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Solutions Manual for Abrams' Clinical
Drug Therapy 13th Frandsen
SOLUTIONS MANUAL SAMPLE PREVIEW
PUBLISHER
Wolters Kluwer
COPYRIGHT RESOURCE TYPE
2024 Solutions Manual
ISBN
9781975222321
,Suggested Answers to Assignments, Chapter 2,
Basic Concepts and Processes
Written Assignments Learning
Objective(s)
1. Students’ answers should include the following: 1
• Drugs must reach and interact with or cross the cell membrane to
stimulate or inhibit cellular function. Most drugs are given to affect body
cells that are distant from the sites of administration, causing systemic
effects. To move through the body and reach their sites of action,
metabolism, and excretion, drug molecules must cross numerous cell
membranes.
2. Students’ answers should include the following: 2
• Routes for absorption—oral, topical, intravenous, subcutaneous,
intramuscular
• Distribution via the bloodstream
• Sites of metabolism—kidney and liver are primary
• Sites of excretion—kidneys and gastrointestinal tract
3. Students’ answers should include the following: 5
Like the physiologic substances that normally regulate cell functions, most
drugs exert their effects by chemically binding with receptors at the cellular
level. Most receptors are proteins located on the surfaces of cell membranes
or within cells. Specific receptors include the following:
• Enzymes involved in essential metabolic or regulatory processes
• Proteins involved in transport
• Structural processes
• Nucleic acids involved in cellular protein synthesis, reproduction, and
other metabolic activities
4. Students’ answers should include the following: 9
• Adverse drug effects in the cardiovascular system include abnormal heart
rate and rhythm, abnormal blood pressure—either too high or too low.
• Adverse drug effects in the respiratory system include bronchospasm.
• Adverse drug effects in the central nervous system include nervousness,
tremor, and decreased level of consciousness.
• Adverse drug effects in the gastrointestinal system include GI upset,
Solutions Manual for Abrams' Clinical Drug Therapy 13th Frandsen
,Written Assignments Learning
Objective(s)
nausea, vomiting, and diarrhea.
• Adverse drug effects in the integumentary system include urticaria and
pruritus.
Group Assignments Learning
Objective(s)
1. Students’ answers should include the following: 2
• Pharmacokinetics involves drug movement through the body to reach
sites of action, metabolism, and excretion. Specific processes are
absorption, distribution, metabolism, and excretion.
o Absorption: process that occurs from the time a drug enters the
body to the time it enters the bloodstream to be circulated.
o Distribution: transport of drug molecules within the body; after
a drug is injected or absorbed into the bloodstream, it is carried
by the blood and tissue fluids to its sites of action, metabolism,
and excretion.
o Metabolism, or biotransformation, is the method by which
drugs are inactivated or biotransformed by the body.
o Excretion: elimination of a drug from the body; effective
excretion requires adequate functioning of the circulatory system
and of the organs of excretion (kidneys, bowel, lungs, and skin).
• Intravenous routes are typically quickest due to pharmacokinetic
absorption, and distribution time is decreased compared to by
mouth/gastrointestinal route.
2. Students’ answers should include the following: 4
• A serum drug level is a laboratory measurement of the amount of a
drug in the blood at a particular time. It reflects dosage, absorption,
bioavailability, half-life, and the rates of metabolism and excretion.
• In clinical practice, measuring serum drug levels is useful in several
circumstances.
o When drugs with a narrow margin of safety are given, because
their therapeutic doses are close to their toxic doses (e.g.,
digoxin, aminoglycoside antibiotics, lithium)
o To document the serum drug levels associated with particular
drug dosages, therapeutic effects, or possible adverse effects
Solutions Manual for Abrams' Clinical Drug Therapy 13th Frandsen
, Group Assignments Learning
Objective(s)
o To monitor unexpected responses to a drug dose such as
decreased therapeutic effects or increased adverse effects
o When a drug overdose is suspected
3. Students’ answers should include the following: 8
• Drug-related variables that affect drug action include dosage, route of
administration, and drug–diet and drug–drug interactions.
• Patient-related variables that affect drug action include age, body weight,
genetic and ethnic characteristics, sex, preexisting conditions, and
psychological factors.
Clinical Assignments Learning
Objective(s)
1. Students’ answers should include the following: 6
• Agonists are drugs that produce effects similar to those produced by
naturally occurring hormones, neurotransmitters, and other substances.
Agonists enhance each medication on the list.
• Antagonists are drugs that inhibit cell function by occupying receptor
sites. Antagonists inhibit each medication on the list.
2. Students’ answers should include the following: 7
• Medications with opposing actions or synergistic actions should be
highlighted that include the following:
• Interactions that can increase the therapeutic or adverse effects of drugs
include the following:
o Additive effects, which occur when two drugs with similar
pharmacologic actions are taken
o Synergism, which occurs when two drugs with different sites or
mechanisms of action produce greater effects when taken
together
o Interference by one drug with the metabolism of a second drug,
which may result in intensified effects of the second drug
o Displacement (i.e., a drug with a strong attraction to protein-
binding sites may displace a less tightly bound drug) of one drug
from plasma protein-binding sites by a second drug, which
increases the effects of the displaced drug. This increase occurs
because the displaced drug, freed from its bound form, becomes
Solutions Manual for Abrams' Clinical Drug Therapy 13th Frandsen
Solutions Manual for Abrams' Clinical
Drug Therapy 13th Frandsen
SOLUTIONS MANUAL SAMPLE PREVIEW
PUBLISHER
Wolters Kluwer
COPYRIGHT RESOURCE TYPE
2024 Solutions Manual
ISBN
9781975222321
,Suggested Answers to Assignments, Chapter 2,
Basic Concepts and Processes
Written Assignments Learning
Objective(s)
1. Students’ answers should include the following: 1
• Drugs must reach and interact with or cross the cell membrane to
stimulate or inhibit cellular function. Most drugs are given to affect body
cells that are distant from the sites of administration, causing systemic
effects. To move through the body and reach their sites of action,
metabolism, and excretion, drug molecules must cross numerous cell
membranes.
2. Students’ answers should include the following: 2
• Routes for absorption—oral, topical, intravenous, subcutaneous,
intramuscular
• Distribution via the bloodstream
• Sites of metabolism—kidney and liver are primary
• Sites of excretion—kidneys and gastrointestinal tract
3. Students’ answers should include the following: 5
Like the physiologic substances that normally regulate cell functions, most
drugs exert their effects by chemically binding with receptors at the cellular
level. Most receptors are proteins located on the surfaces of cell membranes
or within cells. Specific receptors include the following:
• Enzymes involved in essential metabolic or regulatory processes
• Proteins involved in transport
• Structural processes
• Nucleic acids involved in cellular protein synthesis, reproduction, and
other metabolic activities
4. Students’ answers should include the following: 9
• Adverse drug effects in the cardiovascular system include abnormal heart
rate and rhythm, abnormal blood pressure—either too high or too low.
• Adverse drug effects in the respiratory system include bronchospasm.
• Adverse drug effects in the central nervous system include nervousness,
tremor, and decreased level of consciousness.
• Adverse drug effects in the gastrointestinal system include GI upset,
Solutions Manual for Abrams' Clinical Drug Therapy 13th Frandsen
,Written Assignments Learning
Objective(s)
nausea, vomiting, and diarrhea.
• Adverse drug effects in the integumentary system include urticaria and
pruritus.
Group Assignments Learning
Objective(s)
1. Students’ answers should include the following: 2
• Pharmacokinetics involves drug movement through the body to reach
sites of action, metabolism, and excretion. Specific processes are
absorption, distribution, metabolism, and excretion.
o Absorption: process that occurs from the time a drug enters the
body to the time it enters the bloodstream to be circulated.
o Distribution: transport of drug molecules within the body; after
a drug is injected or absorbed into the bloodstream, it is carried
by the blood and tissue fluids to its sites of action, metabolism,
and excretion.
o Metabolism, or biotransformation, is the method by which
drugs are inactivated or biotransformed by the body.
o Excretion: elimination of a drug from the body; effective
excretion requires adequate functioning of the circulatory system
and of the organs of excretion (kidneys, bowel, lungs, and skin).
• Intravenous routes are typically quickest due to pharmacokinetic
absorption, and distribution time is decreased compared to by
mouth/gastrointestinal route.
2. Students’ answers should include the following: 4
• A serum drug level is a laboratory measurement of the amount of a
drug in the blood at a particular time. It reflects dosage, absorption,
bioavailability, half-life, and the rates of metabolism and excretion.
• In clinical practice, measuring serum drug levels is useful in several
circumstances.
o When drugs with a narrow margin of safety are given, because
their therapeutic doses are close to their toxic doses (e.g.,
digoxin, aminoglycoside antibiotics, lithium)
o To document the serum drug levels associated with particular
drug dosages, therapeutic effects, or possible adverse effects
Solutions Manual for Abrams' Clinical Drug Therapy 13th Frandsen
, Group Assignments Learning
Objective(s)
o To monitor unexpected responses to a drug dose such as
decreased therapeutic effects or increased adverse effects
o When a drug overdose is suspected
3. Students’ answers should include the following: 8
• Drug-related variables that affect drug action include dosage, route of
administration, and drug–diet and drug–drug interactions.
• Patient-related variables that affect drug action include age, body weight,
genetic and ethnic characteristics, sex, preexisting conditions, and
psychological factors.
Clinical Assignments Learning
Objective(s)
1. Students’ answers should include the following: 6
• Agonists are drugs that produce effects similar to those produced by
naturally occurring hormones, neurotransmitters, and other substances.
Agonists enhance each medication on the list.
• Antagonists are drugs that inhibit cell function by occupying receptor
sites. Antagonists inhibit each medication on the list.
2. Students’ answers should include the following: 7
• Medications with opposing actions or synergistic actions should be
highlighted that include the following:
• Interactions that can increase the therapeutic or adverse effects of drugs
include the following:
o Additive effects, which occur when two drugs with similar
pharmacologic actions are taken
o Synergism, which occurs when two drugs with different sites or
mechanisms of action produce greater effects when taken
together
o Interference by one drug with the metabolism of a second drug,
which may result in intensified effects of the second drug
o Displacement (i.e., a drug with a strong attraction to protein-
binding sites may displace a less tightly bound drug) of one drug
from plasma protein-binding sites by a second drug, which
increases the effects of the displaced drug. This increase occurs
because the displaced drug, freed from its bound form, becomes
Solutions Manual for Abrams' Clinical Drug Therapy 13th Frandsen
