Advanced Pharmacology
Exam 2 LATEST QUESTIONS
AND VERIFIED CORRECT
ANSWERS
What is distribution? - CORRECT ANSWER-How a drug will be transported to the tissues it needs
to go to in order for it to exert its effects
Drug factors related to distribution: - CORRECT ANSWER--Lipid solubility
-Molecular size
-Degree of ionization
-Duration of action
-Cellular binding
-Therapeutic effects
-Toxic effects
(lipid soluble, small, and non-ionized drugs will distribute more quickly)
Body factors related to distribution: - CORRECT ANSWER--Vascularity (poor perfusion,
disruption of blood flow due to trauma--difficulty distributing)
-Blood barriers (blood-brain-barrier can be problematic if we need to get drugs to the brain--will
need very high dosing since only a small amount of the drug will get through)
-Transport mechanisms
-Plasma binding proteins
-Disease states
-Volume of distribution
,-Drug interactions
What is the key plasma protein involved with protein binding for medications? - CORRECT
ANSWER-Albumin
Why do we monitor albumin? - CORRECT ANSWER-Indicative of nutritional status and how well
protein-bound drugs will be transported to their target locations
What happens to the therapeutic effect of a drug when the patient is elderly and has very low
levels of albumin? - CORRECT ANSWER-The drug does not bind to the protein (albumin) as
much as expected, so there is a lot of free drug floating in the plasma; high risk for drug toxicity
Protein bound means: - CORRECT ANSWER-Inactive form of the drug; does not have any
therapeutic effect when bound to a protein
Free drug means: - CORRECT ANSWER-Active form of the drug (available for therapeutic effect)
What happens when a patient is on two drugs that are competing for the same protein binding
site on the albumin? - CORRECT ANSWER-Some drug interactions can occur. Drugs fight for
binding position, but both drugs do not get enough as the usually would. Leads to higher free
drug levels, decreased overall albumin binding, and potential toxicity for both drugs.
**Unpredictable**
What is the 1st pass effect? - CORRECT ANSWER-PO drug goes through GI tract and absorbs in
the stomach or intestines into local circulation that reaches the liver. The liver inactivates
portions of the drug before it goes into systemic circulation. Some drugs with a very high 1st
pass effect may have to be given IV (goes directly into systemic circulation) or in higher PO doses
(watch for side effects)
,What does a substrate for an enzyme mean? - CORRECT ANSWER-It needs it to undergo
metabolism
What is an enzyme inducer? - CORRECT ANSWER-It increases clearance of the drug (decreased
blood levels of drug--may need dose increase)
What is an enzyme inhibitor? - CORRECT ANSWER-It reduces clearance (increased blood levels
of drug--may need dose decrease)
Who is at risk for drug toxicity? - CORRECT ANSWER-Elderly, those with decreased renal
function
-Cannot properly excrete the drug
What are the key pharmacokinetic changes that occur during pregnancy? - CORRECT ANSWER--
Decreased absorption
-Increased hepatic metabolism
-Increased renal excretion
**Dose adjustments are common during pregnancy
What is the safest drug category for pregnant women? - CORRECT ANSWER-Category A
What is the contraindicated drug category for pregnant women? - CORRECT ANSWER-Category
X
What is pharmacodynamics? - CORRECT ANSWER-What the drug does to the body
, What is a drug's half-life? - CORRECT ANSWER-The time it takes for the concentration of a drug
in the body to be reduced by 50%
How many half-lives does it take to remove most of the drug from the body? - CORRECT
ANSWER-Appx 4
Why is knowing half-life important? - CORRECT ANSWER-When switching to another drug that
cannot be given with the previous drug.
How to determine when drug will be cleared from body: - CORRECT ANSWER-Multiply half-life
of drug by 4
Ex: Half-life of drug A = 8 hours
8 x 4 = 32 hours (how long you'd need to wait before starting the contraindicated new drug B)
What is therapeutic index? - CORRECT ANSWER-Statement of the relative safety of a drug
Which is safer: a wide TI or a narrow TI? - CORRECT ANSWER-A wide TI is safer (more dosing
options before reaching toxic effects)
What is the minimum effective concentration? - CORRECT ANSWER-The minimum amount of
drug required to produce a therapeutic effect
What is receptor desensitization? - CORRECT ANSWER-Decreased responsiveness of the
receptor to the drug; decreased overall effects
How does antibiotic resistance occur? - CORRECT ANSWER-The bacteria find a way to become
resistant to the antibiotic. They multiply leading to an ineffective antibiotic
Exam 2 LATEST QUESTIONS
AND VERIFIED CORRECT
ANSWERS
What is distribution? - CORRECT ANSWER-How a drug will be transported to the tissues it needs
to go to in order for it to exert its effects
Drug factors related to distribution: - CORRECT ANSWER--Lipid solubility
-Molecular size
-Degree of ionization
-Duration of action
-Cellular binding
-Therapeutic effects
-Toxic effects
(lipid soluble, small, and non-ionized drugs will distribute more quickly)
Body factors related to distribution: - CORRECT ANSWER--Vascularity (poor perfusion,
disruption of blood flow due to trauma--difficulty distributing)
-Blood barriers (blood-brain-barrier can be problematic if we need to get drugs to the brain--will
need very high dosing since only a small amount of the drug will get through)
-Transport mechanisms
-Plasma binding proteins
-Disease states
-Volume of distribution
,-Drug interactions
What is the key plasma protein involved with protein binding for medications? - CORRECT
ANSWER-Albumin
Why do we monitor albumin? - CORRECT ANSWER-Indicative of nutritional status and how well
protein-bound drugs will be transported to their target locations
What happens to the therapeutic effect of a drug when the patient is elderly and has very low
levels of albumin? - CORRECT ANSWER-The drug does not bind to the protein (albumin) as
much as expected, so there is a lot of free drug floating in the plasma; high risk for drug toxicity
Protein bound means: - CORRECT ANSWER-Inactive form of the drug; does not have any
therapeutic effect when bound to a protein
Free drug means: - CORRECT ANSWER-Active form of the drug (available for therapeutic effect)
What happens when a patient is on two drugs that are competing for the same protein binding
site on the albumin? - CORRECT ANSWER-Some drug interactions can occur. Drugs fight for
binding position, but both drugs do not get enough as the usually would. Leads to higher free
drug levels, decreased overall albumin binding, and potential toxicity for both drugs.
**Unpredictable**
What is the 1st pass effect? - CORRECT ANSWER-PO drug goes through GI tract and absorbs in
the stomach or intestines into local circulation that reaches the liver. The liver inactivates
portions of the drug before it goes into systemic circulation. Some drugs with a very high 1st
pass effect may have to be given IV (goes directly into systemic circulation) or in higher PO doses
(watch for side effects)
,What does a substrate for an enzyme mean? - CORRECT ANSWER-It needs it to undergo
metabolism
What is an enzyme inducer? - CORRECT ANSWER-It increases clearance of the drug (decreased
blood levels of drug--may need dose increase)
What is an enzyme inhibitor? - CORRECT ANSWER-It reduces clearance (increased blood levels
of drug--may need dose decrease)
Who is at risk for drug toxicity? - CORRECT ANSWER-Elderly, those with decreased renal
function
-Cannot properly excrete the drug
What are the key pharmacokinetic changes that occur during pregnancy? - CORRECT ANSWER--
Decreased absorption
-Increased hepatic metabolism
-Increased renal excretion
**Dose adjustments are common during pregnancy
What is the safest drug category for pregnant women? - CORRECT ANSWER-Category A
What is the contraindicated drug category for pregnant women? - CORRECT ANSWER-Category
X
What is pharmacodynamics? - CORRECT ANSWER-What the drug does to the body
, What is a drug's half-life? - CORRECT ANSWER-The time it takes for the concentration of a drug
in the body to be reduced by 50%
How many half-lives does it take to remove most of the drug from the body? - CORRECT
ANSWER-Appx 4
Why is knowing half-life important? - CORRECT ANSWER-When switching to another drug that
cannot be given with the previous drug.
How to determine when drug will be cleared from body: - CORRECT ANSWER-Multiply half-life
of drug by 4
Ex: Half-life of drug A = 8 hours
8 x 4 = 32 hours (how long you'd need to wait before starting the contraindicated new drug B)
What is therapeutic index? - CORRECT ANSWER-Statement of the relative safety of a drug
Which is safer: a wide TI or a narrow TI? - CORRECT ANSWER-A wide TI is safer (more dosing
options before reaching toxic effects)
What is the minimum effective concentration? - CORRECT ANSWER-The minimum amount of
drug required to produce a therapeutic effect
What is receptor desensitization? - CORRECT ANSWER-Decreased responsiveness of the
receptor to the drug; decreased overall effects
How does antibiotic resistance occur? - CORRECT ANSWER-The bacteria find a way to become
resistant to the antibiotic. They multiply leading to an ineffective antibiotic
