CH-5 Using Drugs Therapeutically – Understanding Pharmacology for Health Professionals : Exam Guide

Chapter 5: Using Drugs Therapeutically 1. A drug that is able to unlock or activate a receptor and produce an effect is known as a/an _____. a. agonist b. antagonist c. blocker d. synergist Answer: a. agonist Correct Feedback: A drug that is able to unlock or active a receptor and produce an effect is known as an agonist. b. antagonist Incorrect Feedback: Antagonists (blockers) are drugs that can fit a receptor, but cannot actually unlock or activate the receptor. c. blocker Incorrect Feedback: Antagonists (blockers) are drugs that can fit a receptor, but cannot actually unlock or activate the receptor. d. synergist Incorrect Feedback: Synergism occurs when two drugs combine to produce an effect that is greater than the independent effect of each drug. 2. A drug’s main action for which it was prescribed by the physician or other healthcare provider is known as a/an ____. a. adverse effect b. drug reaction c. side effect d. therapeutic effect Answer: d. therapeutic effect Correct Feedback: The therapeutic effect is the drug’s main action for which it was prescribed by the physician or other healthcare provider. a. adverse effect Incorrect Feedback: The drug’s main action is not known as an adverse effect. b. drug reaction Incorrect Feedback: The drugs main action is not known as a drug reaction. c. side effect Incorrect Feedback: The drug’s main action is not known as a side effect. 3. A toxic effect of a drug results when _____. a. the drug company does not perform clinical trials for that drug b. the physician decreases the drug dose in elderly patients c. the serum level of a drug is below the therapeutic level d. the serum level of a drug rises above the therapeutic level Answer: d. the serum level of a drug rises above the therapeutic level Correct Feedback: Toxic effects result when the serum level of a drug rises above therapeutic level to a higher level that is toxic. a. the drug company does not perform clinical trials for that drug Incorrect Feedback: The drug company performs clinical trials to discover any toxic effects of a drug. b. the physician decreases the drug dose in elderly patients Incorrect Feedback: A toxic effect is not the result of decreasing the dose; it is the reason the dose was decreased. c. the serum level of a drug is below the therapeutic level Incorrect Feedback: A toxic effect does not result because the serum level is below the therapeutic level. 4. Which of the following increases the likelihood of a drug-drug interaction? a. pharmacogenetics b. polypharmacy c. side effects d. therapeutic effects Answer: b. polypharmacy Correct Feedback: Polypharmacy occurs because many patients take both prescription and several over-the-counter drugs of their own choice. a. pharmacogenetics Incorrect Feedback: Pharmacogenetics is the study of how the genetic makeup of different people affects their response to certain drugs, not drug-drug interactions. c. side effects Incorrect Feedback: A drug’s side effects do not increase the likelihood of a drug-drug interaction. d. therapeutic effects Incorrect Feedback: A drug’s therapeutic effect does not increase the likelihood of a drug-drug interaction. 5. Adrenergic receptors include ______. a. alpha1 and alpha2 receptors b. beta1 and beta2 receptors c. alpha1, alpha2, beta1, and beta2 receptors d. H1 and H2 receptors Answer: c. alpha1, alpha2, beta1, and beta2 receptors Correct Feedback: Adrenergic receptors include alpha1 and alpha2, as well as beta1 and beta2 receptors. a. alpha1 and alpha2 receptors Incorrect Feedback: This is true, but it is not the only correct answer. b. beta1 and beta2 receptors Incorrect Feedback: This is true, but it is not the only correct answer. d. H1 and H2 receptors Incorrect Feedback: Histamine receptors are not adrenergic receptors. 6. A list of the common side effects of a new drug is developed ______. a. after a new drug is prescribed b. when a new drug is reported c. after a drug is approved by the FDA d. as a new drug is being tested Answer: d. as a new drug is being tested Correct Feedback: A list of common side effects of a drug is developed as a new drug is tested. This is part of the clinical trial phase. a. after a new drug is prescribed Incorrect Feedback: The list of side effects is developed before a new drug is prescribed. b. when a new drug is reported Incorrect Feedback: This is nonspecific. Reports on drugs are given during clinical trials as well as after they are approved to be marketed. c. after a drug is approved by the FDA Incorrect Feedback: The list of side effects is developed before a new drug is approved by the FDA. 7. The presence of an antigen combined with an antibody stimulates the release of _______, which produces mild-to-severe allergic symptoms, depending on the amount released. a. acetylcholine b. epinephrine c. histamine d. norepinephrine Answer: c. histamine Correct Feedback: An allergy is a reaction that occurs when the body's immune system identifies a foreign substance (antigen), such as a drug, and antibodies combine with it and release histamine. a. acetylcholine Incorrect Feedback: Acetylcholine, a neurotransmitter of the parasympathetic division of the nervous system, activates cholinergic receptors. It is not involved in an allergic reaction. b. epinephrine Incorrect Feedback: Epinephrine, a neurotransmitter of the sympathetic division of the nervous system, activates adrenergic receptors. It is not involved in an allergic reaction. d. norepinephrine Incorrect Feedback: Norepinephrine, a neurotransmitter of the sympathetic division of the nervous system, activates adrenergic receptors. It is not involved in an allergic reaction. 8. The ______ measurement system for drug doses includes the minim, grain, scruple, and dram. a. apothecary b. drops c. metric d. units Answer: a. apothecary Correct Feedback: The apothecary measurement for drug doses includes the minim, grain, scruple, and dram. b. drops Incorrect Feedback: Drops are a drug measurement, but are not included with the minim, grain, scruple, and dram. c. metric Incorrect Feedback: The metric measurement system does not include the minim, grain, scruple, and dram. d. units Incorrect Feedback: Units are a drug measurement, but are not included with the minim, grain, scruple, and dram. 9. Which measurement system is officially known as the International System of Units (SI)? a. apothecary b. drops c. metric d. units Answer: c. metric Correct Feedback: The metric system is officially known as the International System of Units (SI). a. apothecary Incorrect Feedback: The apothecary system is not known by any other name. b. drops Incorrect Feedback: The drops measurement is not known by any other name. d. units Incorrect Feedback: The unit measurement is not known by any other name. 10. When a cube is formed that is 1 centimeter long on each side, it becomes a measurement of volume that is abbreviated as ____. a. cm b. mg c. kg d. cc Answer: d. cc Correct Feedback: When a cube is formed that is one centimeter long on each side, it becomes a measurement of volume known as a cubic centimeter (cm3 or cc). a. cm Incorrect Feedback: The abbreviation cm means centimeter, a measure of length, not volume. b. mg Incorrect Feedback: The abbreviation mg means milligram, a measure of weight, not volume. c. kg Incorrect Feedback: The abbreviation kg means kilogram, a measure of weight, not volume. 11. The abbreviation used to designate the measurement of drops is ____. a. cm b. gtt c. mEq d. mL Answer: b. gtt Correct Feedback: The Latin word for drops is guttae, and the abbreviation is gtt. a. cm Incorrect Feedback: The abbreviation cm stands for centimeter, not drops. c. mEq Incorrect Feedback: The abbreviation mEq stands for milliequivalent, not drops. d. mL Incorrect Feedback: The abbreviation mL stands for milliliter, not drops. 12. Receptors are specifically designed to interact with natural body chemicals. Which of the following is NOT one of those natural body chemicals? a. enzymes b. hormones c. neurotransmitters d. proteins Answer: d. proteins Correct Feedback: Receptors are specifically designed to interact with natural body chemicals (hormones, enzymes, neurotransmitters), but they can also interact with drugs. Proteins are not part of this group. a. enzymes Incorrect Feedback: Enzymes are natural body chemicals that interact with receptors. b. hormones Incorrect Feedback: Hormones are natural body chemicals that interact with receptors. c. neurotransmitters Incorrect Feedback: Neurotransmitters are natural body chemicals that interact with receptors. 13. An antagonist drug _____. a. occupies but does not activate a receptor b. is similar to inserting the wrong key in a lock c. keeps other drugs from activating the receptor d. all of the above Answer: d. all of the above Correct Feedback: An antagonist drug occupies and blocks a receptor but does not activate it. An antagonist drug keeps other drugs from activating the receptor. a. occupies but does not activate a receptor Incorrect Feedback: This is true, but it is not the only correct answer. b. is similar to inserting the wrong key in a lock Incorrect Feedback: This is true, but it is not the only correct answer. c. keeps other drugs from activating the receptor Incorrect Feedback: This is true, but it is not the only correct answer. 14. A common side effect of narcotic drugs used to treat pain is _____. a. depression b. nausea and vomiting c. loss of hair d. constipation Answer: d. constipation Correct Feedback: A common side effect of narcotic drugs used to treat pain is constipation. a. depression Incorrect Feedback: Narcotic drugs do not commonly cause depression. b. nausea and vomiting Incorrect Feedback: Narcotic drugs do not commonly cause nausea and vomiting. c. loss of hair Incorrect Feedback: Narcotic drugs do not commonly cause loss of hair. 15. A milliequivalent is ______ of an equivalent. a. 1/100 b. 1/1,000 c. 1/100,000 d. 1/1,000,000,000 Answer: b. 1/1,000 Correct Feedback: The combining form mill/i- means one thousand. a. 1/100 Incorrect Feedback: The combining form mill/i- means one thousand. c. 1/100,000 Incorrect Feedback: The combining form mill/i- means one thousand. d. 1/1,000,000,000 Incorrect Feedback: The combining form mill/i- means one thousand. 16. Which of the following is NOT one of the therapeutic effects of a drug? a. curing a disease b. decreasing disease symptoms c. diagnosing a disease or condition d. preventing a disease Answer: c. diagnosing a disease or condition Correct Feedback: The therapeutic effect of a drug is selected to cure a disease, decrease disease symptoms, or prevent a disease. Diagnosing a disease or condition is not related to a therapeutic effect of drugs. a. curing a disease Incorrect Feedback: Curing a disease is a therapeutic effect of drugs. b. decreasing disease symptoms Incorrect Feedback: Decreasing disease symptoms is a therapeutic effect of drugs. d. preventing a disease Incorrect Feedback: Preventing a disease is a desired therapeutic effect of drugs. 17. The systemic effect of a drug is felt _____. a. where the physician intended it to be felt b. throughout the body c. only at the site of administration d. only at the site of the target organ Answer: b. throughout the body Correct Feedback: A systemic effect is felt throughout the body. a. where the physician intended it to be felt Incorrect Feedback: A systemic effect is felt where the physician intended but also at other areas in the body. c. only at the site of administration Incorrect Feedback: A systemic effect is felt throughout the body. d. only at the site of the target organ Incorrect Feedback: A systemic effect is felt throughout the body. 18. Symptoms of an allergic reaction are based on the release of _____. a. an antigen b. an antibody c. anaphylaxis d. histamine Answer: d. histamine Correct Feedback: An allergy is a reaction that occurs when antibodies combine with an antigen and release histamine. a. an antigen Incorrect Feedback: An antigen is a foreign substance, but it is not released. b. an antibody Incorrect Feedback: An antibody is released by the immune system in response to an antigen, but it does not cause an allergic reaction itself. c. anaphylaxis Incorrect Feedback: Anaphylaxis is a severe allergic reaction, but it is not released. 19. When a drug has a narrow margin of safety between the correct dose and the toxic dose, that drug is said to have a low _____. a. first-pass effect b. drug idiosyncrasy c. therapeutic index d. level of adverse effects Answer: c. therapeutic index Correct Feedback: A drug with a low therapeutic index has a narrow margin of safety between the therapeutic dose and the toxic dose. a. first-pass effect Incorrect Feedback: The first-pass effect occurs in the liver and was discussed in Chapter 4. It is not related to the margin of safety. b. drug idiosyncrasy Incorrect Feedback: A drug idiosyncrasy is based on an individual’s unique reaction and is not related to the margin of safety. d. level of adverse effects Incorrect Feedback: A drug with a narrow margin of safety would have a high (not low) level of adverse effects. 20. A drug that can unlock or activate a receptor is known as a/an _____ . a. metabolite b. antagonist c. neurotransmitter d. agonist Answer: d. agonist Correct Feedback: An agonist drug unlocks and activates a receptor. a. metabolite Incorrect Feedback: A metabolite, discussed in Chapter 4, does not unlock a receptor. b. antagonist Incorrect Feedback: An antagonist drug does not unlock a receptor. c. neurotransmitter Incorrect Feedback: A neurotransmitter is a natural body substance, not a drug. 21. Which pair of drugs listed below, if taken together, is an example of the drug-drug interaction known as synergism? a. Alcohol and a tranquilizer drug b. Tylenol and codeine c. Potassium-wasting diuretic drug and potassium-sparing diuretic drug d. All of the above Answer: d. All of the above Correct Feedback: All of these pairs of drugs, when taken together, can produce the drug-drug interaction of synergism. a. Alcohol and a tranquilizer drug Incorrect Feedback: This is true, but it is not the only correct answer. b. Tylenol and codeine Incorrect Feedback: This is true, but it is not the only correct answer. c. Potassium-wasting diuretic drug and potassium-sparing diuretic drug Incorrect Feedback: This is true, but it is not the only correct answer. 22. Which system of drug measurement is used for nearly all drug doses? a. apothecary b. household c. metric d. ratio Answer: c. metric Correct Feedback: Feedback: Metric is the system of measurement used for nearly all drug doses. a. apothecary Incorrect Feedback: The apothecary measurement system has been nearly discontinued. b. household Incorrect Feedback: Household measurement is not a system and is used only by people in their homes. d. ratio Incorrect Feedback: Ratio measurement is not a system and is only used for measuring some drugs. 23. An idiosyncratic drug reaction is ______. a. based on the patient’s genetic makeup b. a common side effect c. based on an allergic reaction d. all of the above Answer: a. based on the patient’s genetic makeup Correct Feedback: An idiosyncratic drug reaction is associated with an individual’s unique reaction to a drug. b. a common side effect Incorrect Feedback: An idiosyncratic drug reaction is not a common side effect. c. based on an allergic reaction Incorrect Feedback: An idiosyncratic drug reaction is not based on an allergic reaction. d. all of the above Incorrect Feedback: Not all of the above statements are correct. 24. The therapeutic effect of a drug is usually exerted _____. a. as a side effect b. on the target organ c. as an adverse effect d. by the release of histamine Answer: b. on the target organ Correct Feedback: The therapeutic effect of a drug is usually directed toward the specific area of the body that has the disease—toward the target organ. a. as a side effect Incorrect Feedback: The therapeutic effect is usually not a side effect. c. as an adverse effect Incorrect Feedback: The therapeutic effect of a drug is not an adverse effect. d. by the release of histamine Incorrect Feedback: An allergic reaction, not a therapeutic effect, releases histamine. 25. A drug-drug reaction in which the two drugs combine to produce an effect greater than the independent effect of each drug is called _____. a. antagonism b. receptor c. anaphylaxis d. synergism Answer: d. synergism Correct Feedback: Synergism occurs when two drugs combine to produce an effect that is greater than the independent effect of each drug. a. antagonism Incorrect Feedback: Antagonism occurs when two drugs produce a lesser effect than either drug. b. receptor Incorrect Feedback: A receptor is a protein molecule on a cell membrane. c. anaphylaxis Incorrect Feedback: Anaphylaxis is a severe allergic reaction. 26. The drug that is measured in inches on a marked piece of applicator paper and used to treat angina pectoris is known as _____. a. nitroglycerin ointment b. topical corticosteroid c. insulin d. Maalox Answer: a. nitroglycerin ointment Correct Feedback: Only one commonly prescribed drug is measured in inches, and that is nitroglycerin ointment (Nitro-Bid), a cardiac drug used to treat angina pectoris. b. topical corticosteroid Incorrect Feedback: Topical corticosteroid drugs are not measured in inches. c. insulin Incorrect Feedback: Insulin drugs are measured in units, not inches. d. Maalox Incorrect Feedback: The antacid drug Maalox is measured in mL or cc, not inches. 27. All of the following are metric measurements EXCEPT _____. a. grain b. milligram c. cubic centimeter d. milliliter Answer: a. grain Correct Feedback: Metric measurements include the milligram, cubic centimeter, and milliliter, but the grain belongs to the apothecary system. b. milligram Incorrect Feedback: Milligram is a metric measurement. c. cubic centimeter Incorrect Feedback: Milligram is a metric measurement. d. milliliter Incorrect Feedback: Milliliter is a metric measurement. 28. Which of the following statements is TRUE? a. Household measurement of a drug using a tablespoon is accurate. b. Insulin is measured in units. c. Penicillin is measured in inches. d. Electrolyte drugs are measured in ratios. Answer: b. Insulin is measured in units. Correct Feedback: All insulin drugs are measured in units, as are some penicillin and vitamin drugs. a. Household measurement of a drug using a tablespoon is accurate. Incorrect Feedback: Household measurement is an inaccurate measurement. c. Penicillin is measured in inches. Incorrect Feedback: Only one drug is measured in inches and that is nitroglycerin ointment. d. Electrolyte drugs are measured in ratios. Incorrect Feedback: Doses of electrolyte drugs are measured in milliequivalents. 29. The abbreviation h.s. means ______. a. before meals b. after meals c. at bedtime d. nothing by mouth Answer: c. at bedtime Correct Feedback: The abbreviation h.s. is Latin for hora somni and means at bedtime (hours of sleep). a. before meals Incorrect Feedback: Before meals is abbreviated as a.c. b. after meals Incorrect Feedback: After meals is abbreviated as p.c. d. nothing by mouth Incorrect Feedback: Nothing by mouth is abbreviated as n.p.o. or NPO. 30. Nitroglycerin ointment is applied with specially marked paper that is measured in ____. a. millimeters b. inches c. milligrams d. size of dose ordered Answer: b. inches Correct Feedback: Only one drug is measured in inches and that is nitroglycerin ointment. A pad of specially marked papers is supplied with the tube of ointment so that the patient can accurately measure each dose. a. millimeters Incorrect Feedback: The specially marked paper used to measure nitroglycerin ointment is not measured in millimeters. c. milligrams Incorrect Feedback: The specially marked paper used to measure nitroglycerin ointment is not measured in milligrams. d. size of dose ordered Incorrect Feedback: The size of the dose ordered is not specific enough. 31. Which type of drug listed below is NOT measured in units? a. insulin b. antacid c. penicillin d. vitamin Answer: b. antacid Correct Feedback: Antacid drugs are liquids that are measured in the metric system. A common dose for the antacid drug Maalox is 30 mL or 30 cc. a. insulin Incorrect Feedback: All insulin drugs are measured in units. c. penicillin Incorrect Feedback: Some penicillins are measured in units. d. vitamin Incorrect Feedback: Some vitamins are measured in units. 32. Pilot Mark Adams is flying a plane today, but his fall allergy symptoms are giving him a runny nose and red, watery eyes. What is the most important fact he should know? a. The antihistamine drug side effect of drowsiness can be used as a therapeutic effect to treat insomnia. b. An allergic reaction involves an antibody and an antigen that combine and release histamine. c. Antihistamine drugs cause a side effect of drowsiness that is undesirable in persons who must drive or operative machinery. d. The perfect drug has a complete therapeutic effect and no side effects. Answer: c. Antihistamine drugs cause a side effect of drowsiness that is undesirable in persons who must drive or operative machinery. Correct Feedback: Antihistamine drugs cause a side effect of drowsiness that is undesirable in persons who must drive or operative machinery. a. The antihistamine drug side effect of drowsiness can be used as a therapeutic effect to treat insomnia. Incorrect Feedback: This is true, but it is not the most important fact he needs to know. b. An allergic reaction involves an antibody and an antigen that combine and release histamine. Incorrect Feedback: This is true, but it is not the most important fact he needs to know. d. The perfect drug has a complete therapeutic effect and no side effects. Incorrect Feedback: This is true, but it is not the most important fact he needs to know. 33. The same drug given by a different route can exert either a local or a systemic effect. An example of this is ______. a. topical Benadryl that relieves skin itching and oral Benadryl that relieves skin itching, nasal stuffiness, and red, watery eyes b. an antihistamine drug that, when taken with grapefruit juice, can cause the adverse effect of heart arrhythmias c. topical lidocaine that is gargled for anesthesia in the mouth and intravenous lidocaine that is used to treat cardiac arrhythmias d. a and c Answer: d. a and c Correct Feedback: Topical Benadryl exerts a local antihistamine effect, while oral Benadryl exerts a systemic antihistamine effect. Topical lidocaine exerts a local anesthetic effect, while intravenous lidocaine exerts a systemic antiarrhythmic effect. a. topical Benadryl that relieves skin itching and oral Benadryl that relieves skin itching, nasal stuffiness, and red, watery eyes Incorrect Feedback: This is true, but it is not the only correct answer. b. an antihistamine drug that, when taken with grapefruit juice, can cause the adverse effect of heart arrhythmias Incorrect Feedback: This is true, but it does not relate to the question of local and systemic effects. c. topical lidocaine that is gargled for anesthesia in the mouth and intravenous lidocaine that is used to treat cardiac arrhythmias Incorrect Feedback: This is true, but it is not the only correct answer. 34. The therapeutic effect of an antagonist or blocker drug is to occupy the receptor site and block ______ from activating the receptor. a. hormones b. neurotransmitters c. other drugs d. all of the above Answer: d. all of the above Correct Feedback: The therapeutic effect of an antagonist or blocker drug is to occupy the receptor site and block body hormones, neurotransmitters, or other drugs from activating the receptor. a. hormones Incorrect Feedback: This is true, but it is not the only correct answer. b. neurotransmitters Incorrect Feedback: This is true, but it is not the only correct answer. c. other drugs Incorrect Feedback: This is true, but it is not the only correct answer. 35. Which statement about cholinergic receptors is FALSE? a. The adjective cholinergic is derived from the word acetylcholine. b. Cholinergic receptors are also known as adrenergic receptors. c. Cholinergic receptors are part of the parasympathetic division of the nervous system. d. Cholinergic receptors respond to the neurotransmitter acetylcholine. Answer: b. Cholinergic receptors are also known as adrenergic receptors. Correct Feedback: Cholinergic receptors are different from adrenergic receptors. Cholinergic receptors respond to the neurotransmitter acetylcholine, while adrenergic receptors respond to the neurotransmitters epinephrine and norepinephrine. a. The adjective cholinergic is derived from the word acetylcholine. Incorrect Feedback: This is a true statement. c. Cholinergic receptors are part of the parasympathetic division of the nervous system. Incorrect Feedback: This is a true statement. d. Cholinergic receptors respond to the neurotransmitter acetylcholine. Incorrect Feedback: This is a true statement. 36. Side effects can be _____. a. mild and temporary b. moderate and annoying c. severe enough that the drug must be stopped d. all of the above Answer: d. all of the above Correct Feedback: Side effects can be mild and temporary, moderate and annoying, or severe enough that the patient must stop taking the drug. a. mild and temporary Incorrect Feedback: This is true, but it is not the only correct answer. b. moderate and annoying Incorrect Feedback: This is true, but it is not the only correct answer. c. severe enough that the drug must be stopped Incorrect Feedback: This is true, but it is not the only correct answer. 37. Toxic effects are more common in elderly patients whose _______ are less able to metabolize and excrete a drug. a. lungs and stomach b. liver and kidneys c. stomach and intestines d. brain and central nervous system Answer: b. liver and kidneys Correct Feedback: It is not uncommon to see toxic symptoms, particularly in elderly patients whose liver and kidneys are less able to metabolize and excrete a drug. a. lungs and stomach Incorrect feedback: The lungs and stomach do not metabolize and excrete a drug. c. stomach and intestines Incorrect feedback: The stomach and intestines do not metabolize and excrete a drug. d. brain and central nervous system Incorrect feedback: The brain and central nervous system do not metabolize and excrete a drug. 38. When toxic effects occur, the physician can respond by _______. a. decreasing the dose of the drug b. lengthening the time between doses c. discontinuing the drug d. all of the above Answer: d. all of the above Correct Feedback: When toxic effects occur, the physician may elect to decrease the dose of the drug, lengthen the time between doses, or discontinue the drug altogether. a. decreasing the dose of the drug Incorrect Feedback: This is true, but it is not the only correct answer. b. lengthening the time between doses Incorrect Feedback: This is true, but it is not the only correct answer. c. discontinuing the drug Incorrect Feedback: This is true, but it is not the only correct answer. 39. The antibiotic drugs gentamicin and kanamycin are known to exert toxic effects on the ear. This is known as _______. a. nephrotoxicity b. liver toxicity c. ototoxicity d. brain toxicity Answer: c. ototoxicity Correct Feedback: The antibiotic drugs gentamicin and kanamycin are known to exert toxic effects on the ears (ototoxicity). a. nephrotoxicity Incorrect Feedback: Nephrotoxicity is toxicity of the kidney. b. liver toxicity Incorrect feedback: Gentamicin and kanamycin are not known to cause liver toxicity. d. brain toxicity Incorrect feedback: Gentamicin and kanamycin are not known to cause brain toxicity. 40. What common problems of the elderly lead to missed drug doses and overdoses? a. vision problems b. memory problems c. taking multiple drugs on different schedules d. all of the above Answer: d. all of the above Correct Feedback: The multiple drugs the elderly take on varying schedules plus the common problems of memory and vision loss increase the possibility of noncompliance (missed doses) or toxicity (overdoses). a. vision problems Incorrect Feedback: This is true, but it is not the only correct answer. b. memory problems Incorrect Feedback: This is true, but it is not the only correct answer. c. taking multiple drugs on different schedules Incorrect Feedback: This is true, but it is not the only correct answer. 41. When the antibiotic drug tetracycline is taken with an antacid, these two drugs _______. a. form an insoluble complex that prevents a therapeutic effect b. cause a side effect of severe diarrhea c. produce an allergic reaction with each other d. show synergy and an increased therapeutic effect of each drug Answer: a. form an insoluble complex that prevents a therapeutic effect Correct Feedback: When the antibiotic drug tetracycline is taken with an antacid, the two drugs combine in the stomach to form an insoluble compound that prevents either drug from exerting a therapeutic effect. b. cause a side effect of severe diarrhea Incorrect Feedback: These two drugs do not cause severe diarrhea. c. produce an allergic reaction with each other Incorrect Feedback: These two drugs do not produce an allergic reaction. d. show synergy and an increased therapeutic effect of each drug Incorrect Feedback: These drugs create an insoluble complex in the stomach that prevents either drug from exerting a therapeutic effect. This is not an example of synergy. 42. Housewife Shannon McGee is taking an MAO inhibitor drug for depression. She knows she should not eat any foods that are high in tyramine to avoid getting hypertension and a headache. She should avoid all of these foods EXCEPT _______. a. chocolate b. cheese c. meat d. Alcohol Answer: c. meat Correct Feedback: MAO inhibitor antidepressant drugs cannot be given with foods rich in the amino acid tyramine because they will cause hypertension, headache, and a possible stroke. Tyramine is present in aged cheeses, alcoholic beverages, bananas, liver, avocados, and chocolate. a. chocolate Incorrect Feedback: Chocolate should be avoided by patients taking an MAO inhibitor drug. b. cheese Incorrect Feedback: Cheese should be avoided by patients taking an MAO inhibitor drug. d. Alcohol Incorrect Feedback: Alcohol should be avoided by patients taking an MAO inhibitor drug. 43. Which of the following drugs is NOT one of the drugs that is still measured in grains by the apothecary system? a. phenobarbital b. desiccated thyroid c. iron d. all of the above Answer: d. all of the above Correct Feedback: Phenobarbital, desiccated thyroid, and iron are just a few of the remaining drugs that have equivalent apothecary and metric doses printed on the drug label. a. phenobarbital Incorrect Feedback: This is true, but it is not the only correct answer. b. desiccated thyroid Incorrect Feedback: This is true, but it is not the only correct answer. c. iron Incorrect Feedback: This is true, but it is not the only correct answer. 44. A drug error can occur because one of the “five rights of drug administration” is not followed, such as _______. a. the nurse does not check the patient’s identification band b. the pharmacy does not carry that particular drug c. the patient has been transferred to surgery d. all of the above Answer: a. the nurse does not check the patient’s identification band Correct Feedback: The five rights of drug administration include (1) the right patient, (2) the right drug, (3) the right dose, (4) the right route, and (5) the right time. b. the pharmacy does not carry that particular drug Incorrect Feedback: This is not one of the five rights of drug administration. c. the patient has been transferred to surgery Incorrect Feedback: This is not one of the five rights of drug administration. d. all of the above Incorrect Feedback: Not all of these answers are included in the five rights of drug administration. 45. A drug dose for a pediatric patient is calculated on the basis of ______. a. age b. height c. weight d. total body surface area Answer: c. weight Correct Feedback: A pediatric drug dose is calculated based on the total body weight of the patient, not the age. Chemotherapy drug doses are calculated based on the patient’s total body surface area. a. age Incorrect Feedback: A pediatric drug dose is not calculated based on age. b. height Incorrect Feedback: A pediatric drug dose is not calculated based on height. d. total body surface area Incorrect Feedback: Chemotherapy drugs, not pediatric drugs, are calculated on the basis of total body surface area. 46. Adrenergic receptors respond to the neurotransmitter acetylcholine from the parasympathetic division of the nervous system. Answer: False Feedback: Adrenergic receptors respond to the neurotransmitters epinephrine and norepinephrine from the sympathetic division of the nervous system, as well as to certain drugs. 47. All drugs have a target organ where they exert their effect. Answer: False Feedback: The therapeutic effect is not always directed toward a target organ. For example, when a physician prescribes an antibiotic drug, the therapeutic effect is intended to destroy or inhibit the growth of disease-causing bacteria, wherever they are within the body. 48. An adverse effect is a type of severe side effect. True Answer: True Feedback: Severe side effects are often referred to as adverse effects. 49. An allergic reaction is a type of side effect caused by the release of histamine. Answer: True Feedback: An allergic reaction is a type of side effect but differs from other side effects in that it has a specific underlying cause: the release of histamine. 50. A patient may take several doses of a drug without having an allergic reaction, but later develop an allergic reaction to that drug. Answer: True Feedback: A patient may take several courses of an antibiotic drug over the years without any reaction, but then the next course of the drug will cause an allergic reaction. 51. One drug can act as a master key to unlock several different receptors in different organs. Answer: True Feedback: One drug can act as a master key to unlock several different receptors in different organs and tissues. 52. Most drugs are associated with at least one or two side effects (sometimes more) that are frequently observed after administration. Answer: True Feedback: Most drugs are associated with at least one or two side effects (sometimes more) that are frequently observed after administration. 53. Once a drug is approved by the FDA and on the market, its advertisements, informational literature, prescribing information, and package inserts for the drug must list the side effects. Answer: True Feedback: Once a drug is approved by the FDA and on the market, its advertisements, informational literature, prescribing information, and package inserts for the drug must list the side effects. 54. Once a drug has been approved by the FDA, if there are reports of severe adverse effects, the drug cannot be taken off the market; but the drug company will be required to add those adverse effects to their list of side effects and warnings. Answer: False Feedback: The FDA can remove a drug from the market, even after it has been approved, if there are reports of severe adverse effects.55. Physicians, pharmacists, and the DEA can report adverse drug effects to the FDA. Answer: False Feedback: Physicians and pharmacists can report adverse drug effects to the FDA. The DEA regulates controlled substances. 56. Before FDA approval, the drug company must show that a drug does not produce toxic effects when administered in therapeutic doses. Answer: True Feedback: Before FDA approval, the drug company must show that a drug does not produce a toxic effect when administered in a therapeutic dose. 57. Once a patient is sensitized to a particular drug, only a full dose of that drug will trigger an allergic reaction. Answer: False Feedback: Once a patient is sensitized to a particular drug, even a small dose can trigger an allergic reaction. 58. A patient who is allergic to one drug can safely take other drugs belonging to that drug group. Answer: False Feedback: Some drugs show cross allergies to other drug groups because of similarities in their molecular structure. 59. Certain ethnic groups, such as those of Asian, Jewish, and African descent, have wellstudied idiosyncratic reactions to certain drugs. Answer: True Feedback: Certain ethnic groups, such as those of Asian, Jewish, and African descent, have well-studied idiosyncratic reactions to certain drugs. 60. When administered simultaneously, some drugs interact with each other in a particular way that either accentuates or diminishes the action of each. Answer: True Feedback: When administered simultaneously, some drugs interact with each other in a particular way that either accentuates or diminishes the action of each. 61. Drugs given by weight are measured in kilograms, milligrams, and micrograms. Answer: False Feedback: Drug measurements are not expressed in terms of kilograms. Kilograms are used to measure a person's weight. 62. The standard adult dose is appropriate for all adults, including elderly, very thin, or very obese patients. Answer: False Feedback: The standard adult dose for a drug is appropriate for most adults. However, patients who are elderly, extremely thin, or extremely obese fall outside this range and may need to have their drug dose adjusted by the physician. 63. The way to optimize the therapeutic effect of a drug and minimize the occurrence of adverse or toxic effects is to take the drug exactly as prescribed. Answer: True Feedback: The way to optimize the therapeutic effect of a drug and minimize the occurrence of adverse or toxic effects is to take the drug exactly as prescribed. 64. An allergic reaction to a drug will only occur if the blood level of the drug is at a toxic level. Answer: False Feedback: An allergic reaction has a specific underlying cause: the release of histamine that occurs even when a drug is at therapeutic levels. 65. Drugs given intravenously exert a systemic effect. True Answer: True Feedback: Drugs given intramuscularly or intravenously exert a systemic effect. 66. Accutane has been associated with the adverse effect of suicide. Answer: True Feedback: In 2001 the FDA required patients to sign a consent form prior to taking Accutane because of a possible link to suicide. 67. Severe side effects are also known as adverse effects. True Answer: True Feedback: Severe side effects are often referred to as adverse effects. 68. When antibiotic drugs are prescribed, their therapeutic effect is directed toward a target organ. Answer: False Feedback: The therapeutic effect is not always directed toward a target organ. For example, when a physician prescribes an antibiotic drug, the therapeutic effect is intended to destroy or inhibit the growth of disease-causing bacteria, wherever they are within the body. 69. One milliliter (mL) and one cubic centimeter (cc) can be used interchangeably as measurements of drug doses. Answer: True Feedback: The measurement of volume known as the cubic centimeter (cm3or cc) is equivalent to the volume contained in a milliliter (mL), and the two volume abbreviations mL and cc are used interchangeably. 70. Drugs given subcutaneously exert either a local or a systemic effect, depending on the type of drug. Answer: True Feedback: Drugs given subcutaneously exert either a local or a systemic effect, depending on the type of drug. 71. All drugs approved by the FDA are entirely safe and without potential side effects and risks. Answer: False Feedback: It should be noted that no drug is entirely safe and without potential side effects and risks. 72. The adverse effects of a particular drug are more common than the side effects of that drug. Answer: False Feedback: Adverse effects are not as commonly observed as side effects. 73. Drug effects are initiated through _______, special protein molecules located on the cell membranes of every cell. Answer: receptors Feedback: Drug effects are initiated through receptors, special protein molecules located on the cell membranes of every cell. 74. Some drugs appear to fit a certain receptor but cannot actually unlock or activate the receptor to produce an effect. These drugs are known as ________ or blockers. Answer: antagonists Feedback: Some drugs appear to fit a certain receptor but cannot actually unlock or activate the receptor to produce an effect. These drugs are known as antagonists or blockers. 75. The most severe symptoms of an allergic reaction are collectively known as _______, which can lead to a type of shock. Answer: anaphylaxis Feedback: The most severe symptoms of an allergic reaction are collectively known as anaphylaxis, which can lead to a type of shock. 76. A drug ________ is a type of drug reaction that is not a side effect and is not based on an allergic reaction. It is an individual’s unique reaction to a drug and it differs from side effects commonly associated with that drug. Answer: idiosyncrasy Feedback: A drug idiosyncrasy is a type of drug reaction that is not a side effect and is not based on an allergic reaction. It is an individual’s unique reaction to a drug and it differs from side effects commonly associated with that drug. 77. ________ occurs when two drugs combine to produce an effect that is greater than the independent effect of each drug. Answer: Synergism Feedback: Synergism occurs when two drugs combine to produce an effect that is greater than the independent effect of each drug. 78. ________ occurs when two drugs combine to produce an effect that is less than the intended effect for either drug. Answer: Antagonism Feedback: Antagonism occurs when two drugs combine to produce an effect that is less than the intended effect for either drug. 79. The therapeutic effect of a drug can be directed toward the specific area of the body that has the disease—toward a _______ (e.g. the heart, in patients with congestive heart failure). Answer: target organ Feedback: The therapeutic effect of a drug can be directed toward the specific area of the body that has the disease—toward a target organ (e.g., the heart, in patients with congestive heart failure). 80. When a drug with a low ________ (a narrow margin of safety between the therapeutic dose and the toxic dose) is administered, it is not uncommon to see toxic symptoms. Answer: therapeutic index Feedback: When a drug with a low therapeutic index (a narrow margin of safety between the therapeutic dose and the toxic dose) is administered, it is not uncommon to see toxic symptoms. 81. An allergy is a reaction that occurs when the body’s immune system identifies a foreign substance such as drug (known as an ________) and initiates an antibody response against it. Answer: antigen Feedback: An allergy is a reaction that occurs when the body’s immune system identifies a foreign substance such as a drug (known as an antigen) and initiates an antibody response to it. 82. ________ is the study of how the genetic makeup of different people affects their response to certain drugs. Answer: Pharmacogenetics Feedback: Pharmacogenetics is the study of how the genetic makeup of different people affects their response to certain drugs. 83. 1. drops A. electrolyte solution 2. inches B. eye and ear medications 3. milliequivalent C. insulin 4. percentage D. nitroglycerin ointment 5. units E. steroid ointments Answer: B Answer: D Answer: A Answer: E Answer: C 84. 1. a.c. A. as needed 2. h.s. B. at bedtime 3. p.r.n. C. before meals 4. q.d. D. every day 5. t.i.d. E. three times a day Answer: C Answer: B Answer: A Answer: D Answer: E Essay Questions 85. Briefly explain the difference between local and systemic effects of drugs, and then give an example of a drug route that produces a local effect and a drug route that produces a systemic effect. Answer: A local effect is limited to the site of administration and those tissues immediately surrounding it. Most drugs applied topically exert a local effect, but a few topical drugs exert a systemic effect. A systemic effect is felt throughout the body. Drugs taken orally, for the most part, usually exert a systemic effect. Also intramuscular and intravenous drugs exert a systemic effect. 86. Many drugs (such as antihistamine drugs) have both a therapeutic effect and side effects. Side effects can either be undesirable or beneficial. Describe how antihistamine drugs can have a side effect that is both undesirable and beneficial. Answer: Many antihistamine drugs, when given orally to treat allergies, produce significant drowsiness. This side effect is undesirable, particularly in patients who must drive or operate machinery. However, this side effect of drowsiness can be utilized as a therapeutic effect when an antihistamine drug is incorporated into a drug that is used to treat insomnia. 87. Some side effects of a drug are common. For the three body systems or drug categories listed here, give one common side effect associated with each: gastrointestinal system, central nervous system, chemotherapy drugs. Answer: Common gastrointestinal side effects include anorexia (lack of appetite), nausea, vomiting, or diarrhea. Common central nervous system side effects include drowsiness, excitement, or depression. Common side effects of chemotherapy drugs include nausea, vomiting, chills, fever, loss of hair, and depression of the bone marrow. Test Bank for Understanding Pharmacology for Health Professionals Susan M. Turley 9780135145708, 9780133911268