Pharmacology Tutoring – Factors Affecting Drug Action By Alaina Darby adarby1@uthsc.edu

Which of the following is not a drug metabolizing enzyme that can influence pharmacogenomics? CYPs UGT VKORC1 HLA-B*1502 D

Causes chelation of some drugs Causes alterations in GI transit time Which of the following is true of infection as a factor affecting absorption? Causes chelation of some drugs Causes alterations in GI transit time Causes decreased weak acid absorption Causes decreased weak base absorption D

The plasma levels of which of the following drugs is increased with OATP mutations? Fexofenadine Digoxin Simvastatin Nelfinavir C

Which of the following is not true of competition for protein binding? Consequences are dependent upon Vd Consequences are dependent upon therapeutic index There are many clinically relevant interactions Sulfonamide competes with bilirubin to cause kernicterus C

Which of the following is true of CYP induction and inhibition? Inhibition usually causes long-lasting action Induction is usually transient Alcohol inhibits enzymes Suicide inhibitors cause longer-lasting action D

Inducer increases drug concentration above therapeutic index Which of the following might cause a toxicity that can be seen in a patient? Inducer increases drug concentration above therapeutic index Inhibitor decreases drug concentration below therapeutic index Inducer decreases drug concentration below therapeutic index Inhibitor increases drug concentration above therapeutic index D

Which of the following is an organic acid that can inhibit tubular secretion? Acetylcholine Probenecid Histamine Quinine B

NaHCO3 administered to increase urine pH Which of the following would be true when trying to decrease streptomycin reabsorption? NaHCO3 administered to increase urine pH NaHCO3 administered to decrease urine pH NH4Cl administered to increase urine pH NH4Cl administered to decrease urine pH A

Atropine and tubocurarine Propranolol and morphine Which of the following would cause competition at the receptor site and antagonize the effects of the other? Atropine and tubocurarine Propranolol and morphine Atropine and acetylcholine Acetylcholine and neostigmine C

Active drug with active metabolites Reduction of enzymatic activity would most greatly decrease the efficacy of which of the following drugs? Active drug with active metabolites Active drug with inactive metabolites Inactive drug with active metabolites Inactive drug with inactive metabolites C

Which of the following is true of clinical trials? The strength of uncontrolled studies is to determine prognostic effects of genetic markers The strength of uncontrolled studies is to determine predictive effects of genetic markers The strength of controlled studies is to determine prognostic effects of genetic markers The strength of controlled studies is to determine predictive effects of genetic markers D

Recombinant drug metabolizing enzymes Primary human cell lines Which of the following can be used to closely model in-vivo systems but only has a limited number of cells? Recombinant drug metabolizing enzymes Primary human cell lines Immortalized human cell lines Induced pluripotent cells from human blood B

Which of the following is true of genome effects? Irinotecan exerts toxic effects through mutations in UGT encoded by the human genome Irinotecan exerts toxic effects through mutations in UGT encoded by the tumor genome Gefitinib exerts toxic effects through mutations in EGFR encoded by the human genome Gefitinib exerts toxic effects through mutations in EGFR encoded by the tumor genome A

Which of the following pairs of enzymes are most indicative of bleeding risk in warfarin therapy? VOKRC1 and CYP3A4 VOKRC1 and CYP2C9 CYP2C9 and CYP4F2 CYP2C9 and CYP3A4 B

N-desmethyl-tamoxifen 4-hydroxy-N-desmethyl-tamoxifen Which of the following is the most clinically relevant metabolite of tamoxifen? N-desmethyl-tamoxifen 4-hydroxy-N-desmethyl-tamoxifen 4-hydroxy-tamoxifen N-didesmethyl-tamoxifen B

Rapid CYP2D6 and rapid CYP3A4 metabolism Which of the following combinations of CYP’s can induce renal failure in codeine administration? Rapid CYP2D6 and rapid CYP3A4 metabolism Rapid CYP2D6 and inhibited CYP3A4 metabolism Inhibited CYP2D6 and rapid CYP3A4 metabolism Inhibited CYP2D6 and inhibited CYP3A4 metabolism B

Tyrosine kinase inhibition Hapten-peptie complexes T-cell receptors Which of the following is not thought to contribute to contribute to drug hypersensitivity reactions such as Stevens Johnsons Syndrome? HLA alleles Tyrosine kinase inhibition Hapten-peptie complexes T-cell receptors B