General Pharmacology: Distribution & Vd

What is the approximate volume of plasma in the body?

What does a small volume of distribution (Vd) indicate about a drug's distribution?

A drug with a large volume of distribution (Vd) is MOST likely to:

In cases of drug toxicity, when is hemodialysis MOST effective?

Which plasma protein is MOST significant for drug binding?

Which of the following conditions can lead to an increase in the free concentration of a drug in the body?

Which statement accurately describes drugs bound to plasma proteins?

A drug is 99% bound to plasma proteins. Displacement of the drug by another agent increases the free fraction by 1%. What is the potential consequence?

Why are non-ionized, highly lipid-soluble drugs able to cross the blood-brain barrier (BBB)?

What is a potential consequence of drugs crossing the placental barrier?

Why do basic drugs tend to accumulate in breast milk?

What is the initial distribution pattern of thiopental due to its high lipid solubility and high blood flow to the brain?

Why does the duration of action of thiopental depend more on redistribution than on metabolism or excretion?

What is the primary site of drug metabolism (biotransformation) in the body?

What is the MOST common consequence of biotransformation?

Which of the following is an example of a drug being metabolized into a toxic metabolite?

What term defines the volume of body fluids at which a drug appears to be distributed?

Which characteristic is typically associated with drugs that have a volume of distribution exceeding 40 liters?

What is a primary clinical significance of understanding a drug's volume of distribution (Vd)?

How does hypoalbuminemia affect the distribution of a drug that is normally highly protein-bound?

A drug is described as having 'redistribution'. What does this mean in a pharmacokinetic context?

Which of the following statements regarding the passage of drugs into breast milk is correct?

A patient with malnutrition has low serum albumin. They are given a drug that is normally 95% bound to albumin. What effect will malnutrition likely have on the drug's free concentration and potential for toxicity?

A drug is known to induce teratogenicity. What route of exposure is its MOST likely cause for its related adverse developmental effects?

After intravenous administration, a highly lipophilic drug rapidly enters the brain, producing a short period of anesthesia. Over time, consciousness is regained, even though plasma concentrations of the drug remain high. What is the MOST likely explanation for this phenomenon?

A patient is taking warfarin, which is 99% bound to albumin in plasma. A second drug is administered that displaces warfarin from albumin, increasing the free fraction of warfarin from 1% to 2%. What is the expected change in warfarin's effect, assuming no other factors are changed?

A researcher is studying a new drug and finds that it has a very high affinity for plasma proteins. Which of the following is a likely consequence of this high affinity?

A drug with a very large volume of distribution is unlikely to be effectively removed from the body during hemodialysis because:

A drug that undergoes first-pass metabolism is given intravenously instead of orally. Which of the following pharmacokinetic parameters is MOST likely to be significantly different?

A drug is known to be a substrate of P-glycoprotein (P-gp). Which of the following effects would you expect from a P-gp inhibitor?

Considering that only the unbound fraction of a drug is able to exert a pharmacological effect, which scenario would lead to a SUPRISINGLY greater-than-expected effect of a drug? NOTE that this is something that would be hard to predict without actually seeing it happen.

A drug is known to undergo significant first-pass metabolism. If the drug is administered intravenously instead of orally, how would you MOST expect the volume of distribution to change (if at all - assume distribution to tissues is related to the amount of drug in the systemic circulation)?

Which of the following drugs would be MOST readily cleared by hemodialysis?

A new drug is developed that is actively transported into cells via a specific transporter protein found in various tissues, including the brain, liver, and kidneys. One potential safety concern is 'oversaturation' of this transporter. Which of the following could occur due to transporter saturation?

Warfarin is a drug with a narrow therapeutic index and is highly bound to albumin. A patient stabilized on warfarin develops a severe infection and is prescribed a sulfonamide antibiotic, which is also highly albumin-bound and known to displace warfarin. In this scenario, what change would we expect?

A physician prescribes Drug X, a weak base with a pKa of 8.0, to a nursing mother. Drug X distributes into the breast milk. Assuming the pH of plasma is 7.4 and the pH of breast milk is 7.0, which of the following statements BEST describes the distribution of Drug X?

A patient with chronic kidney disease has significantly reduced albumin levels. They require treatment with a drug that is normally highly protein-bound. What potential adjustment to the drug regimen might be necessary?

A study shows that a new drug, primarily distributed in the extracellular fluid (ECF), has a volume of distribution of approximately 14 liters in a 70 kg individual. Which of the following BEST describes the drug's distribution characteristics?

A patient is taking a drug that induces CYP3A4 enzymes. The patient begins taking another drug that is metabolized by CYP3A4. How would you MOST expect the second drug to be affected?