Kinetics Final (Conceptual Questions)

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  • 1/64 Questions

    Which is not a part of Pharmacokinetics?

    • Absorption
    • Distribution
    • Metabolism
    • Response
    • Distribution
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About This Quiz

The 'Kinetics Final (Conceptual Questions)' quiz assesses understanding of pharmacokinetics, focusing on concepts such as drug elimination methods, pharmacokinetic models, and time to steady state in IV infusions. It is ideal for students preparing for medical licensing exams.

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  • 2. 

    What is not a use of pharmacokinetic models?

    • Predict plasma drug levels

    • Calculate optimum dosage for individual patients

    • Bioequivalence studies

    • Graph dose-response curves

    Correct Answer
    A. Graph dose-response curves
    Explanation
    A dose-response curve would be classified under pharmacodynamics.

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  • 3. 

    In a two compartment model, k21 describes drug elimination from a system.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    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.

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  • 4. 

    Which is not a method of drug elimination?

    • Protein Binding

    • Metabolism

    • Excretion

    • Dialysis

    Correct Answer
    A. Protein Binding
    Explanation
    Protein Binding does not eliminate the active drug, it can still dissociate after it binds.

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  • 5. 

    In a continuous or intermittent IV infusion, how many half lives does it take to reach steady state?

    • 2

    • 5

    • 8

    • 11

    • E

    Correct Answer
    A. 5
    Explanation
    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.

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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.

    • 2.5

    • 5

    • 7.5

    • 10

    Correct Answer
    A. 5
    Explanation
    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.

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  • 7. 

    Only free drug can be distributed to the tissues.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    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.

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  • 8. 

    The general trend from birth to nine months is that body fat _____________ with age

    • Increases

    • Decreases

    • Stays the same

    Correct Answer
    A. Increases
    Explanation
    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.

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  • 9. 

    With the exception of 1 y.o.a. through puberty, total body water __________ with age.

    • Increases

    • Decreases

    • Stays the same

    Correct Answer
    A. Decreases
    Explanation
    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".

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  • 10. 

    Which pharmacokinetic parameter would hepatic disease be most likely to affect?

    • Absorption

    • Distribution

    • Metabolism

    • Excretion

    Correct Answer
    A. Metabolism
    Explanation
    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.

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  • 11. 

    Which drug is not modeled by non-linear pharmacokinetics?

    • Alcohol

    • Phenobarbital

    • Valproic Acid

    • Phenytoin

    Correct Answer
    A. Phenobarbital
    Explanation
    See lecture 18, slide 41.

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  • 12. 

    Which person is unlikely to be involved in a multidisciplinary approach to individualizing drug therapy?

    • Physician

    • Nurse

    • Accountant

    • Pharmacist

    Correct Answer
    A. Accountant
    Explanation
    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.

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  • 13. 

    In the Cockcroft-Gault equation, an increase in serum creatinine will __________ creatinine clearance.

    • Increase

    • Decrease

    • Not change

    Correct Answer
    A. Decrease
    Explanation
    Serum Creatinine and Creatinine clearance are inversely related.

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  • 14. 

    A premature infant is defined as gestation age of less than

    • 34 weeks

    • 36 weeks

    • 38 weeks

    • 40 weeks

    Correct Answer
    A. 36 weeks
    Explanation
    Lecture 19, slide 5

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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.

    • Acidic; increase

    • Alkaline; increase

    • Acidic; decrease

    • Alkaline; decrease

    Correct Answer
    A. Alkaline; increase
    Explanation
    lecture 19, slide 9.

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  • 16. 

    Premature infants have _________ biliary function compared to older children and adults.

    • Increased

    • Decreased

    • Unchanged

    Correct Answer
    A. Decreased
    Explanation
    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.

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  • 17. 

    Skin is ________ permeable in neonates and infants than adults.

    • More

    • Less

    Correct Answer
    A. More
    Explanation
    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.

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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.

    • Increased; higher

    • Increased; lower

    • Decreased; higher

    • Decreased; lower

    Correct Answer
    A. Increased; higher
    Explanation
    lecture 19, slide 19

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  • 19. 

    The volume of distribution of diazepam, a liphophilic drug, will be higher in ________.

    • Neonates

    • Adults

    Correct Answer
    A. Adults
    Explanation
    Will be higher in adults due to higher body fat. Therefore the drug will have more volume to distribute in.

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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.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    lecture 19, slide 25

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  • 21. 

    Glomerular function ________________ during the first year of life.

    • Increases

    • Decreases

    • Stays the same

    Correct Answer
    A. Increases
    Explanation
    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.

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  • 22. 

    Pharmacodynamics can be defined as...

    • What the body does to the drug.

    • What the drug does to the body.

    • What the body does to the body.

    • What the drug does to the drug.

    Correct Answer
    A. 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."

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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.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    lecture 20, PK-PD models

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  • 24. 

    The pharmacodynamic parameter EC50, is the

    • Maximal effect of the drug

    • Half the maximal effect of the drug

    • Concentration at which the maximal effect of the drug occurs

    • Concentration at which half the maximal effect of the drug occurs

    Correct Answer
    A. Concentration at which half the maximal effect of the drug occurs
    Explanation
    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.

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  • 25. 

    The _____ coefficient determines the steepness of a dose response curve.  A higher coefficient means a steeper curve.

    • Valley

    • Mountain

    • Hill

    • Lake

    Correct Answer
    A. Hill
    Explanation
    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.

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  • 26. 

    What is the product of bone turnover that is used to measure the pharmacodynamic response to ibandronate (Boniva)?

    • C-telopeptide

    • D-pseudopeptide

    • Peptidoglycan

    • Pepto bismol

    Correct Answer
    A. C-telopeptide
    Explanation
    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.

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  • 27. 

    What is the classification system used to grade the severity of liver disease?

    • Higgs-Boson Classification

    • Dewey-Rheims Classification

    • Michaelis-Menton Classification

    • Child-Pugh Classification

    Correct Answer
    A. Child-Pugh Classification
    Explanation
    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.

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  • 28. 

    Which type of drug is most affected by first pass metabolism?

    • High protein binding; high extraction ratio

    • High protein binding; low extraction ratio

    • Low protein binding; high extraction ratio

    • Low protein binding; low extraction ratio

    Correct Answer
    A. Low protein binding; high extraction ratio
    Explanation
    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.

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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.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    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.

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  • 30. 

    Which is not a high extraction ratio drug?

    • Metoprolol

    • Nitroglycerin

    • Warfarin

    • Verapamil

    • Midazolam

    • Morphine

    Correct Answer
    A. Warfarin
    Explanation
    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.

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  • 31. 

    In general; phase II conjugation is more sensitive to cirrhosis than phase I oxidative metabolism.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    The opposite is true.

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  • 32. 

    Warfarin is a highly protein bound drug.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    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.

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  • 33. 

    In what type of liver disease is the main issue alteration in hepatic blood flow?

    • Acute

    • Chronic

    Correct Answer
    A. Chronic
    Explanation
    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.

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  • 34. 

    Ascites increases the volume of distribution of highly hydrophobic drugs.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    Ascites increases the volume of distribution of highly HYDROPHILIC drugs.

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  • 35. 

    Which benzodiazepine is not safe to use in someone with liver failure?

    • Clonazepam

    • Lorazepam

    • Oxazepam

    • Temazepam

    Correct Answer
    A. Clonazepam
    Explanation
    Lorazepam, oxazepam, and temazepam are safe to use in liver failure. Clonazepam is extensively metabolized by CYP2C19 which is highly sensitive to liver disease.

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  • 36. 

    What is the most common chronic condition affecting those age 65 and older?

    • Cancer

    • Diabetes

    • Stroke

    • Hypertension

    Correct Answer
    A. Hypertension
    Explanation
    Both hypertension and arthritis affect over half the population age 65 and older.

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  • 37. 

    What is the most common cause of death in adults over age 65?

    • Alzheimer's

    • Heart Disease

    • Stroke

    • Cancer

    Correct Answer
    A. Heart Disease
    Explanation
    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.

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  • 38. 

    Decreased accomodation of the lens in the elderly causes farsightedness.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    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.

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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.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    An DEcrease in active transport in the elderly will lead to a DEcrease in absorption of vitamin B12, calcium, and iron.

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  • 40. 

    The rate of transdermal drug absorption in the elderly is....

    • Increased

    • Decreased

    • Unchanged

    Correct Answer
    A. Decreased
    Explanation
    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.

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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.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    There is no good evidence to support this practice.

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  • 42. 

    In the elderly, a decrease in the barorecptor reflex can lead to orthostatic hypotension.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    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.

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  • 43. 

    Diphenhydramine is an excellent choice for treating allergies in the elderly.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    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.

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  • 44. 

    In end stage renal disease the volume of distribution of phenytoin is ___________.

    • Increased

    • Decreased

    Correct Answer
    A. Increased
    Explanation
    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.

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  • 45. 

    Which type of drug is more readily removed by dialysis?

    • Water Soluble Drug

    • Lipid Soluble Drug

    Correct Answer
    A. Water Soluble Drug
    Explanation
    Dialysate is aqueous in nature therefore water soluble drugs more readily removed.

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  • 46. 

    Protein binding of acidic drugs (like warfarin) is generally decreased in end stage renal disease.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    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.

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  • 47. 

    In patients with renal disease, meperidine (Demerol) will have less analgesic activity and more CNS stimulatory effects (seizures).

    • True

    • False

    Correct Answer
    A. True
    Explanation
    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.

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  • 48. 

    The formula for rate of excretion is rate of filtration + rate of secretion + rate of reabsorption.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    The formula for rate of excretion is rate of filtration + rate of secretion - rate of reabsorption.

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  • 49. 

    In general, dialysis decreases serum drug concentration.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    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.

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  • Current Version
  • Mar 22, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Dec 10, 2012
    Quiz Created by
    Juicemaster85

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