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page 77
Pharmacology
Questions
PHARMACODYNAMICS
1.
Competitive inhibitors ________ (do/do not) resemble the substrate, while noncompetitive
inhibitors ________ (do/do not) resemble the substrate. (p. 232)
2.
The value of Km reflects the _______________ of the enzyme for its substrate. (p. 232)
3.
True or False: In enzyme kinetics, the lower the Km, the higher the affinity. (p. 232) _____________
4.
5.
A graph of substrate concentration on the x-axis and velocity of the reaction on the y-axis has
_______________ (increasing/decreasing) velocity as substrate is increased, although it will
plateau when the enzyme is saturated. (p. 232)
6.
When velocity is equal to one half of its maximum (V max), the corresponding concentration of
substrate is equal to what value? (p. 232) _____________________________________________
7.
Use the graph below to answer the following questions. (p. 232)
8.
A.
B.
C.
If the y-intercept increases, how is the maximum reaction rate affected? _________________
D.
If the x-intercept moves to the right (increases), how is the Km affected? _________________
page 78
9.
10.
11.
What is the formula for calculating a drugs volume of distribution? (p. 232) ___________________
12.
13.
What is the formula for calculating a drugs clearance? (p. 232) ____________________________
14.
15.
For a drug that is infused at a constant rate, how many half-lives must pass before the drug
reaches approximately 94% of steady-state concentration? (p. 232) ________________________
16.
Given the volume of distribution and clearance of a drug, how is the drugs half-life calculated? (p.
232) __________________________________________________________________________
17.
After one half-life, given constant intravenous infusion of a drug, how close to steady state is the
drugs concentration? How close is it after three half-lives? (p. 232) _________________________
18.
What is the formula for calculating a drugs loading dose? (p. 233) __________________________
19.
What is the formula for calculating the maintenance dose of a drug administered intravenously? (p.
233) __________________________________________________________________________
20.
How do the loading and maintenance doses of drugs differ for patients with renal or liver disease?
(p. 233) ________________________________________________________________________
21.
What is the bioavailability (%) of a drug if it is administered intravenously? (p. 233) _____________
22.
In zero-order elimination of drugs from the body, what is the relationship between the rate of
elimination and the drug concentration? (p. 233) ________________________________________
23.
Name three drugs that exhibit zero-order elimination. (p. 233) _____________________________
24.
In first-order drug elimination, what is the relationship between the rate of elimination and the drug
concentration? (p. 233) ___________________________________________________________
25.
A 24-year-old man attempts suicide by consuming the contents of a small bottle of aspirin. Three
hours later he is brought to the emergency room, where he is administered intravenous saline with
bicarbonate. By what mechanism does this help him? (p. 233) _____________________________
______________________________________________________________________________
26.
A drug that requires a very low dose to achieve its desired effect is _______________
(effective/potent). (p. 233)
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27.
The graph below shows the effects of two types of antagonists on an agonist. What type of
antagonist is represented by curve A? By curve B? (p. 234) _______________________________
28.
29.
How does the efficacy of a partial agonist relate to the efficacy of a full agonist of the same
receptor? (p. 234) ________________________________________________________________
30.
How does the potency of a partial agonist relate to the potency of a full agonist of the same
receptor? (p. 234) ________________________________________________________________
AUTONOMIC DRUGS
31.
32.
Identify the G-protein class for each receptor. (Numbers may be used more than once.) (p. 236)
_____ A. 1
_____ B. 2
_____ C. 1
_____ D. 2
_____ E. D1
_____ F. D2
_____ G. H1
_____ H. H2
_____ I. M1
_____ J. M2
_____ K. M3
_____ L. V1
_____ M. V2
33.
1. Gi
2. Gq
3. Gs
What are the major effects of 1-receptor activation? (p. 236) ______________________________
______________________________________________________________________________
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34.
What are the major functions of 2-receptor activation? (p. 236) ___________________________
______________________________________________________________________________
35.
What are the major functions of 1-receptor activation? (p. 236) ____________________________
______________________________________________________________________________
36.
What is the major effect of 2-receptor activation on the body's vasculature? What is the effect on
the respiratory system? (p. 236) _____________________________________________________
37.
How does 2-receptor activation affect glucagon release? (p. 236) __________________________
38.
In the images below, identify which autonomic drugs work at which site of action. (p. 237)
(Adapted, with permission, from Katzung BG, Trevor AJ. Pharmacology: Examination &
Board Review, 5th ed. Stamford, CT: Appleton & Lange, 1998: 42.)
39.
40.
What symptoms are likely in patients taking cholinomimetic agents? (p. 238) __________________
______________________________________________________________________________
41.
Which pharmacologic agent is used to treat atropine overdose? (p. 238) _____________________
42.
43.
A farmer presents with diarrhea, abdominal pain, wheezing, pinpoint pupils, copious tears, and
salivation. What medications should be prescribed? (p. 238) ______________________________
44.
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45.
A patient recently began taking haloperidol to treat schizophrenia, but visits his physician because
of new-onset Parkinson's-like motor symptoms. What drug could be used to treat these symptoms?
(p. 239) ________________________________________________________________________
46.
What are the two effects of atropine on the eye? (p. 239) _________________________________
47.
48.
Low doses of epinephrine are selective for _______ (1, 2, 1, 2) adrenergic receptors. (p. 240)
49.
50.
Dopamine __________ (is/is not) ionotropic and __________ (is/is not) chronotropic, whereas
dobutamine __________ (is/is not) ionotropic and __________ (is/is not) chronotropic. (p. 240)
51.
52.
What role does dopamine have in treating shock? (p. 240) ________________________________
______________________________________________________________________________
53.
54.
55.
Which sympathomimetics can reduce premature uterine contractions? (p. 240) _______________
56.
What effect does isoproterenol have on pulse pressure and heart rate? (p. 240) _______________
______________________________________________________________________________
57.
What is the effect of clonidine on central adrenergic outflow? On which receptor does it act? (p.
241) __________________________________________________________________________
58.
What is the clinical application and mechanism of action of phentolamine? (p. 241) _____________
______________________________________________________________________________
59.
What is the net effect of epinephrine on blood pressure before and after nonselective -blockade?
Why? (p. 241) ___________________________________________________________________
______________________________________________________________________________
60.
A 63-year-old man is referred long-term care after his first myocardial infarction. Is a -blocker
suggested or contraindicated for this patient? Why? (p. 242) ______________________________
______________________________________________________________________________
61.
How do -blockers work in the setting of angina pectoris? (p. 242) __________________________
______________________________________________________________________________
62.
page 82
63.
Match the specific antidote(s) with each of the toxicities. (p. 243)
_____ A. Acetaminophen
_____ B. Amphetamines
_____ C. Antimuscarinics and
anticholinergics
_____ D. Benzodiazepines
_____ E. -Blockers
_____ F. Carbon monoxide
_____ G. Copper, arsenic, gold
_____ H. Cyanide
_____ I. Digitalis
_____ J. Heparin
_____ K. Iron
_____ L. Lead
_____ M. Mercury, arsenic, gold
_____ N. Methanol, antifreeze
_____ O. Methemoglobin
_____ P. Opioids
_____ Q. Organophosphates, anticholinesterase inhibitors
_____ R. Salicylates
_____ S. TCAs
_____ T. Theophylline
_____ U. tPA, streptokinase
_____ V. Warfarin
65.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
66.
67.
Which medications can cause hemolysis in patients with G6PD deficiency? (pp. 244-245) _______
______________________________________________________________________________
68.
60.
70.
71.
72.
page 83
73.
74.
75.
Which medications can cause nephrotoxicity and ototoxicity? (pp. 244-245) __________________
______________________________________________________________________________
76.
In the chart below, checkmark which of the substances are P-450 inducers vs. inhibitors. (p. 245)
Substance
P-450 inducer
P-450 Inhibitor
78.
Which drugs must be avoided in patients with sulfa allergy? (p. 246) ________________________
______________________________________________________________________________
page 84
MISCELLANEOUS
79.
Match the drug name suffix with its category or usage. (Numbers may be used more than once) (p.
247)
_____ A.
_____ B.
_____ C.
_____ D.
_____ E.
_____ F.
_____ G.
_____ H.
_____ I.
_____ J.
_____ K.
_____ L.
_____ M.
_____ N.
_____ O.
_____ P.
_____ Q.
_____ R.
_____ S.
_____ T.
_____ U.
_____ V.
_____ W.
_____ X.
-afil
-ane
-azepam
-azine
-azole
-barbital
-caine
-cillin
-cycline
-etine
-ipramine
-navir
-olol
-operidol
-oxin
-phylline
-pril
-terol
-tidine
-triptan
-triptyline
-tropin
-zolam
-zosin
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
5-HT1B/1D agonist
1 Antagonist
ACE inhibitor
Antibiotic, protein synthesis inhibitor
Antifungal
antagonist
2 agonist
Barbiturate
Benzodiazepine
Butyrophenone (neuroleptic)
Cardiac glycoside (inotropic)
Erectile dysfunction
H2 antagonist
Inhalational general anesthetic
Local anesthetic
Methylxanthine
Penicillin
Phenothiazine
Pituitary hormone
Protease inhibitor
SSRI
TCA
Answers
PHARMACODYNAMICS
1.
Do; do not.
2.
Affinity.
3.
True.
4.
Enzyme concentration.
5.
Increasing.
6.
Km.
7.
8.
Can; cannot. This is because competitive inhibitors bind the active site of the enzyme, competing
with the substrate, whereas noncompetitive inhibitors bind elsewhere on the enzyme and so are
not affected by substrate concentration.
Copyright 2011 by MedIQ Learning, LLC
page 85
9.
10.
11.
12.
Blood alone (these drugs do not distribute outside the plasma); tissue (these drugs distribute
throughout the body).
13.
Clearance (L/min) = rate of elimination of drug (g/min) / plasma drug concentration (g/L).
14.
The time required to reduce the amount of drug in the body by one half.
15.
Four.
16.
17.
18.
19.
20.
For both diseases, the loading dose does not change, but the maintenance dose decreases.
21.
100%.
22.
23.
24.
The rate of elimination is directly proportional to the drug concentration. A constant fraction (rather
than a constant amount) is eliminated.
25.
Bicarbonate alkalinizes the lumen of the nephrons, which traps acetylsalicylic acid within the lumen
because it is a weak acid and is ionized in a basic environment.
26.
Potent.
27.
28.
Decreases.
29.
30.
A partial agonist may be more potent than, less potent than, or equally as potent as a full agonist.
AUTONOMIC DRUGS
31.
32.
A-2, B-1, C-3, D-3, E-3, F-1, G-2, H-3, I-2, J-1, K-2, L-2, M-3.
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33.
1-Receptor activation increases vascular smooth muscle contraction, as well as pupillary dilator
muscle contraction (mydriasis).
34.
35.
1-Receptor activation increases the following: heart rate and contractility; release from the
kidneys; and lipolysis of adipose tissue.
36.
Vasodilation; bronchodilation.
37.
38.
(Adapted, with permission, from Katzung BG, Trevor AJ. Pharmacology: Examination &
Board Review, 5th ed. Stamford, CT: Appleton & Lange, 1998: 42.)
39.
40.
41.
Physostigmine. It crosses the blood-brain barrier and is able to reverse effects on the CNS and the
peripheral nervous system.
42.
A test in which methacholine is inhaled to stimulate muscarinic receptors and induce bronchoconstriction. The test is used to diagnose asthma.
43.
This patient has the classic signs of organophosphate poisoning, which is treated with atropine and
pralidoxime.
44.
45.
Benztropine.
46.
page 87
47.
48.
1.
49.
1 and 2 (equally).
50.
51.
52.
53.
54.
Acute asthma.
55.
56.
57.
Clonidine is an 2-agonist that decreases central adrenergic outflow. (Remember: the 2-receptor is
responsible for negative feedback).
58.
59.
Before -blockade, epinephrine increases blood pressure. After -blockade, it decreases blood
pressure. This is because epinephrine also activates 2, which lowers blood pressure and is not
blocked.
60.
Suggested. After myocardial infarction, patients should receive -blockers to decrease risk of
mortality.
61.
They decrease heart rate and contractility as well as myocardial oxygen consumption.
62.
63.
A-12, B-15, C-18, D-9, E-10, F-1, G-19, H-17, I-21, J-20, K-6, L-5, M-7, N-8, O-11, P-16, Q-3, R-14,
S-13, T-4, U-2, V-22.
65.
66.
Thrombotic complications.
67.
68.
69.
page 88
70.
71.
72.
73.
74.
75.
76.
Substance
P-450 inducer
P-450 Inhibitor
Barbiturates
Carbamazepine
Cimetidine
Erythromycin
Grapefruit juice
Griseofulvin
Isoniazid
Ketoconazole
Phenytoin
Quinidine
Rifampin
Sulfonamides
77.
Disulfiram inhibits acetylaldehyde dehydrogenase, which breaks down acetaldehyde. Thus alcohol
consumption while taking disulfiram results in nausea, vomiting, headache, and hypotension.
78.
MISCELLANEOUS
79.
A-12, B-14, C-9, D-18, E-5, F-8, G-15, H-17, I-4, J-21, K-22, L-20, M-6, N-10, O-11, P-16, Q-3, R-7,
S-13, T-1, U-22, V-19, W-9, X-2.