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Pharmacology and Mechanisms of Ototoxicity for Audiologists

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1.  Regarding therapeutic index, which of the following statements is true?
  1. Drugs with a wide therapeutic index are often toxic at low concentrations.
  2. Drugs with a narrow therapeutic index are likely to exhibit their intended effects and toxic effects at the same time.
  3. Therapeutic index is the mathematical expression of how drugs are eliminated by the body.
  4. Chemotherapy drugs like cisplatin are regarded to have a wide therapeutic index.
2.  A drug that binds to a receptor and inhibits the normal function of that receptor would be regarded as an:
  1. Antagonist
  2. Agonist
  3. Allergen
  4. Aggressor
3.  Pharmacokinetics can be used to predict which of the following?
  1. Whether or not a patient will experience toxicity.
  2. Whether or not a given drug will work for a patient.
  3. Approximate drug levels based on specific patient characteristics.
  4. If a treatment will be cost effective.
4.  Which of the following is not a pharmacokinetic parameter:
  1. Absorption
  2. Distribution/Metabolism
  3. Incorporation
  4. Elimination
5.  Reactive oxygen species exert damage on sensitive structures through which mechanism?
  1. DNA Crosslinking
  2. Protein misfolding
  3. Free radical chain reactions
  4. Membrane degradation
6.  An example of a common mechanism between renal and cochlear toxicity is:
  1. Disruption of ion gradients necessary for normal function.
  2. Accumulation of stressors and waste secondary to decreases in blood flow.
  3. Both A and B
  4. None of the above
7.  Stress resulting from damage to stria vascularis:
  1. Can lead to increased apoptosis.
  2. Results from the accumulation of waste products.
  3. Is usually reversible when the offending drug is removed.
  4. All of the above
8.  The structure most often found to be damaged by a drug causing vestibular toxicity is:
  1. Stria vascularis
  2. Nerve cells in the spiral ganglion
  3. Basilar membrane
  4. Organ of Corti
9.  Antioxidants are thought to provide otoprotective effects by:
  1. "Scavenging" free radicals inside cells, rendering them inert.
  2. Stabilizing critical enzymes needed for DNA synthesis.
  3. Normalizing ion gradients in the cochlea.
  4. "Chaperoning" proteins to prevent misfolding.
10.  Possible complications of otoprotective therapies may include:
  1. Interference with the therapeutic effect of the toxic drug.
  2. An inability to produce adequate concentrations of the otoprotective drug in the tissues where it is needed.
  3. Novel agents may be prohibitively expensive.
  4. All of the above

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