Question 1

Drugs that have a significant first-pass effect:

Accepted Answer

A)  Must be given by the enteral (oral) route only 
B)  Bypass the hepatic circulation 
C)  Are rapidly metabolized by the liver and may have little if any desired action 
D)  Are converted by the liver to more active and fat-soluble forms 
A)  Must be given by the enteral (oral) route only 
B)  Bypass the hepatic circulation 
C)  Are rapidly metabolized by the liver and may have little if any desired action 
D)  Are converted by the liver to more active and fat-soluble forms C

Question 2

Drugs that are receptor antagonists, such as beta blockers, may cause:

Accepted Answer

A)  Downregulation of the drug receptor 
B)  An exaggerated response if abruptly discontinued 
C)  Partial blockade of the effects of agonist drugs 
D)  An exaggerated response to competitive drug agonists 
A)  Downregulation of the drug receptor 
B)  An exaggerated response if abruptly discontinued 
C)  Partial blockade of the effects of agonist drugs 
D)  An exaggerated response to competitive drug agonists B

Question 3

A laboratory result indicates that the peak level for a drug is above the minimum toxic concentration. This means that the:

Accepted Answer

A)  Concentration will produce therapeutic effects 
B)  Concentration will produce an adverse response 
C)  Time between doses must be shortened 
D)  Duration of action of the drug is too long 
A)  Concentration will produce therapeutic effects 
B)  Concentration will produce an adverse response 
C)  Time between doses must be shortened 
D)  Duration of action of the drug is too long B

Question 4

Phenytoin requires that a trough level be drawn. Peak and trough levels are done:

Accepted Answer

A)  When the drug has a wide therapeutic range 
B)  When the drug will be administered for a short time only 
C)  When there is a high correlation between the dose and saturation of receptor sites 
D)  To determine if a drug is in the therapeutic range 
A)  When the drug has a wide therapeutic range 
B)  When the drug will be administered for a short time only 
C)  When there is a high correlation between the dose and saturation of receptor sites 
D)  To determine if a drug is in the therapeutic range

Question 5

An agonist activates a receptor and stimulates a response. When given frequently over time, the body may:

Accepted Answer

A)  Upregulate the total number of receptors 
B)  Block the receptor with a partial agonist 
C)  Alter the drug's metabolism 
D)  Downregulate the numbers of that specific receptor 
A)  Upregulate the total number of receptors 
B)  Block the receptor with a partial agonist 
C)  Alter the drug's metabolism 
D)  Downregulate the numbers of that specific receptor

Question 6

When a medication is added to a regimen for a synergistic effect, the combined effect of the drugs is:

Accepted Answer

A)  The sum of the effects of each drug individually 
B)  Greater than the sum of the effects of each drug individually 
C)  Less than the effect of each drug individually 
D)  Not predictable, as it varies with each individual 
A)  The sum of the effects of each drug individually 
B)  Greater than the sum of the effects of each drug individually 
C)  Less than the effect of each drug individually 
D)  Not predictable, as it varies with each individual

Question 7

Which of the following statements about the major distribution barriers (blood-brain or fetal-placental) is true?

Accepted Answer

A)  Water soluble and ionized drugs cross these barriers rapidly. 
B)  The blood-brain barrier slows the entry of many drugs into and from brain cells. 
C)  The fetal-placental barrier protects the fetus from drugs taken by the mother. 
D)  Lipid-soluble drugs do not pass these barriers and are safe for pregnant women. 
A)  Water soluble and ionized drugs cross these barriers rapidly. 
B)  The blood-brain barrier slows the entry of many drugs into and from brain cells. 
C)  The fetal-placental barrier protects the fetus from drugs taken by the mother. 
D)  Lipid-soluble drugs do not pass these barriers and are safe for pregnant women.

Question 8

Drugs that are receptor agonists may demonstrate what property?

Accepted Answer

A)  Irreversible binding to the drug receptor site 
B)  Upregulation with chronic use 
C)  Desensitization or downregulation with continuous use 
D)  Inverse relationship between drug concentration and drug action 
A)  Irreversible binding to the drug receptor site 
B)  Upregulation with chronic use 
C)  Desensitization or downregulation with continuous use 
D)  Inverse relationship between drug concentration and drug action

Question 9

Drugs that use CYP 3A4 isoenzymes for metabolism may:

Accepted Answer

A)  Induce the metabolism of another drug 
B)  Inhibit the metabolism of another drug 
C)  Both 1 and 2 
D)  Neither 1 nor 2 
A)  Induce the metabolism of another drug 
B)  Inhibit the metabolism of another drug 
C)  Both 1 and 2 
D)  Neither 1 nor 2

Question 10

Once they have been metabolized by the liver, the metabolites may be:

Accepted Answer

A)  More active than the parent drug 
B)  Less active than the parent drug 
C)  Totally "deactivated" so they are excreted without any effect 
D)  All of the above 
A)  More active than the parent drug 
B)  Less active than the parent drug 
C)  Totally "deactivated" so they are excreted without any effect 
D)  All of the above

Question 11

Which of the following statements about bioavailability is true?

Accepted Answer

A)  Bioavailability issues are especially important for drugs with narrow therapeutic ranges or sustained-release mechanisms. 
B)  All brands of a drug have the same bioavailability. 
C)  Drugs that are administered more than once a day have greater bioavailability than drugs given once daily. 
D)  Combining an active drug with an inert substance does not affect bioavailability. 
A)  Bioavailability issues are especially important for drugs with narrow therapeutic ranges or sustained-release mechanisms. 
B)  All brands of a drug have the same bioavailability. 
C)  Drugs that are administered more than once a day have greater bioavailability than drugs given once daily. 
D)  Combining an active drug with an inert substance does not affect bioavailability.

Question 12

Drugs administered via IV:

Accepted Answer

A)  Need to be lipid soluble in order to be easily absorbed 
B)  Begin distribution into the body immediately 
C)  Are easily absorbed if they are nonionized 
D)  May use pinocytosis to be absorbed 
A)  Need to be lipid soluble in order to be easily absorbed 
B)  Begin distribution into the body immediately 
C)  Are easily absorbed if they are nonionized 
D)  May use pinocytosis to be absorbed

Question 13

Steady state is:

Accepted Answer

A)  The point on the drug concentration curve when absorption exceeds excretion 
B)  When the amount of drug in the body remains constant 
C)  When the amount of drug in the body stays below the minimum toxic concentration 
D)  All of the above 
A)  The point on the drug concentration curve when absorption exceeds excretion 
B)  When the amount of drug in the body remains constant 
C)  When the amount of drug in the body stays below the minimum toxic concentration 
D)  All of the above

Question 14

The time required for the amount of drug in the body to decrease by 50% is called:

Accepted Answer

A)  Steady state 
B)  Half-life 
C)  Phase II metabolism 
D)  Reduced bioavailability time 
A)  Steady state 
B)  Half-life 
C)  Phase II metabolism 
D)  Reduced bioavailability time

Question 15

Which of the following variables is a factor in drug absorption?

Accepted Answer

A)  The smaller the surface area for absorption, the more rapidly the drug is absorbed. 
B)  A rich blood supply to the area of absorption leads to better absorption. 
C)  The less soluble the drug, the more easily it is absorbed. 
D)  Ionized drugs are easily absorbed across the cell membrane. 
A)  The smaller the surface area for absorption, the more rapidly the drug is absorbed. 
B)  A rich blood supply to the area of absorption leads to better absorption. 
C)  The less soluble the drug, the more easily it is absorbed. 
D)  Ionized drugs are easily absorbed across the cell membrane.

Question 16

The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the:

Accepted Answer

A)  Minimum adverse effect level 
B)  Peak of action 
C)  Onset of action 
D)  Therapeutic range 
A)  Minimum adverse effect level 
B)  Peak of action 
C)  Onset of action 
D)  Therapeutic range

Question 17

Therapeutic drug levels are drawn when a drug reaches steady state. Drugs reach steady state:

Accepted Answer

A)  After the second dose 
B)  After four to five half-lives 
C)  When the patient feels the full effect of the drug 
D)  One hour after IV administration 
A)  After the second dose 
B)  After four to five half-lives 
C)  When the patient feels the full effect of the drug 
D)  One hour after IV administration

Question 18

Upregulation or hypersensitization may lead to:

Accepted Answer

A)  Increased response to a drug 
B)  Decreased response to a drug 
C)  An exaggerated response if the drug is withdrawn 
D)  Refractoriness or complete lack of response 
A)  Increased response to a drug 
B)  Decreased response to a drug 
C)  An exaggerated response if the drug is withdrawn 
D)  Refractoriness or complete lack of response

Question 19

Two different pain medications are given together for pain relief. The drug-drug interaction is:

Accepted Answer

A)  Synergistic 
B)  Antagonistic 
C)  Potentiative 
D)  Additive 
A)  Synergistic 
B)  Antagonistic 
C)  Potentiative 
D)  Additive

Question 20

Drug antagonism is best defined as an effect of a drug that:

Accepted Answer

A)  Leads to major physiological and psychological dependence 
B)  Is modified by the concurrent administration of another drug 
C)  Cannot be metabolized before another dose is administered 
D)  Leads to a decreased physiological response when combined with another drug 
A)  Leads to major physiological and psychological dependence 
B)  Is modified by the concurrent administration of another drug 
C)  Cannot be metabolized before another dose is administered 
D)  Leads to a decreased physiological response when combined with another drug

Exam 2: Review of Basic Principles of Pharmacology

Drugs that have a significant first-pass effect:

Drugs that are receptor antagonists, such as beta blockers, may cause:

A laboratory result indicates that the peak level for a drug is above the minimum toxic concentration. This means that the:

Phenytoin requires that a trough level be drawn. Peak and trough levels are done:

An agonist activates a receptor and stimulates a response. When given frequently over time, the body may:

When a medication is added to a regimen for a synergistic effect, the combined effect of the drugs is:

Which of the following statements about the major distribution barriers (blood-brain or fetal-placental) is true?

Drugs that are receptor agonists may demonstrate what property?

Drugs that use CYP 3A4 isoenzymes for metabolism may:

Once they have been metabolized by the liver, the metabolites may be:

Which of the following statements about bioavailability is true?

Drugs administered via IV:

Steady state is:

The time required for the amount of drug in the body to decrease by 50% is called:

Which of the following variables is a factor in drug absorption?

The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the:

Therapeutic drug levels are drawn when a drug reaches steady state. Drugs reach steady state:

Upregulation or hypersensitization may lead to:

Two different pain medications are given together for pain relief. The drug-drug interaction is:

Drug antagonism is best defined as an effect of a drug that:

The Role of the Nurse Practitioner

Rational Drug Selection

Legal and Professional Issues in Prescribing

Adverse Drug Reactions

Factors That Foster Positive Outcomes

Cultural and Ethnic Influences in Pharmacotherapeutics

An Introduction to Pharmacogenomics

Nutrition and Nutraceuticals

Herbal Therapy and Nutritional Supplements

Information Technology and Pharmacotherapeutics

Pharmacoeconomics

Over-The-Counter Medications

Drugs Affecting the Autonomic Nervous System

Drugs Affecting the Central Nervous System

Drugs Affecting the Cardiovascular and Renal Systems

Drugs Affecting the Respiratory System

Drugs Affecting the Hematopoietic System

Drugs Affecting the Immune System

Drugs Affecting the Gastrointestinal System

Drugs Affecting the Endocrine System

Drugs Affecting the Reproductive System

Drugs Affecting the Integumentary System

Drugs Used in Treating Infectious Diseases

Drugs Used in Treating Inflammatory Processes

Drugs Used in Treating Eye and Ear Disorders

Anemia

Chronic Stable Angina and Low-Risk Unstable Angina

Anxiety and Depression

Asthma and Chronic Obstructive Pulmonary Disease

Contraception

Dermatologic Conditions

Diabetes Mellitus

Gastroesophageal Reflux and Peptic Ulcer Disease

Headaches

Heart Failure

Human Immunodeficiency Virus Disease and Acquired Immunodeficiency Syndrome

Hormone Replacement Therapy and Osteoporosis

Hyperlipidemia

Hypertension

Hyperthyroidism and Hypothyroidism

Pneumonia

Smoking Cessation

Sexually Transmitted Infections and Vaginitis

Tuberculosis

Upper Respiratory Infections, Otitis Media, and Otitis Externa

Urinary Tract Infections

Women As Patients

Men As Patients

Children As Patients

Geriatric Patients

Pain Management: Acute and Chronic Pain

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