Chapter·PharmacologyPharmacokinetics (ADME principles)

Phase II metabolism (conjugation reactions)Downloads

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1

A 72-year-old man presents to the emergency department with a 1 hour history of bruising and bleeding. He says that he fell and scraped his knee on the ground. Since then, he has been unable to stop the bleeding and has developed extensive bruising around the area. He has a history of gastroesophageal reflux disease, hypertension, and atrial fibrillation for which he is taking an oral medication. He says that he recently started taking omeprazole for reflux. Which of the following processes is most likely inhibited in this patient?

ASulfation

BOxidation

CFiltration

DAcetylation

EGlucuronidation

2

You are seeing a patient in clinic who recently started treatment for active tuberculosis. The patient is currently being treated with rifampin, isoniazid, pyrazinamide, and ethambutol. The patient is not used to taking medicines and is very concerned about side effects. Specifically regarding the carbohydrate polymerization inhibiting medication, which of the following is a known side effect?

AVision loss

BParesthesias of the hands and feet

CCutaneous flushing

DArthralgias

EElevated liver enzymes

3

A 17-year-old girl is brought to the emergency department 6 hours after she attempted suicide by consuming 16 tablets of acetaminophen (500 mg per tablet). At present, she does not have any complaints or symptoms. The patient is afebrile and vital signs are within normal limits. Physical examination is unremarkable. Laboratory findings show a serum acetaminophen level that is predictive of ‘probable hepatic toxicity’ on the Rumack-Matthew nomogram. Treatment is started with a drug, which is a precursor of glutathione and is a specific antidote for acetaminophen poisoning. Which of the following is an additional beneficial mechanism of action of this drug in this patient?

APromotes glucuronidation of unmetabolized acetaminophen

BPromotes microcirculatory blood flow

CPromotes fecal excretion of unabsorbed acetaminophen

DPrevents gastrointestinal absorption of acetaminophen

EPromotes oxidation of N-acetyl-p-benzoquinoneimine (NAPQI)

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