M4 - Topic Quiz

Proverbs 16:3

D) Giving of maintenance doses

What would most likely be the reason for the drug's increasing plasma concentration towards reaching the therapeutic range?
A. Decreasing clearance of the drug thru time
B. Faster absorption of drug thru time
C. Faster distribution of the drug to the receptor sites
D. Giving of maintenance doses

B) Immediately after the dose is given

The peak concentration for an intravenous bolus dose would be obtained ____.
A. After the excretion phase
B. Immediately after the dose is given
C. After the metabolism phase
D. After the distribution phase

A) I, II and III

Which are TRUE regarding local effect of drugs?
I. Drug is administered at the site where the pharmacological response is desired.
II. Drug preparations intended to produce local effects have minimal absorption to the systemic circulation.
III. Anti-asthma drugs administered via inhalational route produce local effects.
A. I, II and III
B. I and II
C. I and III
D. II and III

b. Fick's Law

Which of the following laws/equations governs the passive diffusion of drug?
a. Noyes-Whitney Equation
b. Fick's Law
c. Henderson-Hasselbalch Equation
d. Arrhenius Equation
e. Partition coefficient

e. Ion-pair transport

Which of the following transport processes is NOT involved in the absorption of drug?
a. Pinocytosis
b. Phagocytosis
c. Receptor-mediated endocytosis
d. Paracellular transport
e. Ion-pair transport

FALSE

True/False: Drug absorption
_____1. High MW drugs diffuse across membrane more easily than low MW drugs.
A. TRUE
B. FALSE

TRUE

_____2. Protein-bound drugs do not easily cross cell membranes.
A. TRUE
B. FALSE

TRUE

_____3. Lipophilic drugs cross cell membrane more easily than hydrophilic drugs
A. TRUE
B. FALSE

TRUE

_____4. Drugs may be transported by passive diffusion, carrier mediated or vesicular transport
A. TRUE
B. FALSE

a. The drug's absorption rate is greater than its elimination rate.

What does the upward slope of Curve II represent?
a. The drug's absorption rate is greater than its elimination rate.
b. Most of the drug has undergone "first-pass effect".
c. The drug's elimination rate is greater than absorption rate.
d. Only a fraction of the drug has undergone "first-pass effect"

c. Intravenous injection

Curve I represents the blood level concentration of a drug administered in what dosage preparation?
a. Oral solution
b. Oral tablet
c. Intravenous injection
d. Intrathecal injection.

b. Decreased bioavailability of the drug

Decreased oral absorption of a drug due to high stomach pH would result to:
a. Decreased gastric toxicity of the drug
b. Decreased bioavailability of the drug
c. Increased clearance of the drug
d. Increased bioavailability

c. Solution

Which of the following DFs would be absorbed the fastest in the GIT?
a. Capsule
b. Tablet
c. Solution
d. Suspension

A. Pharmaceutical alternatives

Amlodipine maleate & Amlodipine besylate
A. Pharmaceutical alternatives
B. Pharmaceutical equivalents
C. Therapeutic alternatives

B. Pharmaceutical equivalents

Oral tablet & oral suspension
A. Pharmaceutical alternatives
B. Pharmaceutical equivalents
C. Therapeutic alternatives

B. Pharmaceutical equivalents

Amoxicillin 250 mg & Amoxicillin 500 mg
A. Pharmaceutical alternatives
B. Pharmaceutical equivalents
C. Therapeutic alternatives

B. Pharmaceutical equivalents

Chlordiazepoxide, 5 mg capsules & Chlordiazepoxide, 5 mg capsules (different manufacturers)
A. Pharmaceutical alternatives
B. Pharmaceutical equivalents
C. Therapeutic alternatives

C. Therapeutic alternatives

Enalapril & Captopril
A. Pharmaceutical alternatives
B. Pharmaceutical equivalents
C. Therapeutic alternatives

B. Pharmaceutical equivalents

Paracetamol 500 mg tab x 100s vs Paracetamol 500 mg tab x 50s
A. Pharmaceutical alternatives
B. Pharmaceutical equivalents
C. Therapeutic alternatives

B. Pharmaceutical equivalents

Paracetamol syrup 125mg/mL, banana flavor vs Paracetamol syrup 125 mg/mL, strawberry flavor
A. Pharmaceutical alternatives
B. Pharmaceutical equivalents
C. Therapeutic alternatives

B. Pharmaceutical equivalents

Same generic names but different release mechanism Extended vs Immediate release
A. Pharmaceutical alternatives
B. Pharmaceutical equivalents
C. Therapeutic alternatives

C) I and IV

Which of the following forms of a drug is favorably absorbed?
I. Non-ionized
II. Water soluble
III. Ionized
IV. Lipids soluble
A. III and IV
B. I and II
C. I and IV
D. II and I

B) Small intestine

The most important organ for the absorption of orally administered drugs
A. Liver
B. Small intestine
C. Stomach
D. esophagus

A) 400mg

How much of a 500mg dose is bioavailable if the administered drug has an absolute bioavailability of 0.80?
A. 400mg
B. 80mg
C. 100mg
D. 40mg

B) 0.6 mL

A newly admitted hospital patient has been taking a brand of digoxin tablets 250 mcg, that are 60% bioavailable. The hospitalist wishes to administer a comparable IV dose using an injection containing digoxin, 0.5 mg/2ml. What is the equivalent dose?
A. 0.15 mL
B. 0.6 mL
C. 150 mL
D. 4.1 mL

D) Drugs are bioequivalent.

Which of the following is established when pharmaceutical equivalents display comparable bioavailabilities when studied under similar experimental conditions?
A. Drugs are biosimilar.
B. Drugs are racemic mixtures.
C. Drugs are generic equivalents.
D. Drugs are bioequivalent.

C) II and III

Which of the following drugs will cross cell membranes easily?
I. Polar drugs
II. Non-polar drugs
III. Lipophilic drugs
IV. Hydrophilic drugs
A. I and III
B. I and IV
C. II and III
D. II and IV

a. I only

Requirements for drug products to be considered "pharmaceutical alternatives" include having the same
I. Active drug
II. Dosage forms
III. Salt or ester
a. I only
b. I and II
c. II & III
d. I & III
e. I, II and III

d. I, II and III

"Pharmaceutical equivalent" drugs products must have the same
I. Therapeutically active ingredients
II. Salt or ester
III. Dosage form and strength
a. I and II
b. II and III
c. I and III
d. I, II and III

a. Decreased protein binding, resulting in a greater free fraction of the drug

Which of the following will be true if a highly protein bound drug is administered to neonates?
a. Decreased protein binding, resulting in a greater free fraction of the drug
b. Increased protein binding, resulting in reduced free fraction of the drug
c. Increased protein binding, resulting in a greater free fraction of the drug

C) II

Which of the following is TRUE regarding acidic drugs?
I. They exist mainly in the ionized form at the stomach
II. They exist in a non-ionized form at an acidic environment.
III. They exist mainly in the polar form in an acidic urine.
A. I
B. III
C. II
D. I, II and III

B) II

Which of the following is/are the ideal characteristic/s of a drug when given to breastfeeding woman?
I. Long half-life
II. High molecular weight
III. High lipid solubility
A. III
B. II
C. II and III
D. I, II and III

c. Sublingual

Which of the following routes of administration bypasses first-pass effect?
a. Oral
b. Rectal
c. Sublingual
d. None of these

b. Glucuronidation

Which of the following process Phase 2 processes may undergo enterohepatic cycling?
a. Oxidation
b. Glucuronidation
c. Hydrolysis
d. Alcohol dehydrogenation

d. Glucuronidation

Which of the following phase 2 processes is inducible and has reduced activity in neonates?
a. Sulfation
b. Glycine conjugation
c. Glutathione conjugation
d. Glucuronidation

c. Glutathione conjugation

Depletion of which conjugation process is associated with paracetamol hepatotoxicity?
a. Sulfation
b. Glycine conjugation
c. Glutathione conjugation
d. Glucuronidation

b. Glucuronidation

Which of the following phase II metabolic reactions makes phase I metabolites readily excretable in urine?
a. Oxidation
b. Glucuronidation
c. Hydrolysis
d. Reduction

c. Methylation

The following processes makes drugs polar, except:
a. Oxidation
b. Glucuronidation
c. Methylation
d. Glutathione conjugation

TRUE

True/False: First-order kinetics
_____1. The half-life is the same regardless of the plasma concentration.
A. TRUE
B. FALSE

FALSE

_____2. The drug is distributed to only 1 compartment outside the vascular system
A. TRUE
B. FALSE

FALSE

_____3. Rate of elimination is proportional to the rate of administration at all times
A. TRUE
B. FALSE

B) I and IV

Drug metabolism happens in most cases, to convert the drug to a compound that is______.
I. More polar
II. More nonpolar
III. More lipid-soluble
IV. More water-soluble
A. II and IV
B. I and IV
C. I and III
D. II and III

D) I and III

Pharmacokinetic variations in Drug Metabolizing Enzymes (DME) are considered significant if _______.
I. Active metabolites are formed
II. The drug has a very wide margin of safety
III. Parent drug is a prodrug that requires activation by the DME
A. I, II and III
B. II
C. III
D. I and III

A) First

What is the order of reaction in which the concentration of a drug is decreasing at a rate that is proportional to the concentration of the drug remaining?
A. First
B. Zero
C. Third
D. Second

B) I and III

Which of the following are the reasons for formulating prodrugs?
I. Improve bioavailability of the drug
II. Develop cheaper therapeutic alternative
III. Promotes site-specific delivery of the drug
A. I
B. I and III
C. I, II and III
D. I and IV

D) Intake of drugs that inhibit it metabolism

A drug was withdrawn from the market due to reports of cardiac arrhythmia caused by unusually high level of the said drug. Which of the following BEST explains this effect?
A. Intake of drugs that enhance its excretion
B. Intake of drugs that are used to treat cardiac arrhythmia
C. Intake of drugs that enhance its metabolism
D. Intake of drugs that inhibit it metabolism

b. First-order kinetics

What is the order of the reaction if the concentration of a drug is decreasing at a rate that is proportional to the concentration of the drug remaining?
a. Zero-order kinetics
b. First-order kinetics
c. Second-order kinetics

b. Zero-order elimination

Which of the following refers to the kinetic orders that distinguishes the elimination of ethanol from the elimination of most other drugs?
a. First-order elimination
b. Zero-order elimination
c. First-pass effect
d. Biliary clearance

C) Ion trapping

The principle involved in urinary pH manipulation to inhibit toxin reabsorption across the renal tubular membranes.
A. Extracorporeal methods
B. Hemodialysis
C. Ion trapping
D. Biliary cycling

B) A higher dose is needed to achieve the target concentration.

Which of the following would be the implication if the drug has an increased clearance in a patient?
A. A lower dose is needed to achieve the target concentration.
B. A higher dose is needed to achieve the target concentration.
C. A faster administration rate is needed to achieve the target concentration.
D. A slower administration rate is needed to achieve the target concentration.

B) decrease in clearance and increase in elimination half-life.

If the enzyme capacity in newborns and infants is reduced, what possible effects would this have on the clearance and elimination half-life of drugs?
A. Increase in clearance and increase in elimination half-life.
B. decrease in clearance and increase in elimination half-life.
C. Increase in clearance and decrease in elimination half-life.
D. decrease in clearance and decrease in elimination half-life

B) I

Which of the following statements is/are TRUE regarding weakly acidic drugs in an alkaline urine?
I. Weakly acidic drugs in alkaline media will exist primarily in its ionized form, which cannot be reabsorbed easily.
II. Weakly acidic drugs in alkaline media will exist primarily in its lipophilic form, which cannot be reabsorbed easily
III. Weakly acidic alkaline media will exist primarily in its nonpolar form, which cannot be reabsorbed easily.
A. II
B. I
C. III
D. II and III

A) Renal impairment increases clearance for drugs primarily dependent on the kidney for elimination

The following are TRUE regarding significant organ impairment on pharmacokinetic variables EXCEPT________.
A. Renal impairment increases clearance for drugs primarily dependent on the kidney for elimination
B. Hepatic impairment may lead in the failure of transforming the drug to its active metabolite
C. Cardiac impairment reduces volume of distribution
D. Hepatic impairment prolongs half-life for drugs highly dependent on the liver for elimination

D) Glomerular filtration rate

The renal clearance of inulin is used as a measurement of ________.
A. Tubular reabsorption
B. Renal blood flow
C. Active renal secretion
D. Glomerular filtration rate

C) 25 %

What percent of drug is removed per hour if the elimination rate constant is 0.25/hr?
A. 0.75%
B. 0.25%
C. 25 %
D. 0.42

A) II and III

Which of the following factors can contribute to a longer duration of a drug?
I. Decreased protein binding
II. Greater tubular reabsorption
III. Reduced polarity
A. II and III
B. I, II and III
C. I and III
D. I and II

C) A partial agonist

A study was carried out in isolated, perfused animal hearts. In the absence of other drugs, Pindolol, a beta-adrenoceptor ligand, caused an increased in heart rate. In the presence of highly effective beta-stimulants, however, Pindolol caused a dose-dependent, reversible decrease in heart rate. Which of the following expressions best describes pindolol?
A. A chemical antagonist
B. An irreversible antagonist
C. A partial agonist
D. A physiologic antagonist

B. Physiologic antagonism

Acetylcholine + Epinephrine
A. Pharmacologic Antagonism
B. Physiologic antagonism
C. Chemical antagonism

B. Physiologic antagonism

Histamine + Epinephrine
A. Pharmacologic Antagonism
B. Physiologic antagonism
C. Chemical antagonism

A. Pharmacologic Antagonism

Glucagon + Propranolol
A. Pharmacologic Antagonism
B. Physiologic antagonism
C. Chemical antagonism

C. Chemical antagonism

Cyanide + sodium thiosulfate
A. Pharmacologic Antagonism
B. Physiologic antagonism
C. Chemical antagonism

C. Chemical antagonism

HCl + Antacid
A. Pharmacologic Antagonism
B. Physiologic antagonism
C. Chemical antagonism

C. Chemical antagonism

Heparin + Protamine SO4
A. Pharmacologic Antagonism
B. Physiologic antagonism
C. Chemical antagonism

C. Chemical antagonism

BAL + Arsenic
A. Pharmacologic Antagonism
B. Physiologic antagonism
C. Chemical antagonism

A. Pharmacologic Antagonism

ASA + Arachidonic acid (for COX)
A. Pharmacologic Antagonism
B. Physiologic antagonism
C. Chemical antagonism

C. Chemical antagonism

Digibind + Digoxin
A. Pharmacologic Antagonism
B. Physiologic antagonism
C. Chemical antagonism

A. Pharmacologic Antagonism

Pancuronium + Sugammadex
A. Pharmacologic Antagonism
B. Physiologic antagonism
C. Chemical antagonism

TRUE

True/False
_____1. R is more effective than S.
A. TRUE
B. FALSE

TRUE

_____2. T is less effective than R & S.
A. TRUE
B. FALSE

TRUE

_____3. R is more potent than S.
A. TRUE
B. FALSE

TRUE

_____4. T is a partial agonist
A. TRUE
B. FALSE

TRUE

_____5. R & S are full agonists
A. TRUE
B. FALSE

B) II, VI, VIII

Which of the following adrenergic receptors are Gi-mediated?
I. a1
II. a2
III. b1
IV. b2
V. M1
VI. M2
VII. M3
VIII. M4
IX. M5
A. III and IV
B. II, VI, VIII
C. I, V, VII, IX
D. I, II, III, IV

A) Nicotinic receptors

Which of the following is a type 1 (ionotropic) receptor?
A. Nicotinic receptors
B. Muscarinic receptors
C. Dopamine receptors
D. GABA-B receptors

C) 5HT3

What is the only ionotropic serotonin receptor?
A. 5HT1
B. 5HT2
C. 5HT3
D. 5HT4

A) Constitutive activity

The activity of the receptor in the absence of a drug (ligand) is called:
A. Constitutive activity
B. Biological response
C. Intrinsic activity
D. Therapeutic efficacy

A) Partial agonist

An agonist that produces less than the full effect.
A. Partial agonist
B. Full agonist
C. Inverse agonist

A) Physiologic antagonism

Two drugs that act on the same tissue or organ through independent receptors resulting in effects in opposite direction is known as:
A. Physiologic antagonism
B. Competitive antagonism
C. Chemical antagonism
D. Irreversible antagonism

C) Chemical antagonist

A drug was shown to reverse the action of a neurotransmitter. It interacts directly with the neurotransmitter and not at all with the neurotransmitter's receptor. What type of antagonism is described?
A. Physiologic antagonist
B. Pharmacologic antagonist
C. Chemical antagonist
D. Partial agonist

C) Chemical antagonism

Which of the following describes the action of protamine against heparin?
A. Physiologic antagonism
B. Competitive antagonism
C. Chemical antagonism
D. Irreversible antagonism

D) If 1mg of Drug R produces the same response as 10mg of Drug S, Drug R is more potent than Drug S

Which of the following statements is correct?
A. The greater the efficacy, the greater the potency
B. If 1 mg drug R produces the same response as 10mg of Drug S, the drug A is more effective than Drug B
C. In selecting a drug, potency is more important than efficacy.
D. If 1mg of Drug R produces the same response as 10mg of Drug S, Drug R is more potent than Drug S

A) Drug concentration at the receptor site

The intensity of the pharmacologic action of the drug is most dependent on
A. Drug concentration at the receptor site
B. Onset of action
C. Protein binding
D. Volume of distribution

D) Toxin D (LD50 = 0.00001 mg/kg)

Which of the following would be most likely to cause death to animals?
A. Toxin A (LD50 = 5mg/kg)
B. Toxin B (LD50 = 1500 mg/kg)
C. Toxin C (LD50 = 8000 mg/kg)
D. Toxin D (LD50 = 0.00001 mg/kg)

C) Occupancy Theory

A receptor model proposes that the magnitude of the biological response is directly proportional to the number of receptors occupied by the drug. According to this theory, maximal response requires maximal receptor occupancy.
A. Lock-and-Key Theory
B. Rate Theory
C. Occupancy Theory
D. Modified Occupancy Theory

B) Modified Occupancy Theory

Which receptor theory BEST explains the existence of spare receptors?
A. Occupancy Theory
B. Modified Occupancy Theory
C. Lock-and-Key Theory
D. Rate Theory

C) Lock-and-Key Theory

A receptor is assumed to possess a fixed three-dimensional structure into which only molecules of complementary shape can fit.
A. Occupancy Theory
B. Modified Occupancy Theory
C. Lock-and-Key Theory
D. Induced Fit Theory

D) Rate Theory

The pharmacologic response produced by a drug is proportional to the frequency of productive encounters between drug and receptor rather than the duration of receptor occupancy.
A. Lock-and-Key Theory
B. Occupancy Theory
C. Modified Occupancy Theory
D. Rate Theory

B) Modified Occupancy Theory

The concept that efficacy and affinity are distinct properties of a drug is MOST closely associated with:
A. Occupancy Theory
B. Modified Occupancy Theory
C. Lock-and-Key Theory
D. Rate Theory

C) Induced Fit Theory

A receptor model proposes that drug binding induces a structural rearrangement of the receptor that enhances complementarity between receptor and ligand.
A. Lock-and-Key Theory
B. Occupancy Theory
C. Induced Fit Theory
D. Rate Theory

A. Hemicholinium

_____1. Blocks the uptake of choline
Column A
_____1. Blocks the uptake of choline
_____2. Blocks the release of ACh
_____3. Stimulates the release of ACh
_____4. Blocks the receptor of ACh
_____5. Blocks the storage of ACh
Column B
A. Hemicholinium
B. Vesamicol
C. Botulinum toxin
D. Latrotoxin
E. Atropine

C. Botulinum toxin

_____2. Blocks the release of ACh

D. Latrotoxin

_____3. Stimulates the release of ACh

E. Atropine

_____4. Blocks the receptor of ACh

B. Vesamicol

_____5. Blocks the storage of ACh

Choline acetyltransferase (ChAT)

What enzyme is responsible in the synthesis of acetylcholine? __________

Acetylcholinesterase (AChE)

What enzyme hydrolyzes ACh? __________

B. Reserpine

_____1. Blocks the storage of dopamine
Column A
_____1. Blocks the storage of dopamine
_____2. Blocks the release of NE
_____3. Stimulates the release of NE
_____4. Blocks tyrosine hydroxylase
_____5. Blocks NET transporter
_____6. Blocks the metabolism of NE
Column B
A. Metyrosine
B. Reserpine
C. Bretylium, Guanethidine, Guanadrel
D. TCAs and SNRIs (including cocaine)
E. MAO inhibitors
F. Amphetamine

C. Bretylium, Guanethidine, Guanadrel

_____2. Blocks the release of NE

F. Amphetamine

_____3. Stimulates the release of NE

A. Metyrosine

_____4. Blocks tyrosine hydroxylase