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SELF-ASSESSMENT QUESTIONS

1. Which of the following drugs is rarely monitored to determine if a drug being taken by the patient is in a safe and/or therapeutic concentration?

A. Tacrolimus

B. Phenytoin

C. Erythromycin

D. Digoxin

The correct answer is C. All the other drugs are commonly monitored for patient safety and/or efficacy.

2. Identify one of the choices from the following that is not an indication for therapeutic drug monitoring.

A. Patient compliance with the prescribed drug regimen is uncertain.

B. The prescribed drug has a low margin of safety, with toxic blood concentrations only slightly greater than therapeutic ones.

C. The prescribed drug has minimal pharmacokinetic variability.

D. The prescribed drug has frequent drug–drug interactions.

The correct answer is C. The opposite is true for choice C—that is, an indication for therapeutic drug monitoring is when the prescribed drug has significant pharmacokinetic variability.

3. Which of the following organs is the primary site for drug metabolism?

A. Kidneys

B. Liver

C. Lungs

D. Gastrointestinal tract

The correct answer is B. With regard to drug metabolism, the liver is the primary site in the body.

4. Impaired function of which of the following organs requires dose adjustment because of reduced elimination for many therapeutic drugs?

A. Kidneys

B. Skin

C. Gastrointestinal tract

D. Lungs

The correct answer is A. Drugs can be eliminated through the kidneys, the liver, the lungs, the skin, the feces, and by other means. However, the elimination of many polar, nonlipophilic drugs is achieved primarily through renal excretion. Reduced drug clearance may occur when a drug that is eliminated by the kidneys is administered to a patient with impaired renal function.

5. Which of the following is a trough drug level?

A. A sample drawn just prior to the next dose

B. A sample drawn 4 hours after administration of a drug

C. A sample collected 5 minutes after drug administration

D. A sample drawn once per month to determine if a drug concentration is in ...

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