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[Ther 201} E1 > Samplex 2014 Set B > Flashcards

Samplex 2014 Set B Flashcards

1
Q

Binding of atropine to cholinergic receptor in bronchial smooth muscles triggers the physiologic response:

A. Sequestration of calcium by ER
B. Binding of cytosolic calcium to calmodulin
C. Myosin and actin interaction inhibited
D. GDP is replaced by GTP in the alpha-subunit of G protein

A

C

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2
Q

Agonist-GABA interaction results to:

A. Opening of voltage-gated sodium channel
B. Hyperpolarization of plasma membrane
C. Generation of action potential
D. Release of calcium from ER and mitochondria

A

B

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3
Q

Binding of insulin to its membrane-bound receptor leads to this cellular response

A. Facilitated diffusion of potassium across plasma membrane
B. Phosphorylation of effector proteins
C. Signal transduction and amplification by generating cAMP and Ca2+
D. Hyperpolarization of the plasma membrane

A

B

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4
Q

Binding of estrogen to cytosolic receptor is the target of antineoplasm intervention

A. Inhibit cellular division
B. Apoptosis
C. Necrosis
D. Inhibit pleomorphic activity

A

A

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5
Q

Which of the following mechanisms is not involved in desensitization/tolerance?

A. Endocytosis
B. Relocalization of receptors
C. Compensation
D. Exocytosis

A

D

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6
Q

A patient has a liver problem resulting to decreased albumin in blood. Which is true:

a. the volume of distribution of lipophilic is more affected than hydrophilic
b. the volume of distribution of hydrophilic is more affected than lipophilic
c. no change in Vd
d. change in Vd cannot be predicted

A

B

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7
Q

A drug that is completely retained in the plasma compartment would have a volume of distribution equal to which of the following (assume a 70 kg person and that plasma volume is 4% of body weight)?

A. 1.4L
B. 2.8L
C. 5.6L
D. 8.4L

A

NA

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8
Q

Which of the following characterizes clearance capacity-limited elimination?

a. constant fraction of remaining drug is eliminated per unit time
b. has a constant half-life
c. clearance varies depending on concentration of the drug
d. rate of elimination is faster when drug concentration is higher

A

C

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9
Q

Which of the following routes of administration is greatly affected by the first pass effect?

a. Intramuscular
b. Intravascular
c. Rectal
d. Inhalation
A

D

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10
Q

Drug A and B are eliminated from the body by metabolism in the liver. Drug A has a clearance of 1.5L/min which is approximately equal to liver blood loss whereas Drug B has a clearance of 0.1 L/min. When these drugs are administered with another drug that increases hepatic drug metabolizing enzymes, which of the following is most likely?

a. Clearance of Drugs A and B will increase
b. clearance of Drugs A and B will decrease
c. Only the clearance of Drug B will Increase
d. Only the clearance of Drug A will increase

A

C

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11
Q

Which of the following apply to the concept of drug accumulation?

    a. occurs if dosing interval is shorter that the drug's half life
    b. directly proportional to the fraction of drug lost
    c. dosing interval longer than six half-lives.
A

A

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12
Q

Which of the following is true of loading dose?

a. directly related to clearance
b. requires monitoring to prevent toxic levels
c. decrease time needed to attain steady state concentration
d. AOTA

A

D

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13
Q

Primary determinant of Css

A. Volume of distribution
B. tmax
C. clearance
D. half life

A

C

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14
Q

You have a patient in the ER presenting with tonic-clonic seizures. Immediate action is needed. What is the best route of administration of diazepam?

A. Intravenous
B. Intramuscular
C. Subcutaneous
D. Rectal

A

A

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15
Q

A drug, almost cleared by glomerular filtration, is given at 100 mg, 3x a day. Creatinine clearance is found out to be1/3 that of normal. What would be the initial dosage?

A. 20 mg, 3x a day
B. 33 mg, 3x a day
C. 100 mg, once a day
D. B and C

A

D

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16
Q

[T/F] Pharmaceutical equivalence does not necessarily imply therapeutic equivalence, as difference in excipients and/or manufacturing process and some other variants can lead to differences in production between formed drugs.

A

T

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17
Q

[T/F] AUCo t and tmax are the most important parameters in the evaluation of bioequivalence.

A

F

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18
Q

[T/F] Since the relative bioavailability of the drug from its tablet form was approximately 100 percent (F = 1) when compared to the oral solution, the drug was completely absorbed systemically.

A

F

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19
Q

[T/F] Based on the table above, Treatment A (generic drug) is considered bioequivalent with Treatment B (innovator drug).

A

F

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20
Q

[T/F] A low bioavailability may result from first pass metabolism during transit through the intestinal epithelium, active efflux transport of drug back into the lumen, and a poorly formulated dosage.

A

T

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21
Q

The following statements are true of the concept of toxicology, except

A. It is the study that involves adverse effects of drugs in their therapeutic dose
B. The toxicity of chemicals are inherent in nature
C. The risk to development of poisoning varies with the degree of exposure
D. Safety is the probability that harm will not occur under specified conditions

A

A

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22
Q

Example(s) of toxic actions affecting cellular dysregulation include(s) the ff:

a. Inhibit ATP synthesis
b. Inhibit gene expression
c. Inhibit membrane function
d. A and B only
e. AOTA

A

B

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23
Q

The following are potential stages in development of toxicity except:

a. Delivery
b. Cell dysfunction/injury
c. Interaction with target molecule
d. A and B only
e. AOTA

A

D

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24
Q

The factors that affects response to toxic agents

a. Duration of exposure
b. Chemical properties of substance
c. Health status of individuals
d. A and B only
e. AOTA

A

E

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25
Q

Example(s) of toxic actions affecting cellular dysregulation include(s) the ff:

a. Inhibit ATP synthesis
b. Inhibit gene expression
c. Inhibit membrane function
d. A and B only
e. AOTA

A

B

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26
Q

On the last stage of potential toxicity the ff. processes are involved:

a. Fibrosis
b. Necrosis
c. Apoptosis
d. A and B only
e. AOTA

A

D

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27
Q

True about the nature of toxic action

a. The toxic action of a drug is not necessarily an exaggeration of its therapeutic effect
b. The intensity of a toxic effect depends on its concentration at the target organ
c. The toxic action of a drug may be brought about by its metabolites
d. A and B only
e. AOTA

A

E

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28
Q

True regarding toxic effects produced by chemicals:

a. Chemical allergy is a genetically induced adverse reaction
b. Delayed reaction is an extension of the immediate effects
c. Substances can have both local and systemic effects
d. A and B only
e. AOTA

A

D

29
Q

Mechanisms involving distribution that the body uses to protect itself from toxic effects of chemicals include:

a. First pass effect
b. Presence of specialized barriers
c. Detoxification
d. A and B only
e. AOTA

A

E

30
Q

The statement regarding kinetic process is/are true:

a. Ion trapping is a mechanism wherein weak acids become ionized in the presence of urinary acidic pH
b. In overdose state, protein binding sites become saturated which results in an increased fraction of unbound drug
c. Bioavailability is a process wherein drugs/substances become inactivated
d. A and B only
e. AOTA

A

B

31
Q

Risk is a product of the ff:

a. Toxicity
b. Exposure
c. Safety
d. A and B only
e. AOTA

A

D

32
Q

Which of the following is/are true of drug interactions.

a. These are interactions between a drug and another substance.
b. These interactions usually occur in vivo.
c. These are not beneficial.
d. A & B are true.
e. All of the above.

A

A

33
Q

True of adverse drug reactions:

a. It can be assumed that interactions observed in some patients will occur in all patients; interactions observed in vitro in animals will also occur in man.
b. Most important interactions involve drugs of low therapeutic margin
c. Interactions demonstrated with certain drugs can be extrapolated to closely related drugs.
d. All of the above
e. A and B only

A

B

34
Q

Type(s) of pharmacodynamic interactions:

a. IV incompatibilities
b. excipients – active ingredients
c. agonist-antagonist interaction
d. A and B.
e. All of the above

A

C

35
Q

Important to consider for Therapeutic Drug Monitoring

a. Narrow margin of safety
b. Narrow margin of therapeutic incidence
c. Good relationship with other drugs
d. all of the above
e. a and b only

A

D

36
Q

Important pharmacokinetics parameters in therapeutic drug monitoring:

a. Half-life
b. Peak concentration
c. Trough concentration
d. A and B only
e. All of the above

A

E

37
Q

Data needed in sample collection in performing therapeutic drug monitoring:

a. Time of collection
b. Biologic fluid submitted
c. Time of first administration
d. A and B only
e. All of the above

A

E

38
Q

Special populations needing therapeutic drug monitoring:

a. People with extremes of age
b. People taking multiple medications
c. People with dosing problems
d. A and B only
e. All of the above

A

E

39
Q

What are the goals of pharmacokinetic analysis?

A.	Determine the effect of the drug
B. 	Establish/adjust dosage regimen
C. 	Rational drug use
D. 	Prognosis of poisoning
E. 	All of the above.
A

E

40
Q

Drug elimination is said to be first order if:

a. The amount of the drug eliminated is a constant fraction of the concentration of the remaining drug.
b. The fraction of the drug eliminated is constant with respect to the amount of the drug eliminated.
c. The log concentration-time curve is linear at the elimination phase.
d. The absolute amount of the drug elimination is independent of the drug concentration.

A

A and B

A and B since they mean the same thing. Drug elimination that follows first order kinetics involves elimination of a constant fraction of drug through time such as the principle of half-life, which is the time when a constant half of the remaining drug is eliminated. First order kinetics must have a non-linear curve when the log-concentration-time curve was graphed. In first-order kinetics, there are no absolute amount of drug elimination, since drugs are eliminated in varying amounts per unit time but in constant fraction. Absolute drug elimination only exists in Zero-order drug elimination.

41
Q

One compartmental model:

a) assume 1st order transfer process
b) assume only one compartment in the body in which drug distribute itself
c) can be applied to zero-order input
d) not applicable to drugs administered subcutaneously
e) not applicable to drugs with enterohepatic circulation

A

A, B, E

One compartmental model:

  • assumption: treats the body as one homogeneous volume.
  • assumption: applicable ONLY to first order kinetics
  • applicable to a mode of administration (oral, IV, etc.)
  • drugs with enterohepatic circulation (enters the bloodstream, exits through the gut and reenters the bloodstream at the second time in the intestines) has other ways of elimination which renders it not applicable to one compartmental model
42
Q

Two compartmental model:

a) the initial rapid decline is due to distribution phase and not elimination phase
b) elimination does not occur until Cmax is attained
c) initial distribution is important for drugs that have narrow margin of safety
d) plasma concentration steady state cannot reflect steady state at the site of action
e) T½ cannot be estimated by plasma concentration – time curve

A

A, C

Two compartmental model (p6 of Compartmental model trans):

  • Fast phase: (α or distribution phase) – upon administration the drug is distributed to peripheral compartments
  • Slow phase: (β or elimination phase) – elimination of the drug from central compartment as soon as the drug is administered
  • Decrease of plasma concentration is faster in the distribution phase
  • Distribution into peripheral compartment continues until free concentration in the central compartment is EQUAL to the free concentration in the peripheral compartment
43
Q

Slow acetylators of isoniazid are predisposed to:

A. cardiopathy
B. peripheral neuropathy
C. renal failure
D. liver failure

A

B

44
Q

Beta lactam such as amoxicillin causes this kind of immunologic drug reaction:

A. drug-IgE complex binding to mast cells
B. specific IgG and IgG antibodies directed at drug hapten cells
C. MHC presentation of drug molecules to T-cell
D. complement activation

A

A

45
Q

Among the immunologically related adverse drug reactions, which among these takes 1-3 weeks to manifest?

A. type I
B. type II
C. type III
D. type IV
A

C

46
Q

Which among the following causes drug-induced vasculitis?

A. allopurinol
B. clarythromycin
C. carbamazepine
D. all of the above
A

D

47
Q

A dermal manifestation of ADR to thiol drugs such as enalapril.

A. pemphigus
B. urticaria
C. morbilliform rash
D. angioedema
A

A

48
Q

A risk factor shared by immune and non-immune reactions.

A. asthma
B. herpes
C. alcoholism
D. SLE
A

D

49
Q

Tinnitus is an unpredictable intolerance to small doses of:

A. aspirin
B. carbamazepine
C. xylocaine
D. primaquine
A

A

50
Q

All of the following can be desensitized except:

A. peripheral neuropathy from rifampicin
B. rash from isoniazid
C. Steven-Johnson syndrome
D. morbilliform rash
A

C

51
Q

Which of the following is/are true regarding the potential benefits of pharmacogenomics?

A. More powerful medicines and lesser side effects
B. Better vaccines
C. Decreased cost of hospitalization
D. All of the above
E. Only A and B are correct
A

D

52
Q

Genetic polymorphism may arise because of the following:

A. Pharmacodynamic variation as in the case of G6PD resulting in xenobiotic induced hemolysis.
B. Polymorphism in the mitochondrial DNa as in the case of aminoglycoside induced deafness.
C. Pharmacokinetic variation requiring increased dosage of warfarin due to warfarin resistance.
D. A and B only
E. All of the above

A

D

53
Q

Variability in drug response may be due to the following intrinsic factors except:

a. genetic differences
b. developmental stage
c. drug interaction
d. sex
e. none of the above

A

C

54
Q

The following statements is/are true regarding phase 1. Pharmacokinetic variations

a. ALDH deficiency may be responsible for flushing seen after small doses of alcohol due to the accumulation of aldehyde
b. an ultra-rapid metabolizer of isoniazid due to CYP2D6 may lead to toxicity
c. TPMT deficiency requires significant dose reduction in the use of thiopurines for cancer chemotherapy
d. only a and b are correct
e. all of the above

A

C

55
Q

The following may be examples of gene and environment interaction

a. hemolysis from naphthalene exposure secondary to G6PD deficiency
b. cyanosis in young infant with methemoglobin reductase deficiency following exposure to well water containing nitrates
c. toxicity from lead even if the blood level is low
d. all of the above
e. only a and b are correct

A

B

56
Q

Protection or susceptibility to cancer when exposed to certain xenobiotics may be associated with genes that code for

a. GSTM
b. NAT2
c. CYP2D6
d. only a and b are correct
e. all of the above

A

B

57
Q

The following statements is/are true

a. when quinidine is taken as prophylaxis from malaria, CYP2D6 will be inhibited, therefore the dose of metoprolol should be increased to control hypertension effectively
b. in the presence of thiopurine S methyltransferase deficiency, the dose of 6 mercaptopurine may be decreased to as low as 5% of the standard dose
c. NAT 1 polymorphism is associated more with the slow acetylator phenotype and urinary bladder cancer
d. all of the above
e. only a and b are correct

A

E

58
Q

Which of the following phase 2 metabolizing enzymes require a very significant dose reduction in the presence of a deficiency

a. CYP2D6
b. CYP2C9
c. TPMT
d. NAT2
e. only a and b are correct

A

C

59
Q

The following condition/s is/are associated with polymorphisms resulting from pharmacodynamic variations

a. slow acetylator phenotype
b. aminoglycoside induced deafness
c. warfarin resistance
d. warfarin sensitivity

A

C

60
Q

Pharmacokinetic variations may involve any of the following

a. transporters
b. metabolizing enzymes
c. receptors
d. only a and b are correct
e. all of the above

A

D

61
Q

Hemolysis associated with the anti-malarial primaquine

A. N-acetyl transferase
B. G6PD deficiency
C. pseudocholinesterase deficiency
D. methemoglobin reductase deficiency

A

B

62
Q

Prolonged apnea from the use of succinylcholine

A. N-acetyl transferase
B. G6PD deficiency
C. pseudocholinesterase deficiency
D. methemoglobin reductase deficiency

A

C

63
Q

Trimodal distribution (fast, intermediate, slow) of isoniazid metabolism

A. N-acetyl transferase
B. G6PD deficiency
C. pseudocholinesterase deficiency
D. methemoglobin reductase deficiency

A

A

64
Q

Cyanosis associated with abnormal hemoglobin following exposure to xenobiotics

A. N-acetyl transferase
B. G6PD deficiency
C. pseudocholinesterase deficiency
D. methemoglobin reductase deficiency

A

D

65
Q

In patients given isoniazid, analysis of parent compound and metabolites in urine differentiates fast from slow acetylators

A. ecogenetics research
B. genetic polymorphism
C. phenocopy
D. phenotype test
E. genotyping study
A

D

66
Q

Intake of drugs that inhibit the CYP2D6 such as quiniline
A. ecogenetics research

B. genetic polymorphism
C. phenocopy
D. phenotype test
E. genotyping study

A

C

67
Q

NAT1 and NAT2

A. ecogenetics research
B. genetic polymorphism
C. phenocopy
D. phenotype test
E. genotyping study
A

E

68
Q

This is the variation in at least 1% of the population.

A. ecogenetics research
B. genetic polymorphism
C. phenocopy
D. phenotype test
E. genotyping study
A

B

69
Q

Interactions and/or susceptibility of various genotypes in the development of cancer

A. ecogenetics research
B. genetic polymorphism
C. phenocopy
D. phenotype test
E. genotyping study
A

A

[Ther 201} E1 (5 decks)

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