Kinetics Final (Conceptual Questions)
Conceptual (no math) questions for Kinetics final
Questions and Answers
- 1.
Which is not a part of Pharmacokinetics?
- A.
Absorption
- B.
Distribution
- C.
Metabolism
- D.
Response
- E.
Distribution
Correct Answer
D. ResponseExplanation
Response is a pharmacodynamic process.Rate this question:
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- 2.
What is not a use of pharmacokinetic models?
- A.
Predict plasma drug levels
- B.
Calculate optimum dosage for individual patients
- C.
Bioequivalence studies
- D.
Graph dose-response curves
Correct Answer
D. Graph dose-response curvesExplanation
A dose-response curve would be classified under pharmacodynamics.Rate this question:
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- 3.
In a two compartment model, k21 describes drug elimination from a system.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
In a two compartment model, k21 does not describe drug elimination from a system. Instead, k21 represents the rate constant for drug distribution from the central compartment to the peripheral compartment. Drug elimination from the system is typically described by k10 or kel.Rate this question:
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- 4.
Which is not a method of drug elimination?
- A.
Protein Binding
- B.
Metabolism
- C.
Excretion
- D.
Dialysis
Correct Answer
A. Protein BindingExplanation
Protein Binding does not eliminate the active drug, it can still dissociate after it binds.Rate this question:
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- 5.
In a continuous or intermittent IV infusion, how many half lives does it take to reach steady state?
- A.
2
- B.
5
- C.
8
- D.
11
- E.
E
Correct Answer
B. 5Explanation
In a continuous or intermittent IV infusion, it takes approximately 5 half-lives to reach steady state. Steady state refers to a point where the rate of drug administration equals the rate of elimination, resulting in a constant concentration of the drug in the body. Each half-life represents the time it takes for the drug concentration to decrease by half. By the time 5 half-lives have passed, the drug concentration will have reached a relatively stable level, indicating steady state.Rate this question:
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- 6.
If clearance is reduced by 50%, how many half lives will it take for a drug to reach steady state in a continuous IV infusion.
- A.
2.5
- B.
5
- C.
7.5
- D.
10
Correct Answer
B. 5Explanation
It always takes 5 half lives for a drug to reach steady state. However, the half life of the drug would double, so it would take twice as long to reach steady state, and the steady state drug concentration would be twice as high. In terms of normal half lives, it would take 10 of the "normal" drug half lives (the half life listed on the package insert) to reach steady state, however, this is not what the question asks.Rate this question:
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- 7.
Only free drug can be distributed to the tissues.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
The statement is true because only free drugs, which are not bound to proteins or other molecules in the bloodstream, can be distributed to the tissues. Bound drugs are unable to interact with target receptors or exert their intended effects. Therefore, for a drug to be effective, it must be in its free form and able to reach the target tissues.Rate this question:
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- 8.
The general trend from birth to nine months is that body fat _____________ with age
- A.
Increases
- B.
Decreases
- C.
Stays the same
Correct Answer
A. IncreasesExplanation
From birth to nine months, the general trend is for body fat to increase with age. This is because during this period, infants experience rapid growth and development, and body fat plays a crucial role in providing energy, insulation, and protection. As they grow, their body composition changes, with an increase in body fat percentage. This is a natural and necessary process for their overall health and development.Rate this question:
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- 9.
With the exception of 1 y.o.a. through puberty, total body water __________ with age.
- A.
Increases
- B.
Decreases
- C.
Stays the same
Correct Answer
B. DecreasesExplanation
As we age, the amount of total body water in our bodies tends to decrease. This is because as we get older, our muscle mass tends to decrease and our body fat tends to increase. Since muscle tissue contains more water than fat tissue, the overall percentage of water in our bodies decreases. Additionally, as we age, our kidneys may become less efficient at conserving water, leading to a further decrease in total body water. Therefore, the correct answer is "decreases".Rate this question:
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- 10.
Which pharmacokinetic parameter would hepatic disease be most likely to affect?
- A.
Absorption
- B.
Distribution
- C.
Metabolism
- D.
Excretion
Correct Answer
C. MetabolismExplanation
Hepatic disease is most likely to affect the metabolism of drugs. The liver is responsible for metabolizing drugs and converting them into their active or inactive forms. When the liver is diseased, its ability to metabolize drugs may be impaired, leading to altered drug levels in the body. This can result in decreased drug effectiveness or increased drug toxicity. Therefore, metabolism is the pharmacokinetic parameter that would be most affected by hepatic disease.Rate this question:
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- 11.
Which drug is not modeled by non-linear pharmacokinetics?
- A.
Alcohol
- B.
Phenobarbital
- C.
Valproic Acid
- D.
Phenytoin
Correct Answer
B. PhenobarbitalExplanation
See lecture 18, slide 41.Rate this question:
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- 12.
Which person is unlikely to be involved in a multidisciplinary approach to individualizing drug therapy?
- A.
Physician
- B.
Nurse
- C.
Accountant
- D.
Pharmacist
Correct Answer
C. AccountantExplanation
An accountant is unlikely to be involved in a multidisciplinary approach to individualizing drug therapy because their role primarily revolves around financial management and record-keeping rather than patient care or medical decision-making. In a multidisciplinary approach, healthcare professionals like physicians, nurses, and pharmacists collaborate to tailor drug therapy to each patient's specific needs and circumstances. The involvement of an accountant is not necessary for this process.Rate this question:
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- 13.
In the Cockcroft-Gault equation, an increase in serum creatinine will __________ creatinine clearance.
- A.
Increase
- B.
Decrease
- C.
Not change
Correct Answer
B. DecreaseExplanation
Serum Creatinine and Creatinine clearance are inversely related.Rate this question:
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- 14.
A premature infant is defined as gestation age of less than
- A.
34 weeks
- B.
36 weeks
- C.
38 weeks
- D.
40 weeks
Correct Answer
B. 36 weeksExplanation
Lecture 19, slide 5Rate this question:
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- 15.
In neonates, infants, and young children gastric pH is more _________ than adults. This will _________ the bio-availability of basic drugs.
- A.
Acidic; increase
- B.
Alkaline; increase
- C.
Acidic; decrease
- D.
Alkaline; decrease
Correct Answer
B. Alkaline; increaseExplanation
lecture 19, slide 9.Rate this question:
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- 16.
Premature infants have _________ biliary function compared to older children and adults.
- A.
Increased
- B.
Decreased
- C.
Unchanged
Correct Answer
B. DecreasedExplanation
Premature infants have decreased biliary function compared to older children and adults. This means that their ability to produce and secrete bile, a substance that aids in digestion, is lower than that of older individuals. This could be due to the immaturity of their liver and biliary system, which may not have fully developed at the time of birth. As a result, premature infants may have difficulties with proper digestion and absorption of nutrients.Rate this question:
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- 17.
Skin is ________ permeable in neonates and infants than adults.
- A.
More
- B.
Less
Correct Answer
A. MoreExplanation
Neonates and infants have thinner and less developed skin compared to adults. This makes their skin more permeable, meaning that substances can more easily pass through their skin and be absorbed into their bodies. This increased permeability is due to the immaturity of their skin barrier function and the higher water content in their skin. As a result, neonates and infants are more susceptible to the absorption of chemicals and substances through their skin, which is why caution must be exercised when applying products or medications to their skin.Rate this question:
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- 18.
Aminoglycosides require a(n) _________ weight based dose in neonates and infants in comparison to adults because they have _______ percentage levels of extracellular fluid.
- A.
Increased; higher
- B.
Increased; lower
- C.
Decreased; higher
- D.
Decreased; lower
Correct Answer
A. Increased; higherExplanation
lecture 19, slide 19Rate this question:
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- 19.
The volume of distribution of diazepam, a liphophilic drug, will be higher in ________.
- A.
Neonates
- B.
Adults
Correct Answer
B. AdultsExplanation
Will be higher in adults due to higher body fat. Therefore the drug will have more volume to distribute in.Rate this question:
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- 20.
Neonates have a decreased level of albumin, and their albumin has decreased affinity for drugs which leads to a decrease in protein binding of drugs. This increases free drug concentration of drugs like Phenytoin.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
lecture 19, slide 25Rate this question:
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- 21.
Glomerular function ________________ during the first year of life.
- A.
Increases
- B.
Decreases
- C.
Stays the same
Correct Answer
A. IncreasesExplanation
During the first year of life, glomerular function increases. This is because as an infant grows, their kidneys also develop and mature. The glomeruli, which are responsible for filtering waste products from the blood and forming urine, become more efficient and capable of higher filtration rates. This increase in glomerular function allows the kidneys to effectively remove waste and maintain fluid balance in the body as the infant grows and their metabolic demands increase.Rate this question:
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- 22.
Pharmacodynamics can be defined as...
- A.
What the body does to the drug.
- B.
What the drug does to the body.
- C.
What the body does to the body.
- D.
What the drug does to the drug.
Correct Answer
B. What the drug does to the body.Explanation
Pharmacodynamics refers to the study of the effects of drugs on the body and how they interact with the body's systems. It focuses on understanding the mechanisms of action of drugs, including how they bind to receptors, alter biochemical pathways, and produce therapeutic or adverse effects. Therefore, the correct answer is "what the drug does to the body."Rate this question:
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- 23.
In a typical dose response curve, increasing the dose by 1mg will have a larger change in response when the original dose is 1 mg versus when the original dose is 10mg.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
lecture 20, PK-PD modelsRate this question:
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- 24.
The pharmacodynamic parameter EC50, is the
- A.
Maximal effect of the drug
- B.
Half the maximal effect of the drug
- C.
Concentration at which the maximal effect of the drug occurs
- D.
Concentration at which half the maximal effect of the drug occurs
Correct Answer
D. Concentration at which half the maximal effect of the drug occursExplanation
The EC50 is the concentration at which half of the maximal effect of the drug occurs. This means that at the EC50 concentration, the drug is exerting its maximum effect on the target. It is an important pharmacodynamic parameter as it helps determine the potency of a drug and provides valuable information for dose-response relationships.Rate this question:
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- 25.
The _____ coefficient determines the steepness of a dose response curve. A higher coefficient means a steeper curve.
- A.
Valley
- B.
Mountain
- C.
Hill
- D.
Lake
Correct Answer
C. HillExplanation
The term "coefficient" refers to a numerical value that quantifies the relationship between two variables. In the context of a dose response curve, the coefficient mentioned here is likely the slope or gradient of the curve. A higher coefficient indicates a steeper curve, meaning that there is a greater change in the response variable (e.g., drug effect) for a given change in the dose variable. Therefore, "Hill" is the correct answer as it best describes the concept of a coefficient determining the steepness of a dose response curve.Rate this question:
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- 26.
What is the product of bone turnover that is used to measure the pharmacodynamic response to ibandronate (Boniva)?
- A.
C-telopeptide
- B.
D-pseudopeptide
- C.
Peptidoglycan
- D.
Pepto bismol
Correct Answer
A. C-telopeptideExplanation
C-telopeptide is a product of bone turnover that is used to measure the pharmacodynamic response to ibandronate (Boniva). It is a marker of bone resorption and is released during the breakdown of collagen in bone. Measuring C-telopeptide levels can help assess the effectiveness of ibandronate in inhibiting bone resorption and treating conditions such as osteoporosis.Rate this question:
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- 27.
What is the classification system used to grade the severity of liver disease?
- A.
Higgs-Boson Classification
- B.
Dewey-Rheims Classification
- C.
Michaelis-Menton Classification
- D.
Child-Pugh Classification
Correct Answer
D. Child-Pugh ClassificationExplanation
The Child-Pugh Classification is a widely used system to grade the severity of liver disease. It assesses the severity based on five clinical and laboratory parameters: serum bilirubin level, serum albumin level, prothrombin time, presence of ascites, and hepatic encephalopathy. Each parameter is assigned a score, and the total score determines the severity of the liver disease, ranging from class A (mild) to class C (severe). This classification system helps in determining the prognosis and guiding treatment decisions for patients with liver disease.Rate this question:
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- 28.
Which type of drug is most affected by first pass metabolism?
- A.
High protein binding; high extraction ratio
- B.
High protein binding; low extraction ratio
- C.
Low protein binding; high extraction ratio
- D.
Low protein binding; low extraction ratio
Correct Answer
C. Low protein binding; high extraction ratioExplanation
Drugs that have low protein binding and high extraction ratio are most affected by first pass metabolism. This means that these drugs have a low affinity for binding to proteins in the blood and are rapidly extracted by the liver during the first pass through the liver. As a result, a significant portion of these drugs is metabolized and inactivated before they can reach systemic circulation. This can lead to a decrease in the bioavailability and effectiveness of the drug.Rate this question:
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- 29.
You should be more concerned with dose adjustment for a drug with a high hepatic extraction ratio than a drug with a low ratio in a patient with liver disease.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
Extraction ratio describes the amount of drug extracted during first pass metabolism. A drug with high first pass metabolism will have a greater percentage change in bioavailability in a patient with liver disease.Rate this question:
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- 30.
Which is not a high extraction ratio drug?
- A.
Metoprolol
- B.
Nitroglycerin
- C.
Warfarin
- D.
Verapamil
- E.
Midazolam
- F.
Morphine
Correct Answer
C. WarfarinExplanation
Warfarin is not a high extraction ratio drug. Extraction ratio refers to the extent to which a drug is removed from the blood by the liver during the first pass. High extraction ratio drugs are extensively metabolized by the liver, resulting in a significant reduction in their bioavailability. Warfarin, however, has a low extraction ratio, meaning it is not extensively metabolized by the liver and has a higher bioavailability compared to high extraction ratio drugs.Rate this question:
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- 31.
In general; phase II conjugation is more sensitive to cirrhosis than phase I oxidative metabolism.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
The opposite is true.Rate this question:
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- 32.
Warfarin is a highly protein bound drug.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
Warfarin is a highly protein bound drug because it binds extensively to plasma proteins, particularly albumin. This binding plays a crucial role in the drug's distribution and elimination from the body. Protein binding helps to keep the drug in circulation and prevents it from being rapidly metabolized or excreted. As a result, only the unbound fraction of warfarin is pharmacologically active. High protein binding also means that interactions with other drugs that also bind to proteins can occur, potentially affecting the therapeutic efficacy and safety of warfarin.Rate this question:
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- 33.
In what type of liver disease is the main issue alteration in hepatic blood flow?
- A.
Acute
- B.
Chronic
Correct Answer
B. ChronicExplanation
In chronic liver disease, the main issue is the alteration in hepatic blood flow. This can occur due to various factors such as cirrhosis, fibrosis, or inflammation of the liver. These conditions can lead to the development of scar tissue, which can obstruct the normal flow of blood through the liver. As a result, the liver may not receive enough oxygen and nutrients, leading to further damage and dysfunction. Therefore, chronic liver disease is characterized by long-term changes in hepatic blood flow, contributing to the progression of the disease.Rate this question:
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- 34.
Ascites increases the volume of distribution of highly hydrophobic drugs.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Ascites increases the volume of distribution of highly HYDROPHILIC drugs.Rate this question:
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- 35.
Which benzodiazepine is not safe to use in someone with liver failure?
- A.
Clonazepam
- B.
Lorazepam
- C.
Oxazepam
- D.
Temazepam
Correct Answer
A. ClonazepamExplanation
Lorazepam, oxazepam, and temazepam are safe to use in liver failure. Clonazepam is extensively metabolized by CYP2C19 which is highly sensitive to liver disease.Rate this question:
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- 36.
What is the most common chronic condition affecting those age 65 and older?
- A.
Cancer
- B.
Diabetes
- C.
Stroke
- D.
Hypertension
Correct Answer
D. HypertensionExplanation
Both hypertension and arthritis affect over half the population age 65 and older.Rate this question:
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- 37.
What is the most common cause of death in adults over age 65?
- A.
Alzheimer's
- B.
Heart Disease
- C.
Stroke
- D.
Cancer
Correct Answer
B. Heart DiseaseExplanation
Heart disease is the most common cause of death in adults over age 65. This is because as people age, their risk factors for heart disease, such as high blood pressure, high cholesterol, and obesity, increase. Additionally, the aging process itself can lead to changes in the heart and blood vessels, making them more susceptible to disease. Heart disease encompasses a range of conditions, including coronary artery disease, heart failure, and arrhythmias, which can ultimately result in heart attacks or sudden cardiac death. Therefore, it is not surprising that heart disease is the leading cause of death in this age group.Rate this question:
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- 38.
Decreased accomodation of the lens in the elderly causes farsightedness.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
As people age, the lens of the eye becomes less flexible and loses its ability to change shape easily. This decreased accommodation of the lens leads to difficulty in focusing on nearby objects, resulting in farsightedness or hyperopia. Therefore, it is true that decreased accommodation of the lens in the elderly causes farsightedness.Rate this question:
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- 39.
An increase in active transport in the elderly will lead to an increase in absorption of vitamin B12, calcium, and iron.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
An DEcrease in active transport in the elderly will lead to a DEcrease in absorption of vitamin B12, calcium, and iron.Rate this question:
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- 40.
The rate of transdermal drug absorption in the elderly is....
- A.
Increased
- B.
Decreased
- C.
Unchanged
Correct Answer
B. DecreasedExplanation
Decrease in tissue blood perfusion and atrophy of the epidermis and dermis lead to a decrease in transdermal drug absorption and a decrease or variable rate in IM & SQ drug absorption.Rate this question:
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- 41.
When a patient is over the age of 65 and has a serum creatinine less than 1, you should round up to 1 for the value of SCr in the Cockcroft-Gault equation.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
There is no good evidence to support this practice.Rate this question:
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- 42.
In the elderly, a decrease in the barorecptor reflex can lead to orthostatic hypotension.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
As people age, their baroreceptor reflex, which helps regulate blood pressure, tends to become less sensitive. This can result in orthostatic hypotension, a condition where blood pressure drops significantly when standing up from a sitting or lying position. This can cause symptoms such as dizziness, lightheadedness, and even fainting. Therefore, it is true that a decrease in the baroreceptor reflex can lead to orthostatic hypotension in the elderly.Rate this question:
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- 43.
Diphenhydramine is an excellent choice for treating allergies in the elderly.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Drugs with anticholinergic side effects should be avoided in the elderly because they can cause mental confusion, memory impairment, delerium, constipation, BPH, incontinence, and glaucoma.Rate this question:
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- 44.
In end stage renal disease the volume of distribution of phenytoin is ___________.
- A.
Increased
- B.
Decreased
Correct Answer
A. IncreasedExplanation
In end stage renal disease, the volume of distribution of phenytoin is increased. This is because renal dysfunction affects the elimination of drugs from the body, leading to a decrease in the clearance of phenytoin. As a result, the drug accumulates in the body and distributes to a larger volume, causing an increase in its volume of distribution.Rate this question:
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- 45.
Which type of drug is more readily removed by dialysis?
- A.
Water Soluble Drug
- B.
Lipid Soluble Drug
Correct Answer
A. Water Soluble DrugExplanation
Dialysate is aqueous in nature therefore water soluble drugs more readily removed.Rate this question:
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- 46.
Protein binding of acidic drugs (like warfarin) is generally decreased in end stage renal disease.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
In end stage renal disease, the kidneys are severely damaged and their function is significantly impaired. This can lead to decreased protein binding of acidic drugs like warfarin. Protein binding refers to the attachment of drugs to proteins in the blood, which affects their distribution and elimination from the body. In renal disease, the balance of protein binding may be disrupted, resulting in decreased binding of acidic drugs. Therefore, the statement that protein binding of acidic drugs is generally decreased in end stage renal disease is true.Rate this question:
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- 47.
In patients with renal disease, meperidine (Demerol) will have less analgesic activity and more CNS stimulatory effects (seizures).
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
Patients with renal disease have impaired kidney function, which can result in the accumulation of meperidine and its metabolite, normeperidine. Normeperidine has CNS stimulatory effects and can increase the risk of seizures. Additionally, meperidine is primarily eliminated through the kidneys, so its clearance is reduced in patients with renal disease. Therefore, meperidine will have less analgesic activity and more CNS stimulatory effects in patients with renal disease.Rate this question:
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- 48.
The formula for rate of excretion is rate of filtration + rate of secretion + rate of reabsorption.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
The formula for rate of excretion is rate of filtration + rate of secretion - rate of reabsorption.Rate this question:
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- 49.
In general, dialysis decreases serum drug concentration.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
Dialysis is a medical procedure used to remove waste products and excess fluids from the blood when the kidneys are unable to perform this function adequately. Since drugs are typically eliminated from the body through the kidneys, dialysis can help remove drugs from the bloodstream, leading to a decrease in serum drug concentration. Therefore, the statement "In general, dialysis decreases serum drug concentration" is true.Rate this question:
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- 50.
In general, CRRT removes more drug than conventional filter hemodialysis.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
CRRT: Continuous Renal Replacement TherapyRate this question:
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