CHAPTER 5
Quiz Yourself
1. A local drug effect is limited to the site of administration and those tissues immediately
surrounding it. A systemic drug effect is not limited to the site of administration
but can be felt throughout the body to varying degrees, causing a therapeutic effect as
well as possible side effects.
2. Lidocaine (Xylocaine) is an example of a drug that can act either locally or systemically to
produce a therapeutic effect, depending on its route of administration. When applied
topically via a gargle, it causes topical anesthesia. When injected into the skin or gums, it
causes local anesthesia. When injected epidurally into the lumbar area, it provides anesthesia
to the lower body. When given intravenously, it acts systemically to stop cardiac
arrhythmias.
3. The therapeutic effect is the drug’s main effect for which it was prescribed by the
physician. The therapeutic effect is selected to cure a disease, decrease disease symptoms,
or prevent a disease. Drug effects other than the therapeutic effect are known as side effects.
4. Common side effects for the GI tract include anorexia, nausea, vomiting, and diarrhea.
Common side effects for the central nervous system include drowsiness, excitement,
or depression.
5. A toxic effect results when the serum levels of a drug rise above the therapeutic level.
Side effects, on the other hand, while varying in severity and type, occur entirely
when the serum level of a drug is within the therapeutic range.
6. The therapeutic index is a measurement of the margin of safety between the therapeutic
dose and the toxic dose for any given drug.
7. The basis for all symptoms associated with an allergic reaction is the local and
systemic release of histamine.
8. In the lock-and-key concept, the lock is a receptor located on the cell membrane. The
key is either an agonist drug that can unlock and activate the receptor, or it can
be an antagonist drug that occupies the lock and blocks other drugs from activating
the receptor. One drug can act as a master key to unlock several different receptors on
different organs; this is what occurs when one drug causes both therapeutic and side
effects.
9. Synergism involves two drugs combining to produce an effect greater than the
independent effects of each drug. The combination drug Tylenol w/ Codeine is an
example of a synergistic drug–drug interaction in which two analgesic drugs work
together to relieve pain. Another example is the combination of a potassium-wasting
diuretic drug with a potassium-sparing diuretic drug in one combination drug.
Antagonism involves two drugs combining to produce an effect less than the
independent effects of each drug. The combination of tetracycline taken with antacids,
causing the formation of an insoluble complex, is an example of an antagonistic drug–drug
reaction
10. Polypharmacy is when a patient takes several different drugs. These may be
prescription drugs and/or OTC drugs.
11. Metric system of measurement.
12. Penicillin or insulin or some vitamins (units). Nitroglycerin ointment (inches).
Potassium (milliequivalents).
13. True.
14. a. a.c.
before meals
b. b.i.d. twice a day
c. g
gram
d. h.s.
hours of sleep, at bedtime
e. mcg
microgram
f. mg
milligram
g. mL
milliliter
h. mEq. milliequivalent
i. p.r.n.
as needed
j. t.i.d.
three times a day
15. A pediatric drug dose is calculated based on the total body weight of the patient, not
the age. Pediatric drug doses are expressed as mg/kg/day (milligrams of drug per
kilogram of body weight per 24-hour period).
16. Chemotherapy drug doses are calculated based on the patient’s total body surface
area.
Chemotherapy drug doses are expressed as mg/m2 (milligrams of drug per
meter squared
of body surface area).
Clinical Applications Questions
1
Do not take with nitrates (drug–drug interaction).
May cause drowsiness (other warning to prevent side effects).
Do not drink (drug–alcohol interaction).
Take with food or milk (other warning to prevent side effects).
Finish all of this medication unless otherwise directed by the prescriber (other warning).
Take with plenty of water (other warning to prevent side effects).
2. a. Yes.
b. Liver and kidneys.
c.
Drug Name
Accupril
Actos
aspirin
Catapres-TTS-1
Lasix
Glucotrol XL
Humulin N
K-Dur
Lanoxin
lorazepam
Metamucil
Prozac
Zantac
Risperdal
Serevent
Used to Treat
hypertension
diabetes mellitus
pain
hypertension
hypertension and congestive heart failure
diabetes mellitus
diabetes mellitus
potassium supplement drug
congestive heart failure
anxiety
laxative drug for constipation
anxiety and depression
heartburn and peptic ulcer
psychosis
bronchodilator drug for lung disease
Synthroid
Celebrex
Zaroxolyn
Ambien
Levaquin
thyroid hormone replacement drug
arthritis pain
diuretic drug for congestive heart failure
insomnia
antibiotic drug for respiratory infection
d. Yes, this patient is at risk for a drug–drug interaction.