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Chapter 4: Routes of Administration and the Drug Cycle Multiple Choice Questions 1. Which of the following is NOT one of the steps involved in the drug cycle? a. absorption b. distribution c. metabolism d. secretion Answer: d. secretion Correct Feedback: Secretion is not one of the steps involved in the drug cycle. The steps include absorption, distribution, metabolism, and excretion. a. absorption Incorrect Feedback: Absorption is one of the steps involved in the drug cycle. b. distribution Incorrect Feedback: Distribution is one of the steps involved in the drug cycle. c. metabolism Incorrect Feedback: Metabolism is one of the steps involved in the drug cycle. 2. When a drug is applied directly to the skin, eyes, or ears, it is administered via the ______ route. a. oral b. sublingual c. topical d. transdermal Answer: c. topical Correct Feedback: When a drug is applied directly to the skin or to the eyes or ears, it is administered via the topical route. a. oral Incorrect Feedback: The oral route of administration is giving drugs through the mouth. b. sublingual Incorrect Feedback: The sublingual route of administration is giving drugs underneath the tongue. d. transdermal Incorrect Feedback: The transdermal route of administration is applied to the skin, but not the eyes and ears. 3. Which is the most convenient route of administration and the one most commonly used? a. injection b. oral c. rectal d. tablets Answer: b. oral Correct Feedback: The oral route of drug administration is the most convenient route of administration and the one most commonly used. a. injection Incorrect Feedback: Injection is not the most common or convenient route of administration. c. rectal Incorrect Feedback: Rectal is not the most common route of administration. d. tablets Incorrect Feedback: Tablets are a form of a drug, not a route of administration. 4. Which route of administration is chosen when the patient is vomiting and a drug cannot be given by injection? a. intradermal b. parenteral c. rectal d. sublingual Answer: c. rectal Correct Feedback: The rectal route is reserved for certain clinical situations, such as when the patient is vomiting and/or the drug cannot be given by injection. a. intradermal Incorrect Feedback: Intradermal is a type of injection. b. parenteral Incorrect Feedback: Parenteral administration includes all routes that involve injection. d. sublingual Incorrect Feedback: The sublingual administration route delivers drugs by placing them under the tongue. This cannot be done if the patient is vomiting. 5. Which of the following is NOT a part of the parenteral route of administration? a. intradermal b. intramuscular c. endotracheal d. intravenous Answer: c. endotracheal Correct Feedback: The four main types of parenteral drug administration are intradermal, subcutaneous, intramuscular, and intravenous. Endotracheal is not a parenteral route of drug administration. a. intradermal Incorrect Feedback: Intradermal is one of the parenteral routes of administration. b. intramuscular Incorrect Feedback: Intramuscular is one of the parenteral routes of administration. d. intravenous Incorrect Feedback: Intravenous is one of the parenteral routes of administration. 6. For most drug forms, absorption involved three steps. Which of the following is NOT one of the three steps of absorption? a. absorb b. disintegrate c. dissolve d. excrete Answer: d. excrete Correct Feedback: The three steps of absorption are disintegrate, dissolve, and absorb. Absorption is the first step of the drug cycle. Excrete or excretion is the final step of the drug cycle. a. absorb Incorrect Feedback: Absorb is one of the three steps of absorption. b. disintegrate Incorrect Feedback: Disintegrate is one of the three steps of absorption. c. dissolve Incorrect Feedback: Dissolve is one of the three steps of absorption. 7. The process of drug metabolism is accomplished in the __________, the principal organ of metabolism. a. intestines b. kidneys c. liver d. stomach Answer: c. liver Correct Feedback: The process of drug metabolism is accomplished in the liver, the principal organ of metabolism, by the action of liver enzymes. a. intestines Incorrect Feedback: The intestines are not the principal organ of metabolism. b. kidneys Incorrect Feedback: The kidneys are not the principal organ of metabolism. d. stomach Incorrect Feedback: The stomach is not the principal organ of metabolism. 8. An intravenous drug can be administered in three different ways. Which of the following is NOT one of the three types of intravenous drug administration? a. bolus b. I.V. piggyback c. I.V. infusion d. port Answer: d. port Correct Feedback: Intravenous administration can be done in one of three ways: bolus, I.V. infusion, I.V. piggyback. A port is a rubber stopper in the intravenous tubing. a. bolus Incorrect Feedback: A bolus is a type of intravenous drug administration. b. I.V. piggyback Incorrect Feedback: I.V. piggyback is a type of intravenous drug administration. c. I.V. infusion Incorrect Feedback: I.V. infusion is a type of intravenous drug administration. 9. Oral drugs that are in a liquid form do NOT go through which of the following steps? a. absorption b. disintegration c. dissolving d. excretion Answer: b. disintegration Correct Feedback: Tablets, capsules, suppositories, and so on, are drug forms that must first disintegrate before they can be absorbed; this step is omitted for drugs that are already in a liquid form. a. absorption Incorrect Feedback: Oral drugs in a liquid form do have to go through absorption from the stomach. c. dissolving Incorrect Feedback: Oral drugs in a liquid form do have to dissolve into the surrounding body fluids. d. excretion Incorrect Feedback: All drugs go through excretion. 10. Which method of drug administration is only used during emergency resuscitation? a. intra-articular b. intracardiac c. intravesical d. intramuscular Answer: b. intracardiac Correct Feedback: Intracardiac administration is only used during emergency resuscitation associated with cardiac arrest. a. intra-articular Incorrect Feedback: The intra-articular route is used to administer a drug into a joint once every few weeks or months, or at any time necessary. c. intravesical Incorrect Feedback: This route is used for the administration of chemotherapy drugs into the bladder to treat bladder cancer, which is not an emergency. d. intramuscular Incorrect Feedback: Intramuscular injection is into a muscle and the drug must then be absorbed; this is not suitable for an emergency. 11. Following drug administration, most drugs go through a well-defined sequence of steps before being excreted from the body. Which of the following demonstrates the correct order of those steps? a. absorption, distribution, metabolism, excretion b. distribution, metabolism, absorption, excretion c. excretion, metabolism, distribution, absorption d. metabolism, distribution, absorption, excretion Answer: a. absorption, distribution, metabolism, excretion Correct Feedback: The correct sequence is absorption, distribution, metabolism, and excretion. b. distribution, metabolism, absorption, excretion Incorrect Feedback: Absorption is out of order in this sequence. c. excretion, metabolism, distribution, absorption Incorrect Feedback: Excretion and absorption are out of order in this sequence. d. metabolism, distribution, absorption, excretion Incorrect Feedback: Absorption and distribution are out of order in this sequence. 12. Drugs given orally are absorbed from the intestines into the blood of the portal vein. Before this vein empties into the general circulation, it passed through the _____. a. intestines b. kidney c. liver d. skin Answer: c. liver Correct Feedback: Drugs given orally are absorbed through the mucous membranes of the stomach or intestines and enter the blood of the portal vein. Before this vein empties into the general circulation, it passes through the liver. a. intestines Incorrect Feedback: The portal vein does not pass through the intestines. b. kidney Incorrect Feedback: The portal vein does not pass through the kidney. d. skin Incorrect Feedback: The portal vein does not pass through the skin. 13. Patients with renal disease and elderly patients with decreased levels of kidney function due to aging are prescribed _____. a. lower doses of drugs b. higher doses of drugs c. the same dose of drugs d. different routes of administration Answer: a. lower doses of drugs Correct Feedback: Patients with renal disease and decreased kidney function are prescribed lower doses of drugs to prevent toxic symptoms due to decreased rates of drug excretion. b. higher doses of drugs Incorrect Feedback: Because of the poor renal function, higher doses of drugs would be toxic. c. the same dose of drugs Incorrect Feedback: An adjustment in the drug dose must be made for patients with renal disease and decreased kidney function. d. different routes of administration Feedback: The route of administration is not going to change the fact that the drug still has to be excreted by the kidneys. 14. The memory aid NAVEL (naloxone, atropine, Valium, epinephrine, lidocaine) helps you remember which drugs can be administered ______. a. through an endotracheal tube b. nasally c. buccally d. topically Answer: a. through an endotracheal tube Correct Feedback: Emergency drugs administered through the endotracheal route are listed in the memory aid NAVEL (naloxone, atropine, Valium, epinephrine, and lidocaine). b. nasally Incorrect Feedback: There is no memory aid to tell which drugs can be administered nasally. c. buccally Incorrect Feedback: There is no memory aid to tell which drugs can be administered buccally. d. topically Incorrect Feedback: There is no memory aid to tell which drugs can be administered topically. 15. All of the following are drugs that are given intravenously EXCEPT _____. a. chemotherapy drugs b. peritoneal dialysis fluids for patients with kidney failure c. Valium to control continuous epileptic seizures d. drugs such as thiopental (Pentothal) for the induction of general anesthesia Answer: b. peritoneal dialysis fluids for patients with kidney failure Correct Feedback: The intraperitoneal route is used to administer dialysis fluids for peritoneal dialysis in patients with kidney failure. a. chemotherapy drugs Incorrect Feedback: Chemotherapy drugs are given intravenously. c. Valium to control continuous epileptic seizures Incorrect Feedback: Valium is given intravenously. d. drugs such as thiopental (Pentothal) for the induction of general anesthesia Incorrect Feedback: thiopental (Pentothal) is given intravenously. 16. Which of these are special words related to the intravenous route of administration? a. piggyback and port b. bolus and push c. infusion and drip d. all of the above Answer: d. all of the above Correct Feedback: Bolus: The whole amount of a drug can be injected in a short period of time through a port (rubber stopper) in the IV tubing by gently pushing on the plunger of the syringe. This is often referred to as IV push. IV infusion: The drug can be injected into the fluid of a large IV bag and administered continuously over several hours. This is known as IV drip. IV piggyback: The drug can be injected into a small IV bag of fluid that is then attached (or piggybacked) onto an existing primary IV line. a. piggyback and port Incorrect Feedback: This is true, but it is not the only correct answer. b. bolus and push Incorrect Feedback: This is true, but it is not the only correct answer. c. infusion and drip Incorrect Feedback: This is true, but it is not the only correct answer. 17. Any liquid drug that can be given by the oral route can also be given by any of these routes EXCEPT _____. a. jejunostomy b. nasogastric c. transdermal d. gastrostomy Answer: c. transdermal Correct Feedback: Any liquid drug that can be given by the oral route can be given by these routes: nasogastric, gastrostomy, or jejunostomy. The transdermal route always involves a transdermal patch, not an oral liquid drug. a. jejunostomy Incorrect Feedback: A liquid drug can be given via the jejunostomy route. b. nasogastric Incorrect Feedback: A liquid drug can be given by the nasogastric route. d. gastrostomy Incorrect Feedback: A liquid drug can be given by the gastrostomy route. 18. Which of the following routes CANNOT be used to administer drugs to an unconscious patient? a. oral b. rectal c. intravenous d. none of the above Answer: a. oral Correct Feedback: The oral route cannot be used for patients who are unconscious. b. rectal Incorrect Feedback: The rectal route is used when the patient is vomiting or is unconscious. c. intravenous Incorrect Feedback: The intravenous route is used when the patient is unconscious. d. none of the above Incorrect Feedback: This is a false statement. 19. Sublingual administration of a drug involves placing it _____. a. on the skin b. under the tongue c. in the vagina d. under the skin Answer: b. under the tongue Correct Feedback: Sublingual administration involves placing the drug (usually in a tablet form) under the tongue. a. on the skin Incorrect Feedback: On the skin is topical administration. c. in the vagina Incorrect Feedback: In the vagina is vaginal administration. d. under the skin Incorrect Feedback: Under the skin is intradermal administration. 20. Which of the following drugs is given by subcutaneous injection? a. insulin for diabetes mellitus b. heparin c. allergy shots d. all of the above Answer: d. all of the above Correct Feedback: Examples of drugs given via the subcutaneous route include insulin for diabetes mellitus, allergy shots, and heparin. a. insulin for diabetes mellitus Incorrect Feedback: This is true, but it is not the only correct answer. b. heparin Incorrect Feedback: This is true, but it is not the only correct answer. c. allergy shots Incorrect Feedback: This is true, but it is not the only correct answer. 21. Which route of administration is commonly abbreviated as PO? a. oral b. parenteral c. rectal d. inhalation Answer: a. oral Correct Feedback: The oral route is routinely abbreviated as PO or p.o. (Latin for per os, meaning through the mouth). b. parenteral Incorrect Feedback: There is no official abbreviation for the parenteral route. c. rectal Incorrect Feedback: There is no official abbreviation for the rectal route. d. inhalation Incorrect Feedback: There is no official abbreviation for the inhalation route. 22. Parenteral administration of a drug commonly includes all of the following routes EXCEPT _____. a. intramuscular b. intravenous c. oral d. subcutaneous Answer: c. oral Correct Feedback: Parenteral administration theoretically includes all routes of administration other than the oral route; but in clinical usage, parenteral administration commonly includes these routes: intradermal, subcutaneous, intramuscular, and intravenous. a. intramuscular Incorrect Feedback: The parenteral route includes intramuscular administration. b. intravenous Incorrect Feedback: The parenteral route includes intravenous administration. d. subcutaneous Incorrect Feedback: The parenteral route includes subcutaneous administration. 23. The first-pass effect describes the _____. a. metabolism of drugs by the stomach b. metabolism of drugs by the liver c. absorption of drugs by the stomach d. excretion of drugs by the kidneys Answer: b. metabolism of drugs by the liver Correct Feedback: This initial metabolism by the liver is referred to as the firstpass effect, because the drug must first pass through the liver before it can enter the general circulation to exert a systemic effect. a. metabolism of drugs by the stomach Incorrect Feedback: The first-pass effect does not involve the stomach. c. absorption of drugs by the stomach Incorrect Feedback: The first-pass effect does not involve the stomach. d. excretion of drugs by the kidneys Incorrect Feedback: The first-pass effect does not involve the kidneys. 24. Which of the following statements is FALSE? a. Different forms of a drug are appropriate for different routes of administration. b. Intradermal injection injects the drug into the subcutaneous fat. c. Some drugs are ineffective when administered by a certain route. d. Drugs may seriously injury the patient if administered by the wrong route. Answer: b. Intradermal injection injects the drug into the subcutaneous fat. Correct Feedback: Intradermal administration involves using a syringe to inject a liquid drug into the dermis, the layer of skin just below the epidermis or skin surface. a. Different forms of a drug are appropriate for different routes of administration. Incorrect Feedback: This statement is true. c. Some drugs are ineffective when administered by a certain route. Incorrect Feedback: This statement is true. d. Drugs may seriously injury the patient if administered by the wrong route. Incorrect Feedback: This statement is true. 25. Which of the following statements is FALSE? a. Each route of administration has distinct advantages and disadvantages. b. Tablets, capsules, and liquids can all given orally. c. When you are administering a topical drug, as you face the patient, your righthand side corresponds to the patient’s right-hand side. d. Topical ophthalmic ointment is specially formulated to be nonirritating to the eye; it is not interchangeable with topical ointments used on the skin. Answer: c. When you are administering a topical drug, as you face the patient, your righthand side corresponds to the patient’s right-hand side. Correct Feedback: When you are administering a topical drug to a patient, remember that, as you face the patient, your right-hand side corresponds to the patient’s left-hand side. a. Each route of administration has distinct advantages and disadvantages. Incorrect Feedback: This statement is true. b. Tablets, capsules, and liquids can all given orally. Incorrect Feedback: This statement is true. d. Topical ophthalmic ointment is specially formulated to be nonirritating to the eye; it is not interchangeable with topical ointments used on the skin. Incorrect Feedback: This statement is true. 26. Which of the following statements is FALSE? a. A tuberculin syringe is calibrated in units. b. When an intradermal injection is positioned correctly, the tip of the needle is still visible through the epidermis. c. An intramuscular injection is placed in the belly (area of greatest mass) of the muscle. d. Drugs injected intramuscularly are absorbed more quickly than with subcutaneous administration. Answer: a. A tuberculin syringe is calibrated in units. Correct Feedback: The tuberculin syringe is calibrated to measure liquid drug doses to the hundredth of a milliliter (mL). b. When an intradermal injection is positioned correctly, the tip of the needle is still visible through the epidermis. Incorrect Feedback: This is a true statement. c. An intramuscular injection is placed in the belly (area of greatest mass) of the muscle. Incorrect Feedback: This statement is true. d. Drugs injected intramuscularly are absorbed more quickly than with subcutaneous administration. Incorrect Feedback: This is a true statement. 27. All of the following are accepted sites for an intramuscular injection in adults EXCEPT _____. a. ventrogluteal b. subcutaneous c. deltoid d. dorsogluteal Answer: b. subcutaneous Correct Feedback: Subcutaneous administration involves using a syringe to inject a liquid drug into the subcutaneous tissue (the fatty layer of tissue just beneath the dermis of the skin but above the muscle layer). a. ventrogluteal Incorrect Feedback: This is an accepted intramuscular injection site. c. deltoid Incorrect Feedback: This is an accepted intramuscular injection site. d. dorsogluteal Incorrect Feedback: This is an accepted intramuscular injection site. 28. All of the following drugs are administered topically EXCEPT ______. a. nitroglycerin tablets or spray b. antibiotic ointment for a skin injury c. timoptic eye drops for glaucoma d. antibiotic drops for an ear infection Answer: a. nitroglycerin tablets or spray Correct Feedback: Drugs given by the sublingual route provide a faster therapeutic effect than those given by the oral route (e.g., nitroglycerin tablets and spray for treating angina attacks). b. antibiotic ointment for a skin injury Incorrect Feedback: This is an example of a topical drug. c. timoptic eye drops for glaucoma Incorrect Feedback: This is an example of a topical drug. d. antibiotic drops for an ear infection Incorrect Feedback: This is an example of a topical drug. 29. Which of the following drugs is manufactured as a transdermal patch? a. Serevent, a bronchodilator drug for asthma b. Monistat for a yeast infection c. synthetic lung surfactant to treat respiratory distress in premature infants d. Nicoderm CQ to stop smoking Answer: d. Nicoderm CQ to stop smoking Correct Feedback: A transdermal patch is worn on the skin and releases the drug slowly over one to two days, providing sustained therapeutic blood levels (e.g., Nicoderm CQ patch to stop smoking). a. Serevent, a bronchodilator drug for asthma Incorrect Feedback: Serevent comes as a powder, not as a transdermal patch. b. Monistat for a yeast infection Incorrect Feedback: Monistat comes as a cream, not a transdermal patch. c. synthetic lung surfactant to treat respiratory distress in premature infants Incorrect Feedback: Surfactant is given via an endotracheal tube. 30. When a drug is given by inhalation, it is absorbed ________. a. through the stomach and intestine b. through the nasal cavity c. through the alveoli of the lungs d. through the breast milk Answer: c. through the alveoli of the lungs Correct Feedback: Inhalation: This route of administration involves the inhaling of a drug that is in a gas, liquid, or powder form. The drug is absorbed through the alveoli of the lungs. a. through the stomach and intestine Incorrect Feedback: Oral drugs, not inhaled drugs, are absorbed through the stomach and intestine. b. through the nasal cavity Incorrect Feedback: Drugs given by the nasal route, not inhaled drugs, are absorbed in the nasal cavity. d. through the breast milk Incorrect Feedback: Drugs are excreted in the breast milk, and this is not related to drugs given by inhalation. 31. Drugs that are not absorbed after oral administration _______ . a. are metabolized in the stomach b. can be used to treat conditions in the stomach or intestine c. are not therapeutically effective d. are excreted in the urine Answer: b. can be used to treat conditions in the stomach or intestine Correct Feedback: Some drugs are not absorbed at all following oral administration (e.g., neomycin, an antibiotic drug). However, nonabsorption of a drug via the oral route can also be turned into a therapeutic advantage. For example, neomycin can be given orally to exert its antibiotic effect solely in the intestinal tract to kill intestinal bacteria prior to abdominal surgery. a. are metabolized in the stomach Incorrect Feedback: The stomach is not the site of drug metabolism. c. are not therapeutically effective Incorrect Feedback: Drugs not absorbed after oral administration can be therapeutically effective. d. are excreted in the urine Incorrect Feedback: Drugs that are not absorbed never enter the blood and so can never become part of the urine and excreted. 32. Drug doses for an elderly patient are decreased because of the patient’s decreased _______. a. need for medication b. activity levels c. mental ability to administer correct doses d. liver and kidney function Answer: d. liver and kidney function Correct Feedback: Patients with renal disease and elderly patients with decreased levels of kidney function due to aging are prescribed lower doses of drugs to prevent toxic symptoms due to decreased rates of drug excretion. a. need for medication Incorrect Feedback: Elderly patients usually have an increased need for medication, not a decreased need. b. activity levels Incorrect Feedback: A decreased activity level is not directly related to drug doses for an elderly person. c. mental ability to administer correct doses Incorrect Feedback: Drug doses are not decreased for an elderly person just because they have a decreased mental ability. 33. Drugs circulate in the blood bound to _______. a. red blood cells b. white blood cells c. albumin d. plasma Answer: c. albumin Correct Feedback: As a drug enters the blood, some of the drug binds to circulating plasma proteins, such as albumin. These large molecules have indentations in their molecular surfaces that permit drug molecules to bind to them. a. red blood cells Incorrect Feedback: Drugs do not bind to red blood cells. b. white blood cells Incorrect Feedback: Drugs do not bind to white blood cells. d. plasma Incorrect Feedback: Plasma is a liquid and does not bind to drugs. 34. All of the following drugs are given via the rectal route of administration EXCEPT _____. a. Monistat cream for a yeast infection b. Tylenol suppositories for a fever c. Anusol cream for hemorrhoids d. Proctofoam-HC for ulcerative colitis Answer: a. Monistat cream for a yeast infection Correct Feedback: The vaginal route is used to treat vaginal infections by means of creams, ointments, and suppositories (e.g., Monistat vaginal cream or suppositories for a yeast infection). b. Tylenol suppositories for a fever Incorrect Feedback: This drug is given by rectal administration. c. Anusol cream for hemorrhoids Incorrect Feedback: This drug is given by rectal administration. d. Proctofoam-HC for ulcerative colitis Incorrect Feedback: This drug is given by rectal administration. 35. An equivalent word for metabolism is _____. a. biotransformation b. metabolite c. distribution d. parenteral Answer: a. biotransformation Correct Feedback: The process of metabolism is also known as biotransformation because the drug is gradually transformed or metabolized from its original active form to a less active, or even inactive, form. b. metabolite Incorrect Feedback: A metabolite is what results after metabolism takes place. c. distribution Incorrect Feedback: Distribution concerns a different step in the drug cycle than that of metabolism. d. parenteral Incorrect Feedback: Parenteral is a route of administration and is not part of the drug cycle. 36. The intravesical route of administration is used to administer chemotherapy drugs into the ____. a. lungs b. peritoneum c. spinal cord d. bladder Answer: d. bladder Correct Feedback: The intravesical route is used for the administration of chemotherapy drugs into the bladder to treat bladder cancer. a. lungs Incorrect Feedback: The intravesical route is not in the lungs. b. peritoneum Incorrect Feedback: The intravesical route is not in the peritoneum. c. spinal cord Incorrect Feedback: The intravesical route is not in the spinal cord. 37. Only drugs given by _____ administration entirely bypass the step of absorption. a. endotracheal b. subcutaneous c. oral d. intravenous Answer: d. intravenous Correct Feedback: Only intravenous injections entirely bypass the step of absorption because the drug is administered directly into a vein and immediately enters the blood. a. endotracheal Incorrect Feedback: Drugs given by an endotracheal tube must still be absorbed from the lungs into the blood. b. subcutaneous Incorrect Feedback: Drugs given by the subcutaneous route must still be absorbed from the fatty tissue into the blood. c. oral Incorrect Feedback: Drugs given by oral route must still be absorbed from the intestine into the blood. 38. As a drug leaves the blood and moves through all the body tissues, it comes in contact with ______. a. receptors b. the blood-brain barrier c. placenta d. all of the above Answer: a. receptors Correct Feedback: When a drug moves into body tissues, its molecules come in contact with cell membranes and exert an effect by interacting with one or more receptors. b. the blood-brain barrier Incorrect Feedback: The blood-brain barrier is not in all the body tissues. c. placenta Incorrect Feedback: The placenta is only present in pregnant women. d. all of the above Incorrect Feedback: Only one of these is true, not all of them. 39. Chronotherapy coordinates the administration of a drug to the body’s sense of need. Answer: False Feedback: Chronotherapy is a method of drug therapy that attempts to coordinate the administration and metabolism of a drug to the body’s own biological rhythms. 40. Before a drug can receive final approval by the FDA, the drug company must clearly state what routes of administration have been found to be safe and effective. Answer: True Feedback: Before a drug can receive final approval by the FDA, the drug company must clearly state what routes of administration have been found to be safe and effective for that drug. 41. A drug will be effective and therapeutic, regardless of the route by which it is administered. Answer: False Feedback: A drug given by the recommended route of administration will be therapeutic; if given by another route, it may be ineffective, harmful, or even fatal. 42. Some drugs are approved for use via more than one route and are manufactured in different drug forms appropriate for those different routes. Answer: True Feedback: Some drugs are approved for use via more than one route and are manufactured in different drug forms appropriate for those different routes. 43. The topical route of administration of drugs has a systemic effect on the body. Answer: False Feedback: The therapeutic effect of a topical drug only extends to the local area. 44. The sublingual route of drug administration provides a faster therapeutic effect than the oral route. Answer: True Feedback: Drugs given by the sublingual route provide a faster therapeutic effect than those given by the oral route. 45. While the nasal administration of a drug is done topically, some nasal spray drugs act systemically throughout the body. Answer: True Feedback: Nasal administration involves spraying a drug into the nasal cavity. This is usually done topically to treat allergy symptoms of nasal stuffiness, but some nasal spray drugs act systemically throughout the body. 46. The inhalation route of drug administration involves the inhaling of a drug that is in a gas, liquid, or powder form. Answer: True Feedback: The inhalation route of administration involves the inhaling of a drug that is in a gas, liquid, or powder form. 47. Systemic absorption of a drug via the rectal route of administration is slow and often unpredictable. Answer: True Feedback: Systemic absorption of a drug via the rectal route of administration is slow and often unpredictable, so this route is not used often. 48. Although other organs are involved to a limited degree, the principal organ of drug excretion is the kidney. Answer: True Feedback: The principal organ of drug excretion is the kidney, although other organs are involved to a limited degree. 49. Parenteral administration theoretically includes all routes of administration other than the oral route. Answer: True Feedback: Parenteral administration theoretically includes all routes of administration other than the oral route. 50. The therapeutic effect of a drug given intravenously takes awhile to be seen in the body as it has to travel through the systemic circulation. Answer: False Feedback: The therapeutic effect of a drug given intravenously is often seen immediately. This is because the drug does not need to be absorbed from tissue, muscle, or the stomach before it can exert its effect. 51. Only intravenous injections entirely bypass the step of absorption because the drug is administered directly into a vein and immediately enters the blood. Answer: True Feedback: The intravenous route entirely bypasses the step of absorption. 52. The umbilical route is used to administer intravenous fluids and draw blood, but is not generally used to give drugs. Answer: True Feedback: The umbilical route is used to administer intravenous fluids and draw blood. It is generally not used to give drugs. 53. Pregnant women are advised to only take drugs that are prescribed by their healthcare provider. Answer: True Feedback: Pregnant women are advised not to take any drugs, even over-the-counter drugs, except those prescribed by a healthcare provider. 54. Absorption involves the movement of a drug from the site of administration through the tissues and into the blood. Answer: True Feedback: Absorption involves the movement of a drug from the site of administration through tissues and into the blood. 55. The blood-brain barrier is a protective barrier between the brain and the capillary walls of blood vessels around the brain, and no drug can penetrate this barrier. Answer: False Feedback: Some drugs are able to pass through the blood-brain barrier and exert a therapeutic effect. 56. Each year, many infants are born addicted to drugs that their mothers took, or they are born with birth defects due to the action of drugs taken by their mothers. Answer: True Feedback: Each year, many infants are born addicted to drugs that their mothers took, or they are born with birth defects due to the action of drugs taken by their mothers. 57. The names Broviac, Hickman, and Groshong are all associated with types of endotracheal tubes. Answer: False Feedback: A central venous line is a special catheter (Broviac, Hickman, or Groshong) tunneled through the subcutaneous tissue of the upper chest, inserted into a large vein, and advanced until its tip is positioned in the superior vena cava. 58. The intra-articular route of administration is used to administer a chemotherapy drug directly into the area of a cancerous tumor. Answer: False Feedback: The intra-arterial route is used for administration of a chemotherapy drug directly into the area of a cancerous tumor. For intra-articular administration, the drug is given into a joint. 59. Following topical administration of a drug, the drug form does not need to undergo disintegration as it quickly dissolves in the tissue fluids of the skin. Answer: True Feedback: Following topical administration of a drug, the drug form does not need to undergo disintegration; it quickly dissolves in the tissue fluids of the skin. 60. The presence or absence of food in the GI tract can reduce the absorption of a drug from 30 percent to as much as 80 percent. Answer: True Feedback: The presence or absence of food (particularly a large or fatty meal) can influence the rate of drug absorption. The presence of food in the GI tract can reduce absorption of a drug from 30 percent to as much as 80 percent. 61. Once a drug is administered, it goes through the four steps of the __________. Answer: drug cycle Feedback: Following administration, most drugs go through a welldefined sequence of four steps before leaving the body. These steps are known as the drug cycle. 62. The _________ route of administration differs from the topical route in that the drug is applied to the skin, but the therapeutic effects are felt systemically, not just at the site of administration. Answer: transdermal Feedback: The transdermal route of administration differs from the topical route in that the drug is applied to the skin, but the therapeutic effects are felt systemically and not just at the site of administration. 63. The oral route of drug administration is abbreviated ____ or ____. Answer: PO; p.o. Feedback: The oral route of drug administration is abbreviated as PO or p.o. (Latin for per os, meaning through the mouth). 64. ________ administration involves placing the drug under the tongue and allowing it to slowly dissolve. Answer: Sublingual Feedback: Sublingual administration involves placing the drug under the tongue and allowing it to disintegrate slowly. 65. __________ administration involves placing the drug in the pocket between the cheek and the lower teeth on one side of the mouth and allowing it to slowly dissolve. Answer: Buccal Feedback: Buccal administration involves placing the drug in the pocket between the cheek and the lower teeth on one side of the mouth and allowing it to disintegrate slowly. 66. ________ is the study of how drugs move through the body in the process of absorption, distribution, metabolism, and excretion. Answer: Pharmacokinetics Feedback: Pharmacokinetics is the study of how drugs move through the body in the process of absorption, distribution, metabolism, and excretion. 67. As a drug enters the blood, some of the drug binds to circulating plasma proteins, such as ______. Answer: albumin Feedback: As the drug enters the blood, some of the drug binds to circulating plasma proteins, such as albumin. 68. The process of metabolism is also known as _______ because the drug is gradually transformed or metabolized from its original active form to a less active, or even inactive, form. Answer: biotransformation Feedback: The process of metabolism is also known as biotransformation because the drug is gradually transformed or metabolized from its original active form to a less active, or even inactive, form. 69. Some drugs are actually administered in an inactive form and remain inactive until they are metabolized. This type of drug is classified as a ________. Answer: prodrug Feedback: Some drugs are actually administered in an inactive form and remain inactive until they are metabolized. This type of drug is classified as a prodrug. 70. Give the medical abbreviation for each of these medical words or phrases. Intramuscular ______________ Intravenous _______________ Subcutaneous ______________ Right eye ____________ Left ear _____________ Both eyes ____________ Answer: IM or I.M.; IV or IV; subQ or SQ or subcu; O.D.; A.S.; O.U. Feedback: The word intramuscular is abbreviated as either IM or I.M. The word intravenous is abbreviated as either IV or IV The subcutaneous route is abbreviated as subQ, SQ, or subcu; there is no one official abbreviation. O.D., oculus dexter means right eye. A.S., auris sinistra means left ear. O.U., oculus unitas means both eyes. Matching Questions 71. 1. intradermal A. apart from the intestine 2. intramuscular B. below; underneath the skin 3. intravenous C. within the muscle 4. parenteral D. within the skin 5. subcutaneous E. within the vein Answer: D Answer: C Answer: E Answer: A Answer: B Feedback: The word intradermal means pertaining to within the skin. The word intramuscular means pertaining to within the muscle. The word intravenous means pertaining to within the vein. The word parenteral means apart from the intestine. The word subcutaneous means pertaining to underneath the skin. 72. 1. A.D. A. both ears 2. A.S. B. left ear 3. A.U. C. left eye 4. O.D. D. right ear 5. O.S. E. right eye Answer: D Answer: B Answer: A Answer: E Answer: C Feedback: 73. List three disadvantages associated with the oral route of drug administration. Answer: 1. It is difficult for some patients to swallow the largest tablets and capsules. 2. The oral route cannot be used for patients who are unconscious or vomiting. 3. Some drugs are inactivated by stomach acid and cannot be given orally. 4. Some drugs cannot be taken with certain foods and beverages because they combine chemically to form an insoluble complex. 5. Some drugs cannot be taken with certain foods because they produce severe side effects. 74. Briefly explain the difference between water-soluble and fat-soluble drugs. Answer: Water-soluble drugs can be excreted in the urine, while fatsoluble drugs are attracted to the lipid structures of the renal tubules. The fat-soluble drugs return to the blood where it is further metabolized by the liver into a more watersoluble form that can be excreted in the urine. 75. Some drugs are not absorbed at all following oral administration. However, nonabsorption of a drug via the oral route can be turned into a therapeutic advantage. Give an example and explain why. Answer: Neomycin can be given orally to exert its antibiotic effect solely in the intestinal tract to kill intestinal bacteria prior to abdominal surgery. Carafate, an antiulcer drug, is not absorbed following oral administration, but that is acceptable because its therapeutic effect is to bind directly to a stomach ulcer and form a protective coating so that it can heal. Metamucil is also not absorbed, but passes through the intestines where it binds with water to increase stool bulk and exert its therapeutic effect to relieve constipation. 76. Explain how to administer a liquid drug to an infant. Answer: For oral administration of a drug to an infant, the liquid drug is mixed with a small amount of formula and given orally through the nipple which has been removed from the bottle of formula. Test Bank for Understanding Pharmacology for Health Professionals Susan M. Turley 9780135145708, 9780133911268
