Describe the purpose for using a loading dose followed by maitenance doses.
3.
The setting in which the drug will be used i.e. IV meds occurs in hopsitals whereas oral meds are more appropriate for outpatient use describes the "clinical situation" of a drug.
A.
True
B.
False
Correct Answer B. False
Explanation This describes the 'intended use of the drug'
Clinical Situation: the urgency of a situation many dictate the the form of the drug preferred for use i.e. emergency situations may require IV administration whereas less urgen situations may be given via oral, subcutaneous, ophthalmic etc
(pg. 9)
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4.
25-50 mg of oral metoprolol has the same minimum effective dose in the serum as 2.5-5 mg of IV metoprolol.
A.
True
B.
False
Correct Answer A. True
Explanation Oral metoprolol goes through the liver and is reduced by approx 10x by the time it reaches the serum. IV metoprolol bypasses the liver and therefore the administered dose is the same as the effective dose in the serum.
(pg. 9)
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5.
How can one determine when steady state is reached for an continuous infusion, based on analyzing a drug serum concentration graph?
A.
Drug concentration will "flat line"
B.
Drug concentration peaks and troughs will be equal
C.
Drug concentration will show steady increase
D.
More than one of the above
Correct Answer A. Drug concentration will "flat line"
Explanation For continuous infusion, steady state is indicated by a flat (horizontal) drug concentration (see pg. 17 top graph)
For intermittent dose, steady state is indicated when the peaks/troughs are equal in amplitude
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6.
Blood from the mesenteric circulation (GI tract) passed through the_______ before entering other organs.
Correct Answer liver
Explanation This is referring to the "first pass effect" of oral meds. Meds absorbed through the GI tract that pass thru the liver can undergo some degree of metabolism on the first pass thru the liver. At times, the effect can be so significant that the oral dose must be much HIGHER than the parenteral dose in order to assure effective serum concentration levels after the intial pass thru the liver (p. 9)
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7.
Which of the following is FALSE in regard to oral drug administration?
A.
One of the easiest routes for pts to dose themselves
B.
Should be acid-stable
C.
Should not be absorbed by the intestinal lining in order to enter bloodstream
D.
Intestinal peristalsis can affect the absorption
Correct Answer C. Should not be absorbed by the intestinal lining in order to enter bloodstream
Explanation Oral agents SHOULD be able to be absorbed and passed through the intestinal lining in order to enter the bloodstream
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8.
Sublingual drug administration uses percutaneous absorption through the mouth and gums
A.
True
B.
False
Correct Answer B. False
Explanation This is the definition of buccal drug administration (not directly in notes, but I had it written in the margin)
Sublingual: meds placed under the tongue for absorb. into the bloodstream thru sublingual capillaries
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9.
Indicate which drugs have a high first pass effect according to lecture.
A.
Metoprolol
B.
Mannitol
C.
Beta blockers
Correct Answer(s) A. Metoprolol C. Beta blockers
Explanation not directly in notes, but I had it written in the margin
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10.
Choose ALL that apply to the formulation of drugs.
A.
Capability of the drug to pass through one or more barriers in the body
B.
Adverse effects of the drug
C.
Intended use of the drug
D.
Clinical situation
E.
Potential misuse of the drug
F.
First pass effect
G.
Drug stability
Correct Answer(s) A. Capability of the drug to pass through one or more barriers in the body C. Intended use of the drug D. Clinical situation F. First pass effect G. Drug stability
11.
The abbreviation for sublingual administration is SL
A.
True
B.
False
Correct Answer B. False
Explanation The National Patient Safety Guidelines discourages the use of SL as an abbrev due to the potential for being mistaken as SC (subcutaneous).
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12.
Which of the following is NOT considered a topical form of drug administration?
If the dose of a drug is 100 mg (assume 100% bioavailability) and the half life is 8 hours, how many half-lifes will it take for less than 2 mg of the drug to still be circulating the serum?
A.
4
B.
5
C.
6
D.
7
Correct Answer C. 6
15.
Legible, clear notice of the condition for which a drug or device is being prescribed is legally necessary when writing a Rx
A.
True
B.
False
Correct Answer B. False
Explanation This is only required if requested by the patient
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16.
Which of the following drugs was presented as an example for having poor drug stability when taken orally.
A.
Vigamox
B.
Dicloxacillin
C.
Insulin
D.
Catapress
Correct Answer C. Insulin
Explanation Drugs such as insulin which are denatured by acid are not effective when administered orally bc they may be destroyed in the low pH environment of the stomach.
pg. 9
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17.
Azithromycin, concentrates ________ and after several doses its half life ___________.
A.
Intracellularly; decreases
B.
Extracellularly; decreases
C.
Extracellularly; increases
D.
Intracellularly; increases
Correct Answer D. Intracellularly; increases
Explanation Azithromycin tablets has a rapid and wide distribution throughout the body and concentrates intracellularly. The half life after a single dose is 11-14 hour, but after several doses the half life increases to 2-4 days.
(pg. 16)
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18.
Another name for intermittent IV administration is "piggyback"
A.
True
B.
False
Correct Answer A. True
Explanation pg. 11
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19.
Which of the following is NOT an appropriate match?
A.
Aa = of each
B.
QD = once a day
C.
Supp = supplemental
D.
U.D. = as directed
E.
None of the above (they are all correct)
F.
More than one of the above is incorrect
Correct Answer F. More than one of the above is incorrect
Explanation qD should never be used for 'once a day'...instead qDay should be used
supp = suppository (not supplemental)
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20.
Both continuous infusion and single doses will eventually reach a steady state after 4-5 half lives.
A.
True
B.
False
Correct Answer B. False
Explanation Single Dose serum concentration rises as the drug is distributed in the circulation. However, because only one dose is administered, the serum concentration decreases as the drug is distributed in the body and then eliminated.
Continuous Infusion serum concentration of the drug will reach steady state after 4-5 haf lives.
(pg. 16-17)
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21.
The optimum recommended dosage frequency of many drugs is often (but not always) determined to be _______ times the half life.
A.
1-2
B.
2-3
C.
3-4
D.
4-5
Correct Answer B. 2-3
22.
The half life of a drug often relates to:
A.
Duration of action
B.
Onset of action
C.
Distribution phase
D.
Therapeutic range
Correct Answer A. Duration of action
Explanation Drug metabolism and excretion also relate to duration of action...if there is an abnormal issue with the metabolism or excretion of a drug, the half life will be LONGER (duration of action will be longer).
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23.
Check off ALL the options that are required on an Rx label.
A.
Patient address
B.
Refills
C.
Date of birth
D.
Dr's license classification
E.
Directions for use
Correct Answer(s) A. Patient address D. Dr's license classification E. Directions for use
24.
Drugs administered ________ reach maximum serum concentration rapidly compared to drugs administered by many other routes.
Correct Answer(s) intravenously
Explanation Topical creams have a very low absorption rate. Eye drops have a lower absorption than IV, but higher than topical creams.
pg. 16
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25.
Check ALL the correct matches
A.
T.I.D. = two times per day
B.
Ung = ointment
C.
Qs = one half
D.
Tab = tablet
E.
Sig = significant warnings
F.
Dr = drop(s)
Correct Answer(s) B. Ung = ointment D. Tab = tablet
Explanation T.I.D. = three times per day (B.I.D. = two times per day)
qs = up to
Sig = directions or "label as"
qtt = drops
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