Questions Mod 1 (PC617)

Question 1

Question:
A drug with a high first pass effect will have
A. More drug available in the circulation for distribution
2. Less drug available in the circulation for distribution
3. Is excreted from the the body more rapidly
4. Causes more free drug in the tissues

Answer 1

B. Less drug available in the circulation for distribution-

Question 2

A patient reports becoming “immune” to a medication because it no longer works to alleviate symptoms. The nurse recognizes that this decreased effectiveness is likely caused by:

a. antagonists produced by the body that compete with the drug for receptor sites.
b. decreased selectivity of receptor sites, resulting in a variety of effects.
c. desensitization of receptor sites by continual exposure to the drug.
d. synthesis of more receptor sites in response to the medication.

Answer 2

c. desensitization of receptor sites by continual exposure to the drug.

Question 3

Your patient is taking cimetidine (Tagamet) which is an inhibitor of the 1A2 isoenzyme in the CYP 450 system. This same patient is taking warfarin (Coumadin) which is metabolized by the same isoenzyme.
1. Is there a drug interaction in this scenario?
A. Yes
B. No
C. Only if taken on an empty stomach
D. Depends on the dose of the drug

Answer 3

Yes

Question 4

What type of reaction will occur? (Cimetadine and Warfarin)
A. The concentration of cimetidine will be increased
B. The concentration of cimetidine will be decreased
C. The concentration of warfarin will be decreased
D. The concentration of warfarin will be increased

Answer 4

D – The concentration of warfarin will be increased as the cimetidine inhibits the isoenzyme that metabolizes warfarin

Question 5

Your patient is a healthy 32 year old who takes St. John’s wort, an inducer of the 3A4 isoenzyme. He has a fear of flying and must fly to Europe on a business trip. You prescribe a small number of alprazolam to use for the trip. Alprazolam is metabolized by this same isoenzyme. Based on your knowledge of the CYP 450 isoenzyme system what will be your order for alprazolam? (The normal dosage range for alprazolam is 0.25 mg to 1.0 mg)
A. Prescribe the 0.25 mg dose
B. Prescribe the 0.5 mg dose
C. Prescribe the 1.0 mg dose

Answer 5

. Prescribe the 1.0 mg dose as St. John’s wort will induce a greater metabolism of the alprazolam and a lower dose may not be effective.