BIOAVAILABILITY AND DISTRIBUTION – PRACTICE MCQs
1. Which route of administration provides 100% bioavailability?
A) Oral
B) Intramuscular
C) Intravenous
D) Subcutaneous
2. What primarily determines bioavailability?
A) Plasma protein binding
B) Absorption rate and absorption ratio
C) Molecular weight
D) Urinary excretion
3. Which dosage form is absorbed the fastest?
A) Tablet
B) Capsule
C) Suspension
D) Solution
4. Which of the following reduces drug bioavailability?
A) Enteric coating
B) Intravenous injection
C) P-glycoprotein in the intestine
D) Acid-stable drug
5. What happens to a drug during first-pass metabolism?
A) It reaches the brain directly
B) It is excreted in urine
C) It is eliminated before entering systemic circulation
D) It bypasses the liver
6. Which statement about absorption kinetics is true?
A) Zero-order drugs are absorbed faster with higher doses
B) First-order drugs are absorbed at a constant rate
C) First-order drug absorption increases with dose
D) Zero-order drugs have no Tmax
7. Vancomycin has poor oral bioavailability because it is:
A) Lipophilic
B) Acid-stable
C) Very hydrophilic
D) A prodrug
8. Which enzyme is mainly responsible for presystemic elimination?
A) Renin
B) Cytochrome P450
C) Lipase
D) Amylase
9. Enterohepatic circulation prolongs drug action because:
A) Drugs are absorbed faster
B) Drugs are excreted faster
C) Drugs continuously cycle between liver and intestine
D) Drugs avoid metabolism
10. Which parameter is most important in evaluating bioavailability?
A) Cmax
B) Tmax
C) Half-life
D) AUC
11. If the AUC for oral drug is 50 and for IV is 100, the bioavailability is:
A) 100%
B) 50%
C) 10%
D) 200%
12. A drug with zero-order kinetics will:
A) Be absorbed faster as dose increases
B) Be absorbed at a constant rate regardless of dose
C) Have variable half-life
D) Not show any plasma concentration
13. Which drug is absorbed through passive diffusion better?
A) Ionized drug
B) Non-ionized drug
C) Hydrophilic drug
D) Charged molecule
14. Lipophilic drugs require:
A) No carriers
B) Protein carriers
C) High solubility in water
D) Acidic pH
15. Plasma protein that binds most drugs is:
A) Globulin
B) Lipoprotein
C) Albumin
D) Alpha-1-acid glycoprotein
16. Which condition decreases albumin levels and increases free drug?
A) Dehydration
B) Hypoalbuminemia
C) Hyperkalemia
D) Hypernatremia
17. Warfarin toxicity may occur when taken with aspirin because:
A) Aspirin inhibits its metabolism
B) Aspirin increases warfarin excretion
C) Aspirin displaces warfarin from plasma proteins
D) Aspirin slows gastric emptying
18. Which drug has a narrow therapeutic index?
A) Paracetamol
B) Digoxin
C) Ibuprofen
D) Amoxicillin
19. A lipophilic drug is likely to have:
A) Low protein binding
B) Low absorption
C) High protein binding
D) Poor membrane crossing
20. Sequestration increases volume of distribution because:
A) Drug is cleared quickly
B) Drug accumulates in plasma
C) Drug accumulates in tissues
D) Drug is metabolized rapidly
21. Thiopental’s action ends due to:
A) Metabolism
B) Excretion
C) Redistribution
D) Dilution
22. A drug with a volume of distribution of 1000L is likely:
A) Highly bound to albumin
B) Mostly in plasma
C) Accumulated in tissues
D) Excreted via kidneys
23. Which of the following can cause ion trapping?
A) Protein binding
B) Redistribution
C) pH difference
D) Liver failure
24. Ion trapping increases drug excretion by:
A) Conjugation in liver
B) Making the drug non-ionized
C) Making the drug ionized in urine
D) Increasing lipophilicity
25. Salicylate poisoning is treated by:
A) Acidifying the urine
B) Giving antibiotics
C) Alkalinizing the urine
D) Diuretics
26. Highly lipophilic drugs:
A) Cannot cross membranes
B) Accumulate in adipose tissue
C) Are rapidly excreted in urine
D) Are poorly absorbed
27. Drugs absorbed in their non-ionized form will:
A) Remain in GI tract
B) Be absorbed into plasma
C) Be trapped in kidneys
D) Be metabolized faster
28. Which of the following is an efflux protein?
A) Cytochrome P450
B) Albumin
C) P-glycoprotein
D) Trypsin
29. Drug redistribution occurs in this order:
A) Plasma → Kidney → Liver
B) Brain → Muscle → Fat
C) Intestine → Liver → Blood
D) Heart → Brain → Stomach
30. Which drug binds to lipoproteins?
A) Digoxin
B) Quinine
C) Cyclosporine
D) Lidocaine
ANSWER KEY
1. C
2. B
3. D
4. C
5. C
6. C
7. C
8. B
9. C
10. D
11. B
12. B
13. B
14. B
15. C
16. B
17. C
18. B
19. C
20. C
21. C
22. C
23. C
24. C
25. C
26. B
27. B
28. C
29. B
30. C
Here are 30 MCQs based on the content of your pharmacology metabolism lecture. The
answers are provided at the end.
MCQs:
1. Where does drug metabolism primarily occur?
A) Kidney
B) Liver
C) Lungs
D) Intestine
2. What is the primary purpose of metabolism in the liver?
A) Making drugs lipophilic
B) Making drugs nonpolar
C) Converting drugs to inactive and polar forms
D) Enhancing drug taste
3. Which of the following is a prodrug?
A) Morphine
B) Enalapril
C) Codeine
D) Digoxin
4. What is the metabolite of enalapril?
A) Morphine
B) Acrolein
C) Enalaprilat
D) Gabapentin
5. Which enzyme converts codeine into morphine?
A) CYP3A4
B) CYP2C9
C) CYP2D6
D) MAO
6. Which drug is excreted without being metabolized?
A) Codeine
B) Lithium
C) Minoxidil
D) Cyclophosphamide
7. Phase I reactions include all EXCEPT:
A) Oxidation
B) Hydrolysis
C) Conjugation
D) Reduction
8. Where are phase I enzymes primarily located?
A) Cytoplasm
B) Plasma
C) Endoplasmic reticulum
D) Nucleus
9. Which reaction is exclusive to microsomal enzymes in Phase II?
A) Sulfation
B) Acetylation
C) Glucuronidation
D) Methylation
10.Which enzyme shows genetic polymorphism and is not inducible?
A) CYP3A4
B) CYP2C9
C) CYP2D6
D) CYP2E1
11.Which of the following undergoes acetylation and can cause lupus-like syndrome
in slow acetylators?
A) Codeine
B) Hydralazine
C) Diazepam
D) Digoxin
12.Which enzyme metabolizes nicotine?
A) CYP1A2
B) CYP2C9
C) CYP2A6
D) CYP2D6
13.Which reaction occurs in the cytoplasm in Phase II?
A) Oxidation
B) Glucuronidation
C) Acetylation
D) Hydrolysis
14.Which enzyme is responsible for metabolizing alcohol at high doses?
A) MAO
B) CYP2D6
C) CYP2E1
D) Aldehyde oxidase
15.What is a possible effect of CYP enzyme induction on prodrugs?
A) Decreased activity
B) Increased toxicity
C) Increased therapeutic effect
D) No change
16.Which enzyme metabolizes warfarin?
A) CYP1A2
B) CYP2C9
C) CYP2D6
D) CYP3A4
17.Which of the following undergoes spontaneous non-enzymatic breakdown?
A) Diazepam
B) Atracurium
C) Acetaminophen
D) Procaine
18.Which is the correct sequence for Isoniazid metabolism?
A) Phase I then Phase II
B) Only Phase I
C) Only Phase II
D) Phase II then Phase I
19.Which CYP enzyme is involved in metabolizing 50% of drugs?
A) CYP2C19
B) CYP3A4
C) CYP2E1
D) CYP1A2
20.Which drugs can cause prolonged apnea in those without plasma cholinesterase?
A) Morphine
B) Succinylcholine and mivacurium
C) Diazepam and midazolam
D) Cocaine and lidocaine
21.Which enzyme breaks down tamoxifen?
A) CYP3A4
B) CYP2C19
C) CYP1A2
D) CYP2E1
22.Which CYP enzyme is involved in the metabolism of caffeine?
A) CYP1A2
B) CYP2D6
C) CYP2A6
D) CYP3A4
23.Which of the following is not a phase I reaction?
A) Reduction
B) Hydrolysis
C) Glucuronidation
D) Oxidation
24.Which drug undergoes N-methylation?
A) Acetaminophen
B) Noradrenaline
C) Morphine
D) Digoxin
25.Which is true about CYP3A4?
A) Responsible for metabolizing alcohol
B) Metabolizes 50% of all drugs
C) Genetically polymorphic
D) Found in cytoplasm
26.What happens if CYP enzymes are inhibited?
A) Drug clearance increases
B) Drug effect decreases
C) Drug accumulates, increasing side effects
D) Drug becomes nonpolar
27.Which of the following induces CYP enzymes?
A) Ketoconazole
B) Fluconazole
C) Rifampicin
D) Cimetidine
28.Which drug inhibits CYP enzymes?
A) Carbamazepine
B) Phenytoin
C) Griseofulvin
D) Erythromycin
29.Which type of metabolite is more dangerous than its parent drug?
A) Enalaprilat
B) N-acetyl-p-benzoquinonimine
C) Glucuronide
D) Sulfate conjugate
30.Which enzyme metabolizes esters like procaine and succinylcholine?
A) Acetylcholinesterase and pseudocholinesterase
B) CYP3A4
C) CYP2C9
D) MAO
Answers:
1. B
2. C
3. B
4. C
5. C
6. B
7. C
8. C
9. C
10.C
11.B
12.C
13.C
14.C
15.C
16.B
17.B
18.D
19.B
20.B
21.B
22.A
23.C
24.B
25.B
26.C
27.C
28.D
29.B
30.A
