears to depend on an oscillating carrier protein, depends on concentration gradient, no energy required. For a few drugs movement occurs faster than predicted.

A) Active transport
B) Passive transport
C) Facilitated diffusion.
D) Simple diffusion

Question 19

In case of severe renal dysfunction, the duration of action of most drugs:

A) Increases
B) Decreases
C) Will not change
Done by: Fawzi Shihadeh, Malik Sulima

Question 20

The onset of effect for a drug given orally is the time for the drug to:

A) Reach the peak plasma concentration.
B) Reach the minimum effective concentration.
C) Reach the concentration of steady state.
D) Begin to be within the therapeutic concentration.
E) To be absorbed from the small intestine

Question 21

The therapeutic range is the range of plasma drug concentrations that clearly defines optimal drug therapy and where adverse effects cannot occur.

Question 22

Which of the following statements best describes first-order kinetics?

A) The same fraction of drug is eliminated during a given time interval
B) The same amount of drug is eliminated during a given time interval
C) The time vs. plasma drug concentration profile is as follow
D) Both A and C

Question 23

In case of liver disorders accompanied by a decline in microsomal enzyme activity the therapeutic effect of this treatment will be:

A) Decreased
B) Increased
C) Remained unchanged

Question 24

Half-life (t %) doesn't depend on:

A) Rate of metabolism
B) Concentration of a drug in plasma
C) Rate of drug elimination
D) Time of drug absorption

Question 25

Oral bioavailability of the drug could be affected by which of the following:

A) Gastric acidity and gastric enzymes
B) Drug formulation
C) Metabolism by liver enzymes prior to reaching the systemic circulation
D) Expression of intestinal P-glycoprotein
E) All the above

Question 26

Alkalinization of urine hastens (facilitates) the excretion of weakly basic drugs:

A) True
B) False
C) False, it hastens acidic drug excretion

Question 27

A small Vd has an important influence on the half-life of a drug, this means that a drug with small Vd has short half-life.

A) True
B) False
C) Maybe true, but not important at all

Question 28

Treatment of pediatric patients sometimes requires considering age- appropriate dosage forms. For example, when treating a 4 year old boy with an inner ear infection, the antibiotic dosage formulation most acceptable to them would be alan:

A) Capsule
B) Oblong large tablet
C) Oral suspension
D) Normal tablet

Question 29

Which of the following phase II metabolic reactions make phase I metabolites readily excretable in urine?

A) Oxidation
B) Reduction
C) Alcohol dehydrogenation
D) Glutathione conjugation
E) None of them

Question 30

Which of the following drugs/or substances may inhibit the hepatic microsomal P450 responsible for the metabolism of substrate drugs

A) Grapefruit juice
B) Ethanol
C) Rifampin
D) Smoking

Question 31

The term bioavailability of a preparation of a drug is a measure of:

A) The relative toxicity of the preparation to laboratory animals
B) The stability of the preparation
C) The availability of the drug from natural sources
D) We simply say: BIOAVAILABLE! Means available to patients
E) None of the above

Question 32

If 3 g of a drug are added and distributed throughout a tank and the resulting concentration is 0.15 g/L, calculate the volume of the tank.

A) 10 L
B) 20 L
C) 30 L
D) 200 L

Question 33

"Ultron" is a new drug for the treatment of hiccups. When administered over a wide concentration range, three dose response relationships were defined in tested subjects. Using vomiting as an unwanted (toxic) effect, what would be the estimated therapeutic index for "Ultron"?

A) 0.01
B) 0.1
C) 10
D)100

Question 34

Metabolic transformation and conjugation usually results in an increase of a substance biological activity

Question 35

Generally, the rate of drug absorption is most rapid when the drug is formulated as a

A) Hard gelatin capsule
B) Solution, e.g syrup
C) Controlled.release product
D) compressed tablet

Question 36

Ampicillin is eliminated by first-order kinetics. Which of the following statements best describes the process by which the plasma concentration of this drug declines

A) The drug is distributed to only 1 compartment outside the vascular system
B) The drug is largely metabolized in the liver after oral administration and has low bioavailability
C) The rate of elimination is proportional to the rate of administration at all times
D) The halflife is the same regardless of the plasma concentration

Question 37

What is implied by {{passive transport}}

A) Transport without energy consumption
B) Engulf of drug by a cell membrane with a new vesicle formation
C) Transport of drugs through a membtane by means of diffusion
D) Transport against conæntration gradient

Question 38

Drug metabolism is mainly done in the kidneys and is responsible for drug elminnation

Question 39

Concerning renal clearance, which of the following is correct

A) Influenced by renal disease
B) None of them
C) Both of them
D) Altered by blood flow

Question 40

If the plasma concentration Of a drug declines with "first-order kinetics," this means that

A) The half-life is thesame regardless of the plasma concentration
B) There Is Only one metabolic for drug disposition
C) The drug is largely metabolized in the liver aftel oral administration and has low bioavailability
D) All of them

Question 41

you want to enhance urine elimination of a basic drug, you need to make the urine

A) More alkaline
B) More acidic
C) Urine pH of no effect

Question 42

The oral bioavailability of most of drugs is less than 100% because

A) Both
B) Incomplete absorption
C) Neither
D) First pass effect

Question 43

Which statement best describes bioavailability

A) All
B) Measurement of the rate and amount of the unchanged drug reaches the systemic circulation
C) Amount of the drug destroyed in the liver before entering systemic circulation
D) Measurement of the relative toxicity of the preparation
E) Movement of drug into body tissues over time

Question 44

Fill the blanks-----------: In case of liver cirrhosis, half-life is---------for paracetamol and should be used in

A) Decreased, higher doses
B) Increased ,lower doses
C) Decreased, lower doses
D) Increased. higher doses

Question 45

The correct sentence/ s concerning prodrug is/are

A) An active drug that is transformed in the body to an inactive metabolite
B) Means inactive drug that is transformed in the body to an active metabolite
C) None of them
D) Medications that are transformed in the bods into toxic metabolites
E) Mostly, medications are prodrugs

Question 46

Smoking is enzyme inhibitor; this can increase the half-life of theophylline in those who are smokers

Question 47

Which of the following is not a pharmacokinetics process

A) Drug metabolites are removed in the urine
B) The drug causes dilation of coronary vessels
C) Movement of drug from the gut into circulation
D) Alteration of the drug by liver enzymes
E) The drug is readily deposited in fat tissue

Question 48

Regarding renal excretion, the following are with importance to be considered

A) Glomerular filtration rate
B) Extent of plasma protein binding of drugs
C) Active renal tubular reabsorption
D) All of them
E) Re-absorption in distal tubules

Question 49

Regarding biotransformation

A) CYP2D6 accounts for the majority of P450 activity
B) Phase one reactions always precede phase two reactions
C) water conjugation is a phase one reaction
D) None of them

Question 50

AII the following statements are correct concerning intravenous drug administration EXCEPT

A) It is painful and stressful for the patient
B) Drugs undergo first-pass metabolism
C) A trained staff is required
D) Risk of bacterial contamination at the site of injection

Question 51

A 12-month-old infant is hospitalized for nausea, vomiting, fevers. He is placed on a rectal treatment to treat the nausea and vomiting. Which of the following statements is true about this route of administration

A) Rectal irritation following administration is uncommon
B) Rectal administration ot medications is well accepted
C) Maximal biotransformation of the drug by the liver
D) Useful if patient is unconscious or vomiting
E) Allows destruction of the medication by gastric enzymes

Question 52

The IV administration of drugs are

A) Rapidly excreted by renal
B) Undergoes the first-pass metabolism
C) Rapidly absorbed
D) bioavailable 100%

Question 53

The same dose of Four different drugs was administered IV to the same lab animal on four different occasions. The following pharmacokinetic data were obtained: Drug Plasma concentration): for drug A 25 ng/mL Drug B: 12 ng/mL Drug C: 44 ng/mL Drug D:90ng/ml. which of the following drugs will have the lowest Vd the following drugs will have the lowest Vd

A) Drug C
B) Drug B
C) Drug A
D) DrugD

Question 54

33 year old female patient is brought to emergency department due to drug overdose and acute toxicity. Which routes of administration is desirable for antidote administration

A) I.V
B) S.L
C) Orally
D) S.C

Question 55

22.Clopidogrel (pro-dug) is metabolized by CYP450 is taken with rifampicin which is a CYP450 inducer. This will lead to

A) No effect on therapeutic effect of Clopidogrel
B) Increase therapeutic response of Clopidogrel
C) Decrease therapeutic response of Clopidogrel
D) Decrease the plasma concentration of Clopidogrel active metabolite

Question 56

Which statement about the distribution of drugs to specific tissues is most correct

A) Distribution to an organ is independent of blood flow
B) Distribution has no effect on the half-life ot the drug
C) Distribution depends on the unbound drug concentration gradient between blood and the tissue
D) Dist ution is independent of the solubility of the drug in that tissue
E) Distribution is increased for drugs that are strongly bound to plasma vroteins

Question 57

Therapeutic index (Tl) is

A) ratio used to evaluate the elimination of a drug
B) ratio used to evaluate the safely and usefulness of a drug for indication
C) ratio used to evaluate the bioavailability of a drug
D) ratio used to evaluate the effectiveness of a erug

Question 58

Principal organ/s for biotransformation of drugs is/are

A) Kidney
B) Kidney and liver
C) Lung
D) Liver
E) Skin

Question 59

Advantages of the rectal route of drug administration are

A) Suitable for children
B) A way to avoid first-pass metabolism. even partially
C) All of them
D) Suitable for unconscious patients
E) Suitable for children and unconscious patients

Question 60

Binding of a drug to plasma proteins will tend to?

A) Decrease half-life.
B) Decrease its rate of glomerular filtration.
C) Increase its rate of biotransformation.
D) None

Question 61

Compared to the average adult dose, the recommended dose of a drug for elderly a patients will likely be?

A) Less than average due to increased biotransformation.
B) Less than average due to decreased renal function or excretion
C) More than average due to decreased plasma protein binding capacity.
D) More than average due to increased renal excretion.

Question 62

Which one of the following statements is applicable to absorption of drugs from the gastrointestinal tract?

A) Absorption of weak acids occurs only from the stomach and not from the small intestine.
B) Some drugs are metabolized extensively by the liver and do not reach the general circulation (first-pass effect)
C) Ingesting drugs with food always enhances drug absorption.
D) None

Question 63

A patient is treated chronically with a drug (A) metabolized by CYP 3A4. Recently he administer another drug (B) which is an enzymatic inducer of the CYP2D6. Which of the following is likely to occur?

A) Longer half life of drug (A)
B) Longer half life of drug (B)
C) Enhanced pharmacological effect of drug A
D) No significant drug interaction
E) Reduced pharmacological effect of drug B

Question 64

In general, biotransformation usually results in a product, which is more?

A) Likely to produce side effects.
B) Likely to distribute intracellularly.
C) Lipid soluble than the original drug.
D) Likely to be reabsorbed by kidney tubules.
E)Water soluble than the original drug

Question 65

Enzyme inhibitors such as Cimetidine and Erythromycin are likely to produce?

A) Increase rate of breakdown of some drugs
B) Increase free level of some drugs
C) Inhibition of certain enzymes. which break down some drugs.
D) Improvement of bioavailability of some drugs

Question 66

What does "affinity" mean?

A) A measure of how tightly a drug binds to plasma proteins
B) measure of how tightly a drug binds to a receptor
C) measure of inhibiting potency ofa drug
D) A measure of bioavailability ofa drug

Question 67

Target proteins, which a drug molecule could bind, is/are ?

A) Only receptors
B) Only ion channels
C) Only carriers
D) All

Question 68

An agonist is a substance that ?

A) Interacts with the receptor without producing any effect
B)Interacts with the receptor and initiates changes in cell function, producing various effects
C) Increases concentration of another substance to produce effect
D) Interacts with plasma proteins and doesn't produce any effect

Question 69

A competitive antagonist is a substance that ?

A) Interacts with receptors and produces submaximal effect
B) Binds to the same receptor site and progressively inhibits the agonist response
C) Binds to the nonspecific sites of tissue
D) None of them

Question 70

Tick the second messenger of G-protein-coupled (metabotropic) receptor ?

A) Adenylyl cyclase
B) Sodium ions
C) Phospholipase C
D)cAmp

Question 71

What is the type Of drug-to-drug interaction, which is connected, with processes of

A) Pharmacodynamic interaction
B) Physical and chemical interaction
C) Pharmaceutical interaction
D)Pharmacokinetic interaction

Question 72

The term "chemical antagonism" means that?

A) Two drugs combine with one another to form an inactive compound
B) Two drugs combine with one another to form a more active compound
C) Two drugs combine with one another to form a more water soluble compound
D) Two drugs combine with one another to form a more fat soluble compound

Question 73

Idiosyncratic reaction of a drug is?

A) A type of hypersensitivity reaction
B) A type of drug antagonism
C) Unpredictable, inherent, qualitatively abnormal reaction to a drug
D) Quantitatively exaggerated response

Question 74

Therapeutic index (TI) is?

A) ratio used to evaluate the safety and usefulness ofa drug for indication
B) ratio used to evaluate the effectiveness of a drug
C) A ratio used to evaluate the bioavailability ofa drug
D) A ratio used to evaluate the elimination ofa drug

Question 75

What does the term "bioavailability" mean?

A) Plasma protein binding degree of substance
B) Permeability through the brain-blood barrier
C) Fraction of an uncharged drug reaching the systemic circulation following any route administration
D) Amount ofa substance in urine relative to the initial dose

Question 76

Drug distribution: Most of drugs are distributed homogeneously?

Question 77

A characteristic of drugs eliminated by zero order kinetic processes is that the half-life is not constant?

Question 78

The volume of distribution of gentamicin, a highly polar watersoluble drug, is 14L
Per 70 kg. This reflects the distribution of gentamicin into?

A) Plasma
B) Plasma, and interstitial fluid (extracellular)
C) Interstitial fluid
D) Total body water
E) Adipose tissue

Question 79

For continuous intravenous infusion as method of administration the time needed to achieve the concentration of steady state depends on the rate of drug administration?

Question 80

For drugs that have first order kinetics, after 4 half-lives about drug will be eliminated?

A) 50%
B) 75%
C) 93%
D) 100%