Download Pharmacology Midterm Exam Questions and Answers and more Exams Nursing in PDF only on Docsity!
PTRS 855 - Midterm Exam (- Introduction to Pharmacology
- Pharmacokinetics - Pharmacodynamics - Infections - Oncological Drugs โ Blood) Questions With Complete Solutions ____________ is the study of the mechanism of action of drugs, the therapeutic and toxic effects, and the relationship between the chemical structure and its activity Correct Answers pharmacodynamics 50% Effect Level Correct Answers the dose required to produce 50% of the maximal effect A compound has to be tested on what first? Correct Answers Cells in culture A drug that binds readily to available receptors even if the concentration of drug is relatively low is said to have _______ for that receptor Correct Answers high affinity A ligand that is ________ binds to the receptor and activates it, while a ligand that is ________ will inhibit the receptor from becoming activated Correct Answers agonist; antagonist A new drug is often discovered and released to the public market without preclinical testing (animals) since the Food and Drug Administration does not require this step Correct Answers false A patient is in the process of having a heart attack due to the sudden formation of an arterial thrombus in his coronary artery.
To break up the clot and save the patient's life, the best drug to use is Correct Answers a fibrinolytic drug (e.g. streptokinase or tPA) A receptor is normally a _______? Correct Answers protein A receptor may undergo a ______ change or become ______? Correct Answers shape, phosphorylated Ability of a drug to initiate a cellular response after the drug binds to its target receptor is referred to as Correct Answers efficacy Acyclovir Correct Answers Treats herpes simplex virus and varicella-zoster virus; inhibits DNA synthesis- it requires a viral protein to activate it so it does not harm the host cell Affinity Correct Answers the drug's ability to bind to its receptor Albumin and age Correct Answers albumin decreases with age so the drug can have toxic effects if too much reaches the target tissue (rather than staying bound to albumin) Albumin and drugs Correct Answers Some drugs will be free in the blood stream and others will bind to albumin; free drugs are the ones that produce desired effects on the target tissues Alkylating drug mechanism Correct Answers exert their effect by reacting with one of the four nucleotide bases in the DNA
Anticancer Antibiotics Correct Answers They kill bacteria by becoming inserted within the DNA strand so that DNA replication or gene expression cannot take place Antifungal Agents Correct Answers amphotericin B, flucytosine, azoles Antimetabolite drugs Correct Answers Interfere with the replication of DNA by either becoming incorporated into the DNA making a nonfunctional segment, or they can slow down the activity of the enzymes involved in DNA replication so that the enzymes work less efficiently Antiviral Agents Correct Answers acyclovir, AZT, indinavir, interferons Are generic or trade name drugs more expensive? Correct Answers trade name drugs Aspirin Correct Answers anti platelet drug; blocks production of thromboxane A2 which stimulates platelet aggregation and is a potent vasoconstrictor; effective in reducing the incidence of a heart attack when given in low doses Aspirin and other antiplatelet drugs are often administered to people with angina pectoris to Correct Answers prevent coronary artery occlusion avir Correct Answers HIV protease inhibitors
Azidothymidine is a drug commonly prescribed for patients with Correct Answers HIV Azoles Correct Answers New type of antifungal drugs; important in fighting infections on a system level or tropically; broad spectrum of action including many candida types, cryptococcus, neoformans, etc; also used to treat amphotericin- resistant fungi; resistance can occur with this drug overtime Azoles are antifungal drugs that have a broad spectrum including Candida types Correct Answers true AZT (Retrovir) Correct Answers Used to fight HIV infections; a reverse transcriptase inhibitor; when used alone viral resistance occurs quickly so the drug must be taken at specific times (8 or 12 hours); side effects include myelosuppression, GI problems and headaches; less common are myopathies which may be important for those in the rehab field working with patients with HIV Bad lipid profile associated with coronary disease Correct Answers high triglyceride level, high total cholesterol level, increased LDL, and reduced HDL Bevacizumab is the antibody that binds to the vascular endothelial growth factor (VEGF) preventing angiogenesis Correct Answers true Bile acid sequestrants Correct Answers lower LDL in the blood by up to 33% within the first week; little affect of HDL (but might increase it a little); originally designed for patients with
Cancer generic names that start with a "V" Correct Answers plant alkaloids Cardiac toxicity that developed as a side effect of chemotherapy is a reversible process Correct Answers false Carrier specificity, expenditure of energy, and ability to transport substances against a concentration gradient are all characteristics of Correct Answers active transport Channel receptors Correct Answers produce an immediate reaction such as ion channels, located in the body where immediate reaction is required by the cells (neurons) Chemotherapy drug common side effects Correct Answers cardiac toxicity, pulmonary fibrosis, peripheral neuropathy, fibrosis, gastrointestinal toxicity, alopecia Chloramphenicol Correct Answers Broad spectrum of activity against both aerobic and anaerobic gram positive and gram negative bacteria (fairly toxic- typhus and rocky mountain spotted fever); binds to the ribosomes responsible for protein production in bacteria; taken orally; side effects include GI problems with diarrhea and vomiting, toxic for infants and results in gray baby fever Cholera- G protein Correct Answers keeps the signaling pathway turned on cillin Correct Answers penicillin antibiotics- bacterial infections
Clearance (CL) Correct Answers the ability of organs to eliminate drugs Clearance depends on .... Correct Answers perfusion of the organ and ability of the organ to extract the drug from the blood Clofibrate Correct Answers fibric acid derivative; used for people who don't respond to the other drugs for high triglyceride levels; it has the highest rate for gallstones and it may also cause cancer of the bile duct in the liver cycline Correct Answers tetracycline antibiotics- bacterial infections Cytokines Correct Answers large category of endogenous proteins that have regulatory capacities with the immune system; includes interferons and interleukins (stimulate immune system cell); tumor necrosis factor may be an anticancer drug; erythropoietin stimulates red blood cell production to treat anemia Daunorubicin and doxorubicin are used to treat acute leukemias Correct Answers true Desensitization Correct Answers producing a decrease in responsiveness of a cell to a drug Dilantin Correct Answers a drug that binds quickly to albumin
Drugs and their metabolites are excreted from the body primarily by Correct Answers kidneys Drugs metabolized in the liver Correct Answers caffeine, benzodiazepines, warfarin, phenytoin, antihistamines, beta- blockers drugs that end in "vir" Correct Answers antiviral drugs Drugs to boost the Immune system Correct Answers cytokines ED50 or TD50 Correct Answers the dose at which 50% of people report that they had a positive response to the drug Efficacy Correct Answers the ability of a drug to initiate a response after binding to its target Enteral route of administration Correct Answers through the GI tract (alimentary); given orally or rectally Examples of intracellular receptors Correct Answers caffeine, testosterone, estrogen, glucocorticoids, progesterone, vitamin D, thyroid hormones Examples of plasma membrane receptors Correct Answers adrenergic ligands, GABA, acetylcholine, dopamine, histamine, serotonin, adenosine, glycine, angiotensin Factors that influence absorption rate Correct Answers routes of administration, dosage forms, circulation at the site of absorption, concentration of the drug
Fibric Acid Derivates Correct Answers prescribed for high triglyceride levels; raise HDL but have little or no effect on LDL levels; risk of gallstones taking gemibrosil and fenofibrate and they can interact with other anticoagulants to cause internal bleeding Flucytosine Correct Answers Narrower spectrum of activity than Amphotericin; inhibits DNA and RNA synthesis and resistance develops to this drug rarely; typically taken in conjunction with other anti fungal meds Fluorouracil is in which category of anticancer drugs? Correct Answers antimetabolites G-protein coupled receptors Correct Answers Act as signal transducers and amplifiers in a signaling cascade Gemfibrozil Correct Answers fibric acid derivative; can treat high cholesterol levels and coronary artery disease Gentamicin Correct Answers Treats gram negative bacteria (pseudomonas aeruginosa, proteus, escherichia coli, klebsiella pneumonia, and enterobacter aerogenes); interferes with bacterial protein synthesis; intramuscularly or IV; side effect of renal function impairment; not for pregnant women Gentamicin is used as antibacterial drug because it interferes with the Correct Answers bacterial protein synthesis
In recent years, the FDA concluded that cell culture experiments became unnecessary for drug testing since computer simulation replaces this step Correct Answers False Indications of toxicity suggest that the drug is reaching lethal levels in the patients ________? Correct Answers blood Indinavir Correct Answers An inhibitor of a protease specific to HIV-1; typically given to HIV positive patients in combination with reverse transcriptase inhibitors; taken in combination it reduces the risk of the virus mutating to become resistant to one line of drug Interferons Correct Answers interfere with viral replication and signal an immune response Interferons as antiviral agents Correct Answers They are endogenous proteins that are inserted into the membrane of a cell after viral infection; blocks subsequent infection by other viral particles; when it is given to a person artificially, it inserts itself into the cell membrane and fools the invading virus leaving the impression that the cell has already been infected; used to treat hep B and C, and kaposk's sarcoma associated with HIV Interleukin-2 Correct Answers The body detects the tumor as foreign and attacks it Intracellular receptors Correct Answers in order for a drug to bind to an intracellular receptor it must either be lipid soluble so
that it can diffuse through the membrane, or it must have a specific transporter within the plasma membrane that carries the drug molecule into the cell Intrathecal administration Correct Answers a special type of injection in which the drug is injected into the subarachnoid space ipine Correct Answers calcium channel blockers Isoniazid Correct Answers Treats tuberculosis or used as a preventative measure (mycobacteria); block the synthesis of the bacterial cell wall and interfere with cellular metabolism; tablets, in syrup, injections; Toxicity- blurred vision and eye pain, difficulty breathy, and seizures; Kanamycin and neomycin Correct Answers Treats gram negative rods (escherichia coli, proteus, enterobacter aerogenes, klebsiella pneumoniae; inhibit protein synthesis in bacteria by binding directly to a ribosome and inhibiting its function; capsules or injections; toxicity- tinnitus, extreme vertigo, decreased renal clearance with increased level of blood urea nitrogen; can not be taken orally for patients with intestinal obstruction LD50 Correct Answers the dose at which 50% of people taking the drug had an adverse affect Ligand- agonist Correct Answers binds to the receptor and activates it
Most anticancer drugs exert severe and potentially toxic side effects because Correct Answers most of these drugs do not discriminate between healthy tissues and cancerous cells Most important side effect of clot busting drugs Correct Answers hemorrhage, so people with a history of internal bleeding should not be given these drugs Movement of drugs into the body Correct Answers absorption, distribution, biotransformation, excretion/elimination Nicotinic acid (Niacin or B3) Correct Answers vitamin that is found in many foods; increases HDL and lower LDL levels; inhibits the synthesis of precursors for LDL particles Nonselective binding Correct Answers at a high enough concentration, a drug will bind to something that it was not designed to bind to Nuclear receptors Correct Answers Diffuse through plasma membrane to target the nucleus olol Correct Answers betablockers Oral administration of penicillin should be done with taking meals since it may be toxic when taken on an empty stomach Correct Answers false Parenteral route of administration Correct Answers through non-alimentary routes: IV, respiratory, topical (anything by the intestines)
parin Correct Answers Heparins Parmacodynamics Correct Answers study of the mechanisms of action of the drug, therapeutic and toxicologic effects, chemical structure-activity relationship Patients who develop notable muscle pain and weakness when taking lipid lowering drugs such as atorvastatin (Lipitor) and simvastatin (Zocor) Correct Answers should be removed immediately from the drug because these symptoms may represent potentially serious myopathies Patients with hepatitis or cirrhosis of the liver will have a _____ rate of biotransformation? Correct Answers lower Penicillin Correct Answers broad spectrum of gram positive bacteria (streptocoocci, meningococci, enterococci, etc.); hinders bacterial wall synthesis; taken orally, intramuscularly, IV, or intrathecal administration; oral should not be taken with meals (amoxicillin can be taken with meals); side effects are mostly allergic reactions; toxic- convulsions in the CSF Pharmacology is based on what? Correct Answers chronic care model Pharmakinetics Correct Answers study of the factors that are involved in getting the drug to its target in the body (transported through the body)
Potency Correct Answers the dose of the drug that produces a given response Priority drugs Correct Answers a drug that is believed to present potential advances in healthcare Researchers at KU found that a new drug, PT-2015, shows LD50 of 10 mg/kg and ED50 of 0.5 mg/kg. What is the therapeutic index of PT-2015? Correct Answers 20 (LD50 / ED50 = TI50) Routes of drug administration Correct Answers enteral, parenteral Selectivity Correct Answers how much affinity an agonist has for one receptor versus another Sites of drug exposure by time Correct Answers visceral organs are first, then skeletal muscles (30 min.), then fat (1- hours) Standard drugs Correct Answers drugs that would provide minor improvements over an existing drug Statin drugs such atorvastatin (Lipitor) and simvastatin (Zocor) inhibit the HMG-CoA reductase enzyme, thereby ______ the production of _____ Correct Answers decreasing; cholesterol Statins Correct Answers inhibit cholesterol biosynthesis; decrease LDL, decrease triglyceride, increase HDL; they do this
by blocking the production of cholesterol in the liver by blocking HMG-CoA reductase which is an enzyme that is involved in the synthesis of cholesterol Sulfonamides Correct Answers Given to treat bacterial infections and are also used for diabetes mellitus, edema and gout; they inhibit bacterial synthesis of folic acid needed for synthesis of nitrogenous bases (A, C, G, T) that are used for DNA synthesis; tablets, oral, injections; side effects include anemia and leukopenia; not used for individuals who have kidney damage, pregnant or lactating women; or people with bone marrow suppression Systemic clearnace Correct Answers sum of all of the individual clearance rates from the organs and tissues Tetracyclines Correct Answers Broad spectrum gram positive and negative bacteria (chlamydiae, mycoplasmas, rickettsiae, and some protozoa and amebas); inhibit bacterial protein synthesis on the ribosomes; tables, capsule, topical, IV; side effects include nausea, vomiting, diarrhea, sore throat, hoarseness, or inflammatory lesions; Toxicity- liver Thalidomide Correct Answers Drug used in the 1950s to prevent morning sickness that was only tested on rats who were immune to the toxic effects The acetylcholine receptor located on the postsynaptic membrane of the skeletal neuromuscular junction is an example of a membrane receptor that Correct Answers functions as an ion channel or pore
