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A collection of pharmacokinetics exam questions from a university course held in fall 2006. The questions cover various aspects of drug clearance, volume of distribution, protein binding, and renal excretion. Students are required to answer true or false questions, identify differences in pharmacokinetic parameters, and match physiological changes to their effects on drug kinetics.
Typology: Exams
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Second Exam
Fall 2006
On my honor, I have neither given nor received unauthorized aid in doing this assignment.
Name
Put all answers on the bubble sheet
TOTAL _______/160 pts
Question Set I (True or False) (25 points)
True (A) or False (B). On the bubble sheet mark A for true or B for false
Mark whether the following statements as true or false for drug A , which is cleared only by hepatic metabolism and has a CLtot of 80 L/h
1: T F This drug is a low extraction drug
2: T F The clearance of another drug eliminated only by the kidney (only filtered not re- absorbed) will be smaller than that of Drug A
3: T F The oral bioavailability of this drug will be significantly smaller than 80%
4: T F The oral bioavailability will depend on liver blood flow
5: T F Drug C, known to induce enzymes also responsible for metabolism of Drug A will significantly affect the clearance of Drug A
Question Set III (Matching) (20 points)
For the physiological changes listed below, select the induced changes on the pharmacokinetic parameters for a lipophilic, unionizable (no acid or basic group in the molecule), protein bound drug that is eliminated only through the kidneys (some answers may be used more than once).
Select the effect on kinetics
Physiological change 7: Decrease in plasma protein binding__ A or C_ __
8: Increase in tissue binding __ C __
9: Decrease in liver blood flow__ E __
10: Increase in urine flow__ A ___
Question Set IV (Matching) (20 points)
(Assume GFR is 130 mL min -1^ , urine flow is 1.5 ml min -1^ ) For the following situations, indicate whether the drug is:
Select from the following choices: (A) filtered (B) reabsorbed (C) actively secreted (D) reabsorbed through transporters
11: A drug with fu = 0.02and a Cl (^) REN = 20 mL min-1^ is _ C __
12: A drug with fu = 0.40 and a Cl (^) REN = 52 mL min-1^ is _ A __
13: A drug with fu = 0.60 and a Cl (^) REN = 0.9 mL min-1^ is __ B _
14: A drug with fu = 1.0 and a Cl (^) REN = 0.3 mL min-1^ is _ D __
Question Set V (10 points)
A hydrophilic drug (predominantly ionized at pH=7.4) is eliminated only by the kidney. Plasma protein binding is 90%. Glomerular filtration rate is normal ( 130 ml/min ). Urine flow is 2ml/min. No active renal secretion or active reabsorption after renal filtration is observed. The volume of distribution is 40 L.
15: What is the clearance? (10 points)
A. 0.15 mL/min B. 13 mL/min C. 1 mL/min D. 130 mL/min
16: Assume a one compartment body model? What is the renal clearance of a typical aminoglycoside in a patient showing a creatinine clearance e of 65 ml /min(10 points). The plasma protein binding for this aminoglycoside is 55 %.
A. 58.5 ml/min
B. 130 ml/min
C. 65 ml/min
D. 29.3 ml/min
E. 35.8 ml/min
Question Set VII
The same dose of Alprazolam was given either alone or with ketoconazole. Explain what is going on by selecting the correct answer from the following list. (5 points)
1: The clearance of alprazalam is increased in the presence of Ketoconazole. 2: Alprazalam is likely to be a low extraction drug. 3: Ketoconazole decreases the volume of distribution of Alprazolam, thereby increasing the half-life of the drug 4: Ketoconazole is likely to increase liver blood flow.
A. 1 B. 2 C. 3, 4 D. 2, 3 E. 1, 2, 3, 4
Question Set VIII (True or False) (30 points)
True (A) or False (B). On the bubble sheet mark A for true or B for false
Mark whether the following statements are true (A) or False (B)
19: T F The renal clearance of a drug depends the tissue binding of the drug.
20: T F The half-life of a drug increases with increasing tissue binding.
21: T F To determine the clearance of a drug, one needs to know whether the drug is a one or two compartment drug.
22: T F Drinking a lot of water (urine flow is doubled) will increase the renal clearance of aminoglycosides
23: T F For an acidic drug with a pka of 2.0, adjustment of the urine pH within physiological ranges will significantly change the renal clearance.
24: T F For a drug with linear pharmacokinetics, hepatic clearance depends on the drug plasma concentration, as the rate of metabolism increases with increasing drug concentrations in the blood.
Question Set IX (True or False)
(15 points) True (A) or False (B). On the bubble sheet mark A for true or B for false
Mark whether the following statements are true (A) or false (B). Assume linear pharmacokinetics for all questions.
25: T F The larger the volume of distribution, the smaller the AUC of a given drug.
26: T F Doubling the dose will double the AUC of a drug
27: T F An increase in fu will decrease AUC of a high-extraction drug given orally.
