Basic Principles Practice Questions

1. A drug, given as a 100 mg single dose, results in a peak plasma concentration of 0.020 mg/mL. The apparent volume of
distribution is (assume a rapid distribution and negligible elimination prior to measuring the peak plasma level). Hint: V d = Drug
in body/Plasma concentration of drug
A. 0.5 L
B. 1 L
C. 2 L
D. 5 L

2. What dose of a drug should be injected intravenously every 8 hours to obtain an average steady-state plasma drug
concentration of 5 mg/L if the drug’s volume of distribution is 30 L and its clearance is 8 L/h? Hint: Required dose = CL x TC x
Dosage Interval
A. 40 mg
B. 80 mg
C. 160 mg
D. 320 mg

3. After a person ingests an overdose of an opioid analgesic, the plasma drug concentration is found to be 16 mg/L. How long will
it take to reach a safe plasma concentration of 2 mg/L if the drug’s half-life is 4 hours?
A. 12 hours
B. 24 hours
C. 48 hours
D. 72 hours

4. In a log dose-response plot, drug efficacy is determined by the maximal height of the measured response on the effect axis,
whereas drug potency is determined by: (Hint: draw a response vs. drug dose curve for a strong and weak drug to help visualize
the difference).
A. number of animals exhibiting an all-or-none response
B. formula, including the affinity of the drug and the number of drug receptors
C. position of the curve along the log-dose axis
D. steepness of the dose-response curve

5. A partial agonist is best described as an agent that:

A. has low potency but high efficacy
B. interacts with more than one receptor type
C. cannot produce the full effect even at high doses
D. blocks the effects of the antagonist

6. Receptors determine the quantitative relationship between drug dose/concentration and pharmacologic effects and they
mediate the actions of both agonists and antagonists. The definition of Kd (dissociation constant) of a drug for a particular
receptor is:
A. the rate at which how quickly the drug associates with the receptor
B. the measure of the drug’s affinity for a given receptor. The concentration of drug required in solution to achieve 50%
occupancy of its receptors
C. the saturating concentration of drug required to occupy the maximal amount of receptors
D. the rate at which the drug dissociates or how quickly it comes off of the receptor

7. One of the following statements does not correctly describe the differences between a competitive and noncompetitive
antagonist.
A. antagonism can be overcome with high doses of agonists in the presence of a competitive antagonist but not likely to
be overcome in the presence of a noncompetitive antagonist.
B. A noncompetitive antagonist binds to a site other than the agonist-binding domain while a competitive antagonist
competes with agonist for the same binding site.
C. A noncompetitive antagonist often induces a conformational change in the receptor and the agonist no longer
recognizes the binding domain. This is not usually observed with a competitive antagonist.
D. The number of receptors appear unchanged in the presence of a competitive or noncompetitive antagonist.
8. A 51-year-old woman with heart failure is to be treated with a diuretic drug. Drugs X and Y have the same mechanism of diuretic
action. Drug X in a dose of 5 mg produces the same magnitude of diuresis as 500 mg of drug Y. This suggests that
a. Drug Y is less efficacious than drug X
b. Drug X is about 100 times more potent than drug Y
c. Toxicity of drug X is less than that of drug Y
d. Drug X is safer than Drug Y
e. Drug X will have a shorter duration of action than drug Y because less of drug X is present for a given effect

9. Mr. Stahelin is admitted to the hospital with pneumonia due to gram-negative bacteria. The antibiotic tobramycin is ordered.
The CL and Vd of tobramycin in Mr. Stahelin are 0.08 L/min and 40 L, respectively
Formulas: Rate in = Rate out at steady state;
Dosage = (Plasma level x Clearance)/Bioavailability
Loading Dose = (Vd x Target Concentration)/Bioavailibility
What maintenance dose should be administered intravenously every 6 h to eventually obtain average steady state plasma
concentration of 4 mg/L?
a. 0.32 mg
b. 19.2 mg
c. 115.2 mg
d. 160 mg
e. 230 mg

10. Mr. Stahelin is admitted to the hospital with pneumonia due to gram-negative bacteria. The antibiotic tobramycin is ordered.
The CL and Vd of tobramycin in Mr. Stahelin are 0.08 L/min and 40 L, respectively
Formulas: Rate in = Rate out at steady state;
Dosage = (Plasma level x Clearance)/Bioavailability
Loading Dose = (Vd x Target Concentration)/Bioavailibility
If you wish to give Mr. Stahelin an IV loading dose to achieve the therapeutic plasma concentration of 4 mg/L rapidly, how much
should be given?
a. 0.1 mg
b. 10 mg
c. 115.2 mg
d. 160 mg
e. None of the above

11. The following are pharmacokinetic data for the drug propranolol in a 70-kg person: clearance, 50 L/h; volume of distribution, 270
L; effective plasma concentration, 20 ng/mL; oral availability (percentage), 25%. Calculate the oral maintenance dosing rate for
propranolol in a 70-kg person.
A. 10 micrograms/h
B. 200 micrograms/h
C. 1 mg/h
D. 4 mg/h
E. 54 mg/h

12. A patient is admitted to the emergency department for treatment of a drug overdose. The identity of the drug is unknown, but it
is observed that when the urine pH is acidic, the renal clearance of the drug is less than the glomerular filtration rate and that when
the urine pH is alkaline, the clearance is greater than the glomerular filtration rate. The drug is probably a
A. Strong acid
B. Weak acid
C. Nonelectrolyte
D. Weak base
E. Strong base

13. A patient is admitted to the emergency room 2 h after taking an overdose of Phenobarbital. The plasma level of the drug at time
of admission is 100 mg/L, and the apparent volume of distribution, half-life, and clearance of Phenobarbital are 35 L, 4 days, and 6.1
L/day, respectively. The ingested dose was approximately
 A. 1 g
B. 3.5 g
C. 6.1 g
D. 40 g
E. 70 g

14. A patient with an arrhythmia is to receive lidocaine by constant IV infusion. The target plasma concentration is 3 mg/L. The
pharmacokinetic parameters for lidocaine in the general population are V d 70 L, CL 35 L/h, and half-life 1.4 h. An infusion is begun.
The plasma concentration of lidocaine is measured 2.8 h later and reported to be 1.5 mg/L. This indicates that the final steady state
plasma concentration in this patient will be.
A. 1.5 mg/L
B. 2.0 mg/L
C. 3.0 mg/L
D. 6.0 mg/L
E. Insufficient data to answer

15. A young man is brought to the emergency room in a deep coma. His friends state that he self-administered a large dose of
morphine 6 h earlier. An immediate blood analysis shows a morphine blood level of 0.25 mg/L. Assuming that the pharmacokinetics
of morphine in this patient are Vd 200 L and the half-life is 3 h, how much morphine did the patient inject 6 h earlier?
A. 25 mg
B. 50 mg
C. 100 mg
D. 200 mg
E. Too little data to predict.

16. A normal volunteer will receive a new drug in a phase I clinical trial. The clearance and volume of distribution of the drug in this
subject are 1.386 L/h and 80 L, respectively. The half-life of the drug in this subject will be approximately
A. 83 h
B. 77 h
C. 58 h
D. 40 h
E. 0.02 h

17. Your 77-year-old patient with a myocardial infarction has a severe cardiac arrhythmia. You have decided to give lidocaine to
correct the arrhythmia. A continuous IV infusion of lidocaine, 1.92 mg/min, is started at 8 AM. The average pharmacokinetic
parameters of lidocaine are Vd 77 L; CL 640 mL/min; half-life 1.8 h. The expected steady-state plasma concentration is approximately
A. 40 mg/L
B. 3.0 mg/L
C. 0.025 mg/L
D. 7.2 mg/L
E. 3.46 mg/L
 Basic Principles Practice Answers

1. A drug, given as a 100 mg single dose, results in a peak plasma concentration of 0.020 mg/mL. The apparent volume of
distribution is (assume a rapid distribution and negligible elimination prior to measuring the peak plasma level). Hint: V d = Drug
in body/Plasma concentration of drug
E. 0.5 L
F. 1 L
G. 2 L
H. 5 L
Vd = 100 mg/0.020 mg/mL = 5000 mL = 5 L
2. What dose of a drug should be injected intravenously every 8 hours to obtain an average steady-state plasma drug
concentration of 5 mg/L if the drug’s volume of distribution is 30 L and its clearance is 8 L/h? Hint: Required dose = CL x TC x
Dosage Interval
E. 40 mg
F. 80 mg
G. 160 mg
H. 320 mg
Dose = 8 L/h x 5 mg/L x 8 h = 320 mg
3. After a person ingests an overdose of an opioid analgesic, the plasma drug concentration is found to be 16 mg/L. How long will
it take to reach a safe plasma concentration of 2 mg/L if the drug’s half-life is 4 hours?
A. 12 hours
B. 24 hours
C. 48 hours
D. 72 hours
16 mg/mL in 4 hours  8 mg/mL in 4 more hours  4 mg/mL in 4 more hours  2 mg/mL. 3
half-lives x 4 hours each = 12 hours
4. In a log dose-response plot, drug efficacy is determined by the maximal height of the measured response on the effect axis,
whereas drug potency is determined by: (Hint: draw a response vs. drug dose curve for a strong and weak drug to help visualize
the difference).
E. number of animals exhibiting an all-or-none response
F. formula, including the affinity of the drug and the number of drug receptors
G. position of the curve along the log-dose axis
H. steepness of the dose-response curve

5. A partial agonist is best described as an agent that:

E. has low potency but high efficacy
F. interacts with more than one receptor type
G. cannot produce the full effect even at high doses
H. blocks the effects of the antagonist

6. Receptors determine the quantitative relationship between drug dose/concentration and pharmacologic effects and they
mediate the actions of both agonists and antagonists. The definition of Kd (dissociation constant) of a drug for a particular
receptor is:
E. the rate at which how quickly the drug associates with the receptor
F. the measure of the drug’s affinity for a given receptor. The concentration of drug required in solution to achieve 50%
occupancy of its receptors
G. the saturating concentration of drug required to occupy the maximal amount of receptors
H. the rate at which the drug dissociates or how quickly it comes off of the receptor

7. One of the following statements does not correctly describe the differences between a competitive and noncompetitive
antagonist.
E. antagonism can be overcome with high doses of agonists in the presence of a competitive antagonist but not likely to
be overcome in the presence of a noncompetitive antagonist.
F. A noncompetitive antagonist binds to a site other than the agonist-binding domain while a competitive antagonist
competes with agonist for the same binding site.
G. A noncompetitive antagonist often induces a conformational change in the receptor and the agonist no longer
recognizes the binding domain. This is not usually observed with a competitive antagonist.
 H. The number of receptors appear unchanged in the presence of a competitive or noncompetitive antagonist.

8. A 51-year-old woman with heart failure is to be treated with a diuretic drug. Drugs X and Y have the same mechanism of diuretic
action. Drug X in a dose of 5 mg produces the same magnitude of diuresis as 500 mg of drug Y. This suggests that
a. Drug Y is less efficacious than drug X
b. Drug X is about 100 times more potent than drug Y
c. Toxicity of drug X is less than that of drug Y
d. Drug X is safer than Drug Y
e. Drug X will have a shorter duration of action than drug Y because less of drug X is present for a given effect
9. Mr. Stahelin is admitted to the hospital with pneumonia due to gram-negative bacteria. The antibiotic tobramycin is ordered.
The CL and Vd of tobramycin in Mr. Stahelin are 0.08 L/min and 40 L, respectively
Formulas: Rate in = Rate out at steady state;
Dosage = (Plasma level x Clearance)/Bioavailability
Loading Dose = (Vd x Target Concentration)/Bioavailibility
What maintenance dose should be administered intravenously every 6 h to eventually obtain average steady state plasma
concentration of 4 mg/L?
a. 0.32 mg
b. 19.2 mg
c. 115.2 mg
d. 160 mg
e. 230 mg
(4 mg/L x 0.08 L/min)/1 = 0.32 mg/min x 360 min = 115.2 mg
10. Mr. Stahelin is admitted to the hospital with pneumonia due to gram-negative bacteria. The antibiotic tobramycin is ordered.
The CL and Vd of tobramycin in Mr. Stahelin are 0.08 L/min and 40 L, respectively
Formulas: Rate in = Rate out at steady state;
Dosage = (Plasma level x Clearance)/Bioavailability
Loading Dose = (Vd x Target Concentration)/Bioavailibility
If you wish to give Mr. Stahelin an IV loading dose to achieve the therapeutic plasma concentration of 4 mg/L rapidly, how much
should be given?
a. 0.1 mg
b. 10 mg
c. 115.2 mg
d. 160 mg
e. None of the above
40 L x 4 mg/L = 160 mg

11. The following are pharmacokinetic data for the drug propranolol in a 70-kg person: clearance, 50 L/h; volume of distribution, 270
L; effective plasma concentration, 20 ng/mL; oral availability (percentage), 25%. Calculate the oral maintenance dosing rate for
propranolol in a 70-kg person.
A. 10 micrograms/h
B. 200 micrograms/h
C. 1 mg/h
D. 4 mg/h
E. 54 mg/h
0.020 ng/mL = 0.020 mg/L; (0.020 mg/L x 50 L/h)/0.25 = 4 mg/h

12. A patient is admitted to the emergency department for treatment of a drug overdose. The identity of the drug is unknown, but it
is observed that when the urine pH is acidic, the renal clearance of the drug is less than the glomerular filtration rate and that when
the urine pH is alkaline, the clearance is greater than the glomerular filtration rate. The drug is probably a
A. Strong acid
B. Weak acid
C. Nonelectrolyte
D. Weak base
E. Strong base
13. A patient is admitted to the emergency room 2 h after taking an overdose of Phenobarbital. The plasma level of the drug at time
of admission is 100 mg/L, and the apparent volume of distribution, half-life, and clearance of Phenobarbital are 35 L, 4 days, and 6.1
L/day, respectively. The ingested dose was approximately
A. 1 g
B. 3.5 g
C. 6.1 g
D. 40 g
E. 70 g
100 mg/L x 35L = 3500 mg = 3.5 g
14. A patient with an arrhythmia is to receive lidocaine by constant IV infusion. The target plasma concentration is 3 mg/L. The
pharmacokinetic parameters for lidocaine in the general population are V d 70 L, CL 35 L/h, and half-life 1.4 h. An infusion is begun.
The plasma concentration of lidocaine is measured 2.8 h later and reported to be 1.5 mg/L. This indicates that the final steady state
plasma concentration in this patient will be.
A. 1.5 mg/L
B. 2.0 mg/L
C. 3.0 mg/L
D. 6.0 mg/L
E. Insufficient data to answer
2 half-lives gives 75% of steady state. After 2 half-lives the plasma concentration was 1.5 mg/mL. Thus 1.5mg/mL/
0.75 = x (mg/mL)/1 1 x (1.5 mg/mL / 0.75 ) = 2.0 mg/mL

15. A young man is brought to the emergency room in a deep coma. His friends state that he self-administered a large dose of
morphine 6 h earlier. An immediate blood analysis shows a morphine blood level of 0.25 mg/L. Assuming that the pharmacokinetics
of morphine in this patient are Vd 200 L and the half-life is 3 h, how much morphine did the patient inject 6 h earlier?
A. 25 mg
B. 50 mg
C. 100 mg
D. 200 mg
E. Too little data to predict.
Half-life = 3 hour. Back tracking 2 half-lives as it was 6 hours earlier: 0.25 mg/L  0.5 mg/L  1 mg/L 1 mg/L x
200 L = 200 mg (Vd = drug in body/plasma conc. of drug)

16. A normal volunteer will receive a new drug in a phase I clinical trial. The clearance and volume of distribution of the drug in this
subject are 1.386 L/h and 80 L, respectively. The half-life of the drug in this subject will be approximately
A. 83 h
B. 77 h
C. 58 h
D. 40 h
E. 0.02 h
Half-life = 0.7 x (Vd/CL) = 0.7 x (80L/1.386 L/h) = 40 h

17. Your 77-year-old patient with a myocardial infarction has a severe cardiac arrhythmia. You have decided to give lidocaine to
correct the arrhythmia. A continuous IV infusion of lidocaine, 1.92 mg/min, is started at 8 AM. The average pharmacokinetic
parameters of lidocaine are Vd 77 L; CL 640 mL/min; half-life 1.8 h. The expected steady-state plasma concentration is approximately
A. 40 mg/L
B. 3.0 mg/L
C. 0.025 mg/L
D. 7.2 mg/L
E. 3.46 mg/L
At steady-state rate in = rate out. 1.92 mg/min/640 mL/min = 0.003 mg/mL =
3.0 mg/L
 Basic Pharmacology Questions
Multiple Choice Identify the letter of the choice that best completes the statement or answers the question.

____ 1. Which route of administration is most likely to subject a drug to a first-pass effect?

a. IV
b. IH
c. Oral
d. Sublingual
e. IM

____ 2. Two drugs may act on the same tissue or organ through independent receptors, resulting in effects in opposite
directions. This is known as

a. physiologic antagonism (opposing effects- same system )

b. chemical antagonism ( does not allow agonist to interact with the receptor)
c. competitive antagonism (same site, reversible (changes potency but not efficacy) or
irreversible – changes efficacy but not potency)
d. irreversible antagonism (same site- antagonist forms a covalent bond)
e. dispositional antagonism

____ 3. A new aminoglycoside antibiotic (5mg/kg) was infused IV over 30 min to a 70 kg volunteer. The plasma
concentration of the drug was measured at various times after the end of the infusion. (Plot the data)
Time after dosing (hour) Plasma Conc (ug/mL)
0.0 18.0
0.5 10.0
1.0 5.8
2.0 4.6
3.0 3.7
4.0 3.0
5.0 2.4
6.0 1.9
8.0 1.3

The elimination half-life of this aminoglycoside is approximately

a. 0.6 hr
b. 1.2 hr
c. 2.1 hr
d. 3.1 hr
e. 4.2 hr

____ 4. In this patient, the apparent volume of distribution is approximately

a. 0.6 L
 b. 19 L
c. 50 L
d. 110 L
e. 350 L

____ 5. Total body clearance of the drug in this patient is

a. 11 L/hr
b. 23 L/hr
c. 35 L/hr
d. 47 L/hr
e. 65 L/hr

____ 6. If a drug is repeatedly administered at dosing intervals equal to its elimination half-life, the number of doses
required for the plasma concentration of the drug to reach steady-state is

a. 2 to 3
b. 4 to 5
c. 6 to 7
d. 7 to 8
e. 8 to 9

____ 7. The pharmacokinetic value that most reliably reflects the amount of drug reaching the target tissue after oral
administration is the

a. peak blood concentration

b. time to peak blood concentration
c. product of the volume of distribution and the first-order rate constant
d. volume of distribution
e. area under the blood concentration versus time curve

____ 8. Which of the following factors modifies the movement of drug molecules from the site of administration into the
body and bodily components?

a. lipid diffusion
b. aqueous diffusion
c. facilitative diffusion
d. receptor-mediated endocytosis
e. all of the above

____ 9. Which of the following is NOT a factor that influences passage of a drug through cell membranes?
 a. its pH
b. its type of action
c. the amount of protein binding
d. its lipid solubility
e. the presence of pores in the membrane

____ 10. Different lots of a drug preparation have the same bioavailability when they

a. are chemically equivalent

b. fulfill the same chemical standards as set by regulatory agencies
c. yield similar concentrations in blood and tissues
d. have been approved by the FDA
e. meet the standards set forth by the US Pharmacopeia

____ 11. Which of the following statements is true?

a. The protein bound drug is the portion of drug that is therapeutically active
b. Drugs cross the placenta mainly by active transport
c. The LD50 is 50% of the minimum dose that is lethal to animals of a specified species
and strain
d. The LD50 is 50% of the average dose that is lethal to animals of a specified species and
strain
e. The maximal intensity of a specified therapeutic effect that a drug is able to produce is
referred to as its efficacy

Basic Principles Practice Questions

Answer Section

MULTIPLE CHOICE

1. ANS: C

2. ANS: A

3. ANS: D

4. ANS: C

5. ANS: A

6. ANS: B

7. ANS: E

8. ANS: E
9. ANS: B

10. ANS: C

11. ANS: E