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Comprehensive USMLE Pharmacokinetics: Master General Principles of Pharmacology with Detailed Explanations and High-Yield Content 2024/2025$17.99
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Comprehensive USMLE Pharmacokinetics: Master
General Principles of Pharmacology with Detailed
Explanations and High-Yield Content
2024/2025
A 22-year-old woman su ering from asthma was prescribed albuterol by inhalation. Albuterol is a
bronchodilating drug with a molecular weight of 239 daltons. Which of the fol- lowing permeation
processes most likely accounted for the transfer of the drug through the bronchial mucosa?
Lipid diffusion
A 34-year-old man on vacation in Mexico was admitted to the hospitalbecause ofvomiting,double
vision,and muscular pa- ralysis.The man reported that he had eaten some canned food from a local
vendor the previous day. After a physical exam- ination, a presumptive diagnosis of botulism was made.
It is known that botulinum toxin causes paralysis by getting in- side the axon terminals of motor nerves,
where it inhibits the release of acetylcholine. Botulinum toxin is a protein with a molecular weight
greater than 100,000 daltons. Which of the following permeation processes most likely accounts for the
transfer of the toxin through the nerve cell membrane?
endocytosis
A 51-year-old woman su ering from hyperthyroidism was administered an oral solution of radioactive
iodine to destroy her thyroid gland. Which of the following permeation processes most likely accounted
for the transfer of the drug across the thyroid cell membrane?
active transport
,A 12-year-old boy recently diagnosed with type 1 diabetes started a therapy with two daily
subcutaneous administrations of insulin. Which of the following permeation processes best explains the
absorption of insulin from the site of injection?
Bulk ow transport( filtration)
A 69-year-old woman was brought to a local hospital emer- gency department by her son, who reported
that his mother was found lethargic, disoriented, and combative a few hours earlier. Additional history
revealed that she had ingested a large number of aspirin tablets in a suicide attempt. An ap- propriate
therapy was instituted, which included the admin- istration of sodium bicarbonate to increase the
elimination of salicylate. Which of the following best explains the mecha- nism of this increased
elimination
Urinary ion trapping of salicylate
A 63-year old man recently diagnosed with hypertension started a therapy with hydrochlorothiazide,
one tablet daily. Hydrochlorothiazide is an acidic drug with a pKa of about 9. Which of the following
parts of the digestive tract most likely represents the main site of absorption of that drug?
small intestine
A26-year-old man became inebriated after drinking several glasses of alcoholic beverages at a party.
Ethanol is a polar, nonionizable drug with an approximate molecular weight of 46 daltons. Which of the
following permeation processes mediated the man's intestinal absorption of ethanol?
aqueous diffusion
A 44-year-old man took a large dose of acetaminophen in aqueous solution to treat an excruciating
headache. Two hours later, the pain was not diminished. Because acet- aminophen should be e ective in
about 30 minutes after its oral administration, which of the following conditions most likely delayed the
oral absorption of the drug in this patient?
The presence of strong pain
,A 22-year-old woman was admitted to the emergency de- partment after a car accident.The woman had
extensive brain trauma and multiple fractures. She complained of severe pain, and the attending
physician planned to administer morphine.The physician knew that the dose should be care- fully
titrated because the entry of morphine into the pa- tient's central nervous system (CNS) was most likely
higher than normal. Which of the following factors is most likely to have increased morphine entry into
the CNS of this patient?
Thebraintraumaofthepatient
A36-year-old woman recently diagnosed with trichomoni- asis started a treatment with metronidazole.
The drug has a hepatic clearance of 4.86 L/h and a renal clearance of 0.54 L/h. On the assumption that
only the liver and kidney are involved in the elimination of this drug, what percentage of the
administered drug will be eliminated by the liver?
4.86/0.54= 90%
A45-year-old man su ering from epilepsy had been receiv- ing carbamazepine, one tablet daily. The drug
has a total clearance of 63 L/h and a hepatic clearance of 62 L/h. The man was recently diagnosed with a
skin infection due to Mycobacterium marinum, and treatment with rifampin and ethambutol was
started. Knowing that rifampin is a potent inducer of microsomal enzymes, which of the following
changes most likely occurred to the pharmacokinetics of carbamazepine?
he half-life of the drug decreased.
A 68-year-old man recently diagnosed with atrial brillation started therapy with atenolol, a β-receptor
blocker. Which of the following changes most likely occurred in cardiac myo- cytes during the rst 2
weeks of therapy?
The β-receptor number increased.
, A2-year-old boy was admitted to the emergency department after a generalized tonic-colonic seizure.
His mother reported that the boy apparently ingested several tablets of propranolol, a β-blocker,which
he had found in his father's dresser drawer. Vital signs on admission were blood pressure 85/50 mm Hg,
heart rate 40 beats per minute (bpm),respiratory rate 20/min. The boy received an intramuscular
injection of glucagon, a hormone that activates glucagon receptors in the heart, caus- ing a signi cant
increase in heart contractility. Which of the following terms best de nes the antagonism between gluca-
gon and β-blockers?
functional
Two new drugs were tested in laboratory animals. Which of the following drug parameters was most
likely recorded to estimate the relative potency of both drugs?
The graded log dose−response curve of both drugs
A 65-year-old woman su ering from atrial brillation had been taking a drug to treat this condition for 6
months. The drug had no intrinsic activity and bound reversibly to β1 re- ceptors. Which of the following
terms best de nes this drug?
Competitive antagonist
A new β-blocker was tested in healthy volunteers. The cu- mulative frequency distribution of subjects
showing a de- crease of 10 bpm in the heart rate was plotted against the log dose. Which of the
following drug parameters can be deter- mined from this cumulative frequency distribution?
Median e ective dose
A65-year-old woman who had been admitted to the hospital with a myocardial infarction developed
ventricular tachy- cardia and received an intravenous injection of lidocaine. Her cardiologist knew that
the dose given must be within the range of doses that have a high probability of therapeutic success.
Which of the following terms best de nes this range?
Response variability
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