Dope Op Ii

Front 1

Volume of distribution increase as body weight increases for a lipophilic drug.

Back 1

true

Front 2

Creatinine clearance is based on body weight.

Back 2

true

Front 3

An obese subject is more likely to receive an overdose than a patient with an ideal body weight for a weakly lipophilic drug given mg/kg.

Back 3

true

Front 4

Changes in drug distribution in obese subject can be the result of increased cardiac output, blood volume, and plasma or tissue binding

Back 4

true

Front 5

Oral bioavailability increases with increasing body weight

Back 5

false

Front 6

Adults have more extracellular body water than children.

Back 6

false

Front 7

How will an increase in tissue binding affect the AUC, Cmax, and half-life (t1/2) of a high-extraction drug?
A: High extraction drug: ↑ AUC, ↓ Cmax, ↓ t1/2
B: High extraction drug : ↔ AUC, ↑ Cmax, ↔ t1/2
C: High extraction drug : ↔ AUC, ↓ Cmax, ↑ t1/2
D: High extraction drug : ↓ AUC, ↔ Cmax, ↑ t1/2
E: High extraction drug: ↑ AUC, ↑ Cmax, ↓ t1/2

Back 7

C: High extraction drug : ↔ AUC, ↓ Cmax, ↑ t1/2

Front 8

Bioavailability is defined as the rate and extent to which the active ingredient is absorbed from a drug product

Back 8

true

Front 9

Bioequivalence is the presence of a significant difference in rate and extent to which the active ingredient from a pharmaceutical alternative becomes available

Back 9

false

Front 10

Bioequivalent products are therapeutically interchangeable

Back 10

true

Front 11

Bioequivalence studies are required for all strengths of a pharmaceutical alternative

Back 11

false

Front 12

Which combination of the following factors makes the serum creatinine level a good choice to estimate renal function? (choose all that are true)
1) Creatinine is endogenous
2) Creatinine is only eliminated by kidney
3) Creatinine is not bound to protein in plasma
4) Creatinine urinary excretion rate is not affected by diseases
5) Creatinine is constantly formed by muscle

Back 12

1, 2, 3, & 5

Front 13

Propranolol is a high-extraction drug and only undergoes liver metabolism. It is combined with phenobarbital. Phenobarbital is a known enzyme inducer. How would you change the dose of propranolol to account for this. Choose the best choice.
A) Increase the dose because the clearance is decreased.
B) Leave the dose the same because clearance does not significantly change.
C) Decrease the dose because clearance is increased.
D) Increase the dose because clearance is significantly increased.

Back 13

B) Leave the dose the same because clearance does not significantly change.

Front 14

What is the minimum extraction ratio for renal filtration if neither active reabsorption nor active secretion takes place? Assume renal blood flow 1200 ml/min, glomerular filtration rate (GFR) 120 ml/min, the urine flow rate 1.2 ml/min.
A) Eren = 1
B) Eren = GFR/(renal blood flow)
C) Eren = (urine flow)/(renal blood flow)
D) Eren = (urine flow)/GFR
E) Not enough information to determine.

Back 14

E) Not enough information to determine.

Front 15

A longer half-life of a drug will cause
A) a larger total body clearance.
B) more fluctuation can be expected at steady state.
C) a shorter dosing interval to maintain a certain fluctuation.
D) a longer time to reach steady state.
E) a larger volume of distribution.

Back 15

D) a longer time to reach steady state.

Front 16

Vancomycin exhibits time-dependent bacterial killing rather than concentration-dependent killing (as in aminoglycosides)

Back 16

true

Front 17

Monitor peak plasma concentrations for vancomycin efficacy rather than trough concentrations

Back 17

false

Monitor trough plasma concentrations for vancomycin efficacy. Vancomycin has slow distribution into peripheral tissues making it difficult to identify the true peak

Front 18

Vancomycin has poor absorption from GI tract

Back 18

true

Front 19

Vancomycin is 80-90% eliminated by liver

Back 19

false

Vancomycin is 80-90% eliminated by kidneys

Front 20

Vancomycin has good tissue penetration except bile, eye, noninflamed meninges

Back 20

true

Front 21

Which of the following statements on bioavailability is correct?
A) Bioavailability reflects rate and extent of absorption.
B) The FDA requires the relative bioavailability is determined from steady-state plasma levels.
C) Differences in bioavailability always lead to difference in therapeutic activity.
D) In case of chronic dosing two tablets with equal rates of bioavailability should be considered bioequivalent.
E) In case of first order kinetics comparison of the amount of unchanged drug in the urine is a proper way to determine relative bioavailability.

Back 21

A) Bioavailability reflects rate and extent of absorption.

Front 22

With aminoglycosides usally Cmax and Cmin are calculated using IV infusion equations. However, with vancomycin it is acceptable to use IV bolus equations to calculate Cmax and Cmin instead of IV infusion equations. Why is it justified to use these equations with vancomycin compared to aminoglycosides?
A) Vancomycin has a lower clearance which results in a smaller fluctuation.
B) Vancomycin has a smaller volume of distribution which results in a larger flucutation.
C) Vancomycin has a higher clearance which results in a larger half-life.
D) Vancomycin has a smaller half-life which results in a smaller fluctuation.
E) Vancomycin has a longer half-life which results in a smaller fluctuation.

Back 22

E) Vancomycin has a longer half-life which results in a smaller fluctuation.

Front 23

Which combination of the following pharmacokinetic changes best describes the elderly and neonates? (choose all that are true)

1. Low renal clearance
2. Longer half-lives
3. Low metabolic clearance
4. Decreased protein binding
5. Relatively less body water

Back 23

1, 2, 3 & 4

Front 24

Which of the following statements is FALSE based on the volume of distribution in obese patients.
A) Hydrophilic drugs display little change in the volume of distribution.
B) The volume of distribution is based on the lipophilicity of the drug.
C) Lipophilic drugs display an increase in the volume of distribution.
D) Hydrophilic drugs display a decrease in the volume of distribution per kilogram.
E) Lipophilic drugs display a decrease in the volume of distribution per kilogram.

Back 24

E) Lipophilic drugs display a decrease in the volume of distribution per kilogram.

Front 25

How will an increase in tissue binding affect the following properties of a high-extraction drug administrated through an intravenous injection?
A) ↑ AUC, ↓ Cmax, ↓ t1/2
B) ↔ AUC, ↑ Cmax, ↔ t1/2
C) ↔ AUC, ↓ Cmax, ↑ t1/2
D) ↓ AUC, ↔ Cmax, ↑ t1/2
E) ↑ AUC, ↑ Cmax, ↓ t1/2

Back 25

C) ↔ AUC, ↓ Cmax, ↑ t1/2

Front 26

Which combination of the following factors makes the serum creatinine level a good choice to estimate renal function? (choose all that are true)
1) Creatinine is endogenous
2) Creatinine is only eliminated by kidney
3) Creatinine is not binding to protein in plasma
4) Creatinine urinary excretion rate is not affected by diseases
5) Creatinine is constantly formed by muscle

Back 26

1, 2, 3, & 5

Front 27

Which statement is wrong?
A) Creatinine clearance is a measurement for kidney function.
B) Bioavailability of high extraction drugs is dependent on plasma protein binding.
C) Clearance and volume of distribution determine the half-life of a drug.
D) A multi-compartment-body model has only one volume of distribution.
E) Clearance determines steady-state plasma levels

Back 27

D) A multi-compartment-body model has only one volume of distribution.

Front 28

Which statement is wrong?
A) Renal clearance can vary with age.
B) Heart failure can have an impact on clearance.
C) Aminoglycosides are used to treat infections with both gram-positive and gram-negative pathogens.
D) Given linear pharmacokinetics, a plot of average steady-state concentration vs. dose results in a straight line.
E) AUC, Cmax and tmax are used to evaluate bioequivalence.

Back 28

E) AUC, Cmax and tmax are used to evaluate bioequivalence.

Front 29

How will an increase in tissue binding affect the clearance, bioavailability and half-life of a high-extraction drug? (5 pts)
A. Clearance is decreased, bioavailability is not changed, Half-life is increased
B. Clearance is decreased, bioavailability is not changed, Half-life is not changed
C. Clearance is not changed, bioavailability is not changed, Half-life is not changed
D. Clearance is decreased, bioavailability is increased, Half-life is increased
E. Clearance is not changed, bioavailability is not changed, Half-life is increased

Back 29

E. Clearance is not changed, bioavailability is not changed, Half-life is increased

Front 30

The dosing interval (τ ) can be greater than drug half-life if:
A) the therapeutic index of the drug is high
B) pharmacologically active metabolites of the drug have
longer half lives than the drug
C) the therapeutic effect of the drug is unrelated to plasma
concentrations
D) both A and B
E) all of the above

Back 30

E) all of the above

Front 31

What is the pharmacokinetic parameter that should be monitored for vancomycin
therapy to achieve the desired efficacy?
A. Clearance
B. AUC
C. Peak concentration
D. Trough concentration
E. Vd

Back 31

D. Trough concentration

Front 32

For bioequivalence the 90% confidence limit for AUC and Cmax must fall between 90-125%.

Back 32

false

80-125%.

Front 33

The extent to which a drug is absorbed partially determines its:
A: elimination rate
B: clearance
C: half-life
D: volume of distribution
E: bioavailability

Back 33

E: bioavailability

Front 34

Which of the following statements about body weight in pharmacokinetics are correct? (choose all that are true)
1) We can roughly assume liver and kidney function are proportional to body weight.
2) Effects of obesity on volume of distribution depend on the lipophilicity of the drug.
3) Physical and chemical properties of drugs determine the impact of body weight on pharmacokinetics.
4) In general, we should always use IBW for drug recommendations.
5) Weakly or moderately lipophilic drugs are poorly distributed in obese patients.

Back 34

1, 2, 3, & 5

Front 35

How will an increase in tissue binding affect the clearance (CL), bioavailability (F), and half-life (t1/2) of a low-extraction drug?
A: ↑ CL, ↓F, ↓ t1/2
B: ↔ CL, ↑F, ↔ t1/2
C: ↔CL, ↔ F, ↑ t1/2
D: ↓ CL, ↔ F, ↑ t1/2
E: ↑ CL, ↑ F, ↓ t1/2

Back 35

C: ↔CL, ↔ F, ↑ t1/2

Front 36

What are the two pharmacokinetic parameters that are evaluated in a bioequivalance study whose log-transformed ratios (test:reference) must pass the two one-sided test about the 90% confidence intervals?
A: Clearance and Volume of distribution
B: Clearance and AUC
C: Cmax and AUC
D: Tmax and AUC
E: AUC and half-life

Back 36

C: Cmax and AUC

Front 37

The total body water (in % of body weight) in neonates is usually smaller than in adults

Back 37

FALSE

Front 38

The glomerular filtration rate (GFR) in neonates is usually smaller than in adults

Back 38

TRUE

Front 39

Patients with an increased body weight tend to have a larger volume of distribution

Back 39

TRUE

Front 40

The effect of body weight on volume of distribution does not depend on the lipophilicity of the drug

Back 40

FALSE

Front 41

Drugs with a high octanol/water lipid partition coefficient (LPD) usually show a larger volume of distribution in obese patients

Back 41

TRUE

Front 42

The allometric body weight model can be used to convert body surface area (BSA) into total body weight (TBW)

Back 42

FALSE

Front 43

The terminal half-life of aminoglycosides is approximately 2 hours

Back 43

FALSE

Front 44

Aminoglycosides cannot pass membranes very well because of their low protein binding

Back 44

FALSE

Front 45

Regarding an aminoglycoside, an obese patient will have a higher Vd than a normal weight person, but it is not proportional to weight.

Back 45

true

Front 46

The loading dose of drugs with polar characteristics is based on TBW.

Back 46

FALSE

(based on IBW)

Front 47

Doses of compounds with high lipid partition coefficients are based on TBW.

Back 47

TRUE

Front 48

For an oral drug, it is possible that the metabolite has a shorter terminal half-life than the parent drug.

Back 48

FALSE

Front 49

In general, in bioequivalence studies blood is collected for 3 or more terminal half lives.

Back 49

TRUE

Front 50

In general, a multiple dose BE study for modified release dosage forms is not recommended.

Back 50

TRUE

Front 51

The AUC extrapolated to time infinity for the first dose is equal to steady-state AUC values over a single dosing day at steady state.

Back 51

TRUE

Front 52

In general, bioequivalence study is required for all strengths if the strengths are proportionally similar and meet dissolution profile comparison criteria.

Back 52

FALSE