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Quiz on Pharmocokinetics - ADME , created by MPusey on 08/01/2015.

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Pharmocokinetics - ADME

Question 1 of 84

1

What is pharmocokinetics?

Select one of the following:

  • What the body does to the drug

  • What the drug does to the body

  • Mechanism of actions of the drug

  • An method of calculating what the dose of the drug should be

  • How the drug is excreted from the body

Explanation

Question 2 of 84

1

Which of the following are included in pharmocokinetics?

Select one or more of the following:

  • Absorption

  • Distribution

  • Metabolism

  • Excretion

  • Mechanism of Action

Explanation

Question 3 of 84

1

Which of the following describes absorption in terms of pharmocokintetics?

Select one of the following:

  • How quickly and by what means the unchanged drug gets into the body

  • How and where the drug moves among fluids and tissues

  • Transformation of the drug into daughter compounds

  • Removal of a drug or metabolite from the body

Explanation

Question 4 of 84

1

What best describes the term distribution in relation to pharmocokinetics?

Select one of the following:

  • How quickly and by what means the unchanged drug gets into the body

  • How and where the drug moves among fluids and tissues

  • Transformation of a drug into daughter compounds

  • Removal of a drug or metabolite from the body

Explanation

Question 5 of 84

1

What description best describes the term metabolism in relation to pharmocokintetics?

Select one of the following:

  • How quickly and by what means the unchanged drug gets into the body

  • How and where the drug moves among fluids and tissues

  • Transformation of a drug into daughter compounds

  • Removal of a drug or metabolite from the body

Explanation

Question 6 of 84

1

Which description best describes the term excretion in relation to pharmocokinetics?

Select one of the following:

  • How quickly and by what means the unchanged drug gets into the body

  • How and where the drug moves among fluids and tissues

  • Transformation of a drug into daughter compounds

  • Removal of a drug or metabolite from the body

Explanation

Question 7 of 84

1

Why is pharmocokinetics important?

Select one or more of the following:

  • Safe use of medicines by doctors

  • Designing dosing regimes

  • Monitoring treatment compliance

  • Substance abuse monitoring

  • Medicine licensing requirements

  • Ensuring the medicine has the correct mechanism of action

Explanation

Question 8 of 84

1

What is the main reason that drugs are withdrawn from development?

Select one of the following:

  • Pharmocokinetics (undesirable effects on the body)

  • Commercial reasons

  • Lack of efficacy

  • Animal toxicity

Explanation

Question 9 of 84

1

In what circumstance do drugs not need to be absorbed into the body?

Select one of the following:

  • When they are injected straight into the blood

  • When they act on the stomach or intestines

  • When they act on where they are excreted

  • When they are only being used for clinical trials

  • When the dose of the drug needs to be really small

Explanation

Question 10 of 84

1

What is bio-availability?

Select one of the following:

  • The percentage of administered drug that enters the circulation

  • The proportion of cells within the body that the drug will affect

  • The proportion of cells within the body that the drug will enter

  • The percentage of administered drug that is absorbed in the stomach

  • The percentage of administered drug that is absorbed in the intestines

Explanation

Question 11 of 84

1

Which route of administration has the highest bio-availability?

Select one of the following:

  • Intravenous injection

  • Oral

  • Inhalation

  • Subcutaneous injection

  • Intramuscular injection

Explanation

Question 12 of 84

1

What is the bio-availability of a drug that is administered intravenously?

Select one of the following:

  • 100%

  • 99%

  • 75%

  • 90%

  • 82%

Explanation

Question 13 of 84

1

Why aren't all drugs given by intravenous injection?

Select one or more of the following:

  • It's inconvenient

  • It requires a hospital setting

  • It's more expensive

  • It causes more side effects

  • The high bio-availability can cause toxicity when using some drugs

Explanation

Question 14 of 84

1

Why is the inhalation of a drug a good route of administration in conditions like asthma?

Select one of the following:

  • Because the drug goes straight to the site of action

  • Because it decreases the side effects

  • Because it is non-invasive

  • Because it prevents the drug being metabolized by the liver prior to reaching the tissues

Explanation

Question 15 of 84

1

What are some disadvantages of giving drugs orally?

Select one or more of the following:

  • They may metabolized by the liver before they reach the target tissue

  • The bio-availability is unlikely to be 100%

  • They cannot be absorbed in the stomach

  • It makes the drug harder to excrete

  • It leads to more side effects

Explanation

Question 16 of 84

1

What will increase the diffuse of drugs into the bloodstream?

Select one or more of the following:

  • Increased surface area to diffuse across

  • Increased concentration of the drug

  • Decreased surface area to diffuse across

  • Decreased concentration of the drug

Explanation

Question 17 of 84

1

Which type of absorption is most common?

Select one of the following:

  • Transcellular absorption

  • Paracellular absorption

Explanation

Question 18 of 84

1

What will be a problem if a drug is too lipophilic?

Select one of the following:

  • It will remain within the cell membrane instead of passing through it

  • It will not pass through the cell membrane

  • It will have more side effects

  • It is likely to have animal toxicity

Explanation

Question 19 of 84

1

What is permeability determined by?

Select one or more of the following:

  • How lipophilic the solute is

  • The size of the solute

  • Whether or not the solute is charged

  • The pH of the particle when it dissolves in the solution

  • The surface area available for diffusion to take place across

Explanation

Question 20 of 84

1

Where are acidic drugs most likely to be absorbed?

Select one of the following:

  • Stomach

  • Intestines

  • Liver

Explanation

Question 21 of 84

1

Where are basic drugs most likely to be absorbed?

Select one of the following:

  • Stomach

  • Intestines

  • Liver

Explanation

Question 22 of 84

1

Why are drugs often weak acids or weak bases?

Select one or more of the following:

  • It allows ion trapping

  • It allows them to be water soluble and lipophilic

  • It means they have a higher efficacy

  • It means they will have less side effects

  • It allows them to pass through cell membranes more easily

Explanation

Question 23 of 84

1

What state are acidic or basic drugs in when they pass through cell membranes?

Select one of the following:

  • Ionized

  • Unionized

  • Metabolized

Explanation

Question 24 of 84

1

Why are acidic drugs more likely to be absorbed in the stomach?

Select one of the following:

  • Because the stomach is acidic and they will be unionized so can move through the cell membrane

  • Because the stomach is basic and they will be unionized so can move through the cell membrane

  • Because the stomach is acidic and they will be ionized so can move through the cell membrane

  • Because the stomach is basic and they will ionized so can move through the cell membrane

Explanation

Question 25 of 84

1

What is ion trapping?

Select one of the following:

  • The prevention of ions leaving the bloodstream once they have been absorbed

  • The prevention of ions leaving the stomach or intestines because they are unable to be absorbed

  • The trapping of ions within the liver because they may be harmful to the body

Explanation

Question 26 of 84

1

What allows ion trapping to occur?

Select one of the following:

  • The pH of the stomach being ~1 and the bloodstream being ~7.4

  • The pH of the stomach being ~7.4 and the bloodstream being ~1

  • The stomach having a higher concentration of potassium than the bloodstream

  • The bloodstream having a higher concentration of potassium than the stomach

Explanation

Question 27 of 84

1

Which drugs are likely to be absorbed most quickly?

Select one of the following:

  • Acidic drugs

  • Basic drugs

  • Drugs that are neither acidic or basic

Explanation

Question 28 of 84

1

What makes up for the fact that basic drugs cannot be absorbed in the stomach?

Select one of the following:

  • The high surface area in the intestines

  • They have a higher efficacy than acidic drugs

  • They have a higher bio-availability than acidic drugs

Explanation

Question 29 of 84

1

Where will aspirin be absorbed?

Select one of the following:

  • Stomach

  • Intestines

Explanation

Question 30 of 84

1

What is the Lipinski rule?

Select one of the following:

  • A method of predicting the likelihood of a successful development of a drug

  • A method of predicting where a drug is most likely to be absorbed

  • A method of predicting the efficacy of a drug

  • A method of predicting the side effects of a drug

  • A method of calculating the appropriate dose of a drug

Explanation

Question 31 of 84

1

What are the Lipinski rules?

Select one or more of the following:

  • Molecular weight > 500

  • No more than 5 H-bond donors

  • No less than 10 H-bond acceptors

  • Log(partition coefficient) < 5

Explanation

Question 32 of 84

1

What is a partition coefficient?

Select one of the following:

  • How lipophilic a drugs is

  • How likely a drug is likely to be absorbed

  • How toxic a drug is

  • Another term for the bio-availability of a drug

Explanation

Question 33 of 84

1

Where will a drug move to most quickly?

Select one of the following:

  • A well-perfused muscle

  • A poorly-perfused area of adipose tissue

Explanation

Question 34 of 84

1

We assume the concentration of a drug is proportional to the concentration at the site of action. True or false?

Select one of the following:

  • True
  • False

Explanation

Question 35 of 84

1

Most drugs follow...

Select one of the following:

  • First order kinetics

  • Zero order kinetics

  • Second order kinetics

Explanation

Question 36 of 84

1

Which of the following describe first order kinetics?

Select one or more of the following:

  • The half life of the drug is constant

  • When the dose of the drug is increased the same fraction of the drug is removed

  • A constant volume of the drug is removed

  • The bigger the dose the longer it takes to remove it

Explanation

Question 37 of 84

1

Which is most desirable for clinically used drugs?

Select one of the following:

  • First order kinetics

  • Zero order kinetics

  • Second order kinetics

Explanation

Question 38 of 84

1

Which of the following are true about zero order drugs?

Select one or more of the following:

  • The half-life of the drug is constant

  • If you increase the drug dose the same fraction of drug is removed

  • A constant volume of the drug is removed

  • The larger the dose of the drug the longer it will take to remove it

  • If there is only a small dose it will follow first order kinetics

  • If there is only a small dose of a drug it will follow second order kinetics

Explanation

Question 39 of 84

1

Alcohol is a zero order drug. True or false?

Select one of the following:

  • True
  • False

Explanation

Question 40 of 84

1

Why are zero order drugs dangerous?

Select one of the following:

  • Because there is saturation of the metabolic pathways

  • Because the drug has a lower efficacy

  • Because the drug will be more slowly removed

  • Because there will be more side effects

Explanation

Question 41 of 84

1

What is volume of distribution?

Select one of the following:

  • The volume of plasma that would be necessary to account for the total amount of drug in the patients body, if the drug was were present throughout the body at the same concentration as in the plasma

  • The concentration of the drug in the plasma, which is used to estimate the concentration of the drug at it's site of action

  • The volume of plasma required to dilute the drug to the necessary concentration to have the desired pharmacological effect on the body

Explanation

Question 42 of 84

1

What is the formula for volume of distribution (Vd)?

Select one of the following:

  • Vd = total amount of drug/concentration of drug in plasma

  • Vd = concentration of drug in plasma/total amount of drug

  • Vd = concentration of drug in bloodstream/total amount of drug

  • Vd = total amount of drug/concentration of drug at site of action

Explanation

Question 43 of 84

1

What is volume of distribution useful for?

Select one or more of the following:

  • Calculating the loading dose required for desired blood concentration

  • Estimating blood concentration in the treatment of overdose

  • Calculating the amount of time required between each dose of the drug

  • Estimating the percentage of the drug that is at the site of action

Explanation

Question 44 of 84

1

What is plasma clearance?

Select one of the following:

  • The volume of plasma cleared of the drug per unit of time

  • The percentage of drug cleared from the plasma per unit time

  • The percentage of plasma cleared of the drug per unit time

Explanation

Question 45 of 84

1

What is the equation for the plasma clearance of drugs?

Select one of the following:

  • Clearance = rate of elimination/concentration of drug in plasma

  • Clearance = concentration of drug in plasma/rate of elimination

  • Clearance = rate of elimination x concentration of drug in plasma

Explanation

Question 46 of 84

1

Which drugs will have a constant plasma clearance?

Select one of the following:

  • First order drugs

  • Zero order drugs

  • Second order drugs

Explanation

Question 47 of 84

1

How is bio-availability measured?

Select one of the following:

  • The fraction of drug in circulation compared to the dose

  • The volume of drug in circulation

  • The percentage of drug that is absorbed in the stomach

  • The percentage of drug that reaches the desired site of action

Explanation

Question 48 of 84

1

Which method of administration is used to calculate the bio-availability of a drug using a different method of administration?

Select one of the following:

  • Intravenous injection

  • Intramuscular injection

  • Oral

  • Inhalation

  • Subcutaneous injection

Explanation

Question 49 of 84

1

What might cause poor bio-availability?

Select one or more of the following:

  • Poor absorption

  • Chemical reactions at the site of delivery

  • First pass metabolism

  • Chemical reaction at the site of action

  • The drug being acidic

Explanation

Question 50 of 84

1

What is first pass metabolism?

Select one of the following:

  • When the concentration of the drug is greatly reduced before it reaches the systemic circulation

  • When the concentration of the drug is greatly reduced before it reaches the pulmonary circulation

  • When the half-life of the drug is very short the very little drug reaches the site of action

Explanation

Question 51 of 84

1

Which route of administration will lead to the lowest concentration of drug in the circulation?

Select one of the following:

  • Oral

  • Intravenous

  • Subcutaneous

  • Intramuscular

Explanation

Question 52 of 84

1

What is multiple dosing designed to achieve?

Select one of the following:

  • A "steady state"

  • The least side effects

  • The highest bio-availability

  • The highest efficacy

Explanation

Question 53 of 84

1

There a no fluctuations in the concentration of drug once it has reached its "steady state" following multiple doses. True or false?

Select one of the following:

  • True
  • False

Explanation

Question 54 of 84

1

When using multiple dosing, when should the next dose of the drug be given to ensure a "steady state" is reached?

Select one of the following:

  • Before the concentration of the drug falls to zero

  • After the concentration of the drug has fallen to zero

  • After the first half life

  • After two half lives

Explanation

Question 55 of 84

1

What does the time taken for the drug to reach a "steady state" depend on?

Select one of the following:

  • The drugs half life

  • The drugs efficacy

  • The drugs bio-availability

Explanation

Question 56 of 84

1

How long does it typically take for the "steady state" to be achieved?

Select one of the following:

  • 4-5 half lives

  • 1 half life

  • 1-2 half lives

  • A variable amount of half lives

Explanation

Question 57 of 84

1

Where can drug metabolism occur?

Select one or more of the following:

  • Site of administration

  • Site of action

  • Bloodstream

Explanation

Question 58 of 84

1

When does drug metabolism and excretion begin to occur?

Select one of the following:

  • Immediately

  • After one half life

  • It is impossible to tell

Explanation

Question 59 of 84

1

What is metabolism typically designed to do?

Select one of the following:

  • Make the drug easier to excrete

  • Reduce the side effects of the drug

  • Increase the amount of time the drug remains in the body

  • Prevent the drugs from being absorbed in the stomach

Explanation

Question 60 of 84

1

Give an example of a drug that is eliminated by the body without being metabolized?

Select one of the following:

  • Digoxin

  • Enalapril

  • Paracetamol

  • Alcohol

Explanation

Question 61 of 84

1

All drug metabolites are inactive. True or false?

Select one of the following:

  • True
  • False

Explanation

Question 62 of 84

1

How many phases are there to drug metabolism?

Select one of the following:

  • 2

  • 3

  • 4

  • 5

Explanation

Question 63 of 84

1

What happens during phase 1 of drug metabolism?

Select one of the following:

  • Introduction of chemically reactive groups

  • A increase in the water solubility of the drug for excretion

  • Removal of reactive groups from the drug

  • Ionization of the drug to prevent it from crossing cell memebranes

Explanation

Question 64 of 84

1

Where does phase 1 of drug metabolism usually take place?

Select one of the following:

  • In the liver

  • In the bloodstream

  • In the kidneys

  • At the site of action

Explanation

Question 65 of 84

1

What enzyme is usually involved in phase 1 of drug metabolism?

Select one of the following:

  • Cytochrome P450

  • Lipases

  • DNA polymerases

  • Amylase

Explanation

Question 66 of 84

1

What usually occurs during phase 2 of drug metabolism?

Select one of the following:

  • Conjugation of the drug with endogenous compounds

  • Addition of reactive groups to the molecule

  • Oxidation of the molecule

  • Hydrolysis of any hydrogen bonds within the molecule

Explanation

Question 67 of 84

1

Which drug is metabolised with phase 2 taking place before phase 1?

Select one of the following:

  • Paracetamol

  • Alcohol

  • Digoxin

  • Enalapril

Explanation

Question 68 of 84

1

Which phase of paracetamol metabolism produces a toxic compound?

Select one of the following:

  • Phase 1

  • Phase 2

Explanation

Question 69 of 84

1

Why is paracetamol more likely to cause problems in alcoholics than in the general population?

Select one of the following:

  • Because alcoholics have more cytochrome P450 so phase 1 is more likely to occur

  • Because alcoholics have no cytochrome P450 so the toxic compound is readily produced

  • Because alcoholics lack thyamine which is a co-enzyme for the phase 2 part of paracetamol metabolism

Explanation

Question 70 of 84

1

Only unbound drugs can be excreted. True or false?

Select one of the following:

  • True
  • False

Explanation

Question 71 of 84

1

Which drugs are likely to be excreted more slowly?

Select one of the following:

  • Lipophilic drugs

  • Hydrophilic drugs

Explanation

Question 72 of 84

1

Why are lipophilic drugs likely to excreted more slowly?

Select one of the following:

  • Because they are likely to be reabsorbed

  • Because they cannot be filtered through the glomerulus

  • Because they are usually bigger

  • Because they are not secreted into the tubules

Explanation

Question 73 of 84

1

All drugs can be secreted into the renal tubules from the bloodstream. True or false?

Select one of the following:

  • True
  • False

Explanation

Question 74 of 84

1

What sort of process is tubular secretion in terms of drug elimination?

Select one of the following:

  • Active process requiring a carrier molecule

  • Passive process requiring an activated protein channel

  • Active process without a carrier molecule

  • Passive diffusion through the membrane

Explanation

Question 75 of 84

1

If renal clearance is slow, the plasma half-life of the drug will be...?

Select one of the following:

  • Longer

  • Shorter

  • Unchanged

Explanation

Question 76 of 84

1

Why can age affect drug metabolism and excretion?

Select one or more of the following:

  • Cytochrome P450 is less efficient in neonates

  • GFR is increased in elderly people

  • Increased percentage of fat in elderly people decreases excretion of lipophilic drugs

  • Cytochrome P450 is less efficient in elderly people

Explanation

Question 77 of 84

1

What disease is most likely to affect the pharmocokinetics of a drug?

Select one of the following:

  • Renal disease

  • Heart disease

  • Parkinson's disease

  • Learning difficulties

Explanation

Question 78 of 84

1

Which is the most common type of adverse drug reaction?

Select one of the following:

  • Type A

  • Type B

Explanation

Question 79 of 84

1

Which of the following describe type A drug reactions?

Select one or more of the following:

  • Reaction related to known drug mechanisms

  • Predictable

  • Unavoidable

Explanation

Question 80 of 84

1

Which of the following may cause type A drug reactions?

Select one or more of the following:

  • Wrong dose administered

  • Drug interactions

  • High therapeutic index of the drug

  • Immunological mechanisms

Explanation

Question 81 of 84

1

Which of the following describe a type 2 drug reaction?

Select one or more of the following:

  • Related to unknown mechanisms of the drug

  • Predictable

  • Unexpected

  • Related to patient individuality

Explanation

Question 82 of 84

1

What is a drawback of the yellow form for monitoring adverse drug reactions?

Select one of the following:

  • It relies on doctors and patients self-reporting

  • It is only accessible to doctors

  • It only reports on one drug at a time

  • It does not monitor drugs throughout their whole lifetime

Explanation

Question 83 of 84

1

What is usually added to the yellow form when more information is required about a drug?

Select one of the following:

  • Black triangle

  • Green form

  • A priority index number

  • A warning about the drug from the BNF

Explanation

Question 84 of 84

1

What is a benefit of the green form?

Select one of the following:

  • It is used to record all significant events, not just adverse effects of a drug

  • It is easily accessible by all

  • It is compulsory to fill it in when an adverse reaction occurs

  • It is clearly visible in a copy of every BNF

Explanation

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