COKO Pharmacology Fundamentals 3 — Questions and Answers
Question 1: The volume of distribution (Vd) of a drug is very large. What does this indicate about the drug's distribution?
- The drug remains mostly in plasma
- The drug is extensively distributed into tissues (Correct answer)
- The drug has poor oral bioavailability
- The drug undergoes rapid renal excretion
Correct answer: The drug is extensively distributed into tissues
A large Vd indicates the drug distributes widely into peripheral tissues rather than remaining in the plasma compartment.
Question 2: A client on ACE inhibitors for hypertension complains of a persistent dry cough. This side effect is best explained by accumulation of:
- Angiotensin II
- Aldosterone
- Bradykinin (Correct answer)
- Renin
Correct answer: Bradykinin
ACE inhibitors block the enzyme that also degrades bradykinin; bradykinin accumulation stimulates cough receptors in the airways.
Question 3: Which type of drug-receptor interaction is reversible and follows the law of mass action?
- Covalent bond
- Competitive antagonism (Correct answer)
- Irreversible inhibition
- Allosteric modulation
Correct answer: Competitive antagonism
Competitive antagonists bind reversibly at the receptor's active site and can be displaced by increasing agonist concentration.
Question 4: A kinesiologist is working with a client who takes a statin for dyslipidemia. Which exercise-related adverse effect should be monitored?
- Exercise-induced bronchospasm
- Statin-associated myopathy or myalgia (Correct answer)
- Orthostatic hypotension
- Exercise intolerance due to bradycardia
Correct answer: Statin-associated myopathy or myalgia
Statins can cause muscle pain, weakness, or in rare cases rhabdomyolysis, which is exacerbated by intense exercise.
Question 5: A drug with a narrow therapeutic index requires careful dosing because:
- It has very high bioavailability
- The toxic dose is close to the effective dose (Correct answer)
- It is rapidly eliminated by the kidneys
- It undergoes extensive first-pass metabolism
Correct answer: The toxic dose is close to the effective dose
A narrow therapeutic index means small dosing errors can result in sub-therapeutic or toxic drug concentrations.
Question 6: Which pharmacokinetic parameter describes the time required for plasma drug concentration to decrease by half?
- Clearance
- Volume of distribution
- Half-life (t½) (Correct answer)
- Peak concentration (Cmax)
Correct answer: Half-life (t½)
Half-life (t½) is the time required for the plasma concentration of a drug to reduce to 50% of its previous value.
Question 7: A client with renal impairment is prescribed a renally-cleared drug. How should the kinesiologist anticipate this may affect the client's pharmacotherapy?
- Faster drug elimination requiring higher doses
- Reduced drug clearance leading to potential drug accumulation (Correct answer)
- Increased first-pass metabolism
- Enhanced drug receptor sensitivity
Correct answer: Reduced drug clearance leading to potential drug accumulation
Renal impairment reduces glomerular filtration and tubular secretion, slowing elimination of renally-cleared drugs and risking accumulation.
COKO Pharmacology Fundamentals 3
The volume of distribution (Vd) of a drug is very large.
What does this indicate about the drug's distribution?