NIH Principals of Clinical Pharmacology
UPDATED ACTUAL Questions and
CORRECT Answers
Some clinical situations require administration of an IV loading (initial) dose of a drug to
establish a therapeutic plasma concentration without delay. Which of the following is a
determinant of the initial plasma concentration of a drug given by rapid IV infusion (i.e. bolus
dose)? - CORRECT ANSWER - The central compartment volume of distribution
The first-order distribution rate constant
The elimination clearance rate
The intercompartmental clearance rate
Which of the following elements is NOT required by federal regulations to be included in every
informed consent form? - CORRECT ANSWER - Confidentiality of records
Compensation for injuries
Requirement for advanced directives
Voluntariness and right to withdraw
Therapeutic Drug Monitoring should be considered for a drug with which of the following
characteristics? - CORRECT ANSWER - Narrow therapeutic index with variable
interpatient pharmacokinetics
Generally well tolerated over a wide therapeutic range
Well-established physiologic biomarker to guide dosing
Therapeutic Drug Monitoring should be considered for all drugs regardless of pharmacokinetic
properties
What is the clinical relevance of P-glycoprotein (P-gp)? - CORRECT ANSWER - P-gp is
an SLC transporter implicated in major drug-drug interactions
P-gp is an ABC transporter implicated in major drug-drug interactions
, P-gp is a hepatic CYP enzyme implicated in major drug-drug interactions
P-gp is an intestinal CYP enzyme implicated in major drug-drug interactions
Drug G is administered in an active form and converted to an inactive metabolite by CYP2D6. If
Drug G is administered to a patient who is a poor metabolizer, what is the likely outcome? -
CORRECT ANSWER - The efficacy will be reduced
The metabolism will be increased
The toxicity will be increased
The metabolism will be as expected
A patient is receiving an aminoglycoside antibiotic for the treatment of a serious infection. PK
samples today revealed a peak within acceptable limits but a trough much lower than the target
concentration. What is the best approach to increase the trough concentration? - CORRECT
ANSWER - Reduce the dosing interval (i.e. shorten the time between doses)
Extend the dosing interval (i.e. lengthen the time between doses)
Increase the dose
Decrease the dose
Which of the following is TRUE regarding pharmacokinetic changes in the elderly? -
CORRECT ANSWER - Drug distribution of hydrophilic drugs increases with age
Phase II reactions change little with age
Renal elimination increases with age
Gastrointestinal absorption increases with age
According to Lipinski's Rule of 5, which of the following characteristics is flagged as likely to
have poor oral absorption? - CORRECT ANSWER - Less than 5 H-bond donors
Molecular weight < 500
c log P < 5
Sum of Ns and Os (H-bond acceptors) > 10
UPDATED ACTUAL Questions and
CORRECT Answers
Some clinical situations require administration of an IV loading (initial) dose of a drug to
establish a therapeutic plasma concentration without delay. Which of the following is a
determinant of the initial plasma concentration of a drug given by rapid IV infusion (i.e. bolus
dose)? - CORRECT ANSWER - The central compartment volume of distribution
The first-order distribution rate constant
The elimination clearance rate
The intercompartmental clearance rate
Which of the following elements is NOT required by federal regulations to be included in every
informed consent form? - CORRECT ANSWER - Confidentiality of records
Compensation for injuries
Requirement for advanced directives
Voluntariness and right to withdraw
Therapeutic Drug Monitoring should be considered for a drug with which of the following
characteristics? - CORRECT ANSWER - Narrow therapeutic index with variable
interpatient pharmacokinetics
Generally well tolerated over a wide therapeutic range
Well-established physiologic biomarker to guide dosing
Therapeutic Drug Monitoring should be considered for all drugs regardless of pharmacokinetic
properties
What is the clinical relevance of P-glycoprotein (P-gp)? - CORRECT ANSWER - P-gp is
an SLC transporter implicated in major drug-drug interactions
P-gp is an ABC transporter implicated in major drug-drug interactions
, P-gp is a hepatic CYP enzyme implicated in major drug-drug interactions
P-gp is an intestinal CYP enzyme implicated in major drug-drug interactions
Drug G is administered in an active form and converted to an inactive metabolite by CYP2D6. If
Drug G is administered to a patient who is a poor metabolizer, what is the likely outcome? -
CORRECT ANSWER - The efficacy will be reduced
The metabolism will be increased
The toxicity will be increased
The metabolism will be as expected
A patient is receiving an aminoglycoside antibiotic for the treatment of a serious infection. PK
samples today revealed a peak within acceptable limits but a trough much lower than the target
concentration. What is the best approach to increase the trough concentration? - CORRECT
ANSWER - Reduce the dosing interval (i.e. shorten the time between doses)
Extend the dosing interval (i.e. lengthen the time between doses)
Increase the dose
Decrease the dose
Which of the following is TRUE regarding pharmacokinetic changes in the elderly? -
CORRECT ANSWER - Drug distribution of hydrophilic drugs increases with age
Phase II reactions change little with age
Renal elimination increases with age
Gastrointestinal absorption increases with age
According to Lipinski's Rule of 5, which of the following characteristics is flagged as likely to
have poor oral absorption? - CORRECT ANSWER - Less than 5 H-bond donors
Molecular weight < 500
c log P < 5
Sum of Ns and Os (H-bond acceptors) > 10
