Module 02: Basic Principles of Pharmacology

Question 1

This is cited as a science dedicated to the study of rate processes such as absorption, distribution, metabolism, and excretion of a drug and the multiple interrelationships affecting same, such as incomplete absorption, saturability in transport, biotransformation, or binding.

Answer 1

Pharmacokinetics

Question 2

What are the different routes for medications?

Answer 2

(A) Oral (PO)
(B) Sublingual route (SL)
(C) Buccal route (Bu)
(D) Intravenous route (IV)
(E) Intramuscular route (IM)
(F) Subcutaneous route (SC or SQ)
(E) Inhalation route (INH)

Question 3

What are the different kinds of medications administered?

Answer 3

(A) Nasal Spray
(B) Rectal (tablets or suppositories)
(C) Vaginal (Tablets or suppositories)
(D) Cutaneous Route
(E) Otic (Ointments or drops)
(F) Ocular or Ophthalmic
(G) Transdermal patches

Question 4

What are the different biochemical paths of drug administration?

Answer 4

(A) Passive diffusion
(B) Facilitated passive diffusion
(C) Active Transport
(D) Pinocytosis

Question 5

This is known as the movement against a concentrated gradient using energy (ATP).

Answer 5

Active Transport

Question 6

This is characterized as the movement along the concentration gradient without energy.

Answer 6

Passive Transport

(1) Simple Diffusion
(2) Facilitated Diffusion

Question 7

This movement involves the transport of extracellular fluids along with its contents of small dissolved molecules (solutes).

Answer 7

Pinocytosis (pino which means to drink and kytos which pertains to the word cell)

Question 8

What are the requirements of pinocytosis in order for it to transpire or occur?

Answer 8

Requires a considerable amount of cellular energy in the form of ATP to run.

Question 9

These are known to activate the process of pinocytosis when they make contact to the plasma membrane.

Answer 9

Ions sugars or amino acids

Question 10

What are the steps of pinocytosis?

Answer 10

(A) Solutes bind to the cell membrane.
(B) The cell membrane starts to fold inwards and the cell membrane continues to fold.
(C) Both ends of the fold meet, producing a pinosome.

Question 11

This pertains to the fraction of administered drug that reaches the systemic circulation intact.

Answer 11

Bioavailability

Question 12

Bioavailability is characterized to be a determiner of what?

Answer 12

It determines the dosage required for each drug via each route of administration.

Question 13

Based on the hypothetical dose-response curve (relationship) in pharmacodynamics, this is known as the location of the curve along the dose axis.

Answer 13

Potency

Question 14

Based on the hypothetical dose-response curve (relationship) in pharmacodynamics, this is characterized as the greatest attainable response.

Answer 14

Maximal efficacy or ceiling effect

Question 15

Based on the hypothetical dose-response curve (relationship) in pharmacodynamics, this is characterized as the change in response per unit dose.

Answer 15

Slope

Question 16

What are the factors causing low bioavailability?

Answer 16

(A) Insufficient time for absorption in the GIT (poorly dissolved drugs)
(B) Chemical reactions that reduce absorption can decrease bioavailability (drug interactions, gastric acids or enzymes, etc.)
(C) Age, sex, physical activity, genetic phenotype, stress disorders (malabsorption syndromes) or previous GI surgery (bariatric surgery) can also affect drug bioavailability

Question 17

Enumerate drug administrations depending on their bioavailability.

Answer 17

(A) Intravenous
(B) Intramuscular
(C) Oral tablet
(D) Sublingual or buccal (powder)
(E) Oral capsule

Question 18

What are the different factors affecting distribution?

Answer 18

(A) Volume distribution
(B) Protein binding
(C) Blood brain barrier

Question 19

This is defined as the theoretical volume of fluid into which the total drug administered would have to be diluted to produce the concentration in plasma.

Answer 19

Volume Distribution

Question 20

What are some drugs that can bind with plasma proteins?

Answer 20

(1) Albumin lipoproteins, a-1acid glycoprotein (AGP)

Question 21

This factor affecting drug distribution is characterized to either enhance or detract from a drug’s performance.

Answer 21

Protein binding

Question 22

Explain the difference between drugs that are minimally-protein bound to those that are highly protein bound drugs?

Answer 22

Drugs that are minimally protein bound penetrate tissue better than those that are highly protein bound drugs, but they are excreted much faster.

Question 23

Why do highly protein-bound drugs increase the risk for toxicity?

Answer 23

Because when administered together they will compete for protein binding sites, thus increasing the risk for toxicity (eg 95% vs 90% protein binding)

Question 24

What are the characteristics of highly protein bound drugs?

Answer 24

(1) Poorer tissue penetration
(2) Decreased access to privileged sites
(3) Slower excretion
(4) Longer plasma half life

Question 25

What are the characteristics of minimally protein bound drugs?

Answer 25

(1) Better tissue penetration (2) Enhanced access to privileged sites (3) Faster excretion (4) Shorter plasma half life

Question 26

What happens to protein binding occurring outside the bloodstream?

Answer 26

Compounds can bind with macromolecules in skin, breast milk, tissues and organs including the placenta. They become stuck and are thus prevented from reaching the site of their intended action.

Question 27

This is known as an endothelial lining in the blood vessels in the brain where cells are tightly pressed together creative a selective semi-permeable membrane between blood and the interstitium of the bran (tight junction proteins).

Answer 27

Blood brain barrier

Question 28

What is the role of the blood brain barrier?

Answer 28

To protect the brain from foreign substances including 98% of available drugs in the market

Question 29

What drugs are known to have the capacity to cross the Blood Brain Barrier by diffusion and others via transport proteins?

Answer 29

Highly lipid soluble drugs and those with low molecular weight (benzodiazepine and enoxaparin)

Question 30

What drugs that cannot cross the Blood Brain Barrier by diffusion and others via transport proteins?

Answer 30

Water soluble drugs (penicillin and atenolol) and drugs not bound with transport proteins (free drugs)

Question 31

This refers to the fraction of a drug that is not bound to serum proteins and is immediately available to distribute in the body, interact with biological membranes, and bind to receptors.

Answer 31

Free drugs

Question 32

What are other biological barriers?

Answer 32

(A) Placental barrier (B) Skin barrier (C) Breastmilk

Question 33

The goal of this process in pharmacokinetics is to make the drug easier to excrete.

Answer 33

Drug metabolism

Question 34

What are some processes that fall under drug metabolism?

Answer 34

Oxidation, reduction, hydrolysis, hydration, conjugation, condensation or isomerization

Question 35

How does drug metabolism work?

Answer 35

It typically inactivates drugs, some drug metabolites are pharmacologically active- sometimes even more so than the parent compound.

Question 36

This is characterized as the principal site of drug metabolism within the human body.

Answer 36

Liver

Question 37

This is known as a drug that requires activation in order to have its therapeutic effect. This is also characterized as an inactive or weakly active substance metabolized into an active pharmacologic substance.

Answer 37

Prodrug

Question 38

Prodrugs are often designed to what?

Answer 38

Improve a drug's bioavailability

Question 39

How do prodrugs work?

Answer 39

Prodrug's parent compounds that contain regions or additional chemical groups that mask the drugs' active zone and or alters drug solubility (promoiety), but can be enzymatically or chemically cleaved or altered by site specific enzymes, exposing the drug's active zone and allowing the drug to activate it's receptor resulting in a therapeutic effect.

Question 40

What is the active drug of codeine?

Answer 40

Morphine

Question 41

What is the active drug of clopidogrel?

Answer 41

Thiol-derivative

Question 42

What is the active drug of enalapril?

Answer 42

Enalaprilat

Question 43

What is the active drug of L-dopamine?

Answer 43

Dopamine

Question 44

What is the active drug of prednisone?

Answer 44

Prednisolone

Question 45

This is known as an estimate of the time it takes for the concentration or amount in the body of that drug to be reducted by exactly one half (50%).

Answer 45

Drug half life (t 1/2)

Question 46

What are some patient specific variables affecting half-life?

Answer 46

(A) Age or gender (B) Blood circulation (C) Diet and fluid excess (CHF) (D) History of previous drug use (E) Kidney and liver function (F) Obesity and pre existing conditions (G) Drugs competing for binding sites (H) Race or ethnicity (can influence the metabolism of certain drugs) (I) smoking (J) Medical procedures (Hemodialysis)

Question 47

What are some drug specific variables affecting half life?

Answer 47

(A) Drug formulation (MR or controlled release preparations extend half life) (B) Drug administration (C) How the drug is cleared from the body (kidneys, liver or lungs) (D) Protein binding (E) Drug interactions (F) Properties of drugs (molecular size or charge) (G) Volume of distribution

Question 48

This type of half life is characterized to be fast but short acting and is usually needed to be taken several times a day.

Answer 48

Short half life

Question 49

This type of half life is characterized to take longer before it starts to work, effects persist longer (long acting) and is dosed either once a day, once a week, once a month or even less.

Answer 49

Long half life

Question 50

This pertains to the act of giving a large initial dose that is significantly higher than the maintenance dose.

Answer 50

Loading dose (therapeutic effects can be achieve while the drug reaches a steady state)

Question 51

This condition affecting drug excretion pertains to the decreased blood flow to the kidneys leading to decreased GFR.

Answer 51

Prerenal

Question 52

How are pre-renal conditions affecting drug excretion manifested?

Answer 52

(A) Dehydration (B) Hemorrhage

Question 53

This condition affecting drug excretion is characterized to affect GFR, tubular secretion and reabsorption.

Answer 53

Intrarenal

Question 54

This condition affecting drug excretion is characterized to obstruct urine flow and affects filtration.

Answer 54

Postrenal

Question 54

How are intrarenal conditions affecting drug excretion manifested?

Answer 54

(A) CKD (B) Glomerulonephritis

Question 55

How are post renal conditions affecting drug excretion manifested?

Answer 55

(A) BPH (B) Stones (C) Neurogenic bladder Drug accumulation may occur resulting to adverse drug reactions.

Question 56

What is the function of the lungs in terms of drug excretion?

Answer 56

(A) Excretion of volatile drug substances (anesthetics i.e Nitrous oxide, butane and propane) (B) Metabolizing drugs to carbon dioxide and water (saliva and sweat)

Question 57

This is characterized to use the tools of nanotechnology. This must be closely evaluated to optimize drug delivery to the target site while minimizing adverse effects.

Answer 57

Nanomedicine

Question 58

These are designed to be long lasting with minimal excretion within organs.

Answer 58

Nanoparticles

Question 59

This is the study of a drug's molecular, biochemical, and physiologic effects or actions. It comes from the Greek words "pharmakon," meaning "drug," and "dynamikos," meaning "power."

Answer 59

Pharmacodynamics (what the drug does to the body)

Question 60

Under the process of pharmacodynamics, the pharmacologic response depends on what>

Answer 60

On the drug binding to its target

Question 61

Under the process of pharmacodynamics, this is known to influence the drugs's effects.

Answer 61

The concentration of the drug at the receptor sites.

Question 62

The process of pharmacodynamics can be affected by physiologic changes due to:

Answer 62

(A) A disorder or disease (eg insulin-resistant DM, malnutrition) (B) Aging process (eg changes in metabolism, alteration in receptor binding) (C) Other drugs (eg drug-drug interactions resulting to competition in receptor binding sites

Question 63

Site some examples wherein some drugs produce effects without altering cellular function and without binding to a receptor:

Answer 63

(A) Some antacids through simple chemical reaction neutralizes gastric acid (B) Alka Seltzer (NaHCO3) (C) Gaviscon (Magnesium trisilicate) (D) TUMS (CaCO3) (E) Sucralfate (Iselpin) (aluminum complex of sucrose octasulfate; soluble in strong acids and alkali but not in water and alcohol)

Question 64

Explain the dose response relationships.

Answer 64

The concentration of the drug at the site of action controls the effect (regardless of the effect through binding or chemical reaction, etc.

Question 65

Regardless of the route administration, explain the relationship between the drug dose and the drug concentration.

Answer 65

At the cellular level their relationship is complex (Pharmacokinetics)

Question 66

Based on dose response relationships (hypothetical dose response curve), this is known as the location of the curve along the dose axis.

Answer 66

Potency

Question 67

Based on dose response relationships (hypothetical dose response curve), this is known as the greatest attainable response.

Answer 67

Maximal efficacy or ceiling effect

Question 68

Based on dose response relationships (hypothetical dose response curve), this is known as the change in response per unit dose.

Answer 68

Slope

Question 69

This is essential to understanding drug action and states that drugs act as agonists, antagonists, or inverse agonists of physiologic receptors and thus can only mimic, intensify, inhibit, or block normal physiologic responses.

Answer 69

Receptor Theory (Drug -receptor interaction)

Question 70

Based on the Receptor Theory (Drug -receptor interaction), these are known to activate receptors and produce a desired response.

Answer 70

Agonist

Question 71

Receptor Theory (Drug -receptor interaction), these are known to prevent receptor activation and block a specific response.

Answer 71

Antagonist

Question 72

Receptor Theory (Drug -receptor interaction), these are characterized to affect multiple receptor sites.

Answer 72

Non specific drugs

Question 73

Receptor Theory (Drug -receptor interaction), these are characterized to affect multiple receptors.

Answer 73

Non-selective drugs

Question 74

This type of mechanism of drug action is characterized to enhance intrinsic activity.

Answer 74

Stimulation

Question 75

This type of mechanism of drug action is characterized to decrease neural activity and bodily functions.

Answer 75

Depression

Question 76

This type of mechanism of drug action is characterized to have noxious affects.

Answer 76

Irritation

Question 77

This type of mechanism of drug action is characterized to replace essential body compounds.

Answer 77

Replacement

Question 78

This type of mechanism of drug action is characterized to selectively kill invading parasites and cancers.

Answer 78

Cytotoxic action

Question 79

This type of mechanism of drug action is characterized to prevent, inhibit or kill infectious organisms.

Answer 79

Antimicrobial action

Question 80

This type of mechanism of drug action is characterized to modify, enhance or depress the immune system.

Answer 80

Modification of immune status

Question 81

What types of drugs are known to have the drug mechanism of stimulation?

Answer 81

Adrenergic drugs that increase heart rate, sweating and respiratory rate during fight or flight response

Question 82

What types of drugs are known to have the drug mechanism of depression?

Answer 82

Barbiturates and opiates

Question 83

What types of drugs are known to have the drug mechanism of irritation?

Answer 83

Astringents

Question 84

What types of drugs are known to have the drug mechanism of replacement?

Answer 84

Insulin, thyroid drugs and hormones

Question 85

What types of drugs are known to have the drug mechanism of cytotoxic action?

Answer 85

Chemotherapy

Question 86

What types of drugs are known to have the drug mechanism of antimicrobial action?

Answer 86

Antibiotics

Question 87

What types of drugs are known to have the drug mechanism of modification of immune status?

Answer 87

Interferons and methotrexate

Question 88

What are the different types of drug interactions?

Answer 88

(1) Drug to drug interaction (2) Drug to herb interaction (3) Drug to allergy interaction (4) Drug to food interaction (5) Drug to disease interaction (6) Drug to gene interaction

Question 89

Based on drug and food interactions, what are drugs that won't work well the patient consumes calcium?

Answer 89

(A) Antibiotics (B) Osteoporosis meds

Question 90

Based on drug and food interactions, what are drugs that won't work well the patient consumes green vegetables?

Answer 90

Anticoagulants

Question 91

Based on drug and food interactions, what are drugs that won't work well the patient consumes bitter oranges?

Answer 91

(A) Benzodiazepines (B) Calcium chain blockers (C) Statins

Question 92

Based on drug and food interactions, what are drugs that won't work well the patient consumes alcohol?

Answer 92

(A) Antibiotics (B) Antidepressants (C) Paracetamol (D) Insulin

Question 93

Based on drug and food interactions, what are drugs that won't work well the patient consumes tyramine foods?

Answer 93

Antidepressants (MAOIs)

Question 94

Based on drug and food interactions, what are drugs that won't work well the patient consumes any food?

Answer 94

(A) Bisphosphonates (B) Hypothyroid drugs (C) Hyperthyroid drugs (D) Digoxin

Question 95

These are characterized as secondary effects that can be predictable (Nitrates for CAD), range from discomfort and annoying to severe or life threatening, and could be desirable (e.g. antihistamines taken at bedtime resulting to sleepiness or drowsiness).

Answer 95

Side effects (One of the reasons why patients stop taking their prescribed medications)

Question 96

These drug reactions are characterized as unwanted effects of a drug of medication. This can be unintentional, unexpected reactions to drug therapy that occur at normal drug dosages.

Answer 96

Adverse drug reactions

Question 96

What are some of the side effects that range from discomfort and annoying to severe or life threatening?

Answer 96

(A) Rashes (B) Fever (C) Constriction of the airways and wheezing (D) Swelling of tissues (such as the larynx and the opening between the vocal cords that closes to stop the flow of air to the lungs (glottis), which impairs breathing) (E) Fall in blood pressure, sometimes to dangerously low levels (leading to anaphylactic shock)

Question 96

What are the different factors that might affect drug side effects?

Answer 96

Chronic illness, age, sex, weight and ethnicity

Question 97

Describe adverse drug reactions.

Answer 97

(A) Reactions range from mild to severe, including anaphylaxis (B) They are always undesirable (C) Must be reported immediately (variance to planned therapy)

Question 98

What are the risk factors for adverse drug reactions?

Answer 98

(1) Hereditary factors (2) Certain preexisting diseases (3) Simultaneous use of several medications (4) Very young or old age (5) Pregnancy and breastfeeding

Question 99

Why is taking several medications simultaneously considered as a risk factor for adverse drug reactions?

Answer 99

(A) Taking several medications, whether prescription or over the counter, contributes to the risk of having an adverse reaction. The number and severity of adverse drug reactions increase disproportionately as the number of drugs taken increases. (B) The use of alcohol, which is also a drug, also increases the risk.

Question 100

This drug reaction refers to serious, often harmful, and sometimes fatal toxic reactions to an accidental overdose of a medication.

Answer 100

Overdose Toxicity

Question 101

Describe overdose toxicity.

Answer 101

(1) May result from drug accumulation (2) Can be unintentional (because of an error on the part of the nurse, doctor, pharmacist or person taking the medication. (3) Could be an intentional overdose (homicide or suicide)