Applied pharmacology for the dental hygienist 9th edition by elena bablenis haveles test bank_watermark

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TEST BANK For Applied Pharmacology for the

Dental Hygienist 9th Edition

by Elena Bablenis Haveles, Chapters 1 - 26

email me rightmanforbloodline1@gmail.com to receive all chapters in pdf format

Chapter 01: Information Sources, Regulatory Agencies, Drug Legislation, and Prescription

Writing

Haveles: Applied Pharmacology for the Dental Hygienist, 9th Edition

MULTIPLE CHOICE

1. Knowledge of pharmacology aids the dental professional in

a. obtaining a patient’s health history.

b. administering drugs in the office.

c. handling emergency situations.

d. selection of a nonprescription medication.

e. All of the above.

ANSWER: E

All of the choices are true. Because many of our patients are being treated with drugs, knowledge

of pharmacology helps in understanding and interpreting patients’ responses to health history

questions. Knowledge of the therapeutic and adverse effects of medications obviously helps in

their proper administration in the office. Emergency situations may be caused by drugs or treated

by drugs; thus, knowledge of pharmacology is of great help, especially because a rapid response

is sometimes required. A clear understanding of the concepts of drug action, drug handling by

the body, and drug interactions will allow the dental practitioner to make proper judgments and

grasp the concepts relevant to new drug therapies on the market.

DIF: Application

REF: Role of the Dental Hygienist (Medication/Health History), Role of the Dental Hygienist

(Medication Administration), Role of the Dental Hygienist (Emergency Situations), Role of the Dental

Hygienist (Nonprescription Medication) | pp. 2-3 OBJ: 1

TOP: NBDHE, 6.0. Pharmacology

2. Which of the following statements is true regarding planning appointments?

a. Whether or not patients are taking medication for systemic diseases is of

little consequence in the dental office.

b. Asthmatic patients should have dental appointments in the morning.

c. Diabetic patients usually have fewer problems with a morning

appointment compared with afternoon appointments.

d. Both B and C are true.

ANSWER: D

Asthmatic patients who experience dental anxiety should schedule their appointments when they

are not rushed or under pressure early in the morning. Diabetic patients usually have relatively

fewer problems with a morning appointment. Patients taking medication for systemic diseases

may require special handling in the dental office.


DIF: Comprehension

REF: Role of the Dental Hygienist (Appointment Scheduling) | p.

3 OBJ: 1 TOP: NBDHE, 6.0. Pharmacology


3. Nutritional or herbal supplements

a. carry the U.S. Food and Drug Administration (FDA) approval for disease states.

b. are not drugs.

c. can cause adverse effects.

d. will not interact with other drugs the patient may be taking.

ANSWER: C

Nutritional or herbal supplements are quite capable of causing adverse effects. The

majority of nutritional or herbal supplements do not carry FDA approval for treating

disease states. These supplements are drugs and can cause adverse effects and interact

with different drugs.

DIF: Comprehension

REF: Role of the Dental Hygienist (Nutritional or Herbal Supplements) | p.


4. Which type of drug name usually begins with a lowercase letter?

a. Brand name

b. Code name

c. Generic name

d. Trade name

ANSWER: C

Before any drug is marketed, it is given a generic name that becomes the “official” name of the

drug. Each drug is assigned only one generic name selected by the U.S. Adopted Name Council,

and the name is not capitalized. The brand name is equivalent to the trade name and is

capitalized. Although the brand name is technically the name of the company marketing the

product, this term is often used interchangeably with the trade name. The code name is the

initial term used within a pharmaceutical company to refer to a drug while it is undergoing

investigation and is often a combination of capital letters and numbers, the letters representing

an abbreviation of the company name.

DIF: Comprehension REF: Drug Names | p.


5. A drug’s generic name is selected by the

a. pharmaceutical company manufacturing it.

b. Food and Drug Administration (FDA).

c. U.S. Adopted Name Council.

d. Federal Patent Office.

ANSWER: C

Each drug is assigned only one generic name (e.g., ibuprofen). It is selected by the U.S. Adopted

Name Council. The generic name is not selected by the FDA or the Federal Patent Office. The

pharmaceutical company manufacturing the drug clearly has an influence on the generic name

given its drug, but the final decision is not the company’s.

DIF: Recall REF: Drug Names | p. 4 OBJ: 3



6. Which of the following is true concerning generic and trade names of drugs?

a. A drug may only have one generic name and one trade name.


b. A drug may only have one generic name, but it may have several trade names.

c. A drug may have several generic names, but it may only have one trade name.

d. A drug may have several generic names and several trade names.

ANSWER: B

Each drug has only one generic name but may have several trade names. For each drug, there is

only one generic name. It is not capitalized, and it becomes the “official” name of the drug. The

pharmaceutical company discovering the drug gives the drug a trade name. The trade name is

protected by the Federal Patent Law for 20 years from the earliest claimed filing date, plus patent

term extensions. Although the brand name is technically the name of the company marketing

the product, it is often used interchangeably with the trade name.

DIF: Comprehension REF: Drug Names | p.


7. Two drugs that are found to be chemically equivalent, but not biologically equivalent

or therapeutically equivalent are said to differ in

a. potency.

b. efficacy.

c. bioavailability.

d. therapeutic index.

ANSWER: C

A preparation can be chemically equivalent yet not biologically or therapeutically equivalent.

These products are said to differ in their bioavailability. The potency of a drug is a function of the

amount of drug required to produce an effect. The efficacy is the maximum intensity of effect or

response that can be produced by a drug. The therapeutic index is the ratio of the lethal dose

for 50% of the experimental animals divided by the effective dose for 50% of the experimental

animals. If the value of the therapeutic index is small, toxicity is more likely.

DIF: Recall REF: Drug Names (Drug Substitution) | p.


8. How many years must pass after a drug patent expires before other drug companies can

market the same compound as a generic drug?

a. 20 years

b. 17 years

c. 7 years

d. 0 years

ANSWER: D

Once a drug patent expires, competing companies may immediately market the same

compound in generic form. The pharmaceutical company discovering the drug gives the drug a

trade name. The trade name is protected by the Federal Patent Law for 20 years from the

earliest claimed filing date, plus the patent term extensions.

DIF: Application REF: Drug Names (Drug Substitution) | p.



9. Two drug formulations that produce similar concentrations in the blood and tissues after

drug administration are termed equivalent.

a. chemically

b. biologically

c. therapeutically

ANSWER: B

Biologic equivalence refers to identical pharmacokinetic parameters of two drug formulations

(bioequivalence, for short). Chemical equivalence indicates that two formulations of a drug meet

the chemical and physical standards established by the regulatory agencies. Therapeutic

equivalence means that two formulations produce the same therapeutic effects over the same

duration.

DIF: Application REF: Drug Names (Drug Substitution) | p.


10. The federal body that determines whether a drug is considered a controlled substance and to

which schedule it belongs is the

a. Food and Drug Administration (FDA).

b. Federal Trade Commission (FTC).

c. Drug Enforcement Administration (DEA).

d. U.S. Pharmacopeia (USP).

ANSWER: C

The DEA regulates the manufacture and distribution of substances with abuse potential. Hence

prescriber DEA numbers must appear on prescriptions for controlled substances. The FDA does

not have any special powers in regard to drugs of abuse. The FTC regulates commerce and

advertising claims of foods, over-the-counter (OTC) products, and cosmetics. The USP regulates

the uniformity and purity of drugs.

DIF: Comprehension

REF: Federal Regulations and Regulatory Agencies (US Drug Enforcement Administration) | p.


11. Which federal regulatory agency decides which drugs require a prescription and which drugs

may be sold over-the-counter (OTC)?

a. FDA

b. OSHA

c. FTC

d. DEA

ANSWER: A

The Food and Drug Administration (FDA) is part of Department of Human and Health Services

(DHHS), and determines what drugs may be sold by prescription and OTC and regulates the

labeling and advertising of prescription drugs. The Occupational Safety and Health Administration

(OSHA) ensures the safety and health of workers in the United States by setting and enforcing

standards. The Federal Trade Commission (FTC) regulates the trade practices of drug companies

and prohibits the false advertising of foods, nonprescription (OTC) drugs, and cosmetics. The

Drug Enforcement Administration (DEA) is a part of the Department of Justice and regulates the


manufacture and


distribution of substances that have a potential for abuse, including opioids, stimulants, and

sedatives.


DIF: Recall

REF: Federal Regulations and Regulatory Agencies (US Food and Drug Administration) | p.


12. Which federal regulatory body regulates the trade practices of drug companies and prohibits

false advertising of foods, nonprescription drugs, and cosmetics?

a. FDA

b. FTC

c. DEA

d. OBRA

ANSWER: B

Consumers who refer to care labels on their clothes, product warranties, or stickers showing the

energy costs of home appliances are using information required by the FTC. Businesses must be

familiar with the laws requiring truthful advertising and prohibiting price fixing. These laws are

also administered by the FTC. When the FTC was created in 1914, its purpose was to prevent

unfair methods of competition in commerce. Over the years, the U.S. Congress has passed

additional laws giving the agency greater authority to police anticompetitive practices. The FDA

grants approval so that drugs can be marketed in the United States. Before the FDA can approve

a drug, the drug must be determined to be both safe and effective. The DEA regulates the

manufacture and distribution of substances that have a potential for abuse. OBRA (Omnibus

Budget Reconciliation Act) is not a regulatory body; it is an act that mandates that pharmacists

must provide patient counseling.

DIF: Recall

REF: Federal Regulations and Regulatory Agencies (Federal Trade Commission) | p.


13. An investigational new drug application (INDA) is submitted .

a. before preclinical trials

b. before phase 1 clinical trials

c. after phase 2 clinical trials

d. before phase 3 clinical trials

ANSWER: B

Preclinical testing usually lasts about 3 years. After the preclinical trials have been completed, an

INDA must be filed with the FDA before a drug company can commence phase 1 clinical trials.

Animal testing data must be accumulated from preclinical trials before filing an INDA. Phase 1 is

the first trial using patients, and phases 2 and 3 follow phase 1. An INDA must be filed before

any testing in humans can commence.

DIF: Recall REF: Clinical Evaluation of a New Drug | p. 5

OBJ: 6


ANSWE


14. Phase 1 clinical trials involve all of the following except which one?

a. Safe dose range

b. Toxic effects of the drug

c. Metabolism

d. Effectiveness

ANSWE


In phase 1 clinical trials, small and then increasing doses are administered to a limited number

of healthy human volunteers, primarily to determine safety. This phase determines the biologic

effects, metabolism, safe dose range in humans, and toxic effects of the drug. The main purpose

of phase 2 is to test effectiveness. Biologic effects, metabolism, safe dose range in humans, and

toxic effects of the drug are, in fact, goals of phase 1 clinical trials.

DIF: Comprehension REF: Clinical Evaluation of a New Drug | p. 5

OBJ: 6


15. Which of the following is determined during a phase 3 clinical evaluation of a new drug?

a. Effectiveness

b. Safety and efficacy

c. Dosage

d. Both A and B

e. Both B and C

ANSWER: E

Both safety and efficacy must be demonstrated during phase 3 of the clinical evaluation of a new

drug. Dosage is also determined during this phase. During phase 3, clinical evaluation takes

place involving a large number of patients who have the condition for which the drug is

indicated. The main purpose of phase 2 clinical evaluation is to test a drug’s effectiveness.


OBJ: 6


16. Which of the following is a Schedule II controlled substance?

a. Heroin

b. Propranolol

c. Amphetamine

d. Dextropropoxyphene (Darvon)

ANSWER: C

Amphetamine, oxycodone, morphine, and secobarbital are all schedule II controlled substances.

Heroin is a schedule I substance. Propranolol is a nonscheduled prescription drug.

Dextropropoxyphene is a schedule IV substance.

DIF: Recall

REF: Drug Legislation (Scheduled Drugs [Table 1.2: Schedules of Controlled Substances]) |

p. 6 OBJ: 6 TOP: NBDHE, 6.0. Pharmacology

17. Controlled substances in schedule require a written prescription with the provider’s

signature and do not permit refills.

ANSWE


a. II, III, and IV

b. II and III

c. III and IV

d. II only

e. III only

ANSWE


Controlled substances in schedule II require a written prescription with the provider’s signature

and do not permit refills. Any prescription for schedule II drugs must be written in pen or indelible

ink or typed. A designee of the dentist, such as the dental hygienist, may write the prescription,

but the prescriber must personally sign the prescription in ink and is responsible for what any

designee has written. Prescriptions for controlled substances in both schedule III and schedule IV

may be telephoned, and no more than five prescriptions in 6 months are permitted.

DIF: Comprehension REF: Drug Legislation (Scheduled Drugs) | p.


18. Schedule III controlled substances may be telephoned to the pharmacist and may be refilled no

more than five times in 6 months.

a. Both parts of the statement are true.

b. Both parts of the statement are false.

c. The first part of the statement is true; the second part is false.

d. The first part of the statement is false; the second part is true.

ANSWER: A

Both parts of the statement are true. Schedule III controlled substances may be telephoned to

the pharmacist and may be refilled as many as five times in 6 months. Both parts of the

statement are true for schedule III and schedule IV controlled substances. Schedule I controlled

substances have no accepted medical use. Schedule II controlled substances require a written

prescription with the provider’s signature, and no refills are permitted. Schedule V controlled

substances can be bought OTC in some states.

DIF: Recall REF: Drug Legislation (Scheduled Drugs) | p.


19. What is the purpose of a “black box warning” on a package insert?

a. It is used to reconstruct the events leading to a fatality resulting from a

medication error.

b. It is issued by the Drug Enforcement Administration (DEA) to

indicate medications that may be used to manufacture illicit drugs

such as methamphetamine.

c. It is used to draw attention to potentially fatal, life threatening, or disabling

adverse effects for different medications.

d. It means that the effects of the drug have not yet been determined.

ANSWER: C

A black box warning is about a drug the FDA has required a manufacturer to prominently display

in a box in the package insert. The intent of the black box is to draw attention to the specific

warning and make sure that both the prescriber and patient understand the serious safety

concerns associated with that drug. A black box on an airplane is used to reconstruct events

prior to a tragedy; however, the black box warning on a medication package insert is used to

warn about safety concerns with the drug. A black box is not used as a warning about illicit use

of medications. All drugs must go through preclinical and clinical trials prior to being marketed.


DIF: Recall REF: Drug Legislation (Black Box Warning) | pp. 6-7

OBJ: 7



20. An “orphan drug” is

a. not related to any other medication currently available.

b. developed specifically to treat a rare medical condition.

c. a drug that has been on the market for longer than 20 years and generic

substitution is permitted.

d. no longer available for use as newer, more effective medications are available.

ANSWER: B

Rare medical conditions with orphan status refer to diseases that occur in fewer than 200,000

people in the United States. Orphan drugs may be related to other medications. Orphan drug

status is not related to the time the drug has been available. Many newer drugs have been

assigned orphan status.

DIF: Recall REF: Drug Legislation (Orphan Drugs) | p.


21. The word stat on a prescription means

a. before meals.

b. at bedtime.

c. immediately.

d. every.

ANSWER: C

The word stat on a prescription means immediately (now). The abbreviation ac means before

meals, hs

means at bedtime, and q means every.

DIF: Recall REF: Table 1.3: Abbreviations Commonly Used in Prescriptions | p.


22. The abbreviation used on prescriptions for four times a day is

a. bid.

b. qid.

c. qd.

d. ud.

ANSWER: B

qid is the abbreviation for quarter in die, or four times a day. bid stands for twice a day, qd stands

for every day, and ud stands for as directed.

DIF: Recall

REF: Prescription Writing (Prescription Label Regulations [Table 1.3: Abbreviations Commonly Used

in Prescriptions]) | pp. 8-9 OBJ: 7 TOP: NBDHE, 6.0. Pharmacology

ANSWE


23. The heading of a prescription contains the following information except the

ANSWE


a. name and address of the prescriber.

b. name and address of the patient.

c. telephone numbers of the patient and the prescriber.

d. date of birth of the prescriber.

e. date of the prescription.

ANSWE


Including the date of birth of the patient on the prescription is important, both to determine the

proper dose for age and also the patient is not confused with another family member (i.e.,

mother or daughter). The heading of a prescription contains the name, address, and telephone

number of the prescriber, as well as the name, address, age, and telephone number of the

patient, and the date of the prescription.

DIF: Comprehension REF: Prescription Writing (Prescriptions [Format]) | p.


24. Which of the following is located in the body of the prescription?

a. The date of the prescription

b. The amount of the drug to be dispensed

c. Directions to the prescriber

d. Refill instructions

ANSWER: B

The Rx symbol, name and dose size or concentration of the drug, amount to be dispensed, and

directions to the patient are all found in the body of the prescription. The date of the prescription

is found in the heading. The directions to the patient rather than prescriber are found in the body

of the prescription. Refill instructions are found in the closing of the prescription.

DIF: Recall REF: Prescription Writing (Prescriptions [Format]) | p.


25. Where is the information regarding the prescriber DEA number commonly found on the

prescription?

a. Superscription

b. Heading

c. Body

d. Closing

ANSWER: D

The signature area of the prescription is found in the closing. It should also include a space for

the DEA number. The superscription is a classical description for where the patient information

and the symbol Rx are found. The heading contains prescriber and patient contact information,

the patient’s date of birth, and the date of prescription. The body contains the Rx symbol, dosage

instructions, and directions to the patient.



ANSWE


26. On a prescription, the directions to the patient are preceded by

a. Rx.

b. Sig.

c. #.

d. Disp.

ANSWE


Sig. is the abbreviation for the Latin word signa, or write. This word precedes the instructions to

the patient. Rx means take thou and precedes the prescription instructions, # denotes the

number of tablets, capsules, and so forth to be dispensed. Disp. is short for dispense and

precedes the amount to be dispensed, analogous to #.



27. Each is an advantage of electronic and fax prescribing except one. Which is the exception?

a. It reduces the likelihood of errors in reading handwritten prescriptions.

b. It reduces the patient’s ability to tamper with a prescription.

c. There is no record of the prescription in the patient’s record.

d. Prescriptions can be faxed to the pharmacy.

ANSWER: C

A written record of the prescription is kept in the patient’s record. Electronic prescribing is the

electronic transmission of a prescription to a pharmacy, which reduces the incidence of errors in

reading handwritten prescriptions and the patient’s ability to tamper with a prescription.

Prescriptions can be faxed to the pharmacy.

DIF: Comprehension

REF: Prescription Writing (Prescriptions [Electronic and Fax Prescribing]) | p.


28. Which drug legislation act was instrumental for the growth of electronic prescribing?

a. Controlled Substance Act

b. Medicare Modernization Act

c. Food, Drug and Cosmetic Act

d. Harrison Narcotic Act

ANSWER: B

The inclusion of e-prescribing in the Medicare Modernization Act of 2003 (MMA) gave momentum

to its use in provider practices across the country. The MMA expanded Medicare to include a

drug benefit program (Medicare Part D), which began in 2006. Electronic prescribing of

controlled substances as mandated by the federal SUPPORT Act of 2018 went into effect in

January of 2021.

This federal mandate affects Medicare Part D prescription plans. Any prescription for a controlled

substance written for a Medicare Part D patient must be electronically prescribed. Many states

have passed legislation that mandates that any opioid prescription (regardless of insurer) must

be electronically prescribed. This legislation has been passed in an attempt to prevent

prescription diversion and tampering. The Controlled Substance Act of 1970 replaced the

Harrison Narcotic Act of 1914, and the Drug Abuse Control Amendments (1965) to the Food,

Drug and Cosmetic Act (1938).

DIF: Comprehension

REF: Prescription Writing (Prescriptions [Electronic and Fax Prescribing]) | p.


29. What would be an advantage for a dentist to call the pharmacy with a prescription for Tylenol #3


rather than hydrocodone for a patient who calls late at night requesting medication for pain

following


root canal therapy?

a. Tylenol #3 is available over-the-counter and does not require a prescription.


b. Tylenol #3 is a not a controlled substance and hydrocodone is a

controlled substance.

c. A prescription for Tylenol #3 (Schedule III) may be telephoned,

whereas hydrocodone (Schedule II) requires a written prescription.

d. Tylenol #3 has greater potency than hydrocodone.

ANSWER: C

Tylenol #3 has moderate abuse potential and prescriptions may be telephoned. Hydrocodone has

high abuse potential and requires a written prescription with the provider’s signature. Tylenol #3

is a Schedule III controlled substance. It is not available over-the-counter and requires a

prescription.

Hydrocodone has more potency and a higher abuse potential than Tylenol #3.

DIF: Application

REF: Drug Legislation (Scheduled Drugs [Table 1.2: Schedules of Controlled Substances]) |


30. Clinical studies of drugs first involve human volunteers during which phase of drug testing?

a. Phase 1

b. Phase 2

c. Phase 3

d. Phase 4

ANSWER: A

Clinical studies of drugs involve humans’ right from the start of Phase 1 clinical trials. In Phase 1

clinical trials, small and then increasing doses of the prospective drug are administered to a

limited number of healthy human volunteers, primarily to determine safety. Larger groups of

humans are given the drug in Phase 2 clinical trials, but humans were involved in Phase 1

clinical trials. Phase 3 involves a large number of patients who have the condition for which the

drug is indicated. Phase 4 involves postmarketing surveillance.


OBJ: 6


MULTIPLE RESPONSE

1. How are computer and online resources enhancing printed books as a source of information

about drugs? (Select all that apply.)

a. Web-based physicians can diagnose patient conditions and prescribe

medication over the Internet.

b. Tablet computers and smart phones may be used for medication

ANSWER:


information databases.

ANSWER:


c. Some publishers have apps that can be downloaded to smart phones.

d. Websites such as WebMD have decision trees whereby patients can identify

their own health condition and determine appropriate treatment and

medication.

e. Older editions of textbooks have been placed in the public domain and are

useful for information about medications and drug interactions.

ANSWER:


Tablet computers and smart phones are being used more and more for recording, storing patient

information, calculating drug doses, and using medication information databases. Some online

websites have apps that can be downloaded to smart phones as well as computer-based online

sites. There are many legal issues with health care professionals dispensing advice over the

Internet. For example, a health care provider may not be licensed to practice in the state where

the person asking for information resides. Websites do not provide the means for patients to

determine their own health condition. There are many sites with useful information, but most

have a disclaimer recommending that the person seek help from a qualified practitioner.

Medications change rapidly, and it is important to use current sources of information.

DIF: Comprehension

REF: Sources of Information (Computers and Online Resources) |


2. Which of the following are true of an off-label use of a drug? (Select all that apply.)

a. Prescribers are allowed to use drugs for off-label use under certain circumstances.

b. The FDA approves the use of drugs for specific indications, which are listed

or labeled on the package insert of the drug.

c. Drug manufacturers have much useful information regarding off-label uses of

their drugs on their websites.

d. Off-label use of drugs is not permitted in the United States.

e. Off-label drugs are repackaged for sale by clandestine organizations outside

the United States and are illegal to transport or distribute.

ANSWER: A, B

Practitioners are allowed to use off-label drugs if good medical practice justifies their use, the use

is well documented in the medical literature, and the drug meets the current standard of

medical care. The FDA approves the use of drugs for specific indications, and they are listed or

labeled on the package insert of the drug. Drug manufacturers are not allowed to bring up offlabel

uses when speaking with the prescribing practitioner, nor can they distribute written

material regarding off-label uses. The off-label use of drugs is permitted in the United States

provided that several rules are followed.

DIF: Comprehension

REF: Drug Legislation (Labeled and Off-Label Uses) | p. 7 OBJ: 7


3. Which of the following are associated with increased patient nonadherence to medication

therapy? (Select all that apply.)

a. Some patients may fear of the side effects of the medication.

ANSWER:


b. A longer duration of drug therapy is associated with the risk for nonadherence

with medication therapy.

c. Increased dosing frequency is associated with nonadherence with

medication therapy.

d. The issue of nonadherence to medication therapy is not important, as

patients reliably take their medication as prescribed.

ANSWER:


Many factors are associated with nonadherence to medication therapy. These include poor

understanding of the disease and a need for medication to treat it, fear of side effects of the

medication, distrust of health care professionals, economic factors, or forgetfulness. Longer

duration of drug therapy and the number of times a day the patient must take a prescription

increase the chances that a patient will not adhere to the regimen. For example, patients are

more compliant with twice-a-day dosing than they are with four-times-a-day dosing. Statistics

reveal that only a minority of patients will take their medication as prescribed.

DIF: Comprehension

REF: Prescription Writing (Role of the Dental Hygienist and Patient Adherence to Medication Therapy) | p.


TRUE/FALSE

1. The body of a prescription includes directions to the patient.

ANSWER: T

The body of the prescription contains the Rx symbol, name, and dose size or concentration of the

drug, amount to be dispensed, and directions to the patient.



2. Refill instructions are found in the body of a prescription.

ANSWER: F

Refill instructions are found in the closing, rather than body, of the prescription.



Chapter 02: Drug Action and Handling

Haveles: Applied Pharmacology for the Dental Hygienist, 9th Edition

MULTIPLE CHOICE

1. A drug is defined as a biologically active substance that can modify

a. the environment.

b. the pH of tissue.

c. cellular function.

d. immune response.

ANSWER: C

A drug can modify cellular function. A general understanding of drug action allows the dental

hygienist to make informed decisions regarding possible drug interactions or adverse reactions

for the patient. It is a concern that discarded drugs may be affecting the environment, but this is

not the definition of a drug. Some drugs may have the capacity to modify body compartment pH;

however,


this is not the definition for a drug. Some drugs may have the capacity to modify the immune

response, but this is not the definition of a drug.


DIF: Recall REF: Introduction | p. 11 OBJ: 1


2. In comparing two drugs, the dose-response curve for the drug that is more efficacious would

a. be closer to the y-axis.

b. be farther from the y-axis.

c. have a greater curve height.

d. have a higher median effective dose (ED50).

ANSWER: C

Efficacy is an expression of maximum intensity of effect or response that can be produced by a

drug. The other choices refer to indicators of drug potency, not efficacy. The potency of a drug is

a function of the amount of drug required to produce an effect. The potency of drug is shown by

the location of that drug’s curve along the log-dose axis (x-axis).

DIF: Comprehension REF: Characterization of Drug Action (Efficacy) | p. 11

OBJ: 1


3. Administering a drug of greater potency is better because drugs of greater potency do not

require as high a dose.





ANSWER: D

The first part of the statement is false, the second part is true. The absolute potency of a drug is

immaterial as long as the appropriate dose is administered. If equally efficacious, both drugs will

produce the same effect. Both meperidine and morphine, for example, have the ability to treat

severe pain, but approximately 100 mg of meperidine would be required to produce the same

action as 10 mg of morphine. The dose of meperidine needed to produce pain relief is larger

than that for morphine.

Less potent drugs require higher doses to produce therapeutic effects whereas more potent drugs

can reach toxic levels at lower doses.

DIF: Application REF: Characterization of Drug Action (Potency) | p.


4. Which of the following statements is true regarding the therapeutic index (TI) of a drug?

a. A drug with a large TI is more dangerous than a drug with a small TI.

b. The formula for TI is ED50/LD50.

c. ED50 is 50% of the effective clinical dose.

d. TI is the ratio of the median lethal dose to the median effective dose.

ANSWER: D

LD50 is the dose causing death in 50% of test animals and ED50 is the dose required to produce

the desired clinical effect in 50% of test animals. The greater the TI, the safer the drug. The

formula is TI


= LD50/ED50. The ED50 is the dose required to produce the desired clinical effect in 50% of test


animals, not 50% of the effective clinical dose.


DIF: Comprehension

REF: Characterization of Drug Action (Therapeutic Index) | p.


5. Which of the following statements is true concerning the mechanism of action of drugs?

a. Drugs are capable of imparting a new function to the organism.

b. Drugs either produce the same action as an exogenous agent or block the

action of an exogenous agent.

c. Drugs either produce the same action as an exogenous agent or block the

action of an endogenous agent.

d. Drugs either produce the same action as an endogenous agent or block the

action of an endogenous agent.

ANSWER: D

Drugs either produce the same action as an endogenous agent or block the action of an

endogenous agent. Drugs do not impart a new function to the organism; they merely either

produce the same action as an endogenous agent or block the action of an endogenous agent.

DIF: Comprehension REF: Mechanism of Action of Drugs | pp. 12-


6. When different drugs compete for the same receptor sites, the drug with the stronger affinity

for the receptor will bind to

a. more receptors than the drug with the weaker affinity.

b. fewer receptors than the drug with the weaker affinity.

c. all of the available receptors.

d. none of the available receptors.

ANSWER: A

When different drugs compete for the same receptor sites, the drug with the stronger affinity for

the receptor will bind to more receptors than the drug with the weaker affinity. More of the drug

with weaker affinity will be required to produce a pharmacologic response. Drugs with a stronger

affinity for receptor sites are more potent than drugs with weaker affinities for the same site.

DIF: Recall REF: Mechanism of Action of Drugs (Receptors) | p.


7. When a drug has affinity for a receptor and produces no effect, it is called a(n)

a. agonist.

b. competitive antagonist.

c. competitive agonist.

d. physiologic agonist.

DIF:

Recall


ANSWER: B

A competitive antagonist has affinity for a receptor, combines with the receptor, competes with

the agonist for the receptor, and produces no effect. An agonist has affinity for a receptor,

combines with the receptor, and produces an effect. Competitive agonist is nonsensical

terminology. A physiologic antagonist has affinity for a site different from that of the agonist in

question.

DIF:

Recall


REF: Mechanism of Action of Drugs (Receptors [Agonists and Antagonists]) | p.


8. A noncompetitive antagonist

a. binds to the same receptor site as the binding site for the agonist.

b. causes a shift to the right in the dose-response curve.

c. enhances the maximal response of the agonist.

d. reduces the maximal response of the agonist.

ANSWER: D

A noncompetitive antagonist reduces the maximal response of the agonist. Noncompetitive

antagonists bind to a receptor site that is different from the binding site for the agonist. A

competitive antagonist will cause a shift to the right in the dose-response curve.

DIF: Recall

REF: Mechanism of Action of Drugs (Receptors [Agonists and Antagonists]) | p.


9. Which of the following is not a subject of pharmacokinetics?

a. Physiologic action of drugs

b. Metabolism of drugs

c. Elimination of drugs

d. Absorption of drugs

ANSWER: A

The physiologic action of drugs is a subject of pharmacology, not pharmacokinetics.

Pharmacokinetics

does have to do with the subjects of absorption, distribution, metabolism, and excretion of drugs.

DIF: Comprehension REF: Pharmacokinetics | p.


10. Which of the following statements is (are) true concerning passage across body membranes?

a. The membrane lipids make the membrane relatively permeable to ions and

polar molecules.

b. The lipid molecules orient themselves so that they form a fluid bimolecular

leaflet structure with the hydrophobic ends of the molecules shielded from

the surrounding aqueous environment.

c. Membrane carbohydrates make up the structural components of the

membrane and help move the molecules across the membrane during the

transport process.

d. Both A and B are true.

e. Both B and C are true.

DIF:

Comprehension


ANSWER: B

DIF:

Comprehension


The lipid molecules orient themselves so that they form a fluid bimolecular leaflet structure with

the hydrophobic ends of the molecules shielded from the surrounding aqueous environment.

The hydrophilic ends are in contact with water. The membrane lipids make the membrane

relatively impermeable to ions and polar molecules. Membrane proteins make up the

structural components of the membrane and help move the molecules across the membrane

during the transport process.

DIF:

Comprehension


REF: Pharmacokinetics (Passage Across Body Membranes) | p.


11. Which of the following choices is the process by which a substance is transported

against a concentration gradient?

a. Passive transfer

b. Active transport

c. Facilitated diffusion

d. Filtration

ANSWER: B

Active transport is a mechanism for movement of substances, often against a concentration

gradient, that uses the energy of the cell to actively pump the substance from one side of a

membrane to the other. Passive transfer and filtration entail the passage of substances in a

manner proportional to their concentration on each side of the membrane. The substances move

without any assistance. Facilitated transport uses a carrier protein but cannot transport

substances against a gradient.

DIF: Recall

REF: Pharmacokinetics (Passage Across Body Membranes [Specialized Transport]) | p.


12. Drugs that are weak electrolytes will cross body membranes best when they are (1)

nonionized, (2) ionized, (3) polar, (4) nonpolar, (5) lipid soluble, (6) water soluble.

a. 1, 3,

b. 51, 3,

c. 61, 4,

d. 51, 4,

e. 62, 4,

5

ANSWER: C

Drugs that are weak electrolytes will cross body membranes best when they are nonionized,

nonpolar, and lipid soluble. These drugs dissociate in solution and equilibrate into a nonionized

form and an ionized form. The nonionized, or uncharged, portion acts as a nonpolar, lipid-soluble

compound that readily crosses body membranes. The ionized portion of drugs that are weak

electrolytes will traverse membranes with greater difficulty because they are less lipid soluble.

DIF: Comprehension

REF: Pharmacokinetics (Passage Across Body Membranes [Effect of Ionization]) | p.


ANSWE


13. Increasing the pH of a solution will cause

ANSWE


a. a greater percentage of a weak base in the solution to be in the ionized form.

b. a greater percentage of a weak acid in the solution to be in the un-ionized form.

c. the hydrogen ion concentration to increase.

d. a greater percentage of a weak base in the solution to be in the un-ionized form.

e. no change in the relative ionization of weak acids or weak bases.

ANSWE


Weak bases become ionized at low pH and un-ionized at higher pH. If the pH of the site rises, the

hydrogen ion concentration will fall. For weak bases, this results in the un-ionized form (B), which

can more easily penetrate tissues. Conversely, if the pH of the site falls, the hydrogen ion

concentration will rise. This results in an increase in the ionized form (BH + ), which cannot easily

penetrate tissues.

DIF: Comprehension



14. When the acidity of the tissue increases, as in instances of infection, the effect of a local

anesthetic decreases; therefore, the local anesthetic is a weak acid.





ANSWER: C

The first part of the statement is true, the second part is false. Infections lead to an

accumulation of acidic waste products, which lowers the pH of the local area. Local anesthetics

must penetrate the nerve cell membrane to cause their action. They become more ionized as the

pH drops. This property is a characteristic of weak bases, not weak acids. Local anesthetics are

weak bases. Weak bases are better absorbed when the pH is greater than the pKa. A weak base

is associated and ionized when the pH is less than the pKa.

DIF: Comprehension



15. Which of the following is true regarding basic principles of drug distribution in the bloodstream?

a. All drugs in the blood are either bound to plasma proteins or free.

b. Only the drug that is bound to plasma proteins can exert the pharmacologic effect.

c. Only the drug that is bound to plasma proteins can pass across cell membranes.

d. The free drug is a reservoir for the drug.

ANSWER: A

All drugs in the blood are either bound to plasma proteins or free. Only the drug that is free can

exert the pharmacologic effect. Only the free drug can pass across cell membranes. The bound

drug is a reservoir for the drug.

DIF: Comprehension

REF: Pharmacokinetics (Distribution [Basic Principles]) | p.


ANSWE


16. The movement of a drug from one site in the body to other sites is called

a. distribution.

b. disruption.

c. dispersion.

d. active transport.

ANSWE


Distribution is the movement of a drug from the site of absorption or injection to other sites.

Disruption is the initial destruction of a tablet coating or capsule during oral absorption.

Dispersion is the spread of concentrated drug particles throughout the stomach or intestines.

Active transport is a process involved in the passage of certain agents, including some drugs,

across membrane barriers and may be involved in not only drug redistribution but also drug

absorption, distribution, or excretion.

DIF: Comprehension

REF: Pharmacokinetics (Distribution [Basic Principles]) | p.


17. The distribution of a drug is determined by

a. blood flow to the organ.

b. presence of certain barriers.

c. plasma protein–binding capacity.

d. solubility of the drug.

e. All of the above.

ANSWER: E

All of the above choices are correct. If the blood circulation to an organ is low, it will receive less

drug. The more membranes and barriers a drug needs to cross, the slower the rate at which it will

reach the organ in question. The binding of drugs to plasma proteins reduces the concentration

of drug that can leave the circulation and be taken up by an organ. The relative level of fat or

water solubility of a drug will influence where and how rapidly a drug will distribute. The

distribution of a drug is determined by several factors, such as the size of the organ, the blood

flow to the organ, the solubility of the drug, the plasma protein–binding capacity, and the

presence of certain barriers (e.g., blood-brain barrier, placenta).

DIF: Recall REF: Pharmacokinetics (Distribution [Basic Principles]) | p.


18. If one dose of a drug is administered and the drug’s half-life in the body is 3 hours, what

percentage of the drug would be left after four half-lives?

a. 50%

b. 6.25%

c. 2%

d. Insufficient information to

determine

ANSWER: B

The half-life is the time required for a drug level to fall to one half of its concentration. The drug

concentration would go to 50% 25% 12.5% 6.25% in four half-lives. The

information given is more than sufficient to answer the question. One needs merely to count the

number of half-lives and divide the percentage drug in half for every half-life passed since the

drug was administered.

DIF: Application REF: Clinical Pharmacokinetics (Half-Life) | p.


19. One dose of a drug is administered that has a half-life of 8 hours. Assuming first-order kinetics,


how much time is needed for this drug to be over 96% eliminated from the body?


a. 8 hours


b. 40 hours

c. 60 hours

d. 120 hours

ANSWER: B

Assuming first-order kinetics, 40 hours would be required for this drug to be over 96%

eliminated from the body. Five half-lives are needed to reduce the levels of a drug to 3.125% of

the original levels, or eliminate over 96%. For a drug with an 8-hour half-life, this amounts to five

half-lives 8 hours per half-life, or 40 hours.

DIF: Application REF: Clinical Pharmacokinetics (Kinetics) | p.


20. The half-life of a drug is most related to its

a. onset.

b. duration.

c. safety.

d. time to peak concentration.

ANSWER: B

Half-life is the amount of time required for a drug to fall to one half of its blood level. It is an

expression of how long the drug lasts in the body. Onset is the time at which a drug starts to take

effect. The half-life does not predict the relative safety of a drug; safe drugs can have long or short

half-lives. Time to peak concentration refers to how much time is required for a drug to reach

effective levels in the body, not how long a drug lasts in the body.

DIF: Comprehension REF: Clinical Pharmacokinetics (Half-Life) | p.


21. Enterohepatic circulation of a drug involves the secretion of a metabolized drug into the

intestine. If enterohepatic circulation is blocked, the level of the drug in the serum will fall.

a. Both statements are true.

b. Both statements are false.

c. The first statement is true, the second statement is false.

d. The first statement is false, the second statement is true.

ANSWER: A

Both statements are true. Enterohepatic circulation involves the secretion of a metabolite, such

as a conjugated drug, via the bile into the intestine. While in the intestine, the metabolite is

broken down (deconjugated), and the active drug can be reabsorbed into the circulation. If this

process is blocked, then the reactivated drug cannot reenter the circulation, and the serum level

will fall accordingly. Both of the statements are true as written. The circular pattern continues

with some drug escaping with each passing. This process prolongs the effect of a drug.

DIF: Comprehension

REF: Pharmacokinetics (Distribution [Enterohepatic Circulation]) | p.



22. If redistribution occurs between specific sites and nonspecific sites, a drug’s action will

be

a. prolonged.


b. extended.

c. decreased.

d. terminated.

ANSWER: D

If redistribution occurs between specific sites and nonspecific sites, a drug’s action will be

terminated. Redistribution of a drug is the movement of a drug from the site of action to

nonspecific sites of action. A drug’s duration of action can be affected by redistribution of the

drug from one organ to another.

DIF: Recall REF: Pharmacokinetics (Redistribution) | p.


23. The is the most common site for biotransformation.

a. kidney

b. blood plasma

c. liver

d. small intestine

ANSWER: C

The liver is the most common site for biotransformation. Biotransformation is the body’s way of

changing a drug so that the kidneys can more easily excrete it. The liver rather than kidney, blood

plasma, or small intestine is the most common site for biotransformation.

DIF: Comprehension

REF: Pharmacokinetics (Metabolism (Biotransformation)) | p.


24. The metabolite formed during metabolism (biotransformation) is usually polar and lipid

soluble than its parent compound.

a. more; more

b. more; less

c. less; more

d. less; less

ANSWER: B

The metabolite is usually more polar and less lipid soluble than its parent compound, meaning

that renal tubular reabsorption of the metabolite will be reduced because reabsorption favors

lipid-soluble compounds. Metabolites are also less likely to bind to plasma or tissue proteins and

less likely to be stored in fat tissue. Drugs must pass through various membranes such as

cellular membranes, blood capillary membranes, and intracellular membranes. The lipid in the

membranes makes them relatively impermeable to ions and polar molecules. Decreased renal

tubular absorption, decreased binding to the plasma or tissue proteins, and decreased fat

storage cause the metabolite to be excreted more easily.

DIF: Recall REF: Pharmacokinetics (Metabolism (Biotransformation)) | p.


25. All of the following choices are true with regard to cytochrome P-450 hepatic microsomal enzymes


except that they


a. can be induced to speed up drug metabolism.

b. can be inhibited to slow down drug metabolism.


c. exist as numerous isoenzymes.

d. inactivate drugs through conjugation reactions.

ANSWER: D

Cytochrome P-450 hepatic microsomal enzymes inactivate drugs but not through conjugation.

They are involved in phase I metabolism and metabolize drugs through oxidation, reduction, and

hydrolysis reactions. Phase II reactions involve conjugation with glucuronic acid, sulfuric acid,

acetic acid, or an amino acid. Cytochrome P-450 hepatic microsomal enzymes can be induced

to speed up drug metabolism or inhibited to reduce or slow down drug metabolism. They exist as

numerous isozymes that have specificity for certain drugs. Examples of isoenzymes include

cytochrome P-450 and 3A4.

DIF: Application

REF: Pharmacokinetics (Metabolism (Biotransformation) [First-Pass Effect]) | p. 16 | Pharmacokinetics

(Metabolism (Biotransformation [Cytochrome P-450 Induction and Inhibition]) | p. 16 OBJ: 4 TOP:

NBDHE, 6.0. Pharmacology

26. Which of the following reactions is considered to be in the category of phase II drug metabolism?

a. Conjugation

b. Reduction

c. Hydrolysis

d. Oxidation

ANSWER: A

Phase II reactions involve conjugation with glucuronic acid, sulfuric acid, acetic acid, or an amino

acid. The most common conjugation occurs with glucuronic acid. Reduction, hydrolysis, and

oxidation are all examples of phase I drug metabolism.

DIF: Recall

REF: Pharmacokinetics (Metabolism (Biotransformation) [First-Pass Effect]) | p.


27. If a drug displays zero-order elimination kinetics

a. elimination increases as the dose of the drug is increased.

b. a constant amount is eliminated per unit time.

c. the drug is not eliminated and is retained in the body.

d. the elimination of the drug cannot be predicted mathematically.

ANSWER: B

With zero-order kinetics, the metabolism or excretion mechanisms for a drug in the body are

saturated, meaning that they are at their maximal level. If more drug is given, then the body

cannot keep up, and the drug levels will increase. The body cannot adjust to more drug, and

elimination of a drug will remain the same as the dose of the drug is increased. If the drug is

eliminated but a longer time is required, then it would for a first-order elimination. The elimination

of the drug can be mathematically predicted.

DIF: Comprehension REF: Clinical Pharmacokinetics (Kinetics) | p.



28. Which of the following processes in the kidney can result in retention of a drug in the

body?

a. Glomerular filtration


b. Active tubular secretion

c. Passive tubular diffusion

d. All of the above

ANSWER: C

Passive tubular diffusion is a process whereby solutes such as drugs, which are concentrated in

the renal tubular fluid, can diffuse out of the tubule and back into the circulation. The drugs must

be un- ionized and lipid soluble to passively diffuse back to the circulation. Glomerular filtration

and active tubular secretion are ways in which drugs and their metabolites enter the renal

tubular fluid on their way to the collecting duct and the urine.

DIF: Application REF: Pharmacokinetics (Metabolism (Biotransformation) [Excretion]) | p.


29. Which is true regarding excretion when tubular urine is more alkaline?

a. Both weak acids and weak bases are excreted more rapidly.

b. Weak acids are excreted more rapidly, and weak bases are excreted more slowly.

c. Weak acids are excreted more slowly, and weak bases are excreted more rapidly.

d. Both weak acids and weak bases are excreted more slowly.

ANSWER: B

The process of passive tubular diffusion favors the reabsorption of nonionized, lipid-soluble

compounds. The more ionized, less lipid-soluble metabolites have more difficulty penetrating the

cell membranes of the renal tubules and are likely to be retained in the tubular fluid and

eliminated in the urine. When tubular urine is more alkaline, weak acids are excreted more

rapidly and weak bases are excreted more slowly. When the tubular urinary pH is more acid than

the plasma, weak acids are excreted more rapidly and weak bases are excreted more slowly.

DIF: Recall REF: Pharmacokinetics (Metabolism (Biotransformation) [Excretion]) | p.


30. Which term refers to the time required for a drug to begin to have its effect?

a. First pass

b. Duration

c. Onset

d. Efficacy

ANSWER: C

Onset is the time at which a drug starts to take effect. First pass refers to the metabolism of

drugs by the liver during their movement from the gastrointestinal tract to the systemic

circulation via the portal circulation. Duration is the amount of time the drug is active in the

body. Efficacy is an assessment of the effectiveness of a drug and does not refer to how quickly

or how long a drug acts in the body.

DIF: Recall

REF: Routes of Administration and Dose Forms (Routes of Administration) | p.


31. An enteral route of administration would be


a. intravenous.

b. oral.


c. sublingual.

d. transdermal.

ANSWER: B

Enteral means situated or occurring inside of the gastrointestinal tract (intestines). Intravenous,

sublingual, and transdermal routes of administration bypass the gastrointestinal tract.

DIF: Recall



32. What of the following choices is considered the safest, least expensive, and most convenient

route for administering drugs?

a. Inhalation

b. Rectal

c. Oral

d. Subcutaneous

ANSWER: C

Oral administration requires no sophisticated devices, is slow enough in onset to gauge reactions

and stop the next dose, and is easy for a patient to administer without assistance. Inhalation and

subcutaneous administration require devices, such as inhalers and needles, and the drug is

irretrievable once administered. Rectal dosing has lower patient acceptance, and absorption can

be variable.

DIF: Recall



33. Advantages of oral administration of a drug include all the following except

a. large surface area for drug absorption.

b. many different dose forms that may be administered orally.

c. more predictable response than intravenous administration.

d. the simplest way to introduce a drug into the body.

ANSWER: C

Intravenous administration offers a more predictable response than the oral route because the

drug is injected directly into the bloodstream, bypassing many physiologic barriers, the hostile

environment of the gastrointestinal tract, and drug-metabolizing enzymes that are encountered

during oral absorption of a drug. Others are all characteristics of oral administration.

DIF: Comprehension

REF: Routes of Administration and Dose Forms (Routes of Administration [Oral Route]) | p.


34. Which organ is involved in the first-pass effect after oral administration of a drug?

a. Kidney

b. Lungs

c. Liver


d. Spleen

ANSWER: C


On oral administration, drugs are absorbed and are carried via the portal circulation to the liver,

where a percentage of the drug may be metabolized before entering the systemic circulation.

After oral dosing, drugs reach the kidney, lungs, and spleen after passing through the liver.

DIF: Comprehension

REF: Pharmacokinetics (Metabolism (Biotransformation) [First-Pass Effect]) | p.


35. Which of the following routes of drug administration produces the most rapid drug response?

a. Intravenous

b. Intramuscular

c. Subcutaneous

d. Intradermal

ANSWER: A

Intravenous administration produces the most rapid drug response, with an almost immediate

onset of action. Because the injection is made directly into the blood, the absorption phase is

bypassed. The intramuscular route, subcutaneous route, and intradermal route all have slower

drug response rates than intravenous drug administration.

DIF: Recall

REF: Routes of Administration and Dose Forms (Routes of Administration [Intravenous Route]) | p.


36. What route is used to administer the tuberculosis skin test?

a. Intramuscular

b. Intradermal

c. Intravenous

d. Subcutaneous

ANSWER: B

Intradermal administration is used to provide local, rather than systemic, action. Local

anesthetics are also given this way. The other routes are all chosen when systemic action is

desired. Intramuscular, intradermal, and subcutaneous routes of administration are not used to

administer the tuberculosis skin test.

DIF: Recall

REF: Routes of Administration and Dose Forms (Routes of Administration [Intradermal Route]) | p.


37. What type of administration involves the injection of solutions into the spinal subarachnoid space?

a. Intrathecal route

b. Intraperitoneal route

c. Intravenous route

d. Intradermal route

ANSWER: A


The intrathecal route is used for injection of solutions into the spinal subarachnoid space.

Intraperitoneal route refers to placing fluids into the peritoneal cavity. Intravenous route refers to

administering drugs directly into the blood circulation. Intradermal route refers to injecting a drug

just under the skin.

DIF: Recall

REF: Routes of Administration and Dose Forms (Routes of Administration [Intrathecal Route]) | p. 22 OBJ:

7 TOP: NBDHE, 6.0. Pharmacology

38. Drug preparations may be administered for local or systemic effects. Which is an example of a

dose form used for a local effect?

a. Sublingual tablet

b. Transdermal patch

c. Ophthalmic ointment

d. Subcutaneous injection

ANSWER: C

Ophthalmic ointments and drops are used specifically for treating the eye, not for treating a

systemic disorder. Administration of a sublingual tablet leads to rapid entry of the drug into the

systemic circulation. A transdermal patch is a specialized dose form for the controlled delivery of a

drug into the systemic circulation. A subcutaneous injection is applied into the subcutaneous

areolar tissue to gain access to the systemic circulation.

DIF: Comprehension

REF: Routes of Administration and Dose Forms (Routes of Administration [Topical Route]) | p.


39. Application of a transdermal patch is an example of parenteral administration because the

drug is delivered in a manner that bypasses the gastrointestinal tract.

a. Both parts of the statements are true.

b. Both parts of the statements are false.



ANSWER: A

Both parts of the statement are true. A transdermal patch is designed to provide continuous

controlled release of medication through a semipermeable membrane over a given period after

application to the intact skin. Drugs given by the enteral route are placed directly into the

gastrointestinal tract by oral or rectal administration. Parenteral means situated or occurring

outside of the gastrointestinal tract (intestines). Examples of routes that bypass the

gastrointestinal tract include various injection routes, inhalation, and topical administration. In

practice, the term parenteral usually refers to an injection.

DIF: Comprehension



40. A patient’s perception that a pill without active ingredients is having a pharmacologic effect is

termed


a. tachyphylaxis.

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