Quiz 1

Question 1

What are the rights of drug delivery?

What are the other 4 Rs?

Answer 1

Drug Delivery:
Patient
Drug
Dose
Route
Time
Documentation

4 Rs:
Reason
Response
Refuse
Expiration Date

Question 2

How are drugs distributed?

Answer 2

through blood

Question 3

What are agonist and antagonist drugs?

Answer 3

Agonists = mimic (promote) normal receptor activity

Antagonists = inhibit (block) normal receptor activity

Question 4

What fruit is a suicide inhibitor of CYP3A4?

Answer 4

grapefruit

It destroys some of the CYP3A4 in the small intestine

Question 5

What happens when a substrate and inhibitor interact?

Answer 5

The inhibitor “gums up” the substrate
(holding the person up at checkout)

Question 6

What types of drugs can cross the blood-brain barrier?

Answer 6

lipid-soluble drugs because our cells are made of lipid bilayer

Question 7

Which route is the first pass effect?

Answer 7

The liver, with the drug taken orally

Question 8

What is the fastest way a drug is administered?

Answer 8

IV

Question 9

What does a narrow therapeutic drug index (TDI) mean?

Answer 9

The drug is dangerous if more than the recommended dose is taken

Question 10

What is a prodrug? Example?

Answer 10

a pharmacologically inactive compound that is converted into an active drug within the body

Codeine → Morphine

Question 11

Which population has the slowest drug metabolism?

Answer 11

Neonates

Question 12

What happens to lipid-soluble drugs in the kidney?

Answer 12

Lipid-soluble drugs can pass through cell membranes and may be reabsorbed in the renal tubules instead of being excreted.

Question 13

What is an adverse drug reaction? Example?

Answer 13

Adverse drug reactions (ADRs) refer to harmful effects caused by medications, such as liver toxicity from excessive acetaminophen use.

Question 14

What is genetic polymorphism?

Answer 14

Genetic polymorphism is a variation in a gene that affects how a person metabolizes and responds to drugs

Question 15

Which of the following drugs is most affected by genetic polymorphism?
A) Penicillin
B) Warfarin
C) Acetaminophen
D) Aspirin

Answer 15

Warfarin

Genetic differences in CYP450 enzymes can significantly impact warfarin metabolism, affecting drug efficacy and safety.

Question 16

What does a drug inhibitor do?

Answer 16

Inhibitors prevent enzyme activity, leading to slower drug breakdown and increased drug levels in the body. (metabolism)

Question 17

Which drug property makes it harder to cross cell membranes?

Answer 17

Ionized (charged) drugs do not easily pass through lipid membranes and often require transport mechanisms.

Question 18

Which routes bypass the first pass effect?

Answer 18

IV, IM, and SUB-Q

Question 19

What is a loading dose?

Answer 19

A loading dose is a high initial dose used to quickly achieve therapeutic levels in the body.

Achieving plateau in a drug with a long half-life can be expedited by giving a large initial loading dose

Question 20

What is first-order drug elimination?
What is zero-order drug elimination?

Answer 20

First-order elimination is a process where a percentage of the drug is cleared per unit of time

Zero-order elimination occurs at a fixed rate, so excess drug can accumulate and cause toxicity (e.g., alcohol).

Question 21

Which of the following is a type of hypersensitivity reaction that can lead to anaphylaxis?
A) Type I (IgE-mediated)
B) Type II (cytotoxic)
C) Type III (immune complex)
D) Type IV (delayed hypersensitivity)

Answer 21

Type I reactions (IgE-mediated) can cause anaphylaxis, a severe and potentially fatal allergic response.

Question 22

What are the four stages of pharmacokinetics?

Answer 22

Absorption, Distribution, Metabolism, Excretion.

Question 23

What is the first-pass effect?

Answer 23

The liver metabolizes oral drugs before they reach systemic circulation, reducing effectiveness.

Question 24

What factors affect drug absorption?

Answer 24

Route of administration, solubility, blood flow, pH, and ionization.

Question 25

What happens to weak acids in acidic environments? What happens to weak bases in basic environments?

Answer 25

They remain non-ionized and are more easily absorbed.

Question 26

How do ionized and polar drugs enter cells?

Answer 26

Through specialized transporters. - active transport and protein binding

Question 27

What is the blood-brain barrier (BBB)?

Answer 27

A selective barrier that only allows lipid-soluble drugs and those with special transporters to pass.

Question 28

How does protein binding affect drug distribution?

Answer 28

Drugs bound to plasma proteins (e.g., albumin) are inactive until they unbind.

Question 29

What factors affect drug distribution?

Answer 29

Blood flow, lipid solubility, protein binding.

Question 30

What happens to drugs stored in fat?

Answer 30

They are released slowly, prolonging their effects.

Question 31

What enzyme family is involved in drug metabolism?

Answer 31

Cytochrome P450 (CYP450).

Question 32

What does CYP450 in the liver do to drugs?

Answer 32

Metabolizes drugs into active, inactive, or toxic forms.

Question 33

What happens when a drug is a CYP450 inhibitor? What happens when a drug is a CYP450 inducer?

Answer 33

Inhibitor: It slows metabolism, increasing drug levels (risk of toxicity). Inducer: It speeds up metabolism, decreasing drug levels (reducing effectiveness).

Question 34

How are lipid-soluble drugs excreted?

Answer 34

They must first be metabolized into water-soluble forms.

Question 35

Which drugs are excreted through exhalation?

Answer 35

Anesthetics

Question 36

What is the most common form of drug elimination?

Answer 36

First-order elimination (percentage per unit of time).

Question 37

What is the minimum effective concentration (MEC)? What is the toxic concentration?

Answer 37

MEC: The lowest blood level of a drug needed for therapeutic effects. TC: The blood level at which a drug starts causing toxicity.

Question 38

What is steady state? How many does does it take to reach steady state?

Answer 38

When the amount of drug eliminated between doses = the dose administered 5 doses

Question 39

What is a maintenance dose?

Answer 39

Regular doses given to maintain steady state. After a loading dose

Question 40

What is a teratogenic drug?

Answer 40

A drug that harms fetal development.

Question 41

What are the signs of anaphylaxis?

Answer 41

Swelling, hives, difficulty breathing.

Question 42

What is a prolonged Q-T interval drug?

Answer 42

A drug that delays heart repolarization, increasing the risk of heart arrhythmias.

Question 43

What are the most common drug allergies?

Answer 43

Penicillin, sulfa drugs.

Question 44

Vocab PharmacoTHERAPEUTICS PharmacoECONOMICS PharmacoEPIDEMIOLOGY PharmacoGENOMICS PharmacoMETRICS Pharmaceuticals PharmacoVIGILANCE

Answer 44

PharmacoTHERAPEUTICS: how to use the drug. PharmacoECONOMICS: compare prices of drugs PharmacoEPIDEMIOLOGY: the human response to the drug PharmacoGENOMICS: individual variations; specifically how genes can affect a person’s response to a drug; we respond differently to drugs! PharmacoMETRICS: measurement; quantitative analysis Pharmaceuticals (AKA Big pharma): the manufacturers of a drug PharmacoVIGILANCE: drug safety.

Question 45

Pros and Cons of Short half life Pros and cons of long half life

Answer 45

short: pros: frequent doses = faster steady state rapid discontinuation less expensive cons: peaks and valleys are extreme poor compliance with frequent dosing more missed doses long: pros: peaks and valleys are not extreme good compliance with better dosing fewer missed doses cons: less frequent doses= long steady state cannot be discontinued rapidly more expensive

Question 46

What is drug half-life? What is is dependent on and what does it determine?

Answer 46

Drug half-life = amount of time required for serum concentration of a drug to decrease by 50% - dependent on rate of drug excretion - determines frequency of administration