Nokea
After teaching a group of nursing students about pharmacokinetics, the instructor determines that the teaching was successful when the students identify which of the following as the site for the metabolism of most drugs?
- A. Liver
- B. Lungs
- C. Kidneys
- D. Intestinal mucosa
Correct Answer: A
Rationale: Although the kidneys, lungs, plasma, and intestinal mucosa may aid in the metabolism of drugs, most drugs are metabolized by the liver.
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The patient has a diagnosis of multiple sclerosis and is taking the drug interferon beta-1a (Rebif). The patient takes this drug by subcutaneous injection three times a week. The dosage is 44 mcg per injection. If the patient takes an injection on Monday, how much of the drug would still be in the patient's system when she takes her next injection on Wednesday, assuming the half-life of the drug is 24 hours?
- A. 22 mcg
- B. 16.5 mcg
- C. 11 mcg
- D. 5.5 mcg
Correct Answer: C
Rationale: The half-life of a drug is the time it takes for the amount of drug in the body to decrease to 1 half the peak level it previously achieved. On Tuesday, there would be 22 mcg remaining in the body, so option A is incorrect. On Wednesday 11 mcg would remain, so option C is the correct answer. At 12 hours before taking the next dose on Wednesday, there would be 16.5 mcg remaining. If the injection were not taken on Wednesday, 12 hours after the dose was due, there would be 5.5 mcg remaining.
Which of the following statements CORRECTLY describes the mechanism of action of imatinib mesylate in chronic myeloid leukemia:
- A. Inhibitor of tyrosine kinase
- B. Inhibitor of topoisomerase 1
- C. Inhibitor of topoisomerase 2
- D. It is an alkylating agent
Correct Answer: A
Rationale: Imatinib inhibits BCR-ABL tyrosine kinase in CML.
A patient has a drug level of 50 units/mL and the drug's half-life is 1 hour. If concentrations above 25 units/mL are considered toxic and no more drug is given, how long will it take for the blood level to reach the nontoxic range?
- A. 30 minutes
- B. 1 hour
- C. 2 hours
- D. 3 hours
Correct Answer: C
Rationale: Half-life is the time required for the serum concentration of a drug to decrease by 50%. After 1 hour, the serum concentration would be 25 units/mL (50/2). After 2 hours, the serum concentration would be 12.5 units/mL (25/2) and reach the nontoxic range.
Which of the following statements about pancreatic enzymes is true?
- A. Dosing may be titrated according to the decrease of steatorrhea
- B. The amount of carbohydrates in the meal drives the amount of enzyme used
- C. The amount of medication used is increased with a cystic fibrosis pulmonary flare
- D. The FDA and Internet-available formulations are bioequivalent
Correct Answer: A
Rationale: Pancreatic enzyme dosing adjusts based on steatorrhea reduction; carbs aren't the driver, and flares don't increase it.
Which of the following vitamin or mineral supplements may by teratogenic if a pregnant woman takes more than the recommended amount?
- A. Iron
- B. Vitamin A
- C. Vitamin B6
- D. Vitamin C
Correct Answer: B
Rationale: Excess vitamin A (retinol) is teratogenic, potentially causing congenital malformations.