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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Pharmacokinetics Quizzes & Trivia
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. 

    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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  • 3. 

    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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  • 4. 

    In physiologic-based Pharmacokinetic Models, organs can be divided into non-eliminating organs and eliminating organs.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Physiologic-based Pharmacokinetic Models categorize organs into non-eliminating organs and eliminating organs. This classification is based on the organ's ability to eliminate drugs from the body. Non-eliminating organs do not play a significant role in drug elimination, while eliminating organs are responsible for drug metabolism and excretion. Therefore, the statement is true.

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  • 5. 

    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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  • 6. 

    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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  • 7. 

    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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  • 8. 

    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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  • 9. 

    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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  • 10. 

    Mean Residence Time (MRT) makes the assumption that drug elimination occurs on the primary constitutive element in a system.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    The explanation for the given correct answer is that the Mean Residence Time (MRT) is a pharmacokinetic parameter that represents the average time a drug molecule spends in the body before being eliminated. It assumes that drug elimination primarily occurs on the primary constitutive element in a system, which refers to the main organ or tissue responsible for drug metabolism and excretion. Therefore, the statement that MRT assumes drug elimination occurs on the primary constitutive element is true.

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  • 11. 

    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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  • 12. 

    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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  • 13. 

    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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  • 14. 

    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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  • 15. 

    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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  • 16. 

    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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  • 17. 

    A substitution of one nucleotide for another nucleotide in a sequence of DNA is called a ......

    • Addition

    • Single Nucleotide Polymorphism

    • Deletion

    • Frame Shift

    Correct Answer
    A. Single Nucleotide Polymorphism
    Explanation
    A substitution of one nucleotide for another nucleotide in a sequence of DNA is called a Single Nucleotide Polymorphism. This refers to a genetic variation that occurs when a single nucleotide (A, T, C, or G) in the DNA sequence is changed. SNPs are the most common type of genetic variation and can have various effects on gene function and protein production. They can be associated with increased susceptibility to certain diseases or have no effect at all.

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  • 18. 

    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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  • 19. 

    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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  • 20. 

    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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  • 21. 

    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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  • 22. 

    Allometry is the study of biological scaling and is one use of a physiologic-based pharmacokinetic model.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Allometry is indeed the study of biological scaling, which examines how the size and shape of organisms influence their physiological processes. It specifically focuses on the relationship between the size of an organism and its various biological characteristics. A physiologic-based pharmacokinetic model, on the other hand, is a mathematical representation of how drugs are distributed and eliminated in the body. While allometry is not the only use of this model, it is one of the applications that can be explored to understand how drug metabolism and pharmacokinetics vary across different species and body sizes. Therefore, the statement that allometry is one use of a physiologic-based pharmacokinetic model is true.

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  • 23. 

    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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  • 24. 

    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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  • 25. 

    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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  • 26. 

    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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  • 27. 

    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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  • 28. 

    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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  • 29. 

    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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  • 30. 

    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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  • 31. 

    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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  • 32. 

    In general, CRRT removes more drug than conventional filter hemodialysis.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    CRRT: Continuous Renal Replacement Therapy

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  • 33. 

    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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  • 34. 

    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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  • 35. 

    In mutation notation, P34S means that...

    • The 34th amino acid changed from a proline to a serine

    • The 34th amino acid changed from a serine to a proline

    • This was the 34 mutation identified on this gene

    • I am hoping for a 34% on the test

    Correct Answer
    A. The 34th amino acid changed from a proline to a serine
    Explanation
    In mutation notation, P34S means that the 34th amino acid in the gene sequence has undergone a change from a proline to a serine.

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  • 36. 

    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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  • 37. 

    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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  • 38. 

    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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  • 39. 

    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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  • 40. 

    Mean Residence Time can be used in normal modeling systems and non-compartmental analysis.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Mean Residence Time (MRT) is a useful parameter in both normal modeling systems and non-compartmental analysis. In normal modeling systems, MRT helps in determining the time it takes for a substance to leave the system or be eliminated. In non-compartmental analysis, MRT is used to estimate the average time a drug or substance remains in the body. Therefore, the statement that MRT can be used in both normal modeling systems and non-compartmental analysis is true.

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  • 41. 

    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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  • 42. 

    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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  • 43. 

    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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  • 44. 

    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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  • 45. 

    If a drug is metabolized by CYP2D6 and the patient is homozygous for mutant variation that decreases the expression of CYP2D6, and they have a homozygous mutant receptor genotype that decreases the target receptor's affinity for the drug, the response seen will be one of ________ efficacy and _______ toxicity.

    • High; high

    • High; low

    • Low; high

    • Low; low

    Correct Answer
    A. Low; high
    Explanation
    If a drug is metabolized by CYP2D6 and the patient is homozygous for mutant variation that decreases the expression of CYP2D6, and they have a homozygous mutant receptor genotype that decreases the target receptor's affinity for the drug, the response seen will be one of low efficacy and high toxicity. This is because the decreased expression of CYP2D6 will result in slower metabolism of the drug, leading to lower efficacy. Additionally, the decreased affinity of the receptor for the drug will result in a reduced response, further contributing to low efficacy. On the other hand, the slower metabolism of the drug can lead to its accumulation in the body, increasing the risk of toxicity. Therefore, the response seen will be characterized by low efficacy and high toxicity.

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  • 46. 

    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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  • 47. 

    The eGFR equation takes into account a person's race and sex.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    The eGFR is multiplied by 0.742 if the patient is female and by 1.21 is the patient is African American.

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  • 48. 

    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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  • 49. 

    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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  • Mar 22, 2023
    Quiz Edited by
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  • Dec 10, 2012
    Quiz Created by
    Juicemaster85

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