Pharmacokinetics Slides 96-124, Teresa's Portion
The last part of the Pharmacokinetics powerpoint
- 1.
What is the process of expelling or removing, especially of waste products from the body?
- A.
Excretion
- B.
Exoneration
- C.
Elimination or clearance
- D.
Eruption
Correct Answer
C. Elimination or clearanceExplanation
The process of expelling or removing waste products from the body is known as elimination or clearance. This involves the removal of waste materials, such as urine, feces, and sweat, from the body to maintain proper functioning and balance. Excretion refers to the process of eliminating metabolic waste products, while exoneration refers to being cleared of blame or responsibility. Eruption refers to the sudden appearance of something, usually in a violent or explosive way.Rate this question:
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- 2.
Elimination or clearance is also the process by which the active form of a drug is removed from the bloodstream by either __________ or __________.
- A.
Excretion or diffusion
- B.
Metabolism or excretion
- C.
Metabolism or diffusion
Correct Answer
B. Metabolism or excretionExplanation
Metabolism or excretion refers to the processes by which the active form of a drug is eliminated from the bloodstream. Metabolism involves the chemical alteration of the drug by enzymes in the body, converting it into inactive or less active forms that can be easily eliminated. Excretion, on the other hand, involves the removal of the drug or its metabolites from the body through urine, feces, sweat, or breath. Both metabolism and excretion play crucial roles in eliminating drugs from the bloodstream and preventing their accumulation to toxic levels.Rate this question:
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- 3.
Which of the following is NOT a process in which a drug is excreted? (According to her powerpoint)
- A.
Sweat
- B.
Urine
- C.
Breast milk
- D.
Defecation
- E.
Tears
- F.
Exhaled air
Correct Answer
E. TearsExplanation
Tears are not a process in which a drug is excreted. Drugs can be excreted through various routes such as urine, sweat, breast milk, defecation, and exhaled air. However, tears are not involved in the excretion of drugs from the body.Rate this question:
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- 4.
The formula for excretion is: Excretion = ________ + _________ - __________
- A.
Reabsorption; Secretion; Filtration
- B.
Reabsorption; Filtration; Secretion
- C.
Secretion; Filtration; Reabsorption
Correct Answer
C. Secretion; Filtration; ReabsorptionExplanation
Excretion= Filtration + Secretion - ReabsorptionRate this question:
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- 5.
What the term that describes the amount of plasma that the drug can be totally removed from per unit time?
- A.
Plasma filtration rate
- B.
Drug removal rate
- C.
Clearance
Correct Answer
C. ClearanceExplanation
CL systemic= CL hepatic + CL renal + …. etc.Rate this question:
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- 6.
What is the benefit of the enterohepatic cycle?
- A.
Drugs MW> 300. This process is not beneficial to the body at all.
- B.
Drugs MW> 300. This process eliminates and excretes the drug from your system.
- C.
Drugs MW> 300. This process reduces the elimination of a drug and prolongs its half-life and duration of action in the body.
Correct Answer
C. Drugs MW> 300. This process reduces the elimination of a drug and prolongs its half-life and duration of action in the body.Explanation
The enterohepatic cycle refers to the process in which drugs are absorbed in the intestines, transported to the liver, and then secreted back into the intestines through the bile. This cycle allows for the reabsorption of drugs, reducing their elimination from the body. As a result, the drug's half-life is prolonged, meaning it remains in the body for a longer duration and has a prolonged action. This can be beneficial in certain cases where maintaining therapeutic drug levels in the body is desired.Rate this question:
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- 7.
What is half-life?
- A.
The time it takes your body to absorb a drug.
- B.
Amount of time required to eliminate 50% of the drug existing in the body.
- C.
50% of the dosage that you are required to take.
Correct Answer
B. Amount of time required to eliminate 50% of the drug existing in the body.Explanation
Half-life refers to the amount of time it takes for half of the drug to be eliminated from the body. This means that after one half-life, only 50% of the drug remains in the body, and after each subsequent half-life, the amount of drug in the body is reduced by half. It is an important concept in pharmacology as it helps determine the dosing frequency and duration of a drug to maintain therapeutic levels in the body.Rate this question:
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- 8.
What component is not a consideration when clinicians design a Dose Regimen?
- A.
Further refine or optimize this regimen to achieve maximum benefit with minimum adverse effects.
- B.
Decide whether continuous administration or intervals of time and dose will be used.
- C.
Take into account patient and drug factors and how rapidly the steady state must be achieved.
- D.
The proportion of patients whom the Dose Regimen was successful.
Correct Answer
D. The proportion of patients whom the Dose Regimen was successful.Explanation
The proportion of patients whom the Dose Regimen was successful is not a consideration when clinicians design a Dose Regimen. Clinicians focus on factors such as refining and optimizing the regimen for maximum benefit with minimum adverse effects, deciding on the administration method (continuous or intervals), and considering patient and drug factors for achieving steady state. However, the success rate of the regimen in patients is not taken into account during the design process.Rate this question:
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- 9.
Which is not one of the 3 Dosage Regimens mentioned her powerpoint?
- A.
Continuous-infusion regimens
- B.
Fixed-dose/fixed-time regimens
- C.
Minimal risk regimens
- D.
Optimization of dose
Correct Answer
C. Minimal risk regimensExplanation
1. Continuous-infusion regimens
2. Fixed-dose/fixed-time regimens
3. Optimization of doseRate this question:
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- 10.
What is the goal of the continuous-infusion regimen?
- A.
To eliminate as much of the drug out of the system by flushing it out.
- B.
To increase the plasma concentration of a drug to reach Steady State, which is the time at which the rate of administration equals the rate of elimination.
- C.
To keep the plasma concentration of a drug low in the system, so it does not have a huge effect.
Correct Answer
B. To increase the plasma concentration of a drug to reach Steady State, which is the time at which the rate of administration equals the rate of elimination.Explanation
The goal of the continuous-infusion regimen is to increase the plasma concentration of a drug to reach Steady State, which is the time at which the rate of administration equals the rate of elimination. This ensures that the drug is maintained at a therapeutic level in the body, allowing for a consistent and effective treatment.Rate this question:
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- 11.
Does a faster rate of infusion change the time needed to achieve steady state?
- A.
Yes
- B.
No
Correct Answer
B. NoExplanation
A faster rate does not affect the time it takes to reach steady state. Only the steady state concentration changes with a faster infusion rate. (From graph on powerpoint slide 111)
Influence of the rate of drug infusion on the steady state:
Css= Dosing rate/ CL
Although increasing rate of drug infusion increases the rate at which any given concentration in the plasma is achieved, it DOES NOT influence the time required to reach the ultimate steady-state concentration. This is because the steady-state concentration rises directly with the infusion rate.Rate this question:
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- 12.
The shape of the graph of the time required to reach the steady-state drug concentration is a:
- A.
Bell shaped curve
- B.
Linear curve
- C.
Parabola shaped curve
- D.
Exponential curve
Correct Answer
D. Exponential curveExplanation
First-order process
Exponential approach to steady state
Rate to reach steady state= rate of total eliminationRate this question:
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- 13.
What is the main determinant of the rate approaching steady state?
- A.
T1/2
- B.
CL
- C.
Concentration
Correct Answer
A. T1/2Explanation
t1/2 is the only determinant of the rate of approaching the steady state.
This rate is only affected by factors that affect the half life
The rate of approach to steady state is not affected by the rate of drug infusion.Rate this question:
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- 14.
When infusion is stopped, plasma concentration ______________ with the ________ time course observed in approaching the steady state.
- A.
Declines to zero; different
- B.
Declines to zero; same
- C.
Increases to steady state; same
- D.
Increases to steady state; different
Correct Answer
B. Declines to zero; sameExplanation
When infusion is stopped, plasma concentration declines (washes out) to zero with the same time course observed in approaching the steady state.Rate this question:
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- 15.
Continuous-infusion regimens can be a: in fixed-dose/fixed-time interval regimens (e.g., ‘one tablet every 4 hours’)
- A.
Single administration of a drug (e.g., zolpidem, a sleep-inducing agent)
- B.
Continued administration of a drug IV or orally
- C.
Both
- D.
Neither
Correct Answer
C. BothExplanation
Continuous-infusion regimens can be both in fixed-dose/fixed-time interval regimens and involve the single administration of a drug. This means that continuous-infusion regimens can be used in situations where a fixed dose of a drug is given at regular intervals, such as taking one tablet every 4 hours. Additionally, continuous-infusion regimens can also involve the administration of a drug continuously over a period of time, either intravenously or orally. Therefore, the correct answer is that continuous-infusion regimens can be both in fixed-dose/fixed-time interval regimens and involve the single administration of a drug.Rate this question:
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- 16.
Fixed-dose/fixed-time regimens consists of:
- A.
Multiple IV injections
- B.
Multiple oral administrations
- C.
Neither
- D.
Both
Correct Answer
D. BothExplanation
Fixed-dose/fixed-time regimens consist of both multiple IV injections and multiple oral administrations. This means that patients following this regimen will receive a specific dose of medication at predetermined times, either through intravenous injections or oral administrations. The combination of both delivery methods allows for a more targeted and effective treatment approach, ensuring that patients receive the necessary medication in the most appropriate way for their condition.Rate this question:
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- 17.
The goal of fixed-dose/fixed-time regimen is to:
- A.
To increase the absorption of the drug due to a sudden decline in plasma concentration
- B.
To prevent the plasma concentration of the drug from reaching steady state
- C.
Give multiple administrations of a drug in short intervals to reach steady state
Correct Answer
C. Give multiple administrations of a drug in short intervals to reach steady stateExplanation
Accumulation occurs because most drugs are given at intervals shorter than 5 half-lives and are eliminated exponentially with time.
Accumulation stops when, within the dosing interval, the rate of loss (driven by an elevated plasma concentration) exactly balances the rate of drug administration (steady state).Rate this question:
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- 18.
What is the "maintenance of dose" goal of Optimization of dose?
- A.
Maintain a steady state concentration within the therapeutic window.
- B.
Reach steady state as quickly and effectively as possible.
- C.
Find the best dosage to have the maximum effect desired.
Correct Answer
A. Maintain a steady state concentration within the therapeutic window.Explanation
The "maintenance of dose" goal of optimization of dose is to maintain a steady state concentration within the therapeutic window. This means that the goal is to keep the drug concentration in the body at a level that is effective for treating the condition, but not too high that it causes toxicity. By maintaining a steady state concentration within the therapeutic window, the desired therapeutic effects of the drug can be achieved while minimizing the risk of adverse effects.Rate this question:
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- 19.
What is the goal of "loading dose" of the Optimization of dose regimen?
- A.
To give the maximum dose possible to the patient.
- B.
To achieve desired plasma levels of a drug faster (e.g., lidocaine for arrhythmias).
- C.
To reduce the amount of drug in the plasma level.
Correct Answer
B. To achieve desired plasma levels of a drug faster (e.g., lidocaine for arrhythmias).Explanation
The goal of a "loading dose" in the optimization of dose regimen is to achieve desired plasma levels of a drug faster. This is particularly important in cases such as lidocaine for arrhythmias, where immediate action is required. By administering a higher initial dose, the drug can quickly reach therapeutic levels in the bloodstream, allowing for faster and more effective treatment. This loading dose strategy helps to achieve the desired therapeutic effect in a shorter period of time.Rate this question:
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- 20.
Loading doses can be:
- A.
A single dose
- B.
A series of doses
- C.
Neither
- D.
Both
Correct Answer
D. BothExplanation
Done to achieve desired plasma levels of a drug faster (e.g., lidocaine for arrhythmias).
Most useful for drugs that are eliminated from the body relatively slowly. Such drugs require only a low maintenance dose to keep them at a therapeutic concentration but would not be able to reach the steady state for a long time without a loading dose.Rate this question:
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- 21.
Which is NOT a disadvantage of loading doses?
- A.
Increase risk of drug toxicity
- B.
Longer time for concentration to fall if excess drug level occurs
- C.
Difficult to control the concentration once it reaches a certain point
Correct Answer
C. Difficult to control the concentration once it reaches a certain pointExplanation
Disadvantages:
Increased risk of drug toxicity
Longer time for concentration to fall if excess drug level occursRate this question:
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- 22.
What is the importance of dose adjustment?
- A.
To monitor drug concentration and correlating it with therapeutic benefits can also be helpful to individualize therapy
- B.
To have a fallback in case you overdose someone
- C.
To monitor and assess the side effects of a dose at a certain point
Correct Answer
A. To monitor drug concentration and correlating it with therapeutic benefits can also be helpful to individualize therapyExplanation
The ‘average patient’ approach overlooks interpatient variability.
Pharmacokinetic principles can be used to optimize therapy while minimizing side effects and toxicities.
Monitoring drug concentration and correlating it with therapeutic benefits can also be helpful to individualize therapyRate this question:
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- 23.
When dosages are doubled, halved, or stopped during steady-state administration, the time required to achieve a new steady-state level is ___________ of the route of administration.
- A.
Dependent
- B.
Independent
- C.
Neither
Correct Answer
B. IndependentExplanation
Graph on slide 123Rate this question:
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