Chapter 2. Review of Basic Principles of Pharmacology

Chapter 2. Review of Basic Principles of Pharmacology 1.A patient’s nutritional intake and laboratory results reflect hypoalbuminemia. This is

critical to prescribing because:

Distribution of drugs to target tissue may be affected.

2. Drugs that have a significant first-pass effect:

Are rapidly metabolized by the liver and may have little if any desired action

3.The route of excretion of a volatile drug will likely be the:

Lungs

• Medroxyprogesterone (Depo Provera) is prescribed intramuscularly (IM) to create a

storage reservoir Increase the length of time a drug is available and active

• The NP chooses to give cephalexin every 8 hours based on knowledge of the drug’s:

Biological half-life

• Azithromycin dosing requires that the first day’s dosage be twice those of the other 4 days

of the prescription. This is considered a loading dose. A loading dose:

Rapidly achieves drug levels in the therapeutic range

• The point in time on the drug concentration curve that indicates the first sign of a

therapeutic effect is the:

Onset of action

• Phenytoin requires that a trough level be drawn. Peak and trough levels are done:

To determine if a drug is in the therapeutic range

• A laboratory result indicates that the peak level for a drug is above the minimum toxic

concentration. This means that the:

Concentration will produce an adverse response

• Drugs that are receptor agonists may demonstrate what property?

Desensitization or downregulation with continuous use

11. Drugs that are receptor antagonists, such as beta blockers, may cause:

An exaggerated response if abruptly discontinued

12. Factors that affect gastric drug absorption include:

Lipid solubility of the drug

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13. Drugs administered via IV:

Begin distribution into the body immediately

• When a medication is added to a regimen for a synergistic effect, the combined effect of the

drugs is:

Greater than the sum of the effects of each drug individually

• Which of the following statements about bioavailability is true?

Bioavailability issues are especially important for drugs with narrow therapeutic ranges or sustained-release mechanisms.

16.Which of the following statements about the major distribution barriers (blood-brain or fetal- placental) is true?The blood-brain barrier slows the entry of many drugs into and from brain cells.

17.Drugs are metabolized mainly by the liver via phase I or phase II reactions. The purpose of

both of these types of reactions is to:

Change drug molecules to a form that an excretory organ can excrete

18. Once they have been metabolized by the liver, the metabolites may be:

More active than the parent drug Less active than the parent drug Totally “deactivated” so they are excreted without any effect

• All drugs continue to act in the body until they are changed or excreted. The ability of the

body to excrete drugs via the renal system would be increased by:

Unbinding a nonvolatile drug from plasma proteins

20. Steady state is:

When the amount of drug in the body remains constant

• Two different pain medications are given together for pain relief. The drug—drug interaction

Additive 22.Actions taken to reduce drug—drug interaction problems include all of the following

EXCEPT:

Prescribing a third drug to counteract the adverse reaction of the combination

• Phase I oxidative-reductive processes of drug metabolism require certain nutritional

elements. Which of the following would reduce or inhibit this process?Neither Protein malnutrition OR Iron-deficiency anemia 2 / 3

• The time required for the amount of drug in the body to decrease by 50% is called:

Half-life

• An agonist activates a receptor and stimulates a response. When given frequently over time,

the body may:

Downregulate the numbers of that specific receptor

26. Drug antagonism is best defined as an effect of a drug that:

Is modified by the concurrent administration of another drug 27.Instructions to a client regarding self-administration of oral enteric-coated tablets should include which of the following statements?“To achieve best effect, take the tablet with at least 8 ounces of fluid.” 28.The major reason for not crushing a sustained-release capsule is that, if crushed, the

coated beads of the drugs could possibly result in:

Toxicity

• Which of the following substances is the most likely to be absorbed in the intestines rather

than in the stomach?Sodium bicarbonate

• Which of the following variables is a factor in drug absorption?

A rich blood supply to the area of absorption leads to better absorption

• An advantage of prescribing a sublingual medication is that the medication is:

Absorbed rapidly

32. Drugs that use CYP 3A4 isoenzymes for metabolism may:

Induce and inhibit the metabolism of another drug

• Therapeutic drug levels are drawn when a drug reaches steady state. Drugs reach steady

state:

After four to five half-lives

34. Upregulation or hypersensitization may lead to:

An exaggerated response if the drug is withdrawn Chapter 7. Cultural and Ethnic Influences in Pharmacotherapeutics

1.Cultural factors that must be taken into account when prescribing include(s):

Who the decision maker is in the family regarding health-care decisions Attitudes regarding the use of drugs to treat illness

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