E01_07 Prescribing: Hepatic/Renal Diseases

Question 1

2017_Hepatic/Renal

Clearance of isoniazid is increased if:

A. Urine is alkaline
B. Urine is acidic
C. pH is not a factor

Answer 1

A. Urine is alkaline

Question 2

2017_Hepatic/Renal

In the presence of hepatic insufficiency, the loading dose of an IV administered and hepatically cleared drug needs to be:

A. Increased
B. Decreased
C. Same

Answer 2

C. Same

Question 3

2017_Hepatic/Renal

In the presence of hepatic insufficiency, the loading dose of an orally administered and hepatically cleared drug needs to be:

A. Increased
B. Decreased
C. Same

Answer 3

B. Decreased

Question 4

2017_Hepatic/Renal

In the presence of decreased protein binding, the maintenance dose of a high extraction ratio and hepatically cleared drug needs to be:

A. Increased
B. Decreased
C. Same

Answer 4

C. Same

Question 5

2017_Hepatic/Renal

For a renal high extraction ratio drug, we expect a:

A. Higher bioavailability
B. Lower bioavailability
C. This extraction has no effect on bioavailability

Answer 5

C. This extraction has no effect on bioavailability

Question 6

2017_Hepatic/Renal

Which two constitute the dual elimination pathway of phenytoin:

Answer 6

A. CYP2C9 and CYP2C19

Question 7

2018_Hepatic/Renal

In liver disease, which isozyme is last to decrease?

A. 2D6
B. 3A4
C. 2C19
D. 2C9

Answer 7

A. CYP2D6

2C19 is the first to decline

2C19 -> 1A2 -> 3A -> 2D6

Question 8

2018_Hepatic/Renal

If there are no studies done and the patient is Child Pugh class A (mild), how much of the dose will you give?

A. 75% maintenance dose
B. 50% maintenance dose
C. 25% maintenance dose

Answer 8

B. 50% maintenance dose

A – 50% of normal dose
B – 25%
C – use drugs with clinical safety data

Question 9

2018_Hepatic/Renal

Warfarin is metabolized by CYP3A and then ketoconazole (a CYP3A inhibitor) was given. What is likely to happen?

A. Increased risk of bleeding
B. Decreased risk of bleeding
C. No effect

Answer 9

A. Increased risk of bleeding

Question 10

2018_Hepatic/Renal

If the protein binding of a drug is decreased, what happens to the loading dose?

a Increased
b Decreased
c No change

Answer 10

?

Question 11

2016_Hepatic/Renal

True or False. In cirrhotic patients, BA of drugs with high extraction ratio is mor affected than low extraction ratio drugs.

Answer 11

True

Question 12

2016_Hepatic/Renal

If with hepatic derrangement, only systemic clearance is affected.

Answer 12

True

Question 13

2016_Hepatic/Renal

True or False. In patients with hepatic derangement, decrease in function of CYP3A is faster than CYP2D6.

Answer 13

True.

2D6 is last