ASIPP Pharmacology Questions Flashcards
1
Q
- Which of the following statements about antiplatelet
drugs is false?
A. Abciximab is a monoclonal antibody that binds to the
glycoprotein IIb/IIIa receptor
B. Decreased formation of thromboxane underlies the antiplatelet
action of aspirin
C. Ibuprofen reversibly inhibits cyclooxygenase in platelets
D. Ticlopidine is an inhibitor of the platelet thrombin
receptor
E. Dipyridamole is occasionally used with warfarin in patients
with artifi cial heart valves
A
- Answer: D
2
Q
1351. Which of the following is an antidepressant agent that selectively inhibits serotonin (5-HT) uptake with minimal effect on norepinephrine uptake A. Protriptyline B. Maprotiline C. Fuoxetine D. Desipramine E. Amoxapine
A
- Answer: C
Source: Smith H, Board Review 2005
3
Q
- A patient with Zollinger-Ellison syndrome has been
receiving high doses of cimetidine for 7 weeks. A
frequent adverse effect of cimetidine is
A. Agranulocytosis
B. Systemic lupus erythematosus
C. Inhibition of hepatic metabolism of other drugs
D. Antiestrogenic effects
E. Hypertension
A
- Answer: C
4
Q
1353. The opioid which has been implicated in Torsade de Pointes is: A. Morphine B. Meperidine C. Buprenorphine D. Methadone E. Propoxyphene
A
- Answer: D
Source: Smith H, Board Review 2005
5
Q
1354. Which one of the following drugs is used in the treatmentof male impotence and activates prostaglandin E1 receptors? A. Alprostadil B. Fluoxetine C. Mifepristone D. Sildenafil E. Zafirlukast
A
- Answer: A
6
Q
- A phase II clinical trials typically involve
A. Measurement of the pharmacokinetics of the new drug
in normal volunteers
B. Double-blind evaluation of the new drug in thousands of
patients with target disease
C. Postmarketing surveillance of drug toxicities
D. Evaluation of the new drug in 50 to several hundred
patients with the target disease
E. Collection of data regarding late-appearing toxicities fro
patients previously studies in phase I trials
A
- Answer: D
7
Q
- Recreational use of drugs sometimes leads to
dependence. Which of the following is LEAST likely to cause physical dependence?
A. Amphetamine
B. Cocaine
C. Heroin
D. Mescaline
E. Secobarbital
A
- Answer: D
8
Q
1357. Morphine 300 mg po is equivalent to: A. Morphine 10mg intrathecally B. Sufentanyl 100mcg intrathecally C. Morphine 1mg intrathecally D. Fentanyl 1mcg intrathecally E. Codeine 60 mg orally
A
- Answer: C
Explanation:
MSO4 300mg po is equivalent to 100mg IV, 10mg
epidurally, or 1mg intrathecally. Sufentanyl is 20 times as
potent as MSO4, and fentanyl is 3 times as potent.
Source: Trescot AM, Board Review 2004
9
Q
1358. The most likely cause of these signs and symptoms is overdosage of A. Aspirin B. Acetaminophen C. Dextromethorphan D. Diphenhydramine E. Ethanol
A
- Answer: A
10
Q
1359. Which of the following local anesthetics is the least protein bound? A. Lidocaine B. Bupivacaine C. Ropivacaine D. Mepivacaine E. Procaine
A
- Answer: E
Source: Day MR, Board Review 2004
11
Q
- After an intravenous bolus injection of lidocaine,
the major factors determining the initial plasma
concentration are
A. Dose and clearance
B. Dose and apparent volume of distribution
C. Apparent volume of distribution and clearance
D. Clearance and half-life
E. Half-life and dose
A
- Answer: B
12
Q
1361. Which one of the following effects of the opioid analgesics is most likely to be mediated via activation of mu receptors? A. Cough suppression B. Elevation of arterial PCO2 C. Emesis D. Sedation E. Vasodilation
A
- Answer: B
13
Q
- A 38-year-old divorced woman who lived alone visited a
psychiatrist because she was depressed. Her symptoms
included low self-esteem, with frequent ruminations
on her worthlessness, and hypersomnia. She was
hyperphagic and complained that her limbs felt heavy.
An initial diagnosis was made of a major depressive
disorder with atypical symptoms. Treatment was
initiated with amitriptyline, but after 2 months the
patient had not improved signifi cantly. Which one of
the following drugs is MOST likely to have therapeutic
value in this depressed patient?
A. Buprenorphine
B. Diazepam
C. Paroxetine
D. Methylphenidate
E. Risperidone
A
- Answer: C
14
Q
- In the management of this patient, which one of the
following procedures is not likely to have therapeutic
value?
A. Alkalinization of the urine
B. Correction of metabolic acidosis and electrolyte imbalance
C. Gastric lavage with an endotracheal tube in place
D. Hemodialysis, if pH or CNS signs are not readily controlled
E. Treatment with acetylcysteine
A
- Answer: E
15
Q
1364. The phenothiazines have a variety of actions at different receptor types. However, they do NOT appear to interact with receptors for A. Dopamine B. Histamine C. Nicotine D. Norepinephrine E. Muscarine
A
- Answer: A
16
Q
1365. Of the following, which is a phase II biotransformation reaction? A. Sulfoxide formation B. Nitro reduction C. Ester hydrolysis D. Sulfate conjugation E. Deamination
A
- Answer: D
Source: Smith H, Board Review 2005
17
Q
1366. Which of the following is a selective inhibitor of monoamine oxidase type B (MAO-B) and, therefore, useful in treating parkinsonism? A. Bromocriptine B. Carbidopa C. Selegiline D. Phenelzine E. Tranylcypromine
A
- Answer: C
Explanation:
* Two types of MAO have been found:
- MAO-A, which metabolizes norepinephrine and
serotonin, and
- MAO-B, which metabolizes dopamine.
A. Bromocriptine is a dopamine receptor agonist.
B. Carbidopa inhibits the peripheral metabolism of Ldopa.
- It is also useful in the treatment of parkinsonism.
C. Selegiline is a selective inhibitor of MAO-B. It therefore inhibits the breakdown of dopamine and
prolongs the therapeutic effectiveness of L-dopa in
parkinsonism.
D. Phenelzine and tranylcypromine are nonselective
MAOIs.
Source: Katzung
18
Q
- Psychiatric evaluation of a patient after 6 weeks of
treatment with a monoamine oxidase inhibitor
(MAOI) shows no improvement. The psychiatrist now
writes a prescription for fl uoxetine which the patient
starts two days after her fi nal dose of the MAOI. Since
the MAOIs used as antidepressants continue to exert
effects for 2 or more weeks after discontinuance, the
most likely result of the administration of fl uoxetine
now will be to cause
A. A rapid amelioration of her depressive symptoms
B. Electrocardiographic abnormalities
C. Extrapyramidal dysfunction
D. The serotonin syndrome
E. Weight gain
A
- Answer: D
19
Q
1368. The antidepressant with the least sedation side effect is: A. Desipramine B. Trazadone C. Nortriptyline D. Maprotiline E. Amitriptiline
A
- Answer: A
Explanation:
Tricyclic antidepressants (TCA) have been known to be
effective in managing chronic pain. Unfortunately, their
side effect profi le very often limits their clinical use. Some
of the major side effects include orthostatic hypotension,
anticholinergic effects, weight gain, sedation, cardiac
conduction disturbances, sexual dysfunction and
restlessness.
TCA’s with lower sedating effects include Protriptyline,
amoxapine, desipramine and imipramine. Trazadone is an
atypical antidepressant. It inhibits serotonin uptake, blocks
serotonin 5-HT2 receptors, a1 receptor antagonist. Its
most common side effects are sedation and orthostatic
hypotension. At low doses it is used an adjunct for
insomnia.
Source: Chopra P, 2004
20
Q
1369. The side effects of intravenous (IV) local anesthetics are related to central nervous system (CNS) toxicity. Signs are all of the following EXCEPT A. Metallic taste B. Tinnitus C. Agitation D. Increased appetite E. Convolusions
A
- Answer: D
Source: Raj P, Pain medicine - A comprehensive Review -
Second Edition
21
Q
- Damage to dopamine neurons in the midbrain is a
central feature of the pathophysiology of Parkinsons
disease. The loss of midbrain dopamine in this disease
is accompanied by
A. An increase in the dopamine transporter
B. A decrease in dopamine 1 receptor density
C. An increase in dopamine 2 receptor density
D. A decrease in dopamine synthesis in remaining dopamine
neurons
E. An increase in both dopamine 1 and dopamine 2 receptor
density
A
- Answer: E
Explanation:
(Cooper, pp 317-322.)
· Although there are hypotheses and models of
neurotransmitter dysfunction for many psychiatric and
neurologic diseases, Parkinson’s disease remains the
model disorder in which damage to a specifi c neural
pathway characterized by a particular neurotransmitter
can explain most or all of the pathophysiology of the
disease.
· Patients with Parkinson’s disease have biochemical
evidence of greatly decreased dopamine function in the
brain because of degeneration of the nigrostriatal tract. A
neurotoxic model of the disease, produced in primates by
administration of a derivative of meperidine (MPTP),
demonstrated that severe damage to dopaminecontaining
nigrostriatal neurons produced nearly all of the signs and
symptoms of Parkinsons disease.
· As dopamine neurons in the nigrostriatal tract
degenerate, compensatory changes occur that also
contribute to the pathophysiology. These changes include
a
matching loss of the dopamine transporter and a compensatory rise in both dopamine 1 and dopamine 2
postsynaptic receptor density. The remaining dopamine
neurons synthesize and release more dopamine as a
compensatory mechanism. These secondary physiologic
changes probably explain some of the signs and symptoms
seen in patients with advanced Parkinson’s disease who are
being treated with agents that augment dopamine
production. One example is the “on-off ’ phenomenon in
which patients have abnormal increases in movement after
administration of dopamine-augmenting agents, probably
because of hypersensitive dopamine receptors in
remaining neurons of the nigrostriatal tract.
Source: Ebert 2004
22
Q
- Of the following characteristics, which is unlikely to be
associated with the process of facilitated diffusion of
drugs?
A. The transport mechanism becomes saturated at high
drug concentrations
B. The process is selective for certain ionic or structural
confi gurations of the drug
C. If two compounds are transported by the same mechanism,
one will competitively inhibit the transport of
the other
D. The drug crosses the membrane against concentration
gradient and the process requires cellular energy
E. The transport process can be inhibited noncompetitively
by substances that interfere with cellular metabolism
A
- Answer: D
Explanation:
Reference: Hardman, pp 3-4.
Drugs can be transferred across biologic membranes by
passive processes (i.e., fi ltration and simple diffusion) and
by specialized processes (i.e., active transport, facilitated
diffusion, and pinocytosis). Active transport is a carriermediated
process that shows all of the characteristics listed
in the question. Facilitated diffusion is similar to active
transport except that the drug is not transported against a
concentration gradient and no energy is required for this
carrier-mediated system to function. Pinocytosis usually
involves transport of proteins and macromolecules by a
complex process in which a cell engulfs the compound
within a membrane-bound vesicle.
Source: Stern-2004
23
Q
- The three scales of the Minnesota Multiphasic Personality
Inventory (MMPI) included in the “conversion V” are:
A. Hypochondriasis, psychasthenia, depression
B. Hypochondriasis, depression, hysteria
C. Paranoia, hysteria, depression
D. Social introversion, depression, hysteria
E. Hypochondriasis, anxiety, somatization
A
- Answer: B
Explanation:
Many patients with prolonged chronic pain have elevation
of the hypochondriasis, depression, and hysteria scores of
2 or more standard deviations above the mean. This is
considered clinically signifi cant. Patients with acute pain
frequently have slightly elevated hypochondriasis,
depression, and hysteria scores, but not to a clinically
signifi cant degree. Once the pain resolves, the mild
elevation returns closer to or within the normal range.
Source: Kahn CH, DeSio JM. PreTest Self Assessment and
Review. Pain Management. New York, McGraw-Hill, Inc.,
1996.
24
Q
- A young woman presents with a several-year history
of ulcerative colitis. Recently she has been treated
with alprazolam 0.5 mg Q 8 hrs. This pharmacologic
treatment can be expected to:
A. Reduce stress and anxiety
B. Result in long-term improvement
C. Reduce interpersonal dilemmas
D. Produce a mild stimulus
E. Be used without development of tolerance
A
- Answer: A
Explanation:
(Baum, pp 224.)
· Traditionally, minor tranquilizers have been used as a
standard approach to the treatment of psychophysiologic
disorders. However, they fail to deal with the underlying
psychological, social, or physiologic problem, especially
on a long-term basis. They are effective in providing
short-term relief for high levels of stress or anxiety and
can be more effective if combined with behavior therapy or psychotherapy.
·Interpersonal dilemmas are not affected, though they may
seem to be temporarily dulled with minor tranquilizers.
· Minor tranquilizers often have the side effect of
drowsiness, can lead to tolerance with the need for
increased dosages, and can produce withdrawal symptoms
of insomnia, tremors, and even hallucinations.
Source: Ebert 2004
25
Q
1374. Which of the following is highly selective inhibitor of cyclooxygenase II? A. Aspirin B. Acetaminophen C. Ibuprofen D. Celecoxib E. Piroxicam
A
- Answer: D
Explanation:
Reference: Katzung, p 603.
Celocoxib is a cyclooxygenase II inhibitor. Aspirin,
ibuprofen, and piroxicam are relatively nonselective
inhibitors of cyclooxygenases. Acetaminophen has no
effect on cyclooxygenases
Source: Stern - 2004
26
Q
1375. The elimination half-life of which of the following tetracyclines remains unchanged when the drug is administered to an anuric patient? A. Methacycline B. Oxytetracycline C. Doxycycline D. Tetracycline E. None of the above
A
- Answer: C
Explanation:
Reference: Hardman, pp 1129-1131.
All teracyclines can produce negative nitrogen balance and
increased blood urea nitrogen (BUN) levels. This is of
clinical importance in patients with impaired renal
function. With the exception of doxycycline, tetracyclines
should not be used in patients that are anuric. Doxycycline
is excreted by the GI tract under these conditions, and it
will not accumulate in the serum of patients with renal
insuffi ciency.
Source: Stern-2004
27
Q
- Which one of the following statements about cocaine
is false?
A. Blocks sodium channels in axonal membranes
B. Blood pressure increase is due to its ability to release norepinephrine
from sympathetic nerve terminals
C. Cardiac arrhythmias may occur at high doses
D. Derived from a botanical source
E. Topical application can provide local anesthesia and restrict
bleeding
A
- Answer: B
28
Q
- With increasing concentrations of a local anesthetic, the
order of effect is
A. Pain fi bers—sensory fi bers—motor fi bers
B. Sensory fi bers—pain fi bers—motor fi bers
C. Pain fi bers—motor fi bers—sensory fi bers
D. Sensory fi bers—motor fi bers—pain fi bers
E. Sensory fi bers—motor fi bers—pain fi bers
A
- Answer: A
Explanation:
Reference: Katzung, pp 439-441.
The primary effect of local anesthetics is blockade of
voltage channel-gated Na channels.
Progressively increasing concentrations of local
anesthetics results in an increased threshold of excitation,
a slowing of impulse conduction, a decline in the rate of
rise of the action potential, a decrease in the height of the
action potential, and eventual obliteration of the action
potential.
Local anesthetics fi rst block small unmyelinated or lightly
myelinated fi bers (pain), followed by heavily myelinated
but small-diameter fi bers (sensory) and then largerdiameter
fi bers (proprioception, pressure, motor).
Source: Stern - 2004
29
Q
1378. Two drugs may act on the same tissue or organ through independent receptors, resulting in effects in opposite directions. This is known as A. Physical antagonism B. Chemical antagonism C. Competitive antagonism D. Irreversible antagonism E. Dispositional antagonism
A
- Answer: A
Explanation:
Reference: Hardman, p 68.
Physiologic, or functional, antagonism occurs when two
drugs produce opposite effects on the same physiologic
function, often by interacting with different types of
receptors. A practical example of this is the use of
epinephrine as a bronchodilator to counteract the
bronchoconstriction that occurs following histamine
release from mast cells in the respiratory tract during a
severe allergic reaction. Histamine constricts the
bronchioles by stimulating histamine H1 receptors in the
tissue; epinephrine relaxes this tissue through its agonistic
activity on b2-adrenergic receptors.
Chemical antagonism results when two drugs
combine with each other chemically and the activity of
one or both isblocked. For example, dimercaprol chelates
lead and reduces the toxicity of this heavy metal.
Competitive antagonism, or inactivation, occurs when two
compounds compete for the same receptor site; this is a
reversible interaction. Thus, atropine blocks the effects of
acetylcholine on the heart by competing with the
neurotransmitter for binding to cardiac muscarinic
receptors. Irreversible antagonism generally results from
the binding of an antagonist to the same receptor site as
the agonist by covalent interaction or by a very slowly
dissociating noncovalent interaction. An example of this
antagonism is the blockade produced by
phenoxybenzamine on a-adrenergic receptors, resulting in
a long-lasting reduction in the activity of
norepinephrine.
Dispositional antagonism occurs when one drug alters the
pharmacokinetics (absorption, distribution,
biotransformation, or excretion) of a second drug so that
less of the active compound reaches the target tissue. For
example, Phenobarbital induces the biotransformation of
warfarin, reducing its anticoagulant activity.
Source: Stern-2004
30
Q
- Which of the following is most correct about modern
psychopharmacology?
A. There is a one-diagnosis-one-drug approach
B. Many variables affect the practice of psychopharmacology
C. Medications must be given in large dosages for months
to work
D. Monitoring is rarely necessary and dose adjustments are
infrequently warranted
E. Medications exert their effect with in hours.
A
- Answer: B
Source: Cole EB, Board Review 2003
31
Q
- The drug of choice for the management of osteoporosis
caused by high-dose use of glucocorticoids is
A. Alendronate
B. Calcitonin
C. Mestranol
D. Oxandrolone
E. Vitamin D
A
- Answer: A
32
Q
- Carisoprodol (Soma®) is associated with all of the
following EXCEPT:
A. Potentially habituating, with potential for abuse
B. Hepatic impairment
C. Excessive sedation
D. Direct central brain stem activity
E. Dizziness, vertigo, ataxia and tremor
A
- Answer: D
Source: Hansen HC, Board Review 2004
33
Q
1382. Synaptic action of catecholamines is terminated by A. Monoamine oxidase B. Tyrosine hyroxylase C. Norepinephrine transporter D. Catechol-O-methyl transferase E. Aromatic amino transferase
A
- Answer: B
34
Q
1383. The correct arrangement of local anesthetics in order of their ability to produce cardiotoxicity from most to least is A. Bupivacaine, lidocaine, ropivacaine B. Bupivacaine, ropivacaine, lidocaine C. Ropivacaine, bupivacaine, lidocaine D. Lidocaine, ropivacaine, bupivacaine E. Lidocaine, bupivacaine, ropivacaine
A
- Answer: B
Explanation:
* All local anesthetics have a dose-dependent effect on
cardiac contractility and conduction velocity. The
cardiodepressant effect generally parallels the anesthetic potency.
* Bupivacaine has been shown to be 16 times more toxic
than lidocaine, well out of proportion to the potency ratio
and two times more toxic than ropivacaine despite similar
nerve-blocking potency
35
Q
1384. The primary determinant of local anesthetic potency is A. pKa B. Molecular weight C. Lipid solubility D. Concentration E. Protein binding
A
- Answer: C
36
Q
- Among the local anesthetics used for intravenous
regional anesthesia (Bier block), the most rapidly
metabolized and thus least toxic is the following:
A. Etidocaine
B. Lidocaine
C. Ropivacaine
D. Prilocaine
E. Mepivacaine
A
- Answer: D
Explanation:
Prilocaine is the most rapidly metabolized of the amide
local anesthetics and therefore least toxic.
2-chloroprocaine is hydrolyzed rapidly in the blood and,
therefore would appear to be ideal, but it has been
associated with a high incidence of thrombophlebitis and
is therefore not recommended.
Maximum doses of local anesthetics are as follows:
prilocaine, 3 to 4 mg/kg; lidocaine, 1.5 to 3 mg/kg;
ropivacaine, 1.2 to 1.8 mg/kg.
37
Q
- Acetyl salicylic acid (aspirin) exerts its action by:
A. Prostaglandin synthesis
B. Inhibiting platelet aggregation
C. Antipyretic action at the hypothalamus
D. Inactivating cyclooxygenase
E. All of the above
A
- Answer: E
Source: Hansen HC, Board Review 2004
38
Q
1387. Adrenergic receptors are coupled to A. G proteins B. Tyrosine kinase C. Sodium channels D. Cyclo-oxygenase E. Nerve growth factor
A
- Answer: A
39
Q
1388. The pKa of Lidocaine is: A. 7.4 B. 7.6 C. 7.7 D. 8.0 E. 8.2
A
- Answer: C
Source: Day MR, Board Review 2004
40
Q
1389. The nephrogenic diabetes insipidus may be caused by: A. Fluoxetine B. Haloperidol C. Lithium D. Phenytoin E. Diazepam
A
- Answer: C
Explanation:
Reference: Katzung, p 493.
Lithium treatment frequently causes polyuria and
polydipsia. The collecting tubule of the kidney loses the
capacity to conserve water via antidiuretic hormone. This
results in signifi cant free-water clearance, which is
referred to as nephrogenic diabetes insipidus.
Source: Stern - 2004
41
Q
1390. Clinically signifi cant methemoglobinemia may result from administration of large doses of A. Chloroprocaine B. Bupivacaine C. Etidocaine D. Prilocaine E. Lidocaine
A
- Answer: D
Explanation:
Large doses of prilocaine, usually greater than 600 mg
epidurally, can result in clinically signifi cant
methemoglobinemia. Prilocaine is metabolized by the
liver to o-toluidine, which is responsible for the oxidation
of hemoglobin to methemoglobin. Methemoglobinemia
can be treated with IV methylene blue, or it will resolve
spontaneously.
Source: Hall and Chantigan.
42
Q
- Which of the following statements is most correct?
A. Maximum effi cacy of a drug is directly correlated with
its potency
B. The therapeutic index if the LD50 (or TD50) divided by
the ED50
C. A partial agonist has no effect on its receptors unless
another drug is present
D. Graded dose-response data provide information about
the standard deviation of sensitivity to the drug in the
population studied
E. Quantal dose-response curves provide information
about the effi cacy of a drug
A
- Answer: B
43
Q
- The toxicity spectrum of aspirin does not include
A. Increased risk of encephalopathy in children with viral
infections
B. Increased risk of peptic ulcers
C. Hyperprothrombinemia
D. Metabolic acidosis
E. Respiratory alkalosis
A
- Answer: C
44
Q
1393. The earliest sign of lidocaine toxicity is: A. Shivering B. Nystagmus C. Lightheadedness and dizziness D. Tonic-clonic seizures E. Nausea and vomiting
A
- Answer: C
Explanation:
* The initial symptoms of local anesthetic toxicity are
lightheadedness and dizziness. Patients also may note
perioral numbness and tinnitus.
* Progressive central nervous system (CNS) excitatory
effects include visual and auditory disturbances, shivering,
twitching, and ultimately generalized tonic-clonic seizures.
* CNS depression can ensue, leading to respiratory
depression or arrest.
45
Q
1394. Of the following antiepileptic agents, which is associated with causing psychosis? A. Phenobarbital B. Ethosuximide C. Phenytoin D. Vigabatrin E. Valproic acid
A
- Answer: D
Explanation:
Reference: Katzung, pp 404-405.
Vigabatrin can induce psychosis. It is recommended that it
not be used in patients with preexisting depression and
psychosis.
Source: Stern - 2004
46
Q
1395. A patient on Lorazepam for fi bromyalgia has been out of drug for four days. He presents with rhinorrhea, etc. Treatment of choice is: A. Clonidine B. Gabapentin C. Diazepam D. Oxycodone E. Methadone
A
- Answer: C
47
Q
1396. The quinolone derivative that is most effective against Pseudomonas aeruginosa is A. Norfl oxacin B. Ciprofl oxacin C. Ofl oxacin D. Enoxacin E. Lomefl oxacin
A
- Answer: B
Explanation:
Reference: Hardman, p 1065
Ciprofl oxacin is a fl uorinated quinolone derivative highly
effective against P.aeruginosa.
Other derivatives in this class have less activity toward
this organism, although they are effective against other
common Gram-negative organisms.
Source: Stern-2004
48
Q
- Akathisia, Parkinson-like syndrome, galactorrhea, and
amenorrhea are side effects of perphenazine, caused
by
A. Blockade of muscarinic receptors
B. Blockade of Alpha-adrenergic receptors
C. Blockade of dopamine receptors
D. Supersensitivity of dopamine receptors
E. Stimulation of nicotinic receptors
A
- Answer: C
Explanation:
Reference: Hardman, pp 414-416.
Unwanted pharmacologic side effects produced by
phenothiazine antipsychotic drugs (e.g., perphenazine)
include Parkinson-like syndrome, akathisia, dystonias,
galactorrhea, amenorrhea, and infertility. These side effects
are due to the ability of these agents to block dopamine
receptors.
The phenothiazines also block muscarinic and aadrenergic
receptors, which are responsible for other
effects.
Source: Stern - 2004
49
Q
- A 59-year-old woman with a 60 pack-year smoking
history was diagnosed with lung cancer 2 months
ago. She now enters the hospital in coma. Her serum
calcium is 16 mg/dL. Which of the following (given
with IV fl uids) would be most useful to reduce serum
calcium in this patient rapidly?
A. Acetazolamide
B. Furosemide
C. Hydrochlorothiazide
D. Mannitol
E. Spironolactone
A
- Answer: B
50
Q
1399. Which of the following is considered to be the most cardio-toxic? A. Bupivacaine S-isomer B. Bupivacaine racemic mixture C. Bupivacaine R-isomer D. Ropivacaine E. Lidocaine
A
- Answer: C
Explanation: (Raj, Practical Mgmt of Pain, 3rd Ed, page 566, Stoelting,
Pharmacology and Physiology of Anesthetic Practice, 3rd
Ed., page 170-171)
All local anesthetics can produce a dose dependent
depression of cardiac conduction velocity, including intraatrial,
AV nodal, His-Purkinje, and intraventricular
pathways. Part of local anesthetic cardiac toxicity is due to
blockade of cardiac sodium channels. Accidentally
administered bupivacaine can lead to precipitous
hypotension, dysrhythmias, and A-V heart block. The
dissociation of highly lipid soluble bupivacaine from Na+
channels is slow.
Bupivacaine is a racemic mixture, wherein the R
enantiomer is more toxic than the S-enantiomer.
Ropivacaine is a pure S-enantiomer which is intermediate
in toxicity between lidocaine and bupivacaine
Source: Shah RV, Board Review 2004
51
Q
- A patient with terminal cancer is suffering from pain that
is gradually increasing in intensity. In the management
of pain in such a patient
A. Physical dependency occurs universally in later stages of
the disease
B. To delay the development of dependency, opioid analgesics
should never be given for initial management of
chronic pain
C. Meperidine is more effective than morphine in cancer
pain states
D. Nonsteroidal anti-infl ammatory drugs may control
symptoms during a signifi cant portion of the course
of the disease
E. The placebo effect is absent
A
- Answer: D
52
Q
1401. Intrathecal baclofen may be indicated for A. Spasticity B. Neuropathic Pain C. nociceptive Pain D. somatic Pain E. Pelvic pain
A
- Answer: A
Source: Lou Etal. Pain Practice: march 2001
53
Q
- The consumption of shellfi sh harvested during a “red
tide” (due to a large population of a dinofl agellate
species) is not recommended. This is because the
shellfi sh are likely to contain
A. Arsenic
B. Botulinum toxins
C. Cyanide
D. Saxitoxin
E. Tetrodotoxin
A
- Answer: D
54
Q
- A 23-year-old heroin addict was brought to a hospital
suffering from marked bradykinesia, muscle rigidity,
and tremor at rest. Unfortunately, the extrapyramidal
dysfunction was permanent in this patient, since he
had self-administered this agent this is cytotoxic to
nigrostriatal dopaminergic neurons.
A. MDMA
B. MPTP
C. Ma-huang
D. Meperidine
E. Mescaline
A
- Answer: B
55
Q
1404. Which of the following local anesthetics may cause methemoglobinemia? A. Prilocaine B. Ropivacaine C. Bupivacaine D. Procaine E. Chloroprocaine
A
- Answer: A
Explanation:
(Stoelting, 3rd Ed, pa 164-5)
Prilocaine is an amide local anesthetic that is metabolized
to orthotoluidine. Orthotoluidine is an oxidizing
compound that is capable of converting hemoglobin to
methemoglobin. If the dose of prilocaine exceeds 600mg,
there may be enough methemoglobin (3-5 g/dl) to cause
the patient to appear cyanotic. Methemoglobinemia is
readily reversed by the administration of methylene blue,
1-2 mg/kg intravenously over 5 minutes. This effect,
however, may be short lived, since the methylene blue may
be cleared before converting all of the methemoglobin to
hemoglobin.
Source: Shah RV, Board Review 2004
56
Q
- A 24-year-old schizophrenic man has been treated for
several years with haloperidol but, since parkinsonismlike
effects are worsening, the drug is discontinued and
treatment is started with olanzapine. Which one of
the following statements about the new medication is
false?
A. Antipsychotic effects may take several weeks to develop
B. Alleviates some of the negative symptoms of schizophrenia
C. Causes agranulocytosis
D. Has a greater affi nity for serotonin receptors than for
dopamine receptors in the CNS
E. Less effect on pituitary function than haloperidol
A
- Answer: C
57
Q
- Of the following, which is unlikely to be associated
with receptors bound to plasma membranes, their
interaction with ligands, and the biologic response to
this interaction?
A. Structurally, these receptors have hydrophobic amino
acid domains, which are in contact with the membrane,
and hydrophilic regions, which extend into the extracellular
fl uid and the cytoplasm
B. Chemical interactions of ligands with these receptors
may involve the formation of many types of bonds, including
ionic, hydrogen, van der Waals’, and covalent
C. Ligand-receptor interactions are often stereospecifi c
(i.e., one stereoisomer is usually more potent than the
other)
D. In some cases, a ligand that acts as an agonist at membrane-
bound receptors increases the activity of an intracellular second messenger
E. Activation of membrane-bound receptors and subsequent
intracellular events elicit a biologic response
through the transcription of DNA
A
- Answer: E
Explanation:
Reference: Hardman, pp 31-34.
* Based upon the molecular mechanisms with which
receptors transduce signals, four major classes of
receptors have been identifi ed:
- ion channel receptors,
- receptors that interact with G proteins,
- receptors with tyrosine kinase activity, and
- nuclear receptors.
* The fi rst three types of receptors are complex membrane
bound proteins with hydrophilic regions located within
the lipoid cell membrane and hydrophilic regions located
within the lipoid cell membrane and hydrophilic portions
found protruding into the cytoplasm of the cell and the
extracellular milieu; when activated, all of these receptors
transmit (or transduce) information presented at the
extracellular surface into ionic or biochemical signals
within the cell (i.e., second messengers). Nuclear receptors
are found in the nucleus of the cell, not bound to plasma
membranes. In addition, these receptors do not transduce
information by second-messenger systems; rather, they
bind to nuclear chromatin and elicit a biologic response
through the transcription of DNA and alterations in the
formation of cellular proteins. Ligand binding to all types
of receptors may involve the formation of ionic, hydrogen,
hydrophobic, van der Waals’, and covalent bonds. In most
cases, ligand-receptor interactions are stereospecifi c; for
example, natural (-)-epinephrine is 1000 times more
potent than (+)-epinephrine.
Source: Stern-2004
58
Q
- Although it does not act at any histamine receptor,
epinephrine reverses many effects of histamine.
Epinephrine is a
A. Competitive inhibitor of histamine
B. Noncompetitive antagonist of histamine
C. Physiologic antagonist of histamine
D. Chemical antagonist of histamine
E. Metabolic inhibitor of histamine
A
- Answer: C
59
Q
- Which of the following is a true labeled indication
for prescribing CNS stimulants?
A. Narcolepsy
B. Enhanced alertness for driving
C. Reversing opioid induced sedation
D. Chronic pain associated with thalamic strokes
E. Fibromaylgia syndrome
A
- Answer: A
Source: Cole EB, Board Review 2003
60
Q
1409. Which of the following are hydrolyzed by plasma pseudocholinesterases? A. Lidocaine B. Ropivacaine C. Bupivicaine D. Tetracaine E. Etidocaine
A
- Answer: D
Explanation:
(Raj, Practical Mgmt of Pain, 3rd Ed. Page 558)
Plasma pseudocholinesterases hydrolyze the ester linkage
of ester local anesthetics. Amide local anesthetics undergo
biotransformation in the liver.
Source: Shah RV, Board Review 2004
61
Q
1410. The serum concentration of lidocaine would be highest with which route of administration…..specifi cally at 60 minutes after administration? A. Intravenous B. Epidural C. Brachial Plexus D. Intercostal E. Subarachnoid
A
- Answer: D
Explanation:
(Raj, Practical Mgmt of Pain, 3rd Ed., page 565)Similarly
the peak concentrations would be
Intercostal > Epidural > Intravenous = Brachial Plexus >
Subcutaneous
Source: Shah RV, Board Review 2004
62
Q
1411. The serum concentration of lidocaine would be highest with which route of administration…..specifi cally at 5 minutes after administration? A. Intravenous B. Intercostal C. Epidural D. Brachial Plexus E. Subcutaneous
A
- Answer: A
Explanation:
(Raj, Practical Mgmt of Pain, 3rd Ed., page 565, fi gure 39-
6) Ok, a trick question.
The actual peak concentrations of these routes at 5
minutes would be on the order of micrograms per
milliliter IV> Intercostal> Epidural> Brachial Plexus >
Subcutaneous
Source: Shah RV, Board Review 2004
63
Q
1412.Which one of the following statements about pentazocine
is false?
A. Analgesia is at least equivalent to that of codeine
B. Causes sedation
C. Classifi ed as a mixed agonist-antagonist
D. Full agonist at mu receptors
E. May interfere with the analgesic effects of morphine
A
- Answer: D
64
Q
- Absorption is most dependent upon which of the
following?
A. Gastric pH >7
B. Liver metabolism
C. Gastric & intestinal motility
D. Presence of some liquid in stomach when medications
are taken
E. Amount and volume of drug administered
A
- Answer: C
Source: Cole EB, Board Review 2003
65
Q
- A patient has been taking aspirin for rheumatoid
arthritis for 8 years. Exacerbations are becoming
worse and she asks the physician about drugs that
might stop the progression of the disease. Which
one of the following is not a disease-modifying (slowacting)
antirheumatic drug?
A. Auranofi n
B. Hydroxychloroquine
C. Methotrexate
D. Penicillamine
E. Rofecoxib
A
- Answer: E
66
Q
- Accidental poisonings are common with both aspirin
and ibuprofen, two OTC drugs available in tasty
chewable tablets. In cases of overdose, aspirin is more
likely than ibuprofen to cause
A. Autonomic instability
B. Hepatic necrosis
C. Metabolic acidosis
D. Thrombocytopenia
E. Ventricular arrhythmias
A
- Answer: C
67
Q
- All of the following medications can cause sexual
dysfunction. However, the following drug does not
inhibit desire or decrease arousal.
A. Amphetamines
B. Phenothiazines
C. alpha -Methyldopa
D. Guanethidine
E. Tricyclic Anti-Depressents
A
- Answer: A
Explanation:
(Sierles, pp 393-397.)
- Side effects on sexual function are frequently
produced by antihypertensives, other cardiovascular
compounds, and psychotropic medications
.
- Sexual dysfunctions can be produced through
anticholinergic parasympathetic and sympathetic
ganglionic-blocking, antiandrogenic, ß-adrenergic,
progestational, antihistaminic, and dopamine antagonist
actions.
- Tricyclics, phenothiazines,lpha-methyldopa, and
guanethidine all have the effect of decreasing sexual
arousal. They can also inhibit desire and produce orgasmic
diffi culties.
- Amphetamines can produce orgasmic diffi culties, but
do not appear to inhibit desire or decrease arousal.
- The physician must always consider that drug
combinations can create untoward effects on sexual
function.
Source: Ebert 2004
68
Q
- Which of the following statements is true?
A. Acetaminophen leads to more toxicity annually than
NSAIDs
B. Aspirin is known to have a lower annual associated toxicity
cost compared to acetaminophen
C. NSAIDs cause fewer GI toxicity events than acetaminophen
and aspirin
D. Acetaminophen use is associated with a lower annual
toxicity cost
E. Aspirin produces a temporary effect on platelet aggregation
A
- Answer: D
Source: Jackson KC. Board Review 2003
69
Q
- Distribution of medication into the brain is most
commonly governed by which of the following?
A. Regional cerebral blood fl ow
B. Abnormalities in the blood-brain barrier
C. Percent of the drug that is protein bound
D. Relative density of target receptors for binding
E. Gastric and intestinal motility
A
- Answer: A
Source: Cole EB, Board Review 2003
70
Q
1419. Norepinephrine will cause contraction of the smooth muscle in A. Bronchioles B. Pupils C. Intestine D. Arterioles E. Ciliary body
A
- Answer: D
Explanation:
(Guyton, pp 701-703.)
The catecholamines nor,
epinephrine and epinephrine will activate both alpha and
ß-adrenergic receptors. When the a1-adrenergic receptors
are stimulated, they activate a G protein, which in turn
activates phospholipase C that hydrolyzes PIP2 and
produces IP3 and DAG. The IP3 causes the release of Ca2+
from the sarcoplasmic reticulum, which in turn increases
muscle contraction. alpha1 adrenergic receptors
predominate on arteriolar smooth muscle, so theses
muscles contract when stimulated with norepinephrine.
The bronchi, pupillary, and ciliary smooth muscles all
contain beta receptors, which cause smooth muscle
relaxation. The intestinal smooth muscle relaxation is
initiated by an alpha2-aradrenergic receptor
71
Q
- When an inactive substance or condition induces a
therapeutic change, the procedure (result) is called
A. Nonpharmaceutical reaction
B. Modulated conditioning
C. Placebo effect
D. Reaction formation
E. Fantasy reaction
A
- Answer: C
Explanation:
(Carlson, pp 352-359.)
· Testosterone administered postpubertally to castrated
rats can restore aggressiveness to almost normal levels.
Similarly, neonatal female mice develop masculine
aggressive behavior on receiving androgens. Androgens
also promote aggression in humans.
· Boys are more aggressive than girls at ages 3 to 10, as
has been demonstrated in studies of children.
Source: Ebert 2004
72
Q
- A 35-year-old female who has never been pregnant
suffers each month from pain, discomfort, and mood
depression at the time of menses. She may benefi t
from the use of this selective inhibitor of the reuptake
of serotonin.
A. Amitriptyline
B. Bupropion
C. Mirtazapine
D. Paroxetine
E. Trazodone
A
- Answer: D
73
Q
- Carbidopa is useful in the treatment of Parkinson’s
disease because it
A. Is a precursor of levodopa
B. Is a dopaminergic receptor agonist
C. Prevents peripheral biotransformation of L-dopa
D. Prevents a breakdown of dopamine
E. Promotes a decreased concentration of L-dopa in the
nigrostriatum
A
- Answer: C
Explanation:
Reference: Hardman, pp 510
Carbidopa is an inhibitor of aromatic L-amino acid
decarboxylase. It cannot readily penetrate the central
nervous system (CNS) and, thus, decreases the
decarboxylation of L-dopa in the peripheral tissues. This
promotes an increased concentration of L-dopa in the
nigrostriatum, where it is converted to dopamine. In
addition, the effective dose of L-dopa can be reduced.
Source: Stern - 2004
74
Q
- Which of the following best describes the protein
binding properties of albumin for local anesthetics?
A. Low affi nity, low capacity
B. Low affi nity, high capacity
C. High affi nity, low capacity
D. High affi nity, high capacity
E. High affi nity only
A
- Answer: B
Source: Day MR, Board Review 2004
75
Q
1424. Intractable itching is best treated with: A. Chlorpromazine B. Pimozide C. Haloperidol D. Risperidone E. Clozapine
A
- Answer: A
76
Q
- Which of the following local anesthetics has the lowest
ratio of dosage for cardiovascular collapse to dosage
required for central nervous system toxicity?
A. Lidocaine
B. Etidocaine
C. Bupivacaine
D. Prilocaine
E. Chloroprocaine
A
- Answer: C
Explanation:
In general, there is an overall direct correlation between
anesthetic’s potency and its direct depressant effect on
myocardial contractility.
A. Ratio for lidocaine and mepivacaine is 7.1.
B. Ratio for etidocaine is 4.4
C. The ratio of dosage required for cardiovascular
collapse in animal models compared with that required to
produce neurologic symptoms is the lowest for
bupivacaine and levo-bupivacaine (2.0)
- Ratio for ropivacaine is 2.2
D. Ratio for prilocaine is 3.1;
E. Ratio for procaine and chloroprocaine is 3.7
77
Q
1426. Which of the following corticosteroids has the highest anti-infl ammatory potency A. Cortisone B. Prednisone C. Triamcinolone D. Methylprednisone E. Dexamethasone
A
- Answer: E
Source: Smith H, Board Review 2005
78
Q
- Which best describes the mechanism of interaction of
cimetidine with benzodiazepine?
A. It decreases benzodiazepine’s metabolism
B. It decreases benzodiazepine’s sensitivity at the site of
action
C. It decreases benzodiazepine’s renal excretion
D. It decreases benzodiazepine’s plasma protein binding
E. It decreases benzodiazepine’s intestinal absorption
A
- Answer: A
Explanation:
Reference: Hardman, p 906. Katzung, p 1127.
Cimetidine inhibits the activity of cytochrome P450,
slowing benzodiazepam metabolism.
Source: Stern - 2004
79
Q
1428. The first local anesthetic used clinically was A. Cocaine B. Tetracaine C. Lidocaine D. Bupivacaine E. Mepivacaine
A
- Answer: A
80
Q
1429. The highest concentration of phenol clinically used in neurolytic blocks is: A. 6% B. 10% C. 20% D. 40% E. 100%
A
- Answer: B
Source: Day MR, Board Review 2004
81
Q
1430. Among the following agents, the selective dopamine receptor (D2) agonist is: A. Fluphenazine B. Bromocriptine C. Promethazine D. Haloperidol E. Chlorpromazine
A
- Answer: B
Explanation:
Reference: Hardman, pp 282-283.
Central dopamine receptors are divided into D1 and D2
receptors. Antipsychotic activity is better correlated to
blockade of D2 receptors.
Haloperidol, a potent antipsychotic, selectively antagonizes
at D2 receptors.
Phenothiazine derivatives, such as chlorpromazine,
fl uphenazine, and promethazine, are not selective for D2
receptors.
Bromocriptine, a selective D2 agonist, is useful in the
treatment of parkinsonism and hyperprolactinemia. It
produces fewer adverse reactions than do nonselective
dopamine receptor agonists.
Source: Stern - 2004
82
Q
1431. One of the following antipsychotics requires weekly blood counts. A. Chlorpromazine B. Clozapine C. Haloperidol D. Olanzapine E. Molindone
A
- Answer: B
Explanation:
Reference: Katzung, p 486.
Clozapine causes agranulocytosis in 1% to 2% of treated
patients. It is generally reversible on discontinuation of the
drug.
Weekly blood tests are recommended for patients who are
treated with clozapine.
Agranulocytosis occurs rarely with other high-potency
antipsychotic agents.
Source: Stern - 2004
83
Q
1432. The maximum dose of lidocaine containing 1:200,000 epinephrine that can be administered to a 70-kg patient for regional anesthesia is A. 50 mg B. 100 mg C. 200 mg D. 500 mg E. 1000 mg
A
1432. Answer: D Explanation: The maximum dose of local anesthetics containing 1:200,000 epinephrine that can be used for major nerve blocks is: Lidocaine, 500mg Mepivacaine, 500mg Prilocaine, 600mg Bupivacaine, 225mg Etidocaine, 400mg Tetracaine, 200mg.
84
Q
- Which one of the following drugs mimics the activity of
metenkephalin in the dorsal horn of the spinal cord?
A. Deprenyl (selegiline)
B. Trihexyphenidyl
C. Baclofen
D. Morphine
E. Phenobarbital
A
- Answer: D
Explanation:
Reference: Hardman, pp 521-522.
* The enkephalins are endogenous agonists of the opioid
receptors.
- The enkephalins are located in areas of the brain and
spinal cord related to the perception of pain. These areas
include the laminae I and II of the spinal cord, the spinal
trigeminal nucleus, and the periaqueductal gray.
* Selegiline and trihexyphenidyl are anti-Parkinsonism
drugs.
* Baclofen is a skeletal muscle relaxant agonist for the
GABA receptor.
Source: Stern - 2004
85
Q
1434. Which of the following local anesthetics is useful for topical (surface) administration only? A. Procaine B. Bupivacaine C. Etidocaine D. Benzocaine E. Lidocaine
A
- Answer: D
Explanation:
Reference: Katzung, p 437.
Local anesthetics are agents that, when applied locally,
block nerve conduction; they also prevent generation of a
nerve impulse. All contain a lipophilic (benzene)
functional group and most a hydrophilic (amine) group.
Benzocaine does not contain the therminal hydrophilic
amine group; thus, it is only slightly soluble in water and is
slowly absorbed with a prolonged duration. It is,
therefore, only useful as a surface anesthetic.
Source: Stern -2004
86
Q
1435. A drug that specifi cally enhances metabolically the activity of brain dopamine is A. Benztropine B. Selegiline C. Trihexyphenidyl D. Bromocriptine E. Chlorpromazine
A
- Answer: B
Explanation:
Reference: Hardman, p 451.
Selegiline inhibits MAO-B, thus delaying the metabolic
breakdown of dopamine.
Selegiline is effective alone in parkinsonism and increases
the effectiveness of L-dopa.
Benztropine and trihexyphenidyl are cholinergic
antagonists in the brain.
Bromocriptine is a dopamine receptor agonist.
Chlorpromazine is an antipsychotic drug with
antiadrenergic properties.
Source: Stern - 2004
87
Q
- A 45-year-old patient is to have reconstructive surgery
on a hand that was recently injured in an accident. The
anesthesiologist plans to use regional anesthesia of the
arm for a fairly long procedure. The amide-type local
anesthetic with the longest duration of action is
A. Cocaine
B. Bupivacaine
C. Lidocaine
D. Procaine
E. Tetracaine
A
- Answer: B
88
Q
1437. Which of the following NSAIDs is the most likely to promote headache? A. Sulindac B. Peroxicam C. Diclofenac D. Ketoprofen E. Indomethacin
A
- Answer: E
Source: Smith H, Board Review 2005
89
Q
- Among the local anesthetics used for intravenous
regional anesthesia (Bier block) the most rapidly
metabolized and thus least toxic accentis:
A. Etidocaine
B. Lidocaine
C. Ropivacaine
D. Prilocaine
E. Mepivacaine
A
- Answer: B
Source: Smith H, Board Review 2005
90
Q
1439. The antidepressant below with the highest risks of inducing seizures is: A. Doxepin B. Trazadone C. Amitriptyline D. Maprotiline E. Nortriptyline
A
- Answer: D
Source: Smith H, Board Review 2005
91
Q
- In comparing the following possible routes, which is
associated with the excretion of quantitatively small
amounts of drugs or their metabolic derivatives?
A. Biliary tract
B. Kidneys
C. Lungs
D. Feces
E. Milk
A
- Answer: E
Source: Smith H, Board Review 2005
92
Q
1441. Seizures occur at what serum concentration range for lidocaine? A. 10-12 μg/mL B. 10-12 ng/mL C. 100-120μg/mL D. 1-1.2 mg/mL E. 10-12 mg/mL
A
- Answer: A
Explanation:
(Raj, Practical Mgmt of Pain 3rd Ed., pag 565)
As the serum levels of lidocaine rise, the patient may be at
increased risk for seizures. At 10 to 12 micrograms/ml.,
inhibitory pathways in the brain are selectively inhibited,
but facilitatory neurons are unopposed.
Seizures originate in the amygdale and hippocampus.
Lidocaine toxicity presents with prodromal symptoms,
before seizures: slow speech, jerky movements, tremors,
and hallucinations
Source: Shah RV, Board Review 2004
93
Q
1442. Inhibitors of serotonin (5-HT) uptake such as paroxetine (Paxil®) interact signifi cantly with which of the following drugs? A. Chlorpromazine B. Tranylcypromine C. Halothane D. Benztropine E. Digoxin
A
- Answer: B
Explanation:
Reference: Katzung, p 1130.
Fatalities have been reported when fl uoxetine and MAO
inhibitors (MAOIs) such as tranylcypromine have been
given simultaneously.
The MAOIs should be stopped at least two weeks before
the administration of fl uoxetine or paroxetine.
Source: Stern - 2004
94
Q
1443. True comments regarding COX II specifi c inhibitors include immunity from: A. Potential Nephrotoxicity B. Platelet Inhibition C. Gastrointestinal Erosion D. None of the Above E. All of the above
A
- Answer: D
Source: Hansen HC, Board Review 2004
95
Q
- Which best describes the primary actions of nonsteroidal
anti-infl ammatory drugs (NSAIDS)?
A. Their predominant classic activity is in the CNS
B. They have no analgesic ceiling effect
C. They are potent inhibitors of cyclooxygenase
D. They promote neutrophil phagocytosis
A
- Answer: C
Source: Smith H, Board Review 2005
96
Q
- Haloperidol may best be characterized by which of the
following statements?
A. It is classifi ed as a phenothiazine
B. It is a selective D2 receptor agonist
C. Its mechanism of action is completely different from that
of chlorpromazine
D. It is more potent as an antipsychotic drug than is chlorpromazine
E. It produces a lower incidence of
A
- Answer: D
Explanation:
Reference: Hardman, pp 407-412.
Haloperidol is a butyrophenone derivative with the same
mechanism of action as the phenothiazines, that is,
blockade of dopaminergic receptors.
It is more selective for D2 receptors.
Haloperidol is more potent on a weight basis than the
phenothiazines, but produces a higher incidence of extrapyramidal reactions than does chlorpromazine
Source: Stern - 2004
