Chapter 11: Basic Principles of Pharmacology

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1. When was the oldest prescription known to be written?

a. 700 BC
b. 700 years ago
c. 5000 BC
d. 5000 years ago

d

2. In which of the following publications would a paramedic find a list of substances (drugs) with their formulas, uses, and methods of preparation?

a. A dictionary
b. A formulary
c. A pharmacopeia
d. An almanac

b

3. Which of the following drugs is derived from the leaves of the foxglove plant?

a. Atropine
b. Benzodiazepine
c. Digitalis
d. Morphine

c

4. Which of the following drugs was discovered in the mid-1940s and used widely in World War II to fight infection?

a. Bactrim
b. Penicillin
c. Phenobarbital
d. Tetanus antitoxin

b

5. Which of the following is the best description of the FDA classification of a drug developed for the diagnosis or treatment of rare diseases?

a. A class II drug
b. An expensive drug
c. An experimental drug
d. An orphan drug

d

6. The manufacturer's name "amiodarone hydrochloride" is an example of which type of drug name?

a. Chemical name
b. Generic name
c. Official name
d. Trade name

b

7. Valium is an example of which type of drug name?

a. Chemical name
b. Generic name
c. Official name
d. Trade name

d

8. The chemical formula 7-chloro-1,3-dihydro-1-methyl-5-phnyl-2H-1,4-benzodiaepin-2-one is an example of which type of drug name?

a. Chemical name
b. Generic name
c. Official name
d. Trade name

a

9. Vitamin B1 is the trade name for which of the following drugs?

a. Cordarone
b. Diazepam
c. Quinine
d. Thiamine hydrochloride

d

10. Aspirin is an example of which of the following types of drug names?

a. Chemical name
b. Generic name
c. Official name
d. Trade name

b

11. Which of the following drugs comes is derived from a plant?

a. Alpha interferon
b. Atropine
c. Insulin
d. Milk of magnesia

b

12. Which of the following drugs has been derived from an animal source?

a. Bismuth
b. Digitalis
c. Insulin
d. Morphine

c

13. Which of the following drugs is derived from minerals or mineral products?

a. Bismuth
b. Insulin
c. Nicotine
d. Salicylate

a

14. Which of the following drugs is an example of a synthetic drug?

a. Barbiturates
b. Heroine
c. Opium
d. Quinine

a

15. Which of the following drugs comes from a recombinant DNA technology source?

a. Erythropoietin
b. Estrogen
c. Insulin
d. Oral contraceptives

a

16. Which of the following are examples of the three main areas of drugs classifications used by the Anatomical Therapeutic Chemical Classification System?

a. Body system, mechanism of action, and class of agent
b. Body system, method of creation, and level of addiction
c. Generic name, trade name, and chemical name
d. Toxicity, level of addiction, and mechanism of action

a

17. Which of the following drug classifications is an example of a drug's mechanism of action?

a. Cardiac therapy
b. Chemical classification
c. Therapeutic classification
d. Physiologic classification

c

18. Which of the following drug classifications would best describe the bronchodilation effects of Brethine?

a. Body system
b. Class of agent
c. Mechanism of action
d. Physiologic classification

c

19. Which of the following terms is the best example of the use the classification system when describing the selective calcium channel blocker verapamil?

a. Class of agent
b. Method of action
c. Physiologic classification
d. Therapeutic classification

a

20. Which of the following is designated as the official reference source for drugs marketed in the United States?

a. American Hospital Formulary Service
b. Medical Drug Consult
c. Physician's Desk Reference
d. United States PharmacopeiaNational Formulary

d

21. How frequently is the Physician's Desk Reference updated?

a. Weekly
b. Monthly
c. Biannually
d. Annually

d

22. Which of the following acts was the first in the United States to standardize the name, strength, quality, and purity of drugs?

a. The Durham-Humphrey Amendments
b. The Federal Food, Drug and Cosmetic Act
c. The Harrison Narcotics Act
d. The Pure Food and Drug Act

d

23. Which act or amendment established the five schedules (classifications) of substances based on their accepted medical use in the United States, abuse potential, and potential for addiction?

a. The Comprehensive Drug Abuse Prevention and Control Act
b. The Controlled Substances Act
c. The Harrison Narcotics Act
d. The Pure Food and Drug Act

a

24. According to the Schedule of Controlled Substances, what is the drug schedule classification of marijuana?

a. I
b. II
c. III
d. IV

a

25. According to the Schedule of Controlled Substances, cocaine is classified as what schedule of drug?

a. I
b. II
c. III
d. IV

b

26. Which of the following agencies has the authority to set public standards for prescription and over-the-counter medicines?

a. Food and Drug Administration
b. Medical Drug Control
c. Physician's Desk Reference
d. United States Pharmacopeia

d

27. Which of the following tests evaluates the effects of a substance on an organism?

a. Assay
b. Bioassay
c. Biotransformational
d. In vivo

b

28. Which of the following best describes why standardization of drugs is necessary?

a. Drugs are produced by the same company under different names.
b. Drugs do not vary by dose and length of action based on where the drug is made.
c. Drugs have different doses depending on whether they are brand-name or generic drugs.
d. Drugs may vary by strength and activity among drug manufacturers.

d

29. Once a bioassay is conducted, the results are compared to agreed-upon standards as set by which of the following agencies?

a. DEA
b. FDA
c. USP
d. USPS

c

30. How many phases are there in the FDA-approval process for investigational drugs?

a. One
b. Three
c. Four
d. Five

c

31. What phase of the approval process for investigational drugs includes being tested on a relatively small number of patients to evaluate the common short-term side effects and risks?

a. Phase I
b. Phase II
c. Phase III
d. Phase IV

b

32. Once a drug has been developed, what is the next step the pharmaceutical company must take to gain FDA approval?

a. List the medication on the stock market to recoup development costs.
b. Put the drug into the U.S. Pharmacopoeia before allowing any sales.
c. Secure a patent on the medication, then sell it to various pharmacies.
d. Test the drug's effectiveness as an investigational medication.

d

33. Why is it important to know and understand the medications a patient is taking?

a. For billing purposes
b. For documentation purposes
c. For safe medication administration
d. For testing purposes

c

34. What is the best course of action to take if there is any doubt about the administration of a medication?

a. Administer the medicine if you think it will help the patient.
b. Confer with your partner.
c. Contact medical control.
d. Do not administer any medications when you have doubts.

c

35. An online physician orders morphine sulfate (100 mg) to be given to a patient for pain. What is the paramedic's best course of action?
a. Administer the medication.
b. Give another pain drug.
c. Question the doctor about the order.
d. Verify the dose with the partner.

c

36. Which of the following would be an example of a sympathomimetic response from the administration of epinephrine?

a. Bronchoconstriction
b. Bronchodialation
c. Increased gastric motility
d. Pupil constriction

b

37. The parasympathetic division of the nervous system is composed of which cranial nerves?

a. III, VII, IX, and X
b. IV, VII, IX, and XI
c. VII, VIII, IX, and X
d. IX, X, and XI

a

38. Which of the following responses would occur in a patient who has had a prior heart transplant and has vagus nerve stimulation?

a. Decreased heart rate
b. First an increased then a decreased heart rate
c. Increased heart rate
d. No change in heart rate

d

39. What sign or symptom should be expected in a patient who has overdosed on a beta-blocker?

a. Bronchodialation
b. Decreased heart rate
c. Increased heart rate
d. Vasodialation

b

40. What is the term used to describe a molecule that relays signals from a receptor on the surface of a cell to target molecules in a cell's nucleus?

a. Binding regulator
b. Down regulator
c. Second messenger
d. Up regulator

c

41. Which of the following statements most accurately describes the effect that a drug has on the body?

a. Changes an existing body function
b. Gives body tissues or organs new functions
c. Only dilates blood vessels
d. Replaces tissues in the body

a

42. Which of the following statements is most correct regarding the properties of medications?

a. Drugs give an existing function a new advantage.
b. Drugs give tissues and organs new functions.
c. Drugs provide temporary support for declining tissues.
d. Drugs replace the tissue and organ functions.

a

43. Which of the following statements is most correct regarding the general action of a drug in the body?

a. A chemical reaction occurs with molecules in the body.
b. A toxic reaction to the drug occurs at the cellular level.
c. It blocks receptor sites in the body to alleviate illness.
d. It reconfigures receptor sites to enhance body functions.

a

44. Which of the following terms most accurately describes a medicine consisting of an extract in an alcohol solution?

a. Elixir
b. Emulsion
c. Spirit
d. Tincture

d

45. Baby aspirin is an example of which type of drug form?

a. Capsule
b. Gelcap
c. Suppository
d. Tablet

d

46. Which of the following is a parenteral method of administering a drug?

a. Oral
b. Rectal
c. Sublingual
d. Topical

d

47. Which of the following is an enteral method of administering drugs?

a. Intranasal
b. Rectal
c. Topical
d. Tracheal

b

48. How are the solid forms of drugs most frequently administered?

a. Enteral
b. Inhalation
c. Intravenous
d. Parenteral

a

49. Which of the following methods of medication administration is described as readily available, painless, and noninvasive but has limited value in an emergent situation with slow or erratic absorption?

a. Oral
b. Rectal
c. Sublingual
d. Topical

a

50. What method of medication administration is best described as painless, has a rapid onset of action, but requires a responsive, cooperative patient with an intact gag reflex?

a. Buccal
b. IV
c. Oral
d. Topical

a

51. Which of the following methods of medication administration is easily accessible during an active seizure if an IV is unobtainable?

a. IO
b. Rectal
c. SL
d. Tracheal

b

52. Which of the following medication administration methods has an immediate onset and is easily accessible, but is painful, time consuming, and has a significant potential for causing adverse reactions?

a. IM
b. IV
c. Rectal
d. SL

a

53. Which of the following methods of medication administration is limited to the administration of naloxone, atropine, vasopressin, epinephrine, and lidocaine?

a. IM
b. Intralingual
c. IO
d. Tracheal

d

54. Which of the following molecules is the most abundant plasma protein that binds with the widest range of drugs?

a. Albumin
b. Cytokines
c. Fibrinogens
d. Globulins

a

55. Which of the following terms is described as the science of preparing and dispensing drugs?

a. Bioavailability
b. Pharmaceutics
c. Pharmacodynamic
d. Pharmacokinetics

b

56. Which of the following best describes the absorption of topical nitroglycerin in a patient with poor peripheral circulation?

a. Absorption decreases, and the results may be less than desired.
b. Absorption decreases, and the results may be stronger than expected.
c. Absorption is enhanced, and the results may be stronger than expected.
d. Absorption is unchanged, and the results can be typical.

a

57. Which of the following terms is best defined as the passive transport of solutes?

a. Absorption
b. Concentration
c. Diffusion
d. Osmosis

c

58. What are the four main processes of pharmacokinetics?

a. Absorption, distribution, metabolism, elimination
b. Administration, absorption, metabolism, elimination
c. Adsorption, bioavailability, diffusion, metabolism
d. Concentration, administration, solubility, biotransformation

a

59. The method of administration of a drug will have the greatest impact on which of the following actions?

a. Absorption
b. Elimination
c. Excretion
d. Metabolism

a

60. The amount of drug and the speed at which it reaches its intended site of action is best defined by which of the following terms?

a. Bioavailability
b. Dosage
c. Solubility
d. The pH

a

61. What term describes a drug's ability to produce a physiologic response?

a. Affinity
b. Agonist
c. Antagonist
d. Efficacy

d

62. Which of the following terms is used to describe the physiologic response of a drug with the receptor to which it is bound?

a. Affinity
b. Agonist
c. Antagonist
d. Partial agonist

b

63. What term is used to describe the action that occurs when naloxone blocks an opioid?

a. Agonist
b. Antagonist
c. Partial antagonist
d. Receptor

b

64. Which of the following terms describes the amount of a drug that is required to provide a beneficial effect in 50% of the drug-tested population?

a. Lethal does
b. Plasma-level profile
c. Therapeutic dose
d. Therapy state

c

65. Which of the following statements is most correct when referring to a drug with a low therapeutic index?

a. It takes a low dose to have an effect on the body.
b. The dosage of the drug must be carefully monitored and adjusted.
c. The drug is relatively safe.
d. The therapeutic threshold is low.

b

66. Which of the following factors is most correct regarding the absorption of a drug?

a. Fat-soluble drugs are absorbed more readily.
b. Protein-soluble drugs are absorbed more readily.
c. Solubility of the medication is not a factor in absorption.
d. Water-soluble drugs are absorbed more readily.

d

67. Which of the following routes of administration provides the fastest rate of absorption?

a. IV
b. IM
c. PO
d. Sub-Q

a

68. Which of the following statements is most correct when referring to the biotransformation that takes place in the liver?

a. Change of the drug to inactive metabolites
b. Direct transport to the kidneys for excretion
c. Irreversible damage to the liver
d. Removal of the drug through the bile duct

a

69. Which of the following actions is most likely to occur when a patient with chronic renal failure receives a medication?

a. A need for a diuretic to help eliminate the drug
b. Delayed excretion of the drug
c. Kidney stones from an excess of drug in the system
d. Liver failure along with renal failure

b

70. How are IV medications typically administered to severely hypothermic patients?

a. At longer than normal intervals
b. At shorter than normal intervals
c. Once their body temperature returns to normal
d. Only if they are in cardiac arrest

a

71. Which of the following medication response relationships is most affected by a patient taking a medication once a day instead of three times a day?

a. Affinity
b. Efficacy
c. Therapeutic concentration
d. Therapeutic index

c

72. Which of the following terms is used to describe a predictable effect of a drug other than the one for which it is given?

a. Adverse effect
b. Antagonism
c. Interaction
d. Side effect

d

73. What is the term or phrase defined as an unintentional disease or drug effect produced by a prescribed therapy?

a. Anaphylactic reaction
b. Hypersensitivity
c. Iatrogenic response
d. Idiosyncrasy

c

74. Which of the following terms is defined as a prolongation or increase in the effect of a drug by another drug?

a. Adverse effect
b. Cumulative action
c. Drug antagonism
d. Potentiation

d

75. A patient has been given a medication and shortly afterward starts to have difficulty breathing, hypotension, and urticaria. The patient is having what type of reaction to the drug?

a. Anaphylactic reaction
b. Hypersensitivity
c. Summation
d. Tachyphlaxis

a

76. When should a drug with of a pregnancy risk category of X be given to a pregnant patient?

a. If patient's condition warrants the use of the drug
b. If the potential benefits outweigh the risks to the fetus
c. It is contraindicated and should not be given
d. Only if the patient is in her third trimester

c

77. What is the term used to describe a geriatric patient taking a number of prescription and over-the-counter medicines?

a. An additive effect
b. Drug dependence
c. Pharmacogenetics
d. Polypharmacy

d

78. Which of the following methods is the best way to determine pediatric drug dosages?

a. A length-based resuscitation tape
b. Age of the patient
c. Asking the parent
d. Asking the child

a

79. When giving a medication to a pregnant patient, what must a paramedic consider before administration?

a. A drug may be stored in breast milk and given to the baby after birth
b. Giving half the normal dose to avoid drug toxicity in the fetus
c. Giving twice the normal dose because some drug is given to the fetus
d. The drug may pass the placental barrier and affect the fetus

d

80. From the following responses, choose the most appropriate action a paramedic should take when asked to administer a category A drug to a pregnant patient?

a. Give half the dose
b. Give the medication
c. Question the order
d. Refuse the order

b

81. Which of the following concerns should be considered when giving water-soluble medications to a geriatric patient?

a. Higher amount of body water leading to a lower concentration of drug
b. Higher amount of body water leading to rapid elimination of the drug
c. Lower amount of body water leading to a higher concentration of drug
d. Lower amount of body water leading to difficulty with biotransformation

c

82. What type of drug interaction is likely to occur with a patient who has eaten a large meal before taking a PO medication?

a. A greater response to the medication
b. A lesser response to the medication
c. Faster absorption of the medication
d. Slower absorption of the medication

d

83. Which of the following phrases best describes the term polypharmacy?

a. Use of multiple medications by the patient
b. Use of one medication by several older adults
c. Use of one medication to treat multiple conditions
d. Use of several drug stores to fill prescriptions

a

84. Which of the following interactions best describes what occurs when a patient takes nitroglycerin and Cialis at the same time?

a. Drug-drug interaction
b. Drug-food interaction
c. Incomplete interaction
d. Malabsorption interaction

b

85. Which of the following responses best describes the possible drug interaction that can occur if a patient ingests multiple antacids and is prescribed an oral medication?

a. High gastric acidity may impair absorption.
b. Intestinal obstruction may prevent absorption.
c. Low gastric acidity may impair absorption.
d. The dose may be too low for the patient's weight and size.

c

86. Which of the following statements best describes the reason for difficulty controlling bleeding in a patient taking aspirin, Coumadin, and eating garlic?

a. A drug interactions with garlic, aspirin, and Coumadin
b. A possible overdose on his prescribed Coumadin
c. Aspirin blocking the effects of Coumadin
d. Garlic blocking the effects of Coumadin

a

87. Which of the following best describes the improper action that occurs if a paramedic leaves nitroglycerin out in the sun while taking care of a patient?

a. Carefulness
b. Expediency
c. Improper drug storage
d. Proper drug storage

c

88. While checking the drug box at the beginning of a shift, a paramedic notices that some of the medications have ice crystals in the solution. What is the paramedic's best course of action?

a. Place the drug box in the cab of the ambulance to warm the medications.
b. Replace the entire stock of drugs because they were damaged by the cold.
c. Report the incident to the supervisor, and ask to park the ambulance inside.
d. Turn on the heater in the patient compartment to defrost the drugs.

b

89. Upon checking the vehicle and medication supplies, a paramedic notices that the lock on the controlled substances lockbox is broken and medications are missing. What is the next best step the paramedic should take?

a. Get replacement medications, and store in the locked glove box.
b. Refuse to carry controlled substances until the cabinet is fixed.
c. Report the incident to the supervisors and other authorities per protocol.
d. Tape the cabinet shut with duct tape, and get replacement medications.

c

90. Which of the following factors should be considered when assisting a patient with the administration of her or his own nitroglycerin?

a. Improper exposure to heat may have degraded the patient's nitroglycerin.
b. Nitroglycerin has been stored in a dark medicine cabinet.
c. Nitroglycerin must be shaken to be activated.
d. The patient's nitroglycerin may not be a recognized brand.

c

91. What information would be found in a drug profile?

a. Chemical name
b. Cost
c. Pharmacogenetics
d. Pharmacokinetics

d

92. Which of the following most accurately lists the components of a drug profile?

a. Drug interactions, chemical name, and side/adverse effects
b. Generic, trade and chemical names, indications, and dosage
c. Indications, dosage, trade and chemical names, and antidotes
d. Pharmacokinetics, pregnancy risk, how supplied, dosage

d

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