Katzung & Trevor's Pharmacology: Examination & Board Review, 11th edition TESTBANK

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INTRODUCTION 1. A 3-year-old is brought to the emergency department having just ingested a large overdose of tolbutamide, an oral antidiabetic drug. Tolbutamide is a weak acid with a pKa of 5.3. I... t is capable of entering most tissues, including the brain. On physical examination, the heart rate is 100/min, blood pressure 90/50 mm Hg, and respiratory rate 20/min. Which of the following statements about this case of tolbutamide overdose is most correct? (A) Urinary excretion would be accelerated by administration of NH4Cl, an acidifying agent (B) Urinary excretion would be accelerated by giving NaHCO3, an alkalinizing agent (C) Less of the drug would be ionized at blood pH than at stomach pH (D) Absorption of the drug would be slower from the stomach than from the small intestine (E) Hemodialysis is the only effective therapy 2. Botulinum toxin is a large protein molecule. Its action on cholinergic transmission depends on an intracellular action within nerve endings. Which one of the following processes is best suited for permeation of very large protein molecules into cells? (A) Aqueous diffusion (B) Endocytosis (C) First-pass effect (D) Lipid diffusion (E) Special carrier transport 3. A 12-year-old child has bacterial pharyngitis and is to receive an oral antibiotic. She complains of a sore throat and pain on swallowing. The tympanic membranes are slightly reddened bilaterally, but she does not complain of earache. Blood pressure is 105/70 mm Hg, heart rate 100/mm, temperature 37.8 C (100.1 F). Ampicillin is a weak organic acid with a pKa of 2.5. What percentage of a given dose will be in the lipid-soluble form in the duodenum at a pH of 4.5? (A) About 1% (B) About 10% (C) About 50% (D) About 90% (E) About 99% 4. Ampicillin is eliminated by first-order kinetics. Which of the following statements best describes the process by which the plasma concentration of this drug declines? (A) There is only 1 metabolic path for drug elimination (B) The half-life is the same regardless of the plasma concentration (C) The drug is largely metabolized in the liver after oral administration and has low bioavailability (D) The rate of elimination is proportional to the rate of administration at all times (E) The drug is distributed to only 1 compartment outside the vascular system 5. The pharmacokinetics of a new drug are under study in a phase 1 clinical trial. Which statement about the distribution of drugs to specific tissues is most correct? (A) Distribution to an organ is independent of blood flow (B) Distribution is independent of the solubility of the drug in that tissue (C) Distribution into a tissue depends on the unbound drug concentration gradient between blood and the tissue (D) Distribution is increased for drugs that are strongly bound to plasma proteins (E) Distribution has no effect on the half-life of the drug 6. The pharmacokinetic process or property that distinguishes the elimination of ethanol and high doses of phenytoin and aspirin from the elimination of most other drugs is called (A) Distribution [Show More]

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