MCQS: Pharmcokinetics

Question # 1 (Multiple Answer) Factors that could change :intrinsic hepatic clearance include A) hepatic blood flow B) induction state of hepatic enzymes C) hepatic disease Question # 2 (True/False) In rheumatoid arthritis patients, increased alpha1-acidic glycoprotein may be associated with .increased lidocaine protein binding A) true B) false Question # 3 (Multiple Choice) Hepatic flow-dependent drug :elimination refers to A) changes in plasma protein concentration B) rate-limiting step is drug delivery to hepatic elimination sites C) number of functional hepatocytes D) carrier saturation E) drug transfer rates across hepatic cell membrane Question # 4 (Multiple Answer) Characteristic(s) of a drug :whose action is terminate by redistribution include A) generally long-acting B) usually a hydrophilic (not very lipid-soluble) drug C) eventually concentrates usually in adipose (fat) tissue D) tends to partition slowly into organs such as the brain, even though the brain receives a significant fraction of the cardiac output Question # 5 (Multiple Choice) Cytochrome P450 induction (increased, amount of P450 enzyme protein) is often associated :with A) increased enzyme synthesis rates B) reduced enzyme degradation rates C) both D) neither

Question # 6 (Multiple Choice) Microsomal drug metabolizing :enzymes are typically associated with A) rough endoplasmic reticulum B) smooth endoplasmic reticulum Question # 7 (Multiple Answer) Characteristics of drug-protein :binding A) often parallels drug lipid solubility B) drug-plasma albumin binding tends to be relatively nonselective C) real failure he is associated with the reduction in drug-down fraction because of a reduction in plasma albumin concentration D) in rheumatoid arthritis patients, increased alpha1-acidic glycoprotein tends to promote increased lidocaine protein binding E) Surgery may result in increases in alpha1-acidic glycoprotein plasma concentration Question # 8 (Multiple Choice) Examples of "high-extraction" :drugs -- related to hepatic drug clearance A) morphine B) meperidine C) verapamil D) diltiazem E) all the above :Question # 9 (Multiple Choice) Pharmacogenetic effects A) prolonged mivacurium-induced neuromuscular blockade due to atypical cholinesterase B) succinylcholine or volatile anesthetic-induced malignant hyperthermia C) both D) neither Question # 10 (Multiple Answer) Characteristics of drug (conjugates (following conjugation reactions A) more polar B) more readily excreted

C) typically more pharmacologically active Question # 11 (Multiple Choice) Termination of pharmacological :action of thiopental occurs mainly by A) metabolism B) excretion C) redistribution Question # 12 (Multiple Answer) Concerning influence of age on :drug responses:variation in response usually due to A) reduced cardiac output B) reduced hepatic perfusion C) decreased body fat D) increased protein binding E) decreased renal function Question # 13 (Multiple Choice) Reaction type associated with .inactivation of succinylcholine, atracurium, and mivacurium A) conjugation B) hydrolysis C) oxidation D) reduction :Question # 14 (Multiple Answer) Phase II and reactions A) conjugation B) hydrolysis C) oxidation D) reduction Question # 15 (Multiple Choice) Factors affecting renal :clearance of drugs A) the presence of renal disease B) drug secretion rates C) number of functional nephrons D) blood flow E) all of the above Question # 16 (Multiple Choice) Concerning drug-plasma :protein binding

A) Drugs are seldom bound to plasma proteins B) volume of distribution is not influenced by protein binding C) diazepam is an example of the drug that is minimally protein-bound D) drug clearance is influenced by the extent of protein binding Question # 17 (Multiple Choice) Mixed function oxidases system :is referred to as mediating A) phase I system B) phase II system Question # 18 (Multiple Answer) Characteristics of drug-protein binding A) generally theextent of drug-protein binding parallels drug lipids liability B) drug-plasma albumin binding is usually highly selective C) renal failure may decrease drug bound fraction because of reduced plasma albumin D) sulfonamides may displace unconjugated bilirubin from albumin-binding sites (because neonatal bilirubin (encephalopathy Question # 19 (Multiple Answer) Factors affecting hepatic drug :clearance A) drug delivery to liver elimination sites B) extent of plasma protein-bound drug C) blood flow D) carrier saturation E) Wally and filtered in the glomerulus Question # 20 (Multiple Choice) Factors affecting renal drug :secretion rates A) carrier saturation B) drug transfer rates across tubular membranes C) degree of drug-plasma protein binding D) rate of drug delivery to secretory sites E) all the above Question # 21 (Multiple Choice) Concerning drug-plasma

:protein binding A) A relatively small percentage of drugs are bound to some extent to plasma proteins B) drug-plasma albumin binding is often highly selective C) an example of a plasma protein important for drug binding is alpha1-acidic glycoprotein D) volume of distribution is generally unrelated to protein binding E) diazepam is an example of a drug that exhibits little plasma protein binding --------------------------------------------------------------------------

Correct Answers
[HIDE] Question # 1 (Multiple Answer) Factors that could change :intrinsic hepatic clearance include A) hepatic blood flow) B) induction state of hepatic enzymes) C) hepatic disease) Question # 2 (True/False) In rheumatoid arthritis patients, increased alpha1-acidic glycoprotein may be associated with .increased lidocaine protein binding Answer: True

Question # 3 (Multiple Choice) Hepatic flow-dependent drug :elimination refers to Answer: (B) rate-limiting step is drug delivery to hepatic

elimination sites

Question # 4 (Multiple Answer) Characteristic(s) of a drug :whose action is terminate by redistribution include C) eventually concentrates usually in adipose (fat) tissue)

Question # 5 (Multiple Choice) Cytochrome P450 induction (increased, amount of P450 enzyme protein) is often associated :with Answer: (C) both

Question # 6 (Multiple Choice) Microsomal drug metabolizing :enzymes are typically associated with Answer: (B) smooth endoplasmic reticulum

Question # 7 (Multiple Answer) Characteristics of drug-protein :binding A) often parallels drug lipid solubility) B) drug-plasma albumin binding tends to be relatively) nonselective D) in rheumatoid arthritis patients, increased alpha1-acidic) glycoprotein tends to promote increased lidocaine protein binding

Question # 8 (Multiple Choice) Examples of "high-extraction" :drugs -- related to hepatic drug clearance Answer: (E) all the above

:Question # 9 (Multiple Choice) Pharmacogenetic effects Answer: (C) both

Question # 10 (Multiple Answer) Characteristics of drug (conjugates (following conjugation reactions A) more polar) B) more readily excreted)

Question # 11 (Multiple Choice) Termination of pharmacological :action of thiopental occurs mainly by Answer: (C) redistribution

Question # 12 (Multiple Answer) Concerning influence of age on :drug responses:variation in response usually due to A) reduced cardiac output) B) reduced hepatic perfusion) E) decreased renal function)

Question # 13 (Multiple Choice) Reaction type associated with .inactivation of succinylcholine, atracurium, and mivacurium Answer: (B) hydrolysis :Question # 14 (Multiple Answer) Phase II and reactions A) conjugation) B) hydrolysis) C) oxidation) D) reduction)

Question # 15 (Multiple Choice) Factors affecting renal :clearance of drugs Answer: (E) all of the above Question # 16 (Multiple Choice) Concerning drug-plasma :protein binding Answer: (D) drug clearance is influenced by the extent of protein binding

Question # 17 (Multiple Choice) Mixed function oxidases system :is referred to as mediating Answer: (A) phase I system Question # 18 (Multiple Answer) Characteristics of drug-protein binding

A) generally theextent of drug-protein binding parallels drug) lipids liability D) sulfonamides may displace unconjugated bilirubin from) albumin-binding sites (because neonatal bilirubin (encephalopathy

Question # 19 (Multiple Answer) Factors affecting hepatic drug :clearance A) drug delivery to liver elimination sites) B) extent of plasma protein-bound drug) C) blood flow) Question # 20 (Multiple Choice) Factors affecting renal drug :secretion rates Answer: (E) all the above

Question # 21 (Multiple Choice) Concerning drug-plasma :protein binding Answer: (C) an example of a plasma protein important for drug binding is alpha1-acidic glycoprotein