Chapter 01: Basic Pharmacology
Snyder & Keegan: Pharmacology for the Surgical Technologist, 4th Edition

MULTIPLE CHOICE

	1.	A drug that binds to a receptor and stimulates its function is said to be a(n) _______________ drug.
a.	agonist	
b.	antagonist	
c.	idiosyncratic	
d.	pharmacokinetic	

ANS:	A
Agonist drugs bind to or have an affinity (attraction) for a receptor and cause a particular response.

DIF:	1	REF:	14	TOP:	AST Core Curriculum X:B:1:b, agonist

	2.	Which one of the following is not used for the classification of drugs?
a.	Therapeutic action	
b.	Physiologic action	
c.	Affected body system	
d.	Source of origin	

ANS:	D
Drugs are classified by what they do, what they affect, what they are not, and where they come from.

DIF:	1	REF:	4	TOP:	AST Core Curriculum X:B:2, therapeutic actions

	3.	An anticoagulant drug is classified by its
a.	chemical type.	
b.	source of origin.	
c.	physiologic action.	
d.	therapeutic action.	

ANS:	D
Therapeutic action describes what the drug does for a patient; in this example, it works against coagulation.

DIF:	1	REF:	4	TOP:	AST Core Curriculum X:B:2:a, indications

	4.	Prescriptions must include all of the following information except
a.	name of the drug.	
b.	patient’s social security number.	
c.	drug dosage.	
d.	route of administration of the drug.	

ANS:	B
Prescriptions must include the date, name of the patient, name of the drug, dosage, route of administration, and frequency or time of administration. The patient’s social security number will be in the chart but not on a prescription.

DIF:	1	REF:	5	
TOP:	AST Core Curriculum XI:B:2, prescription medications

	5.	An order for a drug to be given as needed is called a _______________ order.
a.	standing	
b.	oral	
c.	stat	
d.	PRN	

ANS:	D
PRN stands for pro re nata, which means that the drug may be given as needed.

DIF:	1	REF:	5	TOP:	AST Core Curriculum XI:D:3:d, PRN

	6.	What does the abbreviation sos mean on a prescription?
a.	One half	
b.	Once, if necessary	
c.	Without	
d.	As desired	

ANS:	B
sos means once, if necessary (see Table 1-3).

DIF:	1	REF:	5	
TOP:	AST Core Curriculum XI:B:2, prescription medications

	7.	How is an order for a drug to be taken every 4 hours indicated on a prescription?
a.	q4h	
b.	qid	
c.	qod	
d.	qs	

ANS:	A
The q means every; the actual number of hours is inserted before the h, which means hours.

DIF:	3	REF:	7	
TOP:	AST Core Curriculum XI:B:2, prescription medications

	8.	How is an order for a drug to be given three times a day indicated on a prescription?
a.	q3h	
b.	hs	
c.	qh	
d.	tid	

ANS:	D
tid means three times a day (see Table 1-4).

DIF:	1	REF:	7	
TOP:	AST Core Curriculum XI:B:2, prescription medications

	9.	Which form of drug preparation tends to act more quickly?
a.	Solid	
b.	Semisolid	
c.	Liquid	
d.	Gas	

ANS:	D
Absorption of drugs given by inhalation is rapid, especially gases such as inhalation anesthetics, because of the huge numbers of capillaries in the alveoli of the lungs.

DIF:	2	REF:	7	TOP:	AST Core Curriculum XI:G:1, gas

	10.	Which one of the following abbreviations indicates an ointment form of a given drug?
a.	gtts	
b.	ung	
c.	susp	
d.	soln	

ANS:	B
ung means ointment.

DIF:	1	REF:	8	TOP:	AST Core Curriculum XI:G:4, semisolid

	11.	Which one of the following abbreviations indicates that a drug is to be given orally?
a.	IM	
b.	PO	
c.	IV	
d.	SC	

ANS:	B
PO means per os or by mouth.

DIF:	1	REF:	9	TOP:	AST Core Curriculum XI:H:4, PO

	12.	How is a medication administered by any route except the mouth?
a.	Systemically	
b.	Sublingually	
c.	Parenterally	
d.	Subcutaneously	

ANS:	C
The term parenteral indicates any route other than the digestive tract.

DIF:	3	REF:	9	TOP:	AST Core Curriculum XI:H:1, injection/parenteral

	13.	Which one of the following terms is the study of the four basic processes of absorption, distribution, metabolism, and excretion in response to drugs?
a.	Pharmacokinetics	
b.	Pharmacodynamics	
c.	Biotransformation	
d.	Sympathomimetics	

ANS:	A
The study of pharmacokinetics focuses on how the body processes drugs.

DIF:	1	REF:	11	TOP:	AST Core Curriculum X:A:2, pharmacokinetics

	14.	Distribution of drugs within the body is carried out through which one of the following body systems?
a.	Respiratory	
b.	Circulatory	
c.	Integumentary	
d.	Urinary	

ANS:	B
Once a drug has been absorbed into the bloodstream, it is transported throughout the body by the circulatory system. Drug molecules eventually diffuse out of the bloodstream to the site of action in the process called distribution.

DIF:	2	REF:	12	TOP:	AST Core Curriculum X:A:2:b, distribution

	15.	The time between the administration of a drug and the first appearance of its effects is called
a.	peak effect.	
b.	onset.	
c.	duration.	
d.	reaction time.	

ANS:	B
The time between the administration of a drug and the first appearance of effects is called the onset.

DIF:	1	REF:	15	TOP:	AST Core Curriculum X:A:3:a, onset

	16.	Which group of drugs is known as receptor blockers?
a.	Antagonists	
b.	Agonists	
c.	Antipyretics	
d.	Analgesics	

ANS:	A
Drugs that bind to a receptor and prevent a response are called antagonists (Fig. 1-11). Antagonists are also called receptor blockers.

DIF:	2	REF:	14	TOP:	AST Core Curriculum X:B:1:c, antagonist

	17.	An expected but unintended effect of a drug is termed a(n) _______________ effect.
a.	idiosyncratic	
b.	adverse	
c.	synergic	
d.	side	

ANS:	D
A side effect is a predictable but unintended effect of a drug.

DIF:	1	REF:	15	TOP:	AST Core Curriculum X:B:3:a, side effects

	18.	Malignant hyperthermia is a(n) _______________ effect to certain drugs.
a.	idiosyncratic	
b.	adverse	
c.	local	
d.	side	

ANS:	A
Most idiosyncratic drug reactions are thought to occur in people with some genetic abnormality, causing either an excessive or an inadequate response to a drug. For example, malignant hyperthermia (see Chapter 16) is a life-threatening response to certain drugs and is attributable to a genetic defect.

DIF:	3	REF:	16	TOP:	AST Core Curriculum X:B:3:b, adverse effects

	19.	Which drug form is used the least in the surgical department?
a.	Semisolid	
b.	Solid	
c.	Liquid	
d.	Gas	

ANS:	B
Solids such as capsules and tablets are rarely used in surgery, because oral administration is required.

DIF:	2	REF:	7	TOP:	AST Core Curriculum XI:G:3, solid

	20.	When a drug travels from the site of administration into the bloodstream, it is called
a.	absorption.	
b.	distribution.	
c.	metabolism.	
d.	excretion.	

ANS:	A
Absorption is the process by which a drug is taken into the body and moves from the site of administration into the blood.

DIF:	2	REF:	11	TOP:	AST Core Curriculum X:A:2:a, absorption

	21.	Drugs are chemically altered via a process called metabolism in the
a.	lungs.	
b.	colon.	
c.	kidney.	
d.	liver.	

ANS:	D
The chemical composition of a drug is changed in the liver by a process called metabolism or biotransformation.

DIF:	1	REF:	11	TOP:	AST Core Curriculum X:A:2:c, metabolism

	22.	Most drugs are excreted and eliminated by the
a.	lungs	
b.	colon	
c.	kidney	
d.	liver	

ANS:	C
Some drug molecules are eliminated in the bile, feces, or skin, but most unchanged drugs and metabolites are excreted by the kidneys and eliminated in urine (Fig. 1-10).

DIF:	1	REF:	11	TOP:	AST Core Curriculum X:A:2:d, excretion

	23.	A drug that enhances the effect of another drug is called a(n)
a.	agonist.	
b.	synergist.	
c.	antagonist.	
d.	receptor blocker.	

ANS:	B
A drug that enhances the effect of another drug is called a synergist.

DIF:	1	REF:	15	TOP:	AST Core Curriculum X:B:1:a, synergist

	24.	Which one of the following types of drug binds to receptor site proteins and then inhibits a response?
a.	Agonist	
b.	Synergist	
c.	Antagonist	
d.	Electrolyte	

ANS:	C
Drugs that bind to a receptor and prevent a response are called antagonists.

DIF:	2	REF:	14	TOP:	AST Core Curriculum X:B:1:c, antagonist

	25.	The abbreviation PO represents which one of the following?
a.	Intramuscularly	
b.	Orally	
c.	Subcutaneously	
d.	Intravenously	

ANS:	B
PO means per os or by mouth.

DIF:	1	REF:	9	TOP:	AST Core Curriculum XI:H:4, PO

	26.	The abbreviation bid represents which one of the following?
a.	Twice a day	
b.	Three times a day	
c.	Four times a day	
d.	Immediately	

ANS:	A
bid means twice a day.

DIF:	1	REF:	7	
TOP:	AST Core Curriculum XI:B:2, prescription medications

	27.	The abbreviation NPO represents which one of the following?
a.	Discontinue	
b.	Immediately	
c.	Keep vein open	
d.	Nothing by mouth	

ANS:	D
NPO means nothing by mouth.

DIF:	1	REF:	7	
TOP:	AST Core Curriculum XI:B:2, prescription medications

	28.	A surgical patient is given a drug during surgery and suspects he or she is having a delayed allergic reaction to the drug, several days later. Which symptom indicates that the patient may be having a delayed drug reaction?
a.	Drowsiness	
b.	Circulatory collapse	
c.	Joint swelling	
d.	Excessive anticoagulation	

ANS:	C
Delayed drug reactions occur days or weeks after a drug is taken and can include fever and joint swelling.

DIF:	2	REF:	15	TOP:	AST Core Curriculum X:B:3:a, side effects

	29.	All are terms used to describe the body’s response or reaction to medications, except
a.	idiosyncratic.	
b.	contraindication.	
c.	side effect.	
d.	hypersensitivity.	

ANS:	B
A contraindication is a reason against giving a particular drug.

DIF:	1	REF:	15	TOP:	AST Core Curriculum X:B:2:b, contraindication

	30.	What drug is given as an antidote to warfarin?
a.	Vitamin K	
b.	Amoxicillin	
c.	Mannitol	
d.	Succinylcholine	

ANS:	A
Vitamin K is given as an antidote for warfarin if the patient has been over-anticoagulated because vitamin K cancels out the effect of warfarin.

DIF:	2	REF:	14	
TOP:	AST Core Curriculum XIII:A:3, anticoagulants and fibrinolytics	

	31.	Volatile anesthetic agents are eliminated from the body via
a.	the kidneys.	
b.	the skin.	
c.	the circulatory system.	
d.	the lungs.	

ANS:	D
Notable exceptions to urinary excretion are the volatile anesthetic agents, which are excreted by the lungs.

DIF:	2	REF:	13	
TOP:	AST Core Curriculum V:I:1:c, Isoflurane; d, Desflurane; e, Sevoflurane

	32.	Which drug administration route causes many drugs to undergo the “first-pass effect”?
a.	Sublingual	
b.	Oral	
c.	Transdermal	
d.	Inhalation	

ANS:	B
Since oral drugs enter the liver through the hepatic portal system, many undergo the first-pass effect, which means they may be altered or nearly inactivated when passing through the liver, potentially reducing the drug’s effectiveness.

DIF:	3	REF:	11	
TOP:	AST Core Curriculum X:A:2:a, absorption | AST Core Curriculum XI:H:4, oral route

	33.	Why would a local anesthetic, injected into an infected wound, not produce the intended effect?
a.	Because the local anesthetic was not strong enough	
b.	Because the local anesthetic was not absorbed	
c.	Because the local anesthetic could not reach the site of action	
d.	Because the local anesthetic could not bind to proteins	

ANS:	C
When a local anesthetic is injected into an infected wound, the local becomes ionized and cannot enter the lipid membrane of the nerves to reach the site of action. See Insight 1-3.

DIF:	3	REF:	12	
TOP:	AST Core Curriculum VI:A:1, Injection | AST Core Curriculum VI:B:1:a, Lidocaine; b, Bupivacaine; c, Mepivacaine	

	34.	How is antibiotic irrigation applied during surgery?
a.	Parenteral	
b.	Topical	
c.	Inhalation	
d.	Emulsion	

ANS:	B
Topical antibiotic irrigation is common in surgery, in which case an antibiotic solution is poured or squirted into the surgical site.

DIF:	2	REF:	9	
TOP:	AST Core Curriculum XIII:A:20, irrigation solutions

	35.	Many antibiotics used in surgery come in _________ form and must be reconstituted.
a.	liquid	
b.	gas	
c.	ointment	
d.	powder	

ANS:	D
Some drugs come in powder form and are contained in glass vials. Such powders must be mixed with a liquid (reconstituted) with sterile water or sodium chloride.

DIF:	1	REF:	7	TOP:	AST Core Curriculum IX:D:1, Combining

	36.	The study of drugs derived from natural sources is called
a.	pharmacology.	
b.	biotechnology.	
c.	pharmacokinetics.	
d.	pharmacognosy.	

ANS:	D
The study of drugs derived from natural sources is called pharmacognosy.

DIF:	1	REF:	2	
TOP:	AST Core Curriculum XI:F:1, Plants; 2, Animals; 3, Minerals	

	37.	Demerol is an example of a
a.	synthetic drug.	
b.	hormone.	
c.	semisynthetic.	
d.	natural drug.	

ANS:	A
Meperidine (Demerol) is an example of a synthetic drug; it is made from chemicals.

DIF:	1	REF:	3	
TOP:	AST Core Curriculum XI:F:4, Laboratory synthesis

MATCHING

Match the following terms with the correct definitions.
a.	Adverse effect	
b.	Bioavailability	
c.	Biotechnology	
d.	Biotransformation	
e.	Side effect	

	1.	Amount of unbound drug molecules able to cause the desired effect

	2.	Expected but unintended action or effect of a drug

	3.	Artificial manipulation of segments of DNA (genetic material)

	4.	Metabolism or breaking down of drug molecules in the liver

	5.	Undesired, potentially harmful effect of a medication

	1.	ANS:	B	DIF:	1	REF:	15	
TOP:	AST Core Curriculum X:B:3, effects		

	2.	ANS:	E	DIF:	1	REF:	12	
TOP:	AST Core Curriculum X:B:3:a, side effects	

	3.	ANS:	C	DIF:	1	REF:	3	
TOP:	AST Core Curriculum XI:F:5, biotechnology

	4.	ANS:	D	DIF:	1	REF:	13	
TOP:	AST Core Curriculum X:A:2:c, metabolism	

	5.	ANS:	A	DIF:	1	REF:	15	
TOP:	AST Core Curriculum X:B:3:b, adverse effects