1.
Why is it that the cornea is a difficult tissue for drugs to penetrate?
2.
What is the definition for 'volume of distribution of a drug'?
3.
Explain why azithromycin (Z-Pak) can deliver the equivalent of 7-10 days of therapy with 5 days of dosing.
4.
The drug propofol (Diprivan) has a short duration of action due to the rapid re-distribution to other tissues via the ____ system.
Correct Answer
D. CNS
Explanation
Short duration of action is also due to its high metabolic clearance and high lipophilicty (pg.21). This drug is able to cross the blood brain barrier.
5.
There are substrates, inhibitors, and inducers for oral meds under the OD scope of practice
Correct Answer
A. True
Explanation
see pg. 25 for a list of inhibitors and inducers of the P450 system that are prescribed by ODs
6.
Check ALL the factors that allow a drug to more easily across plasma membranes.
Correct Answer
A. Smaller molecular structure
Explanation
Drugs that are lipid-soluble, smaller molecular structure and are NOT ionized have a better ability to pass thru plasma membranes (pg. 19).
7.
Ionization makes a drug molecule _____ lipid-soluble
Correct Answer
less
Explanation
Ionization is the process of gaining or losing an electron, resulting in the formation of charged particles called ions. When a drug molecule becomes ionized, it becomes more polar and less lipid-soluble. This is because lipid molecules are nonpolar, while ions are charged and therefore interact more readily with polar molecules. As a result, ionization decreases the ability of a drug molecule to dissolve in lipids and pass through lipid-rich barriers, such as cell membranes. Therefore, the correct answer is "less."
8.
Which of the following conditions DOES NOT result in hypoalbuinermia (low serum albumin levels)?
Correct Answer
E. None of the above (they all result in hypoalbumineria)
Explanation
Patients with extremely low serum albumin levels may not have the full expected drug action of effect due to the fact that protein bound drugs can reach higher concentrations between the blood and tissues.
9.
In general, clinically significant drug interactions are more likely to occur between substrates and either inhibitors and induces of _____ CYP enzyme(s).
Correct Answer
same
Explanation
pg. 24
10.
Which of the following drugs can result in optic neuritis/neuropathy and can deposit in the cornea and affect vision?
Correct Answer
D. Amiodarone (Pacerone, Cordarone)
Explanation
amiodarone is a heart medication...this example was used to demonstrate drug deposition (pg. 21)
11.
Which of the following does NOT require energy nor a transport carrier?
Correct Answer
E. More than one of the above
Explanation
passive diffusion + hydrophillic channels require no energy input and do not need a transport carrier
carrier-assisted diffusion only requires a transport carrier
active transport requires both energy an a transport carrier
(pg.19)
12.
ACE Inhibitors are an example of a type of drug that results in a drug becoming ____ active than the parent drug
Correct Answer
A. More
Explanation
ACE inhibitors are a type of drug that inhibits the angiotensin converting enzyme, which leads to the dilation of blood vessels and a decrease in blood pressure. This action makes the drug more active than the parent drug, as it enhances the drug's ability to lower blood pressure and treat conditions such as hypertension and heart failure.
13.
What percent of patients taking amiodarone present with corneal microdeposits?
Correct Answer
D. 90%
Explanation
Summary of adverse ocular effects of amiodarone:
- optic neuritis (1%)
- corneal microdepsoits (> 90%) causing visual distuburbance (< 10%)
- visual disturbance (2-9%)
- halo vision (esp at night ) (
14.
What most commonly occurs in CYP inhibition?
Correct Answer
C. Inhibitor drug competitively binds to active site of enzyme
Explanation
When the CYP inhibitor drug binds to the active site of the enzyme it prevents normal enzyme binding and routine metabolism from occurring.
pg. 24
15.
Pharmacologic metabolic processes often result in drugs becoming more _____ and more _____-soluble.
Correct Answer
polar, water
Explanation
Pharmacologic metabolic processes often result in drugs becoming more polar and more water-soluble. This means that during metabolism, drugs tend to undergo chemical changes that increase their polarity and their ability to dissolve in water. This is important because polar and water-soluble drugs are more easily absorbed, distributed, and eliminated from the body, making them more effective and safer for use.
16.
What are potential consequences of drug deposition?
Correct Answer
E. More than one of the above
Explanation
Drug deposition occurs when a drug deposits in a specific tissue and accumulates. This may result in SLOWER drug release or eventual changes in the tissues
17.
What general category of antibiotics can lead to permanent teeth staining when given to a child before the age of 8?
Correct Answer
C. Tetracyclins
Explanation
The specific example was doxycycline (Vibramycin), and this is a sub-category of tetracyclines. It can deposit in bones, liver, spleen and teeth
18.
There is more than one cytochrom P450 enzyme
Correct Answer
A. True
Explanation
pg. 24
There have been 100s found although far fewer are found in humans.
We are now aware that CYP enzymes may be involved in the metabolism of approx 75% of all drugs.
19.
Where are P450 isoenzymes located specifically in the liver?
Correct Answer
D. Endoplasmic recticulum of hepatocytes
Explanation
Through an electron transport change that uses NADPH as a proton carrier, a drug bound to cytochrome P450 can be oxidized or reduced
p.23
20.
Which of the following is NOT part of microsomal (P450) oxidation reactions?
Correct Answer
B. Azo-reduction
Explanation
Microsomal oxidation reactions: hydroxylation, dealkylation, oxidation, polarizing atom exchange
azo-reduction is a microsomal REDUCTION reaction
pg. 23
21.
Unbound, or free drugs (aka not bound to serum proteins) will reach __________ between the blood and tissues.
Correct Answer
equilibrium
Explanation
pg. 21
22.
Metabolic reactions can transform an active drug into a less active form or into inactive metabolites. Metabolic reactions can also transform a prodrug into a more active drug or metabolite.
Correct Answer
A. True
Explanation
pg. 22
23.
Choose ALL of the reactions that fall under Phase II reactions:
Correct Answer(s)
A. Glucuronide conjugation
C. Ethereal sulfate conjugation
D. Acetylation
E. Transulfuration
F. Glutathion conjugation
Explanation
pg.23
24.
In Phase I reactions, drugs are ___________ or ___________. In Phase II reactions, a polar molecular group is __________ to the drug which increases its polarity.
Correct Answer(s)
oxidized, reduced, conjugated
Explanation
pg. 23
25.
During drug metabolism, what is the general trend that occurs?
Correct Answer
D. Drugs become more polar
Explanation
pg. 23
26.
When Nepafenac penetrates the cornea, it’s converted into a more active form that acts as:
Correct Answer
C. Analgesic
Explanation
Nepafenac, when it penetrates the cornea, is converted into a more active form that acts as an analgesic. This means that it functions as a pain reliever.
27.
What cytochrome P450 enzyme accounts for nearly half of all CYP activity?
Correct Answer
D. CYP 3A
Explanation
pg. 24