PHARMACOKINETICS
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001. Pharmacokinetics is:
a) The study of biological and therapeutic effects of drugs
b) The study of absorption, distribution, metabolism and excretion of drugs
c) The study of mechanisms of drug action
d) The study of methods of new drug development
Ans: B
002. What does “pharmacokinetics” include?
a) Complications of drug therapy
b) Drug biotransformation in the organism
c) Influence of drugs on metabolism processes
d) Influence of drugs on genes
Ans: B
003. What does “pharmacokinetics” include?
a) Localization of drug action
b) Mechanisms of drug action
c) Excretion of substances
d) Interaction of substances
Ans: C
004. The main mechanism of most drugs absorption in GI tract is:
a) Active transport (carrier-mediated diffusion)
b) Filtration (aqueous diffusion)
c) Endocytosis and exocytosis
d) Passive diffusion (lipid diffusion)
Ans: D
005. What kind of substances can’t permeate membranes by passive diffusion?
a) Lipid-soluble
b) Non-ionized substances
c) Hydrophobic substances
d) Hydrophilic substances
Ans: D
006. A hydrophilic medicinal agent has the following property:
a) Low ability to penetrate through the cell membrane lipids
b) Penetrate through membranes by means of endocytosis
c) Easy permeation through the blood-brain barrier
d) High reabsorption in renal tubules
Ans: A
007. What is implied by «active transport»?
a) Transport of drugs through a membrane by means of diffusion
b) Transport without energy consumption
c) Engulf of a drug by a cell membrane with a new vesicle formation
d) Transport against a concentration gradient
Ans: D
008. What does the term “bioavailability” mean?
a) Plasma protein binding degree of substance
b) Permeability through the brain-blood barrier
c) Fraction of an uncharged drug reaching the systemic circulation following any route administration
d) Amount of a substance in urine relative to the initial dose
Ans: C
009. The reasons determining bioavailability are:
a) Rheological parameters of blood
b) Amount of a substance obtained orally and quantity of intakes
c) Extent of absorption and hepatic first-pass effect
d) Glomerular filtration rate
Ans: C
010. Pick out the appropriate alimentary route of administration when the passage of drugs through the liver is minimized:
a) Oral
b) Transdermal
c) Rectal
d) Intraduodenal
Ans: C
011. Which route of drug administration is most likely to lead to the first-pass effect?
a) Sublingual
b) Oral
c) Intravenous
d) Intramuscular
Ans: B
012. What is characteristic of the oral route?
a) Fast onset of effect
b) Absorption depends on GI tract secretion and motor function
c) A drug reaches the blood passing the liver
d) The sterilization of medicinal forms is obligatory
Ans: B
013. Tick the feature of the sublingual route:
a) Pretty fast absorption
b) A drug is exposed to gastric secretion
c) A drug is exposed to more prominent liver metabolism
d) A drug can be administrated in a variety of doses
Ans: A
014. Pick out the parenteral route of medicinal agent administration:
a) Rectal
b) Oral
c) Sublingual
d) Inhalation
Ans: D
015. Parenteral administration:
a) Cannot be used with unconscious patients
b) Generally results in a less accurate dosage than oral administration
c) Usually produces a more rapid response than oral administration
d) Is too slow for emergency use
Ans: C
016. What is characteristic of the intramuscular route of drug administration?
a) Only water solutions can be injected
b) Oily solutions can be injected
c) Opportunity for hypertonic solution injections
d) The action develops slower, than at oral administration
Ans: B
017. Intravenous injections are more suitable for oily solutions:
a) True
b) False
Ans: B
018. Correct statements listing characteristics of a particular route of drug administration include all of the following EXCEPT:
a) Intravenous administration provides a rapid response
b) Intramuscular administration requires a sterile technique
c) Inhalation provides slow access to the general circulation
d) Subcutaneous administration may cause local irritation
Ans: C
019. Most of the drugs are distributed homogeneously.
a) True
b) False
Ans: B
020. Biological barriers include all except:
a) Renal tubules
b) Cell membranes
c) Capillary walls
d) Placenta
Ans: A
021. What is the reason for the complicated penetration of some drugs through the brain-blood barrier?
a) High lipid solubility of a drug
b) Meningitis
c) Absence of pores in the brain capillary endothelium
d) High endocytosis degree in a brain capillary
Ans: C
022. The volume of distribution (Vd) relates:
a) Single to a daily dose of an administrated drug
b) An administrated dose to a body weight
c) An uncharged drug reaching the systemic circulation
d) The amount of a drug in the body to the concentration of a drug in the plasma
Ans: D
023. For the calculation of the volume of distribution (Vd) one must take into account:
a) Concentration of a substance in plasma
b) Concentration of substance in urine
c) Therapeutical width of drug action
d) A daily dose of a drug
Ans: A
024. A small amount of the volume of distribution is common for lipophylic substances easy penetrating through barriers and widely distribute in plasma, interstitial and cell fluids:
a) True
b) False
Ans: B
025. The term “biotransformation” includes the following:
a) Accumulation of substances in a fat tissue
b) Binding of substances with plasma proteins
c) Accumulation of substances in a tissue
d) Process of physicochemical and biochemical alteration of a drug in the body
Ans: D
026. Biotransformation of the drugs is to render them:
a) Less ionized
b) More pharmacologically active
c) More lipid soluble
d) Less lipid soluble
Ans: D
027. Tick the drug type for which microsomal oxidation is the most prominent:
a) Lipid soluble
b) Water soluble
c) Low molecular weight
d) High molecular weight
Ans: A
028. Pick out the right statement:
a) Microsomal oxidation always results in the inactivation of a compound
b) Microsomal oxidation results in a decrease in compound toxicity
c) Microsomal oxidation results in an increase of ionization and water solubility of a drug
d) Microsomal oxidation results in an increase in the lipid solubility of a drug thus its excretion from the organism is facilitated
Ans: C
029. Stimulation of liver microsomal enzymes can:
a) Require the dose increase of some drugs
b) Require the dose decrease of some drugs
c) Prolong the duration of the action of a drug
d) Intensify the unwanted reaction of a drug
Ans: A
030. Metabolic transformation (phase 1) is:
a) Acetylation and methylation of substances
b) Transformation of substances due to oxidation, reduction or hydrolysis
c) Glucuronide formation
d) Binding to plasma proteins
Ans: B
031. Biotransformation of a medicinal substance results in:
a) Faster urinary excretion
b) Slower urinary excretion
c) Easier distribution in the organism
d) Higher binding to membranes
Ans: A
032. Conjugation is:
a) Process of drug reduction by special enzymes
b) Process of drug oxidation by special oxidases
c) Coupling of a drug with an endogenous substrate
d) Solubilization in lipids
Ans: C
033. Which of the following processes proceeds in the second phase of biotransformation?
a) Acetylation
b) Reduction
c) Oxidation
d) Hydrolysis
Ans: A
034. Conjugation of a drug includes the following EXCEPT:
a) Glucoronidation
b) Sulfate formation
c) Hydrolysis
d) Methylation
Ans: C
035. Metabolic transformation and conjugation usually result in an increase of a substance's biological activity:
a) True
b) False
Ans: B
036. In the case of liver disorders accompanied by a decline in microsomal enzyme activity the duration of action of some drugs is:
a) Decreased
b) Enlarged
c) Remained unchanged
d) Changed insignificantly
Ans: B
037. Half-life (t ½) is the time required to:
a) Change the amount of a drug in plasma by half during the elimination
b) Metabolize half of an introduced drug into the active metabolite
c) Absorb half of an introduced drug
d) Bind half of an introduced drug to plasma proteins
Ans: A
038. Half-life (t ½) doesn’t depend on:
a) Biotransformation
b) Time of drug absorption
c) Concentration of a drug in plasma
d) Rate of drug elimination
Ans: B
039. Elimination is expressed as follows:
a) Rate of renal tubular reabsorption
b) Clearance speed of some volume of blood from a substance
c) Time required to decrease the amount of drug in plasma by one-half
d) Clearance of an organism from a xenobiotic
Ans: D
040. The elimination rate constant (Kelim) is defined by the following parameter:
a) Rate of absorption
b) Maximal concentration of a substance in plasma
c) Highest single dose
d) Half-life (t ½)
Ans: D
041. The most rapidly eliminated drugs are those with high glomerular filtration rates and actively secreted but aren’t passively reabsorbed:
a) True
b) False
Ans: A
042. Systemic clearance (CLs) is related with:
a) Only the concentration of substances in plasma
b) Only the elimination rate constant
c) Volume of distribution, half-life and elimination rate constant
d) Bioavailability and half life
Ans: C
PART II PHARMACODYNAMICS
001. Pharmacodynamics involves the study of the following EXCEPT:
a) Biological and therapeutic effects of drugs
b) Absorption and distribution of drugs
c) Mechanisms of drug action
d) Drug interactions
Ans: B
002. Pharmacodynamics involves the study of the following?
a) Mechanisms of drug action
b) Biotransformation of drugs in the organism
c) Distribution of drugs in the organism
d) Excretion of drug from the organism
Ans: A
003. Pharmacodynamics involves the following?
a) Information about the main mechanisms of drug absorption
b) Information about unwanted effects
c) Information about biological barriers
d) Information about the excretion of a drug from the organism
Ans: B
004. Pick out the answer which is the most appropriate to the term “receptor”
a) All types of ion channels modulated by a drug
b) Enzymes of oxidizing-reducing reactions activated by a drug
c) Active macromolecular components of a cell or an organism which a drug molecule has to combine with in order to elicit its specific effect
d) Carriers activated by a drug
Ans: C
005. What does “affinity” mean?
a) A measure of how tightly a drug binds to plasma proteins
b) A measure of how tightly a drug binds to a receptor
c) A measure of inhibiting potency of a drug
d) A measure of bioavailability of a drug
Ans: A
006. Target proteins to which a drug molecule binds are:
a) Only receptors
b) Only ion channels
c) Only carriers
d) All of the above
Ans: D
007. An agonist is a substance that:
a) Interacts with the receptor without producing any effect
b) Interacts with the receptor and initiates changes in cell function, producing various effects
c) Increases the concentration of another substance to produce the effect
d) Interacts with plasma proteins and doesn’t produce any effect
Ans: B
008. If an agonist can produce maximal effects and has high efficacy it’s called:
a) Partial agonist
b) Antagonist
c) Agonist-antagonist
d) Full agonist
Ans: D
009. If an agonist can produce submaximal effects and has moderate efficacy it’s called:
a) Partial agonist
b) Antagonist
c) Agonist-antagonist
d) Full agonist
Ans: A
010. An antagonist is a substance that:
a) Binds to the receptors and initiates changes in cell function, producing a maximal effect
b) Binds to the receptors and initiates changes in cell function, producing submaximal effect
c) Interacts with plasma proteins and doesn’t produce any effect
d) Binds to the receptors without directly altering their functions
Ans: D
011. A competitive antagonist is a substance that:
a) Interacts with receptors and produces submaximal effect
b) Binds to the same receptor site and progressively inhibits the agonist response
c) Binds to the nonspecific sites of tissue
d) Binds to one receptor subtype as an agonist and to another as an antagonist
Ans: B
012. The substance binding to one receptor subtype as an agonist and to another as an antagonist is called:
a) Competitive antagonist
b) Irreversible antagonist
c) Agonist-antagonist
d) Partial agonist
Ans: C
013. The irreversible interaction of an antagonist with a receptor is due to:
a) Ionic bonds
b) Hydrogen bonds
c) Covalent bonds
d) All of the above
Ans: C
014. Mechanisms of transmembrane signalling are the following EXCEPT:
a) Transmembrane receptors that bind and stimulate a protein tyrosine kinase
b) Gene replacement by the introduction of a therapeutic gene to correct a genetic effect
c) Ligand-gated ion channels that can be induced to open or close by binding a ligand
d) Transmembrane receptor protein that stimulates a GTP-binding signal transducer protein (G-protein) which in turn generates an intracellular second messenger
Ans: B
015. Tick the second messenger of the G-protein-coupled (metabotropic) receptor:
a) Adenylyl cyclase
b) Sodium ions
c) Phospholipase C
d) cAMP
Ans: D
016. Tick the substance which changes the activity of an effector element but doesn’t belong to second messenger:
a) cAMP
b) cGMP
c) G–protein
d) Calcium ions
Ans: C
017. The increase of second messengers (cAMP, cGMP, Ca2+ etc.) concentration leads to:
a) Inhibition of intracellular protein kinases and protein phosphorylation
b) Protein kinases activation and protein phosphorylation
c) Blocking of interaction between a receptor and an effector
d) Antagonism with endogenous ligands
Ans: B
018. Tick the substances whose mechanisms are based on interaction with ion channels
a) Sodium channel blockers
b) Calcium channel blockers
c) Potassium channels activators
d) All of the above
Ans: D
019. All of the following statements about efficacy and potency are true EXCEPT:
a) Efficacy is usually a more important clinical consideration than potency
b) Efficacy is the maximum effect of a drug
c) Potency is a comparative measure, that refers to the different doses of two drugs that are needed to produce the same effect
d) The ED50 is a measure of the drug’s efficacy
Ans: D
020. Give the definition of a therapeutical dose:
a) The amount of a substance to produce the minimal biological effect
b) The amount of a substance to produce effects hazardous for an organism
c) The amount of a substance to produce the required effect in most patients
d) The amount of a substance to accelerate an increase of concentration of medicine in an organism
Ans: C
021. Pick out the correct definition of a toxic dose:
a) The amount of substance to produce the minimal biological effect
b) The amount of substance to produce effects hazardous for an organism
c) The amount of substance to produce the necessary effect in most the patients
d) The amount of substance to fast creation of high concentration of medicine in an organism
Ans: B
022. Which effect may lead to toxic reactions when a drug is taken continuously or repeatedly?
a) Refractoriness
b) Cumulative effect
c) Tolerance
d) Tachyphylaxis
Ans: B
023. What term is used to describe a more gradual decrease in responsiveness to a drug, taking days or weeks to develop?
a) Refractoriness
b) Cumulative effect
c) Tolerance
d) Tachyphylaxis
Ans: C
024. What term is used to describe a decrease in responsiveness to a drug which develops in a few minutes?
a) Refractoriness
b) Cumulative effect
c) Tolerance
d) Tachyphylaxis
Ans: D
025. Tachyphylaxis is:
a) A drug interaction between two similar types of drugs
b) Very rapidly developing tolerance
c) A decrease in responsiveness to a drug, taking days or weeks to develop
d) None of the above
Ans: B
026. Drug resistance is a term used to describe the loss of effectiveness of antimicrobial or antitumour drugs. This consideration is:
a) True
b) False
Ans: A
027. Tolerance and drug resistance can be a consequence of:
a) Drug dependence
b) Increased metabolic degradation
c) Depressed renal drug excretion
d) Activation of a drug after hepatic first-pass
Ans: B
028. Tolerance and drug resistance can be a consequence of:
a) Change in receptors, loss of them or exhaustion of mediators
b) Increased receptor sensitivity
c) Decreased metabolic degradation
d) Decreased renal tubular secretion
Ans: A
029. Tolerance develops because of:
a) Diminished absorption
b) Rapid excretion of a drug
c) Both of the above
d) None of the above
Ans: D
030. Dependence is often associated with tolerance to a drug, physical abstinence syndrome, and psychological dependence (craving). This consideration is:
a) True
b) False
Ans: A
031. The situation when failure to continue administering the drug results in serious psychological and somatic disturbances is called?
a) Tachyphylaxis
b) Sensibilization
c) Abstinence syndrome
d) Idiosyncrasy
Ans: C
032. What is the type of drug-to-drug interaction which is connected with processes of absorption, biotransformation, distribution and excretion?
a) Pharmacodynamic interaction
b) Physical and chemical interaction
c) Pharmaceutical interaction
d) Pharmacokinetic interaction
Ans: D
033. What is the type of drug-to-drug interaction which is the result of interaction at receptor, cell, enzyme or organ level?
a) Pharmacodynamic interaction
b) Physical and chemical interaction
c) Pharmaceutical interaction
d) Pharmacokinetic interaction
Ans: A
034. What phenomenon can occur in the case of using a combination of drugs?
a) Tolerance
b) Tachyphylaxis
c) Accumulation
d) Synergism
Ans: D
035. If two drugs with the same effect, taken together, produce an effect that is equal in magnitude to the sum of the effects of the drugs given individually, it is called as:
a) Antagonism
b) Potentiation
c) Additive effect
d) None of the above
Ans: C
036. What does the term “potentiation” mean?
a) Cumulative ability of a drug
b) Hypersensitivity to a drug
c) Fast tolerance developing
d) Intensive increase of drug effects due to their combination
Ans: D
037. The types of antagonism are:
a) Summarized
b) Potentiated
c) Additive
d) Competitive
Ans: D
038. The term “chemical antagonism” means that:
a) two drugs combine with one another to form an inactive compound
b) two drugs combine with one another to form a more active compound
c) two drugs combine with one another to form a more water-soluble compound
d) two drugs combine with one another to form a more fat-soluble compound
Ans: A
039. A teratogenic action is:
a) Toxic action on the liver
b) Negative action on the fetus causing fetal malformation
c) Toxic action on blood system
d) Toxic action on kidneys
Ans: B
040. Characteristic unwanted reaction which isn’t related to a dose or to a pharmacodynamic property of a drug is called:
a) Idiosyncrasy
b) Hypersensitivity
c) Tolerance
d) Teratogenic action
Ans: B
041. Idiosyncratic reaction of a drug is:
a) A type of hypersensitivity reaction
b) A type of drug antagonism
c) Unpredictable, inherent, qualitatively abnormal reaction to a drug
d) Quantitatively exaggerated response
Ans: C
042. The therapeutic index (TI) is:
a) A ratio used to evaluate the safety and usefulness of a drug for an indication
b) A ratio used to evaluate the effectiveness of a drug
c) A ratio used to evaluate the bioavailability of a drug
d) A ratio used to evaluate the elimination of a drug
Ans: A