Lippincott Q and A Pharmacology questions with correct answers

1 A 79-year-old man with end-stage Alzheimer's disease and dysphagia is taking multiple medications. Physical examination reveals xerostomia and a limited gag reflex. Which of the following routes of medication administration would provide the lowest serum drug concentration? (A) Enteral (B) Intramuscular (C) Intrathecal (D) Intravenous (E) Transdermal - Answer ANSWERS 1 The answer is A: Enteral. This patient has dysphagia and Alzheimer's disease. These conditions would make drug administration by mouth difficult and limit direct absorption via the stomach. This route of drug administration would give the lowest serum drug concentrations for the reasons described previously. (B) Intramuscular administration, although painful for the patient, would give acceptable serum drug concentrations. (C) Intrathecal administration would give acceptable therapeutic drug concentrations but would be limited to CNS disease states. (D) Intravenous administration would provide medications via vein and therapeutic drug concentrations. It could be used for various medications. (E) Transdermal administration applies medications to the skin and could achieve therapeutic drug concentrations. 2 A 28-year-old man with seborrheic dermatitis is pre- scribed a topical corticosteroid crème by his derma- tologist in hopes of alleviating the chronic rash and erythema on the cheeks. Which of the following steps is most critical to achieve a therapeutic drug concen- tration in plasma? (A) Absorption (B) Distribution (C) Elimination (D) Glycosylation (E) Metabolism - Answer The answer is A: Absorption. Drug absorption from the site of administration, in this case via the topical route, allows the medication to enter into the skin and then into the plasma. Following this step, the medication can distribute into tissues and also be metabolized in tissues.