Exam 3 Flashcards

1
Q

For a multiple dose regimen of a given drug formulation, shorter intervals between dose administration result in higher steady state peak concentrations. T/F

A

(True)

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2
Q

For a multiple dose regimen of a given drug formulation, shorter intervals between dose administration would require more doses to get to steady state. T/F

A

(True)

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3
Q

During a multiple dose schedule, the more recent a missed dose is, the less the effect the omission has on the current plasma drug concentration. T/F

A

(False)

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4
Q

Plasma protein-bound drugs are usually not active pharmacologically. T/F

A

(True)

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5
Q

When the AUC for a drug increase disproportionately with increasing dose, that drug follows non-linear pharmacokinetics. T/F

A

(True)

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6
Q

Concerning multiple dose regiments, large doses and large intervals between doses do NOT result in wide fluctuations in steady state drug concentrations. T/F

A

(False)

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7
Q

The pharmacologic response to a prodrug will be enhanced during liver impairment. T/F

A

(False)

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8
Q

Which of the following is least likely to affect the absorption of PAYNEKILL?

a. The PH of the absorption environment
b. Microbes of the gastro-intestinal tract
c. The area of the absorption surface
d. The taste of PAYNEKILL
e. The solubility of PAYNEKILL

A

d. The taste of PAYNEKILL

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9
Q

Weakly acidic drugs bind to which of the following plasma proteins?
Weakly basic drugs bind to which of the following plasma proteins?

A

Albumin - Weakly acidic

a-glycoproteins - Weakly basic

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10
Q

A drug is non-restrictively cleared. This suggests it may have a low hepatic Extraction Ratio. T/F

A

(False)

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11
Q

A low-extracting drug is highly plasma protein bound. How does displacing it from binding impact its hepatic elimination?

A

It is increased

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12
Q

A low-extracting drug is highly plasma protein bound. How does displacing it from binding impact its apparent volume of distribution?

A

It is increased

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13
Q

If a Scatchard plot of a drug is nonlinear, which of the following is true?

a. It binds poorly to its target protein
b. It has more than one unique binding site on each molecule of target proteins
c. It fits a two-compartment pharmacokinetic model

A

b. It has more than one unique binding site on each molecule of target proteins

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14
Q

Which of the following is least likely to influence the concentration of proteins in the plasma?

a. Protein synthesis
b. The number of unique binding sites on protein molecule
c. The patient’s genes
d. Age
e. Disease

A

b. The number of unique binding sites on protein

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15
Q

Which of the following are correct?

A

Drugs with low Fe tend to be highly metabolized by the liver

low Fe = low excretion = more metabolized

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16
Q

For drugs that are poorly water soluble, which route of administration typically provides the fastest absorption?

a. Oral
b. Subcutaneous
c. Intramuscular
d. Intranasal

A

c. Intramuscular

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17
Q

When calculating the dose to administer based on Cave the dosing interval is typically

A

Between one and two half lives

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18
Q

In which form of modified release dosage forms is there typically an immediately released “loading dose” as well as a slower, released “maintenance dose”

a. Delayed release
b. Targeted release
c. Repeat action
d. Sustained release

A

d. Sustained Release

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19
Q

Which of the following increases abuse potential?

a. Rapid drug absorption
b. Low potency
c. Poor taste
d. Suppository formulation available

A

a. Rapid drug absorption

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20
Q

Which of the following are advantages of modified release formulation?

a. A consistent Cp and clinical response
b. Minimal fluctuation between Cmax and Cmin
c. Better patient compliance
d. All of the above

A

a. A consistent Cp and clinical response
b. Minimal fluctuation between Cmax and Cmin
c. Better patient compliance
d. (All of the above)

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21
Q

Topping is …

A

When the maintenance dose is released immediately along with the loading dose in a sustained release formulation

22
Q

Biopharmaceuticals …

A

Can demonstrate non-linear pharmacokinetics

23
Q

If a bolus dose is divided into multiple dosages of equal total amount which of the following are true?

a. The total response generally increases as the amount of divisions increases
b. The greatest increase in response occurs with one division
c. The total response generally decreases as the number of divisions increases
d. A and B
e. B and C

A

d. A and B

24
Q

In a linear pharmacokinetic model, doubling the dosage of a drug will …

a. Half the time to get to steady state
b. Double the duration of drug activity
c. Double the half life
d. Double the steady state concentration

A

Double the steady state concentration

25
Q

In which situation(s) would superposition not be valid?

a. Carrier system gets saturated
b. Enzyme induction or inhibition
c. Disease condition changes between doses
d. All of the above

A

a. Carrier system gets saturated
b. Enzyme induction or inhibition
c. Disease condition changes between doses
d. (All of the above)

26
Q

Mixed order elimination means

A

Drug is eliminated by two enzymatic pathways

27
Q

Which situation(s) might result in a higher than expected plasma drug concentration?

a. Enzyme induction
b. Enzyme saturation
c. Competitive inhibitors of metabolizing enzymes
d. A and B
e. B and C

A

c. Competitive inhibitors of metabolizing enzymes

28
Q

Grapefruit juice tends to

A

Increase bioavailability of drugs

29
Q

Which of the following measures extent of absorption?

a. Tmax
b. Cmax
c. AUC
d. A and B
e. B and C

A

a. Tmax
b. Cmax
c. AUC
d. A and B
e. (B and C)

30
Q

Multiple compartments may be needed to model drug elimination because of

a. Varying blood flow rates
b. Tissue uptake and binding
c. Varying drug permeability
d. All of the above

A

a. Varying blood flow rates
b. Tissue uptake and binding
c. Varying drug permeability
d. (All of the above)

31
Q

Which of the following may be associated with achiorhydria?

a. Lower acid levels in stomach
b. Patients with HIV
c. Proton Pump Inhibitors
d. Chelate formation of tetracycline with antacid use
e. All of the above

A

a. Lower acid levels in stomach
b. Patients with HIV
c. Proton Pump Inhibitors
d. Chelate formation of tetracycline with antacid use
e. (All of the above)

32
Q

Sublingual tablets are subject to

A

a. First pass effect
b. (Direct absorption into circulation)
c. Slow absorption
d. All of the above

33
Q

The “depot” effect may be caused by

a. Use of vasoconstrictors
b. Use of less soluble salt formation of a drug
c. Use of pellets
d. Adsorption of a drug on a colloidal surface
e. All of the above

A

a. Use of vasoconstrictors
b. Use of less soluble salt formation of a drug
c. Use of pellets
d. Adsorption of a drug on a colloidal surface
e. (All of the above)

34
Q

For drugs with a high ER, changes in blood flow influence the rate of metabolism. T/F

A

(True)

35
Q

For drugs with a high ER, protein binding of the drug affects the rate of drug metabolism. T/F

A

(False)

36
Q

Which of the following is/are false?

a. Biliary secretion is an active process
b. Facilitated diffusion is an active process
c. Active secretion is an active process
d. A and B
e. A and C

A

b. Facilitated diffusion is an active process

37
Q

Loo-Riegelman is used for a two compartment model while the Wagner-Nelson method is used for a one compartment model. T/F

A

(True)

38
Q

Albumin binds weakly acidic drugs while alpha glycoproteins bind weakly basic drugs. T/F

A

(True)

39
Q

Drugs that are _____ undergo extensive first pass effects

a. Sublingually administered
b. Rectally administered
c. Restrictively cleared – protein bound it takes longer
d. Weakly acidic

A

c. (Restrictively cleared – protein bound it takes longer)

40
Q

How many half-lives are needed to achieve 90% of steady sate concentration?

A

a. (3.32 –> 90%)

a. 3.32 –> 90%
b. 4.32 –> 95%
c. 6.65 –> 99%

41
Q

Which is false about drug accumulation?

a. It is dependent on tau and k
b. Leads to a long elimination half life
c. It is typically mediated by weak binding to tissues or other biomolecules
d. It only occurs if the dosing interval is fixed

A

d. It only occurs if the dosing interval is fixed

42
Q

In general protein binding of a drug may result in

a. Changes in Vd
b. Changes in t1/2
c. Non-linear pharmacokinetics
d. All of the above

A

a. Changes in Vd
b. Changes in t1/2
c. Non-linear pharmacokinetics
d. (All of the above)

43
Q

A curved scatchard plot is indicative of

A

Two binding sites on a protein

44
Q

Which of the following factors affect plasma protein concentrations?

a. Protein synthesis or breakdown
b. Age
c. Disease States
d. Muscle Mass
e. A, B, and C

A

a. Protein synthesis or breakdown
b. Age
c. Disease States
d. Muscle Mass
e. (A, B, and C)

45
Q

Drug displacement from protein has a greater impact on

A

Highly protein-bound drugs

46
Q

The principle of superposition says that

A

Early doses have no effect on the pharmacokinetic parameters of later doses

47
Q

Which of the following does NOT describe drugs that are commonly excreted in the bile?

a. Large in MW
b. Not involved in enterohepatic circulation
c. Highly polar groups attached
d. Are actively secreted
e. Commonly given orally

A

a. Large in MW
b. (Not involved in enterohepatic circulation)
c. Highly polar groups attached
d. Are actively secreted
e. Commonly given orally

48
Q

Which of the following are true?

a. R (ratio of drug in tissue to drug in plasma) may be estimated from the oil/water partition coefficient
b. Large blood flow decreases distribution time
c. R indicates the extent to which an organ accumulates drug
d. If R is large, plasma levels of drug may not correlate well with pharmacodynamic action
e. All of the above

A

a. R (ratio of drug in tissue to drug in plasma) may be estimated from the oil/water partition coefficient
b. Large blood flow decreases distribution time
c. R indicates the extent to which an organ accumulates drug
d. If R is large, plasma levels of drug may not correlate well with pharmacodynamic action
e. (All of the above)

49
Q

If drug clearance is less than inulin clearance, this indicates that

a. Drug is exclusively filtered by glomerular filtration
b. Drug is actively secreted
c. Drug is reabsorbed
d. None of the above

A

c. Drug is reabsorbed

50
Q

For a multi-compartment model, which of the following are incorrect?

a. Drug is distributed rapidly into the central compartment
b. Elimination rate constants for each compartment differ
c. Drug is distributed instantaneously into all compartments
d. Drug is eliminated from the central compartment

A

c. Drug is distributed instantaneously into all compartments