LEIK Pharmacology Review Exam
Questions and Answers Graded A+
First Pass Metabolism - Correct answer-GI Tract ---> Portal Circulation ---> Liver
--->Metabolized ---> Systemic Circulation
1st pass metabolism lowers the amount of drug available.
If high first-pass effect, mostly becomes inactivated and cannot be used, these
meds cannot be given orally. Example: Insulin
Drug Metabolism - Correct answer-The most active organ is the LIVER
(Cytochrome P450 enzyme system)
Others are Kidneys, GI Tract, Lungs
Coumadin and Bactrim - Correct answer-Sulfa drugs will interact with warfarin
(increases the blood level) which results in:
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,*Elevation of INR and Risk of Bleeding!
Potent Inhibitors of the cytochrome P450 (CYP450) System
*Responsible for a number of drug to drug interactions - Correct answer-■
Macrolides (erythromycin, clarithromycin, pediazole)
■ Antifungals (ketoconazole, fluconazole)
■ Cimetidine (Tagament)
■ Citaprolam (Celexa)
■ Cisapride (Propulsid). This drug has been pulled from the U.S. market.
Pharmacology terms - Correct answer-■ Half-life (t½): the amount of time in
which drug concentration decreases by 50%.
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,■ Area under the curve (AUC): the average amount of a drug in the blood after a
dose is given. It is a measure of the availability (bioavailability) of a drug after it is
administered.
■ Minimum inhibitory concentration (MIC): the lowest concentration of an
antibiotic
that will inhibit the growth of organisms (after overnight incubation).
■ Maximum concentration: the highest concentration of a drug after a dose.
■ Trough (minimum concentration): the lowest concentration of a drug after a
dose.
Narrow Therapeutic Index Drugs* - Correct answer-■Warfarin sodium
(Coumadin): monitor INR.
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, ■ Digoxin (Lanoxin): monitor digoxin level, EKG, electrolytes (potassium,
magnesium, calcium).
■ Theophylline: monitor blood levels.
■ Carbamezapine (Tegretol) and phenytoin (Dilantin): monitor blood levels.
■ Levothyroxine: monitor TSH.
■ Lithium: monitor blood levels, TSH (risk of HYPOthyroidism).
Safety Issues: Thiazolidinediones (TZDs)
Pioglitazone (Actos)
*Insulin Sensitizer - Correct answer-Can Cause or exacerbate CHF in some
patients.
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Questions and Answers Graded A+
First Pass Metabolism - Correct answer-GI Tract ---> Portal Circulation ---> Liver
--->Metabolized ---> Systemic Circulation
1st pass metabolism lowers the amount of drug available.
If high first-pass effect, mostly becomes inactivated and cannot be used, these
meds cannot be given orally. Example: Insulin
Drug Metabolism - Correct answer-The most active organ is the LIVER
(Cytochrome P450 enzyme system)
Others are Kidneys, GI Tract, Lungs
Coumadin and Bactrim - Correct answer-Sulfa drugs will interact with warfarin
(increases the blood level) which results in:
©COPYRIGHT 2025, ALL RIGHTS RESERVED 1
,*Elevation of INR and Risk of Bleeding!
Potent Inhibitors of the cytochrome P450 (CYP450) System
*Responsible for a number of drug to drug interactions - Correct answer-■
Macrolides (erythromycin, clarithromycin, pediazole)
■ Antifungals (ketoconazole, fluconazole)
■ Cimetidine (Tagament)
■ Citaprolam (Celexa)
■ Cisapride (Propulsid). This drug has been pulled from the U.S. market.
Pharmacology terms - Correct answer-■ Half-life (t½): the amount of time in
which drug concentration decreases by 50%.
©COPYRIGHT 2025, ALL RIGHTS RESERVED 2
,■ Area under the curve (AUC): the average amount of a drug in the blood after a
dose is given. It is a measure of the availability (bioavailability) of a drug after it is
administered.
■ Minimum inhibitory concentration (MIC): the lowest concentration of an
antibiotic
that will inhibit the growth of organisms (after overnight incubation).
■ Maximum concentration: the highest concentration of a drug after a dose.
■ Trough (minimum concentration): the lowest concentration of a drug after a
dose.
Narrow Therapeutic Index Drugs* - Correct answer-■Warfarin sodium
(Coumadin): monitor INR.
©COPYRIGHT 2025, ALL RIGHTS RESERVED 3
, ■ Digoxin (Lanoxin): monitor digoxin level, EKG, electrolytes (potassium,
magnesium, calcium).
■ Theophylline: monitor blood levels.
■ Carbamezapine (Tegretol) and phenytoin (Dilantin): monitor blood levels.
■ Levothyroxine: monitor TSH.
■ Lithium: monitor blood levels, TSH (risk of HYPOthyroidism).
Safety Issues: Thiazolidinediones (TZDs)
Pioglitazone (Actos)
*Insulin Sensitizer - Correct answer-Can Cause or exacerbate CHF in some
patients.
©COPYRIGHT 2025, ALL RIGHTS RESERVED 4
