1845475
Questão 1
Questão
What is pharmocokinetics?
Responda
-
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
Questão 2
Questão
Which of the following are included in pharmocokinetics?
Responda
-
Absorption
-
Distribution
-
Metabolism
-
Excretion
-
Mechanism of Action
Questão 3
Questão
Which of the following describes absorption in terms of pharmocokintetics?
Responda
-
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
Questão 4
Questão
What best describes the term distribution in relation to pharmocokinetics?
Responda
-
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
Questão 5
Questão
What description best describes the term metabolism in relation to pharmocokintetics?
Responda
-
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
Questão 6
Questão
Which description best describes the term excretion in relation to pharmocokinetics?
Responda
-
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
Questão 7
Questão
Why is pharmocokinetics important?
Responda
-
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
Questão 8
Questão
What is the main reason that drugs are withdrawn from development?
Responda
-
Pharmocokinetics (undesirable effects on the body)
-
Commercial reasons
-
Lack of efficacy
-
Animal toxicity
Questão 9
Questão
In what circumstance do drugs not need to be absorbed into the body?
Responda
-
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
Questão 10
Questão
What is bio-availability?
Responda
-
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
Questão 11
Questão
Which route of administration has the highest bio-availability?
Responda
-
Intravenous injection
-
Oral
-
Inhalation
-
Subcutaneous injection
-
Intramuscular injection
Questão 12
Questão
What is the bio-availability of a drug that is administered intravenously?
Responda
-
100%
-
99%
-
75%
-
90%
-
82%
Questão 13
Questão
Why aren't all drugs given by intravenous injection?
Responda
-
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
Questão 14
Questão
Why is the inhalation of a drug a good route of administration in conditions like asthma?
Responda
-
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
Questão 15
Questão
What are some disadvantages of giving drugs orally?
Responda
-
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
Questão 16
Questão
What will increase the diffuse of drugs into the bloodstream?
Responda
-
Increased surface area to diffuse across
-
Increased concentration of the drug
-
Decreased surface area to diffuse across
-
Decreased concentration of the drug
Questão 17
Questão
Which type of absorption is most common?
Responda
-
Transcellular absorption
-
Paracellular absorption
Questão 18
Questão
What will be a problem if a drug is too lipophilic?
Responda
-
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
Questão 19
Questão
What is permeability determined by?
Responda
-
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
Questão 20
Questão
Where are acidic drugs most likely to be absorbed?
Responda
-
Stomach
-
Intestines
-
Liver
Questão 21
Questão
Where are basic drugs most likely to be absorbed?
Responda
-
Stomach
-
Intestines
-
Liver
Questão 22
Questão
Why are drugs often weak acids or weak bases?
Responda
-
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
Questão 23
Questão
What state are acidic or basic drugs in when they pass through cell membranes?
Responda
-
Ionized
-
Unionized
-
Metabolized
Questão 24
Questão
Why are acidic drugs more likely to be absorbed in the stomach?
Responda
-
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
Questão 25
Questão
What is ion trapping?
Responda
-
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
Questão 26
Questão
What allows ion trapping to occur?
Responda
-
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
Questão 27
Questão
Which drugs are likely to be absorbed most quickly?
Responda
-
Acidic drugs
-
Basic drugs
-
Drugs that are neither acidic or basic
Questão 28
Questão
What makes up for the fact that basic drugs cannot be absorbed in the stomach?
Responda
-
The high surface area in the intestines
-
They have a higher efficacy than acidic drugs
-
They have a higher bio-availability than acidic drugs
Questão 29
Questão
Where will aspirin be absorbed?
Responda
-
Stomach
-
Intestines
Questão 30
Questão
What is the Lipinski rule?
Responda
-
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
Questão 31
Questão
What are the Lipinski rules?
Responda
-
Molecular weight > 500
-
No more than 5 H-bond donors
-
No less than 10 H-bond acceptors
-
Log(partition coefficient) < 5
Questão 32
Questão
What is a partition coefficient?
Responda
-
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
Questão 33
Questão
Where will a drug move to most quickly?
Responda
-
A well-perfused muscle
-
A poorly-perfused area of adipose tissue
Questão 34
Questão
We assume the concentration of a drug is proportional to the concentration at the site of action. True or false?
Responda
- True
- False
Questão 35
Questão
Most drugs follow...
Responda
-
First order kinetics
-
Zero order kinetics
-
Second order kinetics
Questão 36
Questão
Which of the following describe first order kinetics?
Responda
-
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
Questão 37
Questão
Which is most desirable for clinically used drugs?
Responda
-
First order kinetics
-
Zero order kinetics
-
Second order kinetics
Questão 38
Questão
Which of the following are true about zero order drugs?
Responda
-
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
Questão 39
Questão
Alcohol is a zero order drug. True or false?
Responda
- True
- False
Questão 40
Questão
Why are zero order drugs dangerous?
Responda
-
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
Questão 41
Questão
What is volume of distribution?
Responda
-
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
Questão 42
Questão
What is the formula for volume of distribution (Vd)?
Responda
-
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
Questão 43
Questão
What is volume of distribution useful for?
Responda
-
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
Questão 44
Questão
What is plasma clearance?
Responda
-
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
Questão 45
Questão
What is the equation for the plasma clearance of drugs?
Responda
-
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
Questão 46
Questão
Which drugs will have a constant plasma clearance?
Responda
-
First order drugs
-
Zero order drugs
-
Second order drugs
Questão 47
Questão
How is bio-availability measured?
Responda
-
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
Questão 48
Questão
Which method of administration is used to calculate the bio-availability of a drug using a different method of administration?
Responda
-
Intravenous injection
-
Intramuscular injection
-
Oral
-
Inhalation
-
Subcutaneous injection
Questão 49
Questão
What might cause poor bio-availability?
Responda
-
Poor absorption
-
Chemical reactions at the site of delivery
-
First pass metabolism
-
Chemical reaction at the site of action
-
The drug being acidic
Questão 50
Questão
What is first pass metabolism?
Responda
-
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
Questão 51
Questão
Which route of administration will lead to the lowest concentration of drug in the circulation?
Responda
-
Oral
-
Intravenous
-
Subcutaneous
-
Intramuscular
Questão 52
Questão
What is multiple dosing designed to achieve?
Responda
-
A "steady state"
-
The least side effects
-
The highest bio-availability
-
The highest efficacy
Questão 53
Questão
There a no fluctuations in the concentration of drug once it has reached its "steady state" following multiple doses. True or false?
Responda
- True
- False
Questão 54
Questão
When using multiple dosing, when should the next dose of the drug be given to ensure a "steady state" is reached?
Responda
-
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
Questão 55
Questão
What does the time taken for the drug to reach a "steady state" depend on?
Responda
-
The drugs half life
-
The drugs efficacy
-
The drugs bio-availability
Questão 56
Questão
How long does it typically take for the "steady state" to be achieved?
Responda
-
4-5 half lives
-
1 half life
-
1-2 half lives
-
A variable amount of half lives
Questão 57
Questão
Where can drug metabolism occur?
Responda
-
Site of administration
-
Site of action
-
Bloodstream
Questão 58
Questão
When does drug metabolism and excretion begin to occur?
Responda
-
Immediately
-
After one half life
-
It is impossible to tell
Questão 59
Questão
What is metabolism typically designed to do?
Responda
-
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
Questão 60
Questão
Give an example of a drug that is eliminated by the body without being metabolized?
Responda
-
Digoxin
-
Enalapril
-
Paracetamol
-
Alcohol
Questão 61
Questão
All drug metabolites are inactive. True or false?
Responda
- True
- False
Questão 62
Questão
How many phases are there to drug metabolism?
Responda
-
2
-
3
-
4
-
5
Questão 63
Questão
What happens during phase 1 of drug metabolism?
Responda
-
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
Questão 64
Questão
Where does phase 1 of drug metabolism usually take place?
Responda
-
In the liver
-
In the bloodstream
-
In the kidneys
-
At the site of action
Questão 65
Questão
What enzyme is usually involved in phase 1 of drug metabolism?
Responda
-
Cytochrome P450
-
Lipases
-
DNA polymerases
-
Amylase
Questão 66
Questão
What usually occurs during phase 2 of drug metabolism?
Responda
-
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
Questão 67
Questão
Which drug is metabolised with phase 2 taking place before phase 1?
Responda
-
Paracetamol
-
Alcohol
-
Digoxin
-
Enalapril
Questão 68
Questão
Which phase of paracetamol metabolism produces a toxic compound?
Responda
-
Phase 1
-
Phase 2
Questão 69
Questão
Why is paracetamol more likely to cause problems in alcoholics than in the general population?
Responda
-
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
Questão 70
Questão
Only unbound drugs can be excreted. True or false?
Responda
- True
- False
Questão 71
Questão
Which drugs are likely to be excreted more slowly?
Responda
-
Lipophilic drugs
-
Hydrophilic drugs
Questão 72
Questão
Why are lipophilic drugs likely to excreted more slowly?
Responda
-
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
Questão 73
Questão
All drugs can be secreted into the renal tubules from the bloodstream. True or false?
Responda
- True
- False
Questão 74
Questão
What sort of process is tubular secretion in terms of drug elimination?
Responda
-
Active process requiring a carrier molecule
-
Passive process requiring an activated protein channel
-
Active process without a carrier molecule
-
Passive diffusion through the membrane
Questão 75
Questão
If renal clearance is slow, the plasma half-life of the drug will be...?
Responda
-
Longer
-
Shorter
-
Unchanged
Questão 76
Questão
Why can age affect drug metabolism and excretion?
Responda
-
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
Questão 77
Questão
What disease is most likely to affect the pharmocokinetics of a drug?
Responda
-
Renal disease
-
Heart disease
-
Parkinson's disease
-
Learning difficulties
Questão 78
Questão
Which is the most common type of adverse drug reaction?
Responda
-
Type A
-
Type B
Questão 79
Questão
Which of the following describe type A drug reactions?
Responda
-
Reaction related to known drug mechanisms
-
Predictable
-
Unavoidable
Questão 80
Questão
Which of the following may cause type A drug reactions?
Responda
-
Wrong dose administered
-
Drug interactions
-
High therapeutic index of the drug
-
Immunological mechanisms
Questão 81
Questão
Which of the following describe a type 2 drug reaction?
Responda
-
Related to unknown mechanisms of the drug
-
Predictable
-
Unexpected
-
Related to patient individuality
Questão 82
Questão
What is a drawback of the yellow form for monitoring adverse drug reactions?
Responda
-
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
Questão 83
Questão
What is usually added to the yellow form when more information is required about a drug?
Responda
-
Black triangle
-
Green form
-
A priority index number
-
A warning about the drug from the BNF
Questão 84
Questão
What is a benefit of the green form?
Responda
-
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
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