1. Pharmacology Tutoring – Factors Affecting Drug Action
By Alaina Darby

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

3. 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

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

5. 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

6. 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

7. 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

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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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