Harr - Toxicology and Therapeutic Drug Monitoring Flashcards
In which of the following cases is qualitative analysis of the drug usually adequate?
A. To determine whether the dose of a drug with a low therapeutic index is likely to be toxic
B. To determine whether a patient is complying with the physician’s instructions
C. To adjust dose if individual differences or disease alter expected response
D. To determine whether the patient has been taking amphetamines
D. To determine whether the patient has been taking amphetamines
- The term pharmacokinetics refers to the:
A. Relationship between drug dose and the drug blood level
B. Concentration of drug at its sites of action
C. Relationship between blood concentration and therapeutic response
D. The relationship between blood and tissue drug levels
A. Relationship between drug dose and the drug blood level
- The term pharmacodynamics is an expression of the relationship between:
A. Dose and physiological effect
B. Drug concentration at target sites and physiological effect
C. Time and serum drug concentration
D. Blood and tissue drug levels
B. Drug concentration at target sites and physiological effect
- The study of pharmacogenomics involves which type of testing?
A. Familial studies to determine the inheritance of drug resistance
B. Testing drugs with cell cultures to determine the minimum toxic dosage
C. Testing for single nucleotide polymorphisms known to affect drug metabolism
D. Comparison of dose–response curves between family members
C. Testing for single nucleotide polymorphisms known to affect drug metabolism
- Select the five pharmacologic parameters that determine serum drug concentration.
A. Absorption, anabolism, perfusion, bioactivation, excretion
B. Liberation, equilibration, biotransformation, reabsorption, elimination
C. Liberation, absorption, distribution, metabolism, excretion
D. Ingestion, conjugation, integration, metabolism, elimination
C. Liberation, absorption, distribution, metabolism, excretion
- Which route of administration is associated with 100% bioavailability?
A. Sublingual
B. Intramuscular
C. Oral
D. Intravenous
D. Intravenous
- The phrase “first-pass hepatic metabolism” means that:
A. One hundred percent of a drug is excreted by the liver
B. All drug is inactivated by hepatic enzymes after one pass through the liver
C. Some drug is removed from the portal circulation, reducing bioavailability
D. The drug must be metabolized in the liver to an active form
C. Some drug is removed from the portal circulation, reducing bioavailability
- Which formula can be used to estimate dosage needed to give a desired steady-state blood level?
A. Dose per hour = clearance (milligrams per hour) × average concentration at steady state ÷ f
B. Dose per day = fraction absorbed – fraction excreted
C. Dose = fraction absorbed × (1/protein-bound fraction) D. Dose per day = half-life × log Vd (volume distribution)
A. Dose per hour = clearance (milligrams per hour) × average concentration at steady state ÷ f
- Which statement is true regarding the volume distribution (Vd) of a drug?
A. Vd is equal to the peak blood concentration divided by the dose given
B. Vd is the theoretical volume in liters into which the drug distributes
C. The higher the Vd, the lower is the dose needed to reach the desired blood level of drug
D. The Vd is the principal determinant of the dosing interval
A. Vd is equal to the peak blood concentration divided by the dose given
- For drugs with first-order elimination, which statement about drug clearance is true?
A. Clearance = elimination rate ÷ serum level
B. It is most often performed by the liver
C. It is directly related to half-life
D. Clearance rate is independent of dose
A. Clearance = elimination rate ÷ serum level
- Which statement about steady-state drug levels is true?
A. The absorbed drug must be greater than the amount excreted
B. Steady state can be measured after two elimination half-lives
C. Constant IV infusion will give the same minima and maxima as an oral dose
D. Oral dosing intervals give peaks and troughs in the dose–response curve
D. Oral dosing intervals give peaks and troughs in the dose–response curve
- If too small a peak–trough difference is seen for a drug given orally, then:
A. The dose should be decreased
B. Time between doses should be decreased
C. Dose interval should be increased
D. Dose per day and time between doses should be decreased
C. Dose interval should be increased
- If the peak level is appropriate but the trough level too low at steady state, then the dose interval should:
A. Be lengthened without changing the dose per day
B. Be lengthened and dose rate decreased
C. Not be changed, but dose per day increased
D. Be shortened, but dose per day not changed
D. Be shortened, but dose per day not changed
- If the steady-state drug level is too high, the best course of action is to:
A. Decrease the dose
B. Decrease the dose interval
C. Decrease the dose and decrease the dose interval
D. Change the route of administration
A. Decrease the dose
- When should blood samples for trough drug levels be collected?
A. 30 minutes after peak levels
B. 45 minutes before the next dose
C. 1 to 2 hours after the last dose
D. Immediately before the next dose is given
D. Immediately before the next dose is given
- Blood sample collection time for peak drug levels:
A. Varies with the drug, depending on its rate of absorption
B. Is independent of drug formulation
C. Is independent of the route of administration
D. Is 30 minutes after a bolus IV injection is completed
A. Varies with the drug, depending on its rate of absorption