A nurse administers the same medication in the same preparation ...

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A nurse administers the same medication in the same preparation in the same dose to several patients and notes that some patients have a better response to the drug than others. What is the most likely explanation for this phenomenon?
 
  a. Altered bioavailability of the drug
  b. Patient compliance with the therapeutic regimen
  c. Pharmacogenomic differences among individuals
  d. Placebo effects enhancing expectations of drug efficacy

Question 2

A patient asks a nurse why a friend who is taking the same drug responds differently to that drug. The nurse knows that the most common variation in drug response is due to differences in each patient's:
 
  a. drug receptor sites.
  b. hypersensitivity potential.
  c. metabolism of drugs.
  d. psychosocial response.

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Answer to Question 1

ANS: C
Each patient's genetic makeup can determine how that patient responds to drugs both quantitatively and qualitatively, and this is the most likely cause of individual variation when the same drug is given at the same dose. The bioavailability of a drug is determined by the drug's composition and varies across formulations of the drug. The patients in this example were given the same drug. The nurse was administering the medication to the patients, so compliance is not an issue. Nothing in this example indicates that a placebo effect was in play.

Answer to Question 2

ANS: C
The most common source of genetic variation in drug response is related to alterations in drug metabolism and is determined by genetic codes for various drug-metabolizing isozymes. There are known genetic differences in codes for drug target sites, but these are not as numerous as those for metabolic isozymes. Hypersensitivity potential is also genetically determined, but variations produce differences in adverse reactions to drugs and not in drug effectiveness. Psychosocial responses vary for many, less measurable reasons, such as individual personalities and variations in cultures.

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