Deck 21: Therapeutic Drug Monitoring

Question 1

The fractional extent to which a dose of drug reaches its site of action is referred to as:

A) Elimination half-life.
B) Phase I reaction.
C) First- pass effect.
D) Bioavailability.

Answer 1

Bioavailability.

Question 2

Which of the following best reflect the four correct pharmacological parameters that determine serum drug concentration?

A) Absorption, anabolism, bioactivation, excretion
B) Equilibration, biotransformation, reabsorption, elimination
C) Absorption, distribution, metabolism, excretion
D) Ingestion, conjugation, metabolism, elimination

Answer 2

Absorption, distribution, metabolism, excretion

Question 3

Which of the following is an example of an antiarrhythmic drug that has a metabolite with very similar same pharmacological action?

A) Procainamide
B) Phenobarbital
C) Quinidine
D) Caffeine

Answer 3

Procainamide

Question 4

Which of the following compounds selectively inhibits proliferation and activation of CD4+ T cells?

A) Digoxin
B) Beta hCG
C) Progesterone
D) Cyclosporine A

Question 5

The goal of therapeutic drug monitoring (TDM) is to:

A) Provide the patient with the least amount of drug to effect the best outcome.
B) Provide the patient with the cheapest formulation of the drug to effect the best outcome.
C) Provide the patient with the best estimate of a dosage of drug to effect the best outcome.
D) Provide the patient with the optimum dosage of drug to effect the best outcome.

Question 6

The pharmacological response of a drug is initiated when the drug is in which form?

A) Bound to fatty acids
B) Bound to proteins
C) Bound to carbohydrates
D) Free

Question 7

FK506 (tacrolimus) is classified as a (an):

A) Immunosuppressant.
B) Sedative hypnotic.
C) Cardiac glycoside.
D) Antiasthmatic.

Question 8

Plasma clearance of a drug is defined as:

A) The volume of plasma from which all drug appears to be removed in a given volume of blood (e.g., mL/mL).
B) The volume of plasma from which all drug appears to be removed in a given time (e.g., mL/min).
C) The amount of drug removed from urine in a given time (e.g., mg/min).
D) The amount of time it takes for a drug to reach seven half-lives.

Question 9

Steady state of a drug is typically achieved after:

A) Approximately seven half-lives.
B) Approximately two half-lives.
C) The drug is completely absorbed from the gut.
D) The drug first begins to appear in the urine.

Question 10

A drug that is administered into the subarachnoid space or ventricles (intrathecal) is referred to as:

A) Oral.
B) Topical.
C) Parenteral.
D) Enteral.

Question 11

Which of the following compounds relaxes the smooth muscles of the bronchial passages?

A) Acetaminophen
B) Lithium
C) Phenytoin
D) Theophylline

Question 12

Which of the following compounds is a cardiac glycoside that is used in the treatment of congenital heart failure and arrhythmias by increasing the force and velocity of myocardial contraction?

A) Digoxin
B) Carbamazepine
C) Amikacin
D) Phenobarbital

Question 13

Carbamazepine, primidone, and valproic acid are all examples of:

A) Antiarrhythmic drugs.
B) Antidepressant drug.
C) Antibiotics.
D) Antiepileptic drugs.

Question 14

Depakene or Depakote are proprietary names for which of the following compounds?

A) Phenobarbital
B) Dilantin
C) Valproic acid
D) Carbamazepine

Question 15

Phase I biotransformation includes:

A) Attachment of a hydroxyl group.
B) Conjugation with glucuronic acid.
C) Conjugation with sulfate.
D) Conjugation with glutathione.

Question 16

Which of the following compounds is the major metabolite of primidone?

A) Digoxin
B) Theophylline
C) N-acetylprocainamide
D) Phenobarbital

Question 17

A blood sample for a trough drug level should be drawn:

A) During the distribution phase of the drug.
B) 1.5 hours after drug administration.
C) Shortly before drug administration.
D) During phase I biotransformation.

Question 18

Which of the following are the toxic effects of phenobarbital?

A) Atrial fibrillation, hyperactive, and very fast breathing rates
B) Severe tiredness/dizziness, inability to wake up, and very slow breathing rates
C) Ototoxicity and possible nephrotoxicity
D) Spontaneous hemorrhage or life-threatening infections

Question 19

Clearance (CL) of a drug is defined as which of the following?

A) The rate of elimination by all routes normalized to the concentration of drug, in some biological fluids
B) A measure of the apparent space the body has available to contain the drug
C) The time required for an amount of drug in blood to decline to one-half its measured value
D) The fraction of drug dose reaching the systemic circulation following administration by any route

Question 20

Which of the following is bactericidal for Streptococci, Corynebacterium, Clostridia, Listeria, and Bacillus species?

A) Tobramycin
B) Cyclosporine
C) Vancomycin
D) Methotrexate

Question 21

Phenobarbital is classified as a (an):

A) Cardiac glycoside.
B) Anti arrhythmic.
C) Analgesic, antipyretic, and anti-inflammatory.
D) Sedative and hypnotic.