Lippincott Illustrated Reviews:
Pharmacology – Comprehensive Q&A
Test Bank: 200 High-Yield Board-Style
Questions with Clinical Rationales
Chapter 1: Pharmacokinetics
1. A patient with dysphagia and Alzheimer's disease is prescribed a
medication. Which route of administration would result in the lowest
serum drug concentrations?
A) Enteral (oral)
B) Intramuscular
C) Intrathecal
D) Intravenous
E) Transdermal
Answer: A) Enteral (oral)
Rationale: Oral administration in patients with dysphagia can be
problematic due to difficulty swallowing and potentially reduced
absorption. This route is subject to first-pass hepatic metabolism,
significantly reducing bioavailability. Intramuscular, intravenous, and
transdermal routes bypass first-pass metabolism to varying degrees.
Intrathecal administration, while invasive, delivers drug directly to the CNS .
,2. A 28-year-old man with seborrheic dermatitis is prescribed a topical
corticosteroid cream. Which step is most critical to achieve a
therapeutic drug concentration in plasma?
A) Absorption
B) Distribution
C) Elimination
D) Glycosylation
E) Metabolism
Answer: A) Absorption
Rationale: Drug absorption from the site of administration allows the
medication to enter the skin and then into the plasma. Following
absorption, the medication can distribute into tissues and be metabolized.
Topical administration requires adequate penetration through skin layers to
reach systemic circulation .
3. A 31-year-old man with asthma is brought to the emergency
department with acute dyspnea. Albuterol should be administered by
which route?
A) Inhalation
B) Intranasal puff metered dose
C) Subcutaneous
D) Sublingual
E) Topical
,Answer: A) Inhalation
Rationale: Inhalation provides rapid delivery of a drug across a large
surface area of the respiratory tract and is the route of administration of
choice in acute asthma. This route delivers medication directly to the site of
action (bronchial smooth muscle) with rapid onset and minimal systemic
side effects .
4. A 27-year-old female with vulvovaginal candidiasis receives a 100
mg oral dose of fluconazole, resulting in a peak plasma concentration
of 20 mg/mL. What is the volume of distribution?
A) 0.5 L
B) 1 L
C) 3 L
D) 5 L
E) 50 L
Answer: D) 5 L
Rationale: Volume of distribution (Vd) = Dose / Plasma concentration. Vd
= 100 mg / 20 mg/mL = 5 L. This represents the apparent volume in which
the drug is distributed. A small Vd indicates the drug remains primarily in
the plasma compartment .
, 5. A 48-year-old man with end-stage liver disease has elevated liver
function tests. Which medication is likely to be therapeutic and safe in
this patient?
A) Epinephrine
B) Erythromycin
C) Nifedipine
D) Rifampin
E) Verapamil
Answer: A) Epinephrine
Rationale: Patients with end-stage liver disease have impaired cytochrome
P450 metabolism. Drugs metabolized by this system will accumulate to
toxic levels. Epinephrine is not significantly metabolized by the cytochrome
system and can be used with caution. Erythromycin, nifedipine, rifampin,
and verapamil are all metabolized by hepatic CYP enzymes .
6. A patient is prescribed sulfamethoxazole with a half-life of 12 hours.
How long will it take to reach 90% of steady state?
A) 10 hours
B) 20 hours
C) 30 hours
D) 40 hours
E) 50 hours
Answer: D) 40 hours
Pharmacology – Comprehensive Q&A
Test Bank: 200 High-Yield Board-Style
Questions with Clinical Rationales
Chapter 1: Pharmacokinetics
1. A patient with dysphagia and Alzheimer's disease is prescribed a
medication. Which route of administration would result in the lowest
serum drug concentrations?
A) Enteral (oral)
B) Intramuscular
C) Intrathecal
D) Intravenous
E) Transdermal
Answer: A) Enteral (oral)
Rationale: Oral administration in patients with dysphagia can be
problematic due to difficulty swallowing and potentially reduced
absorption. This route is subject to first-pass hepatic metabolism,
significantly reducing bioavailability. Intramuscular, intravenous, and
transdermal routes bypass first-pass metabolism to varying degrees.
Intrathecal administration, while invasive, delivers drug directly to the CNS .
,2. A 28-year-old man with seborrheic dermatitis is prescribed a topical
corticosteroid cream. Which step is most critical to achieve a
therapeutic drug concentration in plasma?
A) Absorption
B) Distribution
C) Elimination
D) Glycosylation
E) Metabolism
Answer: A) Absorption
Rationale: Drug absorption from the site of administration allows the
medication to enter the skin and then into the plasma. Following
absorption, the medication can distribute into tissues and be metabolized.
Topical administration requires adequate penetration through skin layers to
reach systemic circulation .
3. A 31-year-old man with asthma is brought to the emergency
department with acute dyspnea. Albuterol should be administered by
which route?
A) Inhalation
B) Intranasal puff metered dose
C) Subcutaneous
D) Sublingual
E) Topical
,Answer: A) Inhalation
Rationale: Inhalation provides rapid delivery of a drug across a large
surface area of the respiratory tract and is the route of administration of
choice in acute asthma. This route delivers medication directly to the site of
action (bronchial smooth muscle) with rapid onset and minimal systemic
side effects .
4. A 27-year-old female with vulvovaginal candidiasis receives a 100
mg oral dose of fluconazole, resulting in a peak plasma concentration
of 20 mg/mL. What is the volume of distribution?
A) 0.5 L
B) 1 L
C) 3 L
D) 5 L
E) 50 L
Answer: D) 5 L
Rationale: Volume of distribution (Vd) = Dose / Plasma concentration. Vd
= 100 mg / 20 mg/mL = 5 L. This represents the apparent volume in which
the drug is distributed. A small Vd indicates the drug remains primarily in
the plasma compartment .
, 5. A 48-year-old man with end-stage liver disease has elevated liver
function tests. Which medication is likely to be therapeutic and safe in
this patient?
A) Epinephrine
B) Erythromycin
C) Nifedipine
D) Rifampin
E) Verapamil
Answer: A) Epinephrine
Rationale: Patients with end-stage liver disease have impaired cytochrome
P450 metabolism. Drugs metabolized by this system will accumulate to
toxic levels. Epinephrine is not significantly metabolized by the cytochrome
system and can be used with caution. Erythromycin, nifedipine, rifampin,
and verapamil are all metabolized by hepatic CYP enzymes .
6. A patient is prescribed sulfamethoxazole with a half-life of 12 hours.
How long will it take to reach 90% of steady state?
A) 10 hours
B) 20 hours
C) 30 hours
D) 40 hours
E) 50 hours
Answer: D) 40 hours
