Pharmacology Exam 1 Flash Cards

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Title:	Pharmacology Exam 1
Description:	Pharm exam 1
Number of Cards:	140
Save Count:	0
Author:	jacoblwertz9
Created:	2012-02-03
Tags:	pharm pharmacology
Private	No

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- Question
- Answer
- Side 3

- Which of the following displays the first pass effect
  
  A. liver
  B. Small intestine (intraperitoneal route)
  C. Large intestine (rectal route)
  D. All of the above
- D. All of the above
  
  (rectal route is minimal due to bypassing of liver)
- Rank the order of a drug's effect in regards to SPEED:
  
  - Oral
  - Intramuscular (IM)
  - Subcutaneous (SC)
  - Intravenous (IV)
- IV > IM > SC > Oral
- Rank the order of a drug's effect in regards to DURATION:
  
  - Oral
  - Intramuscular (IM)
  - Subcutaneous (SC)
  - Intravenous (IV)
- Oral > SC > IM > IV
- Which is the most common mechanism of drug transport?
  
  A. active transport
  B. Facilitated diffusion
  C. pinocytosis / phagocytosis
  D. Passive diffusion
- D. Passive diffusion
- Drugs always pass between cells because of the presence of gap junctions.
  
  A. both statements are true
  B. both statements are false
  C. the 1st statement is true, the 2nd statement is false
  D. the 1st statement is false, the 2nd statement is true
- B. both statements are false
  
  - pass THROUGH cells
  - TIGHT junctions (zonula occludens)
- T/F
  Larger surface areas absorb drugs FASTER than smaller surface areas.
- True
- Food in the stomach will slow down gastric emptying time, which increases the bioavailability of the drug.
  
  A. both statements are true
  B. both statements are false
  C. the 1st statement is true, the 2nd statement is false
  D. the 1st statement is false, the 2nd statement is true
- C. the 1st statement is true, the 2nd statement is false
  
  (SLOWS ABSORPTION of drug)
- Many drugs slow gastric emptying and may slow absorption of a ANOTHER drug.
  
  A. both statements are true
  B. both statements are false
  C. the 1st statement is true, the 2nd statement is false
  D. the 1st statement is false, the 2nd statement is true
- A. both statements are true
- Which way(s) can a drug pass through a membrane to be absorbed?
  
  A. weak acid in the intestine (basic)
  B. weak base in the intestine (basic)
  C. weak base in the stomach (acidic)
  D. weak acid in the stomach (acidic)
- B. weak base in the intestine (basic)
  
  D. weak acid in the stomach (acidic)
- A weakly basic drug is given to a patient intravenously. It takes longer for the drug to be absorbed than a weakly acidic drug. Why?
- Weak base can still cross the capillaries and gastric mucosa to enter the stomach where they get ionized & trapped.
  
  It get absorbed later when it enters the intestines.
- An acidic drug with a pKa of 4 enters the stomach (pH 2). Do you expect most of the drug to be well absorbed?
- Yes
  
  (for an acid, pKa > pH = absorbed)
- A basic drug with a pKa of 5 enters the stomach (pH 2). Do you expect most of the drug to be well absorbed?
- No
  
  (for a base, pKa > pH = poorly absorbed)
- A drug with a pKa of 8 enters the body with a Kp (partition coefficient) of 0.001. Do you expect this to have better absorption than if the Kp was 0.1?
- No
  
  (smaller Kp = less absorption)
  (Kp = Coil / Cwater)
- What are some factors that can affect the bioavailability?
  
  A. Size of drug
  B. type of capsule of pill
  C. type of inert ingredients
  D. Crystalline properties
  E. All of the above
- E. All of the above
- Drug measurement in the body is based on _____
  
  A. Intracellular fluid
  B. Intravascular fluid (plasma)
  C. Interstitial fluid
  E. Total body water
- B. Intravascular fluid (plasma)
- What is the formula for Volume of Distribution?
- Vd = dose / Cp
- What is the formula for Fractional Volume of Distribution?
- Fract. Vd = Vd / body weight
- Describe how the following factors INCREASE the RATE of drug distribution:
  
  - Lipid solubility (Kp)
  - Ionization (charge)
  - Molecular weight
  - Blood flow
- - ↑ Lipid solubility (Kp)
  - Electrically neutral
  - Low molecular weight
  - ↑ Blood flow
- Describe how the following factors DECREASE the RATE of drug distribution:
  
  - Lipid solubility (Kp)
  - Ionization (charge)
  - Molecular weight
  - Blood flow
- - ↓ Lipid solubility
  - Electrically charged
  - ↑ molecular weight
  - ↓ Blood flow
- Define pharmacodynamic
  
  A. drugs react w/ receptor & create a reaction
  B. how drug molecules move around the body
- A. drugs react w/ receptor & create a reaction
- Define pharmacokinetic
  
  A. drugs react w/ receptor & create a reaction
  B. how drug molecules move around the body
- B. how drug molecules move around the body
  
  (1 drug can displace another drug to create a higher conc. of the displaced drug)
- T/F
  The kidney can filter free, unbound drug molecules.
- True
- T/F
  There is a barrier b/t CSF & brain and no barrier b/t CSF & blood
- False
  
  - NO barrier b/t CSF & Brain
  - Barrier b/t CSF & Blood
  
  (Blood/Brain barrier)
  (Blood/CSF barrier)
- Match the types of capillaries to the area of the body
  - Fenestrations
  - Zonula occludens (tight junctions)
  - Macular (spot) junctions
  
  A. Capillary Endothelial Cells
  B. Kidney
  C. Blood Brain Barrier
- A. Capillary Endothelial Cells = Macular (spot junctions)
  B. Kidney = Fenestrations
  C. BBB = Zonula occludens (tight junctions)
- If a free, unbound drug is not filtered by the kidney, how can it be eliminated?
- Active transport or secretion
- In the kidney, a highly polar drug is filtered and, once in the tubular fluid, the polar drug can NOT be actively reabsorbed, therefore, it is eliminated.
  
  A. both statements are true
  B. both statements are false
  C. the 1st statement is true, the 2nd statement is false
  D. the 1st statement is false, the 2nd statement is true
- D. the 1st statement is false, the 2nd statement is true
  
  (NON-polar drugs are filtered)
  (Polar drugs cannot be reabsorbed once in tubular fluid)
- Can drugs cross the placenta?
- Yes
  
  (as long as they are SMALL and NEUTRAL)
- A change in the chemical structure of the drug molecule describes ____ of drug metabolism
  
  A. Phase I
  B. Phase II
  C. Phase III
- A. Phase I
- A combination (conjugation) of the drug molecule with a 2nd endogenous substance describes ____ of drug metabolism
  
  A. Phase I
  B. Phase II
  C. Phase III
- B. Phase II
- What is the major enzyme in drug metabolism in the liver?
- Cytochrome P450
  
  (especially CYP3A)
- If Cytochrome P450 is INHIBITED while taking 2 different drugs, what potential problem can occur?
- Potentiation of drug with lower plasma protein biniding affinity
  (decreased metabolism)
  
  Can lead to toxicity
- If Cytochrome P450 is INDUCED while taking 2 different drugs, what potential problem can occur?
- Decreased effect of the 2nd drug
  
  (increased metabolism)
- Name 4 Phase I oxidation reactions mediated by Cytochrome P450
- - Hydroxylation
  - Epoxidation
  - Reduction
  - Dealkylation
  
  (HERD)
- Name 3 Phase I oxidation reactions NOT mediated by Cytochrome P450
- - Hydrolytic
  - Reduction
  - Dehydration (alcohol, aldehyde)
  
  (HRD)
- Name 5 Phase II Reactions
- - Glucuronidation
  - Acetylation
  - Glutathione conjugation
  - Amino Acid conjugation
  - Sulfate conjugation
  
  (GAGAS)
- Which of the following determine the rate of clearance of drugs by the kidney?
  
  A. Glomerular filtration
  B. Tubular reabsorption
  C. Tubular secretion
  D. All of the above
- D. All of the above
- Which of the following is FALSE?
  
  A. Protein-bound drug molecules will be freely filtered
  B. Tubular reabsorption is passive diffusion
  C. Tubular secretion involves active transport
  D. All statements are true
  E. All statements are false
- A. Protein-bound drug molecules will be freely filtered
  
  (NON-bound drugs are freely filtered)
- Drugs that are ONLY FILTERED will be cleared at a rate ___ GFR
  
  A. =
  B. <
  C. >
- A. =
  
  (CR = 1)
- Drugs that are FILTERED & REABSORBED will be cleared at a rate ___ GFR
  
  A. =
  B. <
  C. >
- B. <
  
  (CR < 1)
- Drugs that are FILTERED & SECRETED will be cleared at a rate ___ GFR
  
  A. =
  B. <
  C. >
- C. >
  
  (CR > 1)
- T/F
  Drugs can be secreted in breast milk.
- True
- This process is where non-protein bound drug molecules will be freely filtered
  
  A. Glomerular filtration
  B. Tubular reabsorption
  C. Tubular secretion
- A. Glomerular filtration
- This process involves passive diffusion, depending on concentration, molecular size, Kp, and ionization of a drug.
  
  A. Glomerular filtration
  B. Tubular reabsorption
  C. Tubular secretion
- B. Tubular reabsorption
- This process involves active transport, primarily of anions
  
  A. Glomerular filtration
  B. Tubular reabsorption
  C. Tubular secretion
- C. Tubular secretion
- Drugs that are ONLY FILTERED will be cleared at a rate ___ to the GFR (or CR)
  
  A. =
  B. <
  C. >
- A. =
- Drugs that are FILTERED & REABSORBED will be cleared at a rate ___ to the GFR (or CR)
  
  A. =
  B. <
  C. >
- B. <
- Drugs that are FILTERED & SECRETED will be cleared at a rate ___ to the GFR
  (or CR)
  
  A. =
  B. <
  C. >
- C. >
- What is the formula for Clearance Ratio (CR)?
- CR = Cl / GFR
- What is the best way to increase elimination of a weak base in the urine?
  
  A. alkalinize with sodium bicarbonate
  B. acidify with sodium bicarbonate
  C. alkalinize with ammonium chloride
  D. acidify with ammonium chloride
- D. acidify with ammonium chloride
- Name 5 sites where ion trapping can occur
- 1. urine
  2. stomach
  3. liver
  4. lungs (exhalation)
  5. breast milk
  
  (BULLS)
- Drugs eliminated at a constant AMOUNT per unit time describes:
  
  A. zero order elimination
  B. first order elimination
  C. second order elimination
- A. zero order elimination
- Drugs eliminated at a constant FRACTION per unit time describes:
  
  A. zero order elimination
  B. first order elimination
  C. second order elimination
- B. first order elimination
- What is the formula for half-life (T1/2)?
- T1/2 = 0.7 / Ke
- What is the formula for the Elimination Constant (Ke)?
- Ke = 0.7 / T1/2
  
  Ke = Cl / Vd
- How many half-lives does it take for 95% of a drug to be eliminated?
- ~4.5 half-lives
- What is the formula for clearance (Cl)?
- Cl = (Ke)(Vd)
- What is the formula for Steady-State Plasma Concentration (Css)?
- Css = Q / Cl
  
  Css = Q / (Ke)(Vd)
  
  (Q = infusion rate)
  (Cl x Css = elimination rate)
- What is the formula for the Infusion Rate (Q)?
- Q = Css x Cl
  
  Q = (Css)(Ke)(Vd)
- How many half-lives does it take to reach a new Css?
- 4.5
- T/F
  The amount of time it takes to reach Css depends on Ke and Q.
- False
  
  (Depends on Cl only = Ke)
- What is the formula for Loading Dose (LD)?
- LD = Css x Vd
- Give the % body weight of each body compartment
  
  - Total body water
  - Extracellular Fluid
  - Intracellular Fluid
  - Intravascular Fluid (Plasma)
  - Interstitial Fluid
- - Total body water = 60%
  - Extracellular Fluid = 20%
  - Intracellular Fluid = 40%
  - Intravascular Fluid (Plasma) = 4%
  - Interstitial Fluid = 16%
- Host defense mechanism to arrest blood loss from injured blood vessels describes:
  
  A. Hemostasis
  B. Thrombosis
- A. Hemostasis
- Pathological conditions in which thrombi form and/or occlude blood vessels in organs describes:
  
  A. Hemostasis
  B. Thrombosis
- B. Thrombosis
- What are the 2 most important cofactors in the Coagulation Cascade?
- 1) TF III
  2) Ca²⁺ Phospholipid
- What 2 roles does thrombin have in blood coagulation?
- - Converts fibrinogen into FIBRIN
  - Activates platelets
- T/F
  Coagulation factors are plasma glycoproteins produced by the spleen in a Vitamin E-dependent way.
- False
  
  - Produced by HEPATOCYTES (liver)
  - VITAMIN K-dependent way
- VEINS contain ____ thrombi, while ARTERIES contain ____ thrombi.
  
  - Red
  - White
  - Blue
  - No
- Veins = Red (trapped RBCs)
  Arteries = White (No trapped RBCs)
- Warfarin is a(n):
  
  A. Anticoagulant
  B. Anti-platelet
  C. Thrombolytic drug
  D. Coagulant
- A. Anticoagulant
- Heparin is a(n):
  
  A. Anticoagulant
  B. Anti-platelet
  C. Thrombolytic drug
  D. Coagulant
- A. Anticoagulant
- Vitamin K is a(n):
  
  A. Anticoagulant
  B. Anti-platelet
  C. Thrombolytic drug
  D. Coagulant
- A. Anticoagulant
- Aspirin is a(n):
  
  A. Anticoagulant
  B. Anti-platelet
  C. Thrombolytic drug
  D. Coagulant
- B. Anti-platelet
- Dipyridamole is a(n):
  
  A. Anticoagulant
  B. Anti-platelet
  C. Thrombolytic drug
  D. Coagulant
- B. Anti-platelet
- Streptokinase is a(n):
  
  A. Anticoagulant
  B. Anti-platelet
  C. Thrombolytic drug
  D. Coagulant
- C. Thrombolytic drug
- Tissue Plasminogen Activator (t-PA) is a(n):
  
  A. Anticoagulant
  B. Anti-platelet
  C. Thrombolytic drug
  D. Coagulant
- C. Thrombolytic drug