PHARMACEUTICS
1. Concerning oral administration disadvantages
A) Drug taken orally may cause emesis & may be destroyed by gastric acidity
B) Drug taken orally may be metabolized by gastrointestinal flora
C) Drug taken orally may be in consistently absorbed due to the presence of food
D) All above
2. Typical properties of carrier-mediated drug transport:
A) Active transport
B) Energy requiring
C) Inhibitable
D) All above
3. Driving force in drug movement in aqueous diffusion model:
A) Active transport– energy requiring
B) Facilitated transport
C) Drug concentration gradient
D) None
4. Renal excretion factor most likely to be sensitive to drug ionization state:
A) Glomerular filtration
B) Passive tubular reabsorption
C) Active tubular reabsorption
D) All above
5. Drug(s) which exhibit(s) a high hepatic” first-pass” effect:
A) Lidocaine B) Propranolol
C) Both D) Neither
6. Permanently charged amine form:
A) Primary amine
B) Secondary amine
C) Tertiary amine
D) Quaternary amine
7. For high extraction-ratio drugs, patient to patient bioavailability may vary due to differences in:
A) Hepatic function
B) Blood flow
C) The presence of hepatic disease
D) All above
8. Factors associated with drug absorption that can result in incomplete absorption. FIND OUT THE TRUE ONE.
A) Drug metabolism by gastrointestinal flora
B) Drug hydrophilicity (opposite of lipophilicity)
C) Drug instability in gastric acid
D) Presence of food in the GI tract
E) Drug-drug interactions
9. Drug characteristics contributing to reliable transdermal drug absorption: FIND OUT THE TRUE ONE.
A) Molecular weight less than 1000
B) Drug does not cause histamine release
C) The daily drug requirement is less than 10 mg
D) In saturated aqueous solution, the pH range is 5-9
E) All above
10. Concerning parenteral drug administration: FIND TRUE ONE
A) High predictable compared to oral administration route
B) Not acceptable for unconscious patients
C) Rate of drug systemic absorption insensitive to drug solubility in interstitial fluid
D) Rate of systemic drug absorption following parenteral administration depends on absorbing capillary membrane surface area
11. Pharmacokinetic advantages associated with transdermal drug delivery:
A) Relatively constant, sustained therapeutic plasma drug concentrations
B) Commonly low side-effect incidence
C) Good patient compliance
D) All above
12. Drugs for which “first-pass” pulmonary uptake may exceed 65% of injected dose:
A) Fentanyl B) Alfentanil
C) Sufentanil D) Meperidine
E) all of the above
13. Roots of administration that avoid “first-pass” hepatic effects EXCEPT?
A) Sublingual
B) Oral
C) Transdermal
D) Lower rectal suppositories
E) Inhalation
14. Drugs least likely to penetrate across membranes:
A) Protein-bound drugs
B) Charged drugs
C) Neutral drugs
D) None
15. Available for transdermal drug delivery:
A) Scopolamine
B) Fentanyl
C) Nitroglycerin
D) All above
16. Concerning “first pass” elimination:
A) Drug is first transported across the gut wall into the portal circulation
B) Sometimes extensive drug metabolism may occur in the liver
C) The liver may excrete drug into the bile
D) First-pass effects may reduce drug bioavailability
E) All above
17. Factor(s) which effect a drug’s volume of distribution:
A) patient’s gender & patient’s age
B) Presence of disease
C) Drug pKa
D) Extent of drug-plasma protein binding
E) All above
18. Two most important sites for drug elimination:
A) Pulmonary and liver
B) Liver and gastrointestinal tract
C) Kidney and liver
D) Skin and liver
E) Pulmonary and kidney
19. Concerning transfer of basic drugs such as nonionized local anesthetics from mother to fetus:
A) Fetal pH is higher than maternal pH
B) In fetal distress alkalosis contributes to local anesthetic accumulation
C) Concerning maternal blood: fetal blood — gradient is maintained for continual local anesthetic transfer from maternal circulation to fetal circulation
20. Characteristics of renal drug excretion:
A) Nearly all drugs are filtered at the glomerulus
B) Drugs which are weak acids are excreted faster in acidic urinary pH
C) Drugs which are weak base is our excreted faster in alkaline urinary pH
D) Body fluids where pH differences from blood pH may favor on and trapping include breast milk and aqueous humor (eye)
21. Factors that could change intrinsic hepatic clearance include:
A) Hepatic blood flow
B) Induction state of hepatic enzymes
C) Hepatic disease
D) All Above
22. In rheumatoid arthritis patients, increased alpha1-acidic glycoprotein may be associated with increased lidocaine protein binding.
A) True
B) False
23. Hepatic flow-dependent drug elimination refers to:
A) Changes in plasma protein concentration
B) Rate-limiting step is drug delivery to hepatic elimination sites
C) Number of functional hepatocytes
D) Carrier saturation
E) Drug transfer rates across hepatic cell membrane
24. Characteristic(s) of a drug whose action is terminate by redistribution include:
A) Generally long-acting
B) Usually a hydrophilic (not very lipidsoluble) drug
C) Eventually concentrates usually in adipose (fat) tissue
D) Tends to partition slowly into organs such as the brain, even though the brain receives a significant fraction of the cardiac output
25. Cytochrome P450 induction (increased, amount of P450 enzyme protein) is often associated with:
A) Increased enzyme synthesis rates
B) Reduced enzyme degradation rates
C) Both
D) Neither
26. Microsomal drug metabolizing enzymes are typically associated with:
A) Rough endoplasmic reticulum
B) Smooth endoplasmic reticulum
C) Both
D) Neither
27. Characteristics of drug-protein binding:
A) Often parallels drug lipid solubility
B) drug-plasma albumin binding tends to be relatively nonselective
C) In rheumatoid arthritis patients, increased alpha1-acidic glycoprotein tends to promote increased lidocaine protein binding
D) All above
28. Examples of “high-extraction” drugs – – related to hepatic drug clearance:
A) Morphine
B) Meperidine
C) Verapamil
D) Diltiazem
E) All the above
29. Pharmacogenetic effects:
A) Prolonged mivacurium-induced neuromuscular blockade due to atypical Cholinesterase
B) Succinylcholine or volatile anestheticinduced malignant hyperthermia
C) Both
D) Neither
30. Characteristics of drug conjugates (following conjugation reactions)
A) More polar
B) More readily excreted
C) Typically more pharmacologically active
D) A & B both
31. Termination of pharmacological action of thiopental occurs mainly by:
A) metabolism
B) Excretion
C) Redistribution
D) None
32. Concerning influence of age on drug Responses variation in response usually due to:
A) Reduced cardiac output
B) Reduced hepatic perfusion
C) Decreased renal function
D) All of the above
33. Reaction type associated with inactivation of succinylcholine, atracurium, and mivacurium.
A) Conjugation
B) Hydrolysis
C) Oxidation
D) Reduction
34. Phase II and reactions involve are?
A) Conjugation
B) Hydrolysis
C) Oxidation & reduction
D) All above
35. Factors affecting renal clearance of drugs:
A) The presence of renal disease
B) Drug secretion rates
C) Number of functional nephrons
D) Blood flow
E) All of the above
36. Concerning drug-plasma protein binding:
A) Drugs are seldom bound to plasma proteins
B) Volume of distribution is not influenced by protein binding
C) Diazepam is an example of the drug that is minimally protein-bound
D) Drug clearance is influenced by the extent of protein binding
37. Mixed function oxidases system is referred to as mediating:
A) Phase I system
B) Phase II system
C) Phase III system
D) Phase IV system
38. Characteristics of drug-protein binding
A) Generally the extent of drug-protein binding parallels drug lipids liability
B) Sulfonamides may displace unconjugated bilirubin from albumin-binding sites (because neonatal bilirubin encephalopathy)
C) Both
D) Renal failure may decrease drug bound fraction because of reduced plasma albumin
39. Factors affecting hepatic drug clearance:
A) Drug delivery to liver elimination sites
B) Extent of plasma protein-bound drug
C) Blood flow
D) All above
40. Factors affecting renal drug secretion rates:
A) Carrier saturation & drug transfer rates across tubular membranes
B) Degree of drug-plasma protein binding
C) Rate of drug delivery to secretory sites
D) All the above
41. The rate of drug transport across a cell membrane by lipid diffusion depends on all of the following EXCEPT:
a. Drug size (diffusion constant)
b. Surface area of absorption
c. Lipid partition coefficient
d. Density of transporters
42. The major mechanism of drug transport involved in the transport of drug out of the blood into tissues is:
a. Aqueous diffusion
b. Lipid diffusion
c. Active transport
d. Facilitated transport
43. The distribution of drugs into the central nervous system (brain) usually depends on:
a. Aqueous diffusion
b. Lipid diffusion
c. Active transport
d. Facilitated transport
44. A characteristic of absorption by lipid diffusion is its saturability at high drug concentrations.
A. True
B. False
45. Drugs with low oil: water partition coefficients undergo lipid diffusion more rapidly than drugs with high oil: water partition coefficients.
A. True
B. False
46. Following intravenous administration, drugs are distributed fastest to:
A. the skin, kidney, and brain
B. the liver, kidney, and brain ANS
C. the liver, adipose, and brain
D. the liver, kidney, and adipose
E. the adipose, skin, and brain
47. A fundamental characteristic of all first order pharmacokinetic processes is that the rate of the process is proportional to drug concentration:
A. True
B. False
48. Competition between two drugs for binding to plasma protein(s) can result in a change in the concentration of free drug and potential drug toxicity.
A. True
B. False
49. At pH 9.0, morphine (a weak base containing an ionizable amine group, pKa of 7.0) would exist predominantly in the charged form.
A. True
B. False
50. At pH 5.0, the ratio of the protonated to unprotonated forms of morphine (a weak base containing an ionizable amine group, pKa = 7.0) would be:
a. 1:100
b. 1:10
c. 1:1
d. 100:1
Answers
