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What is the main reason that drugs are withdrawn from development?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