Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RRPA Pharmacology III > CNS Pharmacology Questions > Flashcards

CNS Pharmacology Questions Flashcards

1
Q 
Which of the following should be tried first for initial treatment of mild to moderate pain?
A. Acetaminophen
B. Fentanyl
C. Ketorolac
D. Tramadol
E. Ibuprofen
F. Aspirin
A

A. Acetaminophen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q 
Which of the following is most effective for the treatment of acute musculoskeletal pain?
A. Aspirin
B. Acetaminophen
C. Celecoxib
D. Naproxen
A

D. Naproxen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q 
Strong full opioid agonists are generally indicated for treatment of: 
A. Mild pain
B. Moderate to severe pain
C. Chronic lower back pain
D. High fever (>105C)
E. All of the above
A

B. Moderate to severe pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q 
Antidepressants and antiepileptics are commonly used to treat: 
A. Postherpetic neuralgia
B. Diabetic nephropathy
C. Fibromyalgia pain
D. All of the above
A

D. All of the above

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q 
The mainstays of treatment for neuropathic pain syndromes are: 
A. Antidepressants and antipsychotics
B. Antidepressants and anti-epileptics
C. Opioids
D. COX-2 selective NSAIDS
A

B. Antidepressants and anti-epileptics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

A given dose of local anesthetic is generally less effective in acutely inflamed tissue than in normal tissue because in inflamed tissue:
A. The higher pH rapidly degrades the local anesthetic
B. The lower pH decreases the percentage of ionized local anesthetic (-NH3+ form)
C. The lower pH decreases the percentage of available free base (-NH2 form).
D. Increase extracellular fluid concentrates the local anesthetic

A

C. The lower pH decreases the percentage of available free base (-NH2 form).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which of the following is true about local anesthetics?
A. They are weak acids
B. They are strong bases
C. They are largely in the charged cationic form at normal body pH
D. The charged form of the drug readily penetrates the cell membrane because of the presence of a hydrophilic group
E. The non-ionized form of the drug blocks the Na+ channel

A

C. They are largely in the charged cationic form at normal body pH`

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

The hallmark of use-dependent drugs, such as local anesthetics, is:
A. The more frequent the dosing, the greater their efficacy
B. The greater the probability of channels opening, the greater the degree of block
C. Their high affinity for closed (resting) ion channels
D. Their preferential action in slowly firing cells

A

B. The greater the probability of channels opening, the greater the degree of block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q 
Local anesthetics exert their therapeutic effects by which one of the following nerve fiber types? (multiple correct)
A. Type A-beta
B. Type A-delta
C. Type B
D. Type C
A

B. Type A-delta

D. Type C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which of the following statement concerning nerve blockade with local anesthetics is false?
A. Block is greater in small diameter fibers than in large diameter fibers
B. Block is greater in rapidly firing neurons than in more slowly firing neurons
C. Sensitivity to block is similar for pain neurons and postganglionic sympathetic neurons
D. Block is faster in onset for neurons in the center of a nerve bundle that in the periphery of bundle

A

D. Block is faster in onset for neurons in the center of a nerve bundle that in the periphery of bundle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Termination of the systemic action of local anesthetics:
A. Involved metabolic breakdown primarily by plasma cholinesterase for lidocaine
B. Involves vascular absorption primarily with amide type agents
C. Is enhanced in the presence of vasoconstrictors such as epinephrine with amide type agents
D. Involves metabolic breakdown primarily by plasma cholinesterase for chloroprocaine

A

D. Involves metabolic breakdown primarily by plasma cholinesterase for chloroprocaine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q 
Which of the following adverse effects is associated with inadvertent IV administration of a large dose of lidocaine?
A. Bronchoconstriction
B. Methemoglobinemia
C. Renal failure
D. Seizures
E. Tachycardia
A

D. Seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which statement about the toxicity of local anesthetics is correct?
A. Bupivacaine is the safest local anesthetic to use in patients at risk for cardiac arrhythmia
B. Most local anesthetics cause vasoconstriction
C. Serious cardiac reactions are more likely to occur with lidocaine than with bupivacaine
D. Cocaine may cause cardiac arrhythmias in overdose

A

D. Cocaine may cause cardiac arrhythmias in overdose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q 
Which of the following local anesthetics has the highest level of intrinsic vasodilation activity and is generally co-administered with a vasoconstrictor?
A. Procaine
B. Bupivacaine
C. Lidocaine
D. Mepivacaine
A

B. Bupivacaine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q 
Long-term administration of large doses of prednisone is least likely to cause reduction in the synthesis-release of which hormone?
A. Cortisol 
B. Corticotropin (ACTH)
C. Corticotropin-releasing hormone (CRH)
D. Aldosterone
E. Growth hormone
A

D. Aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q 
A 50y/o woman, who has been an asthmatic for the past 30yrs, presented to the ED with a 2 day history of worsening breathlessness and cough. Chest auscultation revealed bilateral polyphonic inspiratory and expiratory wheeze. Supplemental oxygen, nebulizer albuterol, and ipatropium, as well as IV methylprednisolone were administered. Which of the following is a pharmacologic effect of exogenous glucocorticoids?
A. Increased muscle mass
B. Hypoglycemia
C. Inhibition of leukotriene synthesis
D. Improved wound healing
E. Increased excretion of salt and water
A

C. Inhibition of leukotriene synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q 
Prednisone and methylprednisolone are commonly used anti-inflammatory agents. A side effect that occurs more frequently with prednisone use than with methylprednisolone treatment is: 
A. Hypotension
B. Increased susceptibility to infection
C. Osteoporosis
D. Hypokalemia
A

D. Hypokalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Intra-articular corticosteroid injections:
A. Are generally safe
B. Can cause a local post-injection inflammatory response
C. Are generally given at least 3 months apart
D. All of the above

A

D. All of the above

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q 
Which of the following corticosteroids can not be used for dermatological applications?
A. Cortisol
B. Prednisone
C. Methylprednisolone
D. Dexamathasone
E. Triamcinolone
A

B. Prednisone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which of the following patient would most likely have suppression of the HPA axis and require a slow taper of corticosteroid therapy?
A. Patient taking 40mg prednisone daily for 7 days to treat an asthma exacerbation
B. Patient taking 10mg of prednisone daily for 6 months for RA
C. Patient using fluticasone nasal spray daily for 6 months for allergic rhinitis
D. Patient receiving an intra-articular injection of methylprednisolone acetate for OA

A

B. Patient taking 10mg of prednisone daily for 6 months for RA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

A 34y/o pregnant woman in the second trimester of pregnancy has been taking ibuprofen as adjunctive therapy for RA pain. She asks you if it could harm the baby. You could tell her that:
A. There is no evidence that ibuprofen causes fetal harm
B. Use of ibuprofen during pregnancy decreases the risk of miscarriage
C. Use of ibuprofen in 3rd trimester of pregnancy may cause premature closure of the ductus arteriosus in the neonate
D. It is safe to continue taking ibuprofen until delivery

A

C. Use of ibuprofen in 3rd trimester of pregnancy may cause premature closure of the ductus arteriosus in the neonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Unlike full opioid agonists, acetaminophen and NSAIDs:
A. Have anticholinergic effects
B. Cannot be used inpatient with renal impairment
C. Have a dose ceiling on their analgesic effect
D. Are not metabolized in the liver

A

C. Have a dose ceiling on their analgesic effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Which of the following statements about NSAIDs is true?
A. All NSAIDs interfere with platelet function
B. NSAIDs do not increase the risk of serious cardiovascular events
C. All NSAIDs, except celecoxib, can cause renal toxicity
D. Full doses of NSAIDs are more effective than full doses of acetaminophen for treatment of arthritis pain

A

D. Full doses of NSAIDs are more effective than full doses of acetaminophen for treatment of arthritis pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q 
A 68y/o man with chronic shoulder pain tells you he has heard favorable things from other patients about the lack of side effects with Celebrex. You could tell him that compared to non-selective NSAIDs, celecoxib appears to cause: 
A. Less severe GI toxicity
B. An increase in bleeding time
C. More cardiac toxicity
D. More GI ulceration and perforation
A

A. Less severe GI toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q 
Which of the following NSAIDs does not interfere with platelet function and prolong bleeding time?
A. Celecoxib
B. Diclofenac
C. Ibuprofen
D. Naproxen
E. All of the above
A

A. Celecoxib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q 
Which of the following decreases renal blood flow and may cause hypertension and renal failure, particularly in elderly patients? (multiple correct)
A. Acetaminophen 
B. Opioids 
C. Celecoxib
D. Ibuprofen
E. All of the above
A

C. Celecoxib

D. Ibuprofen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

A 28y/o patient asks you what the difference is between acetaminophen and ibuprofen. You could tell her that, in comparison to NSAIDs such as ibuprofen, acetaminophen has:
A. No clinically significant anti-inflammatory activity
B. Less risk of GI side effects
C. Less risk of renal toxicity
D. All of the above

A

D. All of the above

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Which of the following is preferred for treatment of chronic non cancer pain?
A. Mixed opioid agonist/antagonist
B. Partial opioid agonist
C. Extended-release opioid
D. Nonpharmacologic and nonopioid pharmacologic therapy

A

D. Nonpharmacologic and nonopioid pharmacologic therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q 
Which OTC category contains agents most likely to result in additive CNS depression if given to a patient who has been prescribed opioid analgesics for pain?
A. Analgesics (ibuprofen)
B. Antihistamines (diphenhydramine)
C. Laxatives (psyllium seed)
D. H2 blockers (ranitidine)
E. Antidiarrheal agents (loperamide)
A

B. Antihistamines (diphenhydramine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q 
Tolerance usually develops rapidly to most of the adverse effects of opioids except: 
A. Respiratory depression
B. Sedation
C. Constipation
D. Nausea
A

C. Constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

A patient who develops tolerance to a fixed dose of morphine (multiple correct):
A. Will be equally tolerant to all effects of that dose of morphine
B. Probably will be tolerant to the analgesic effect of hydrocodone
C. Often can be relieved of pain if the dose of morphine is increased
D. Will remain tolerant to that dose or morphine for greater than 3 months

A

B. Probably will be tolerant to the analgesic effect of hydrocodone
C. Often can be relieved of pain if the dose of morphine is increased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q 
A young male patient is brought to the ED in an anxious and agitated state. He is subsequently determined to have signs and symptoms of the opioid abstinence syndrome. Which drug will be most effective in alleviating the symptoms experienced by this patient?
A. Buprenorphine
B. Codeine
C. Diazepam (benzodiazepine)
D. Methadone
E. Tramadol
A

D. Methadone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Naloxone:
A. Increases the threshold for pain
B. Can help manage opioid-induced constipation
C. Antagonizes respiratory depression induced by ethanol
D. Has a longer duration of action than morphine

A

B. Can help manage opioid-induced constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q 
Codeine and tramadol are both: 
A. Full opioid agonists
B. Metabolized by CYP2D6
C. Contraindicated for use in children after a tonsillectomy
D. All of the above
A

D. All of the above

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q 
A 64y/o man with metastatic lung cancer is being treated with extended-release morphine 80mg/day for severe pain. The dose has relieved his pain, but he is complaining of severe constipation. To minimize this adverse effect, he should have been treated early in his course with: 
A. Extended-release morphine/naltrexone
B. Hydrocodone
C. Stimulant or osmotic laxative
D. Methadone
A

C. Stimulant or osmotic laxative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Which of the following statements about fentanyl is correct?
A. Causes less histamine release than morphine
B. Withdrawal symptoms can be relieved by naloxone
C. Active metabolites can cause seizures
D. 100 times more powerful than morphine
E. More effective than hydrocodone by oral route

A

A. Causes less histamine release than morphine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q 
Tramadol: 
A. Has a dual mechanism of action
B. Needs slow dose titration to improve tolerability
C. Can cause seizures
D. All of the above
A

D. All of the above

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Meperidine:
A. Has a potentially toxic active metabolite
B. Should only be used for short-term treatment of moderate to severe acute pain
C. Should not be taken with a monoamine oxidase inhibitor
D. All of the above

A

D. All of the above

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q 
A 25y/o woman has a long history of depressive symptoms accompanied by body aches and pain secondary to a car accident 2 years ago. Physical and laboratory tests are unremarkable. Which of the following drugs might be useful in this patient? (multiple correct)
A. Amitriptyline (TCAD)
B. Fluoxetine (SSRI)
C. Sertraline (SSRI)
D. Mertazapine (a2 antagonist)
E. Duloxetine (SNRI)
A

A. Amitriptyline (TCAD)

E. Duloxetine (SNRI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q 
An adequate trial of medication for treatment of depression generally would be: 
A. 2 weeks
B. 2-4 weeks
C. 4-8 weeks
D. 12-16 weeks
A

C. 4-8 weeks

41
Q 
Which agent would be a poor choice in a 70y/o with depressive symptoms due to the drug having significant a1 receptor antagonism, thus having a higher risk for falls due to orthostatic hypotension?
A. Fluoxetine (SSRI)
B. Amitriptyline (TCAD)
C. Bupropion (NDRI)
D. Phenelzine (MAOI)
E. Sertraline (SSRI)
A

B. Amitriptyline (TCAD)

42
Q

Fluoxetine is comparable to the tricyclic antidepressant amitriptyline in:
A. Producing orthostatic hypotension
B. Causing dry mouth and blurred vision
C. Producing life-threatening EKG changes
D. Alleviating the symptoms of depression

A

D. Alleviating the symptoms of depression

43
Q

A 26y/o man is receiving pharmacotherapy for a psychiatric disorder. He comes to the ER with elevated blood pressure, sweating, headache, and vomiting. His companion tells the physician that the patient became ill at a party where he ate triple-cheese pizza and was drinking Guinness beer. The patient is most likely taking a drug from which therapeutic class?
A. Serotonin selective reuptake inhibitors
B. Tricyclic antidepressants
C. Monoamine oxidase inhibitors
D. Serotonin norepinephrine reuptake inhibitors

A

C. Monoamine oxidase inhibitors

44
Q 
To be effective in acute and chronic pain management, tramadol and codeine must be converted to an active form by CYP2D6. Cases of inadequate pain control have occurred when these agents were administered to patients who were being treated with: 
A. Fluoextine
B. Amitriptyline
C. Bupropion
D. Escitalopram
A

A. Fluoextine

45
Q 
SSRIs are much less effective than tricyclic antidepressants in the management of: 
A. Bulimia
B. Chronic pain of neuropathic origin
C. Generalized anxiety disorder
D. Obsessive-compulsive disorder
E. Premenstrual dysphoric disorder
A

B. Chronic pain of neuropathic origin

46
Q 
Mirtazapine might be a good choice for treatment of depression in patients who complain of: 
A. Sexual dysfunction
B. Insomnia
C. Weight gain
D. Constipation
A

B. Insomnia

47
Q 
Bupropion: 
A. Is not sedating
B. Does not cause weight gain
C. Is contraindicated in patients with seizure disorder
D. All of the above
A

D. All of the above

48
Q

A 36y/o woman presents with symptoms of major depression that are unrelated to a general medical condition, bereavement, or substance abuse. She is not currently taking any prescription or OTC medications. Drug treatment is to be initiated with sertraline. In your information to the patient, you would tell her:
A. Sertraline may take 2 weeks or longer for onset of anti-depressive effect
B. It is preferable that she take the drug in the morning
C. Some nausea and GI upset may be present
D. She should notify you if she anticipates using other prescription drugs
E. All of the above

A

E. All of the above

49
Q

Which of the following statements concerning the side effects and toxicities of antidepressant drug use is false?
A. Concomitant use of SSRIs and MAOIs may results in a serotonin syndrome
B. SSRI (e.g. fluoxetine) can induce hypomania in patients with bipolar disorder
C. Tricyclic antidepressants (e.g. amitriptyline) have a lower incidence of anticholinergic side effects than SSRIs
D. Inhibitors of dopamine and norepinephrine reuptake (e.g. bupropion) have been observed to cause anxiety and restlessness due to their mild stimulant action
E. None of the above

A

C. Tricyclic antidepressants (e.g. amitriptyline) have a lower incidence of anticholinergic side effects than SSRIs

50
Q

Regarding the clinical use of antidepressants, which statement is accurate?
A. Chronic use of SSRIs (venlafaxine) increases the activity of hepatic drug-metabolizing enzymes
B. In the treatment of major depressive disorders, citalopram is usually more effective than paroxetine
C. MAOIs can be effective in depressions with attendant ancient, phobic features, and hypochondriasis
D. Weight gain often occurs during the first few weeks in patients taking SSRIs

A

C. MAOIs can be effective in depressions with attendant ancient, phobic features, and hypochondriasis

51
Q 
A recently widowed 76y/o female patient was treated with a benzodiazepine for several weeks after the death of there husband, but she did not like the daytime sedation it caused even at low dosage. Living independently, she has no major medical problems but appears rather infirm for age and has poor eyesight. Because her depressive symptoms are not abating, you decide on a trial of an antidepressant medication. Which would be the most appropriate choice for this patient?
A. Amitriptyline
B. Trazadone
C. Metazapine
D. Phenelzine
E. Citalopram
A

E. Citalopram

52
Q 
The drug of choice for maintenance treatment of bipolar disorder is: 
A. Carbamazepine
B. Lamotrigine
C. Lithium
D. Valproate
A

C. Lithium

53
Q

Which of the following statement concerning the treatment of bipolar disorder with lithium is true?
A. Lithium will alleviate the manic phase of bipolar disorder within 24 hours
B. Excessive intake of sodium chloride will decrease lithium plasma levels
C. Lithium does not cross the blood brain barrier
D. Lithium does not cross the placental barrier
E. Lithium is a safe drug with a wide therapeutic index

A

B. Excessive intake of sodium chloride will decrease lithium plasma levels

54
Q

Concurrent administration of lithium and a thiazide diuretic, an ACE inhibitor, or an NSAID can:
A. Increase the risk of GI bleeding
B. Decrease the renal clearance of lithium
C. Cause hypotension
D. Cause hypokalemia

A

B. Decrease the renal clearance of lithium

55
Q 
A 30y/o patient is on drug therapy for a psychiatric problem. He complains that he feels "flat" and that he gets confused at times. He has been gaining weight and has lost his sex drive. As he moves his hands, you notice a slight tremor. He tells you that since he has been on this medication, he is always thirst and frequently has to urinate. The drug he is taking is most likely: 
A. Carbamazepine
B. Olanzapine
C. Lithium
D. Valproic acid
A

C. Lithium

56
Q

Which statement about the pathophysiologic basis of schizophrenia is most accurate?
A. All clinically effective antipsychotic drugs have high affinity for dopamine D2 receptors
B. Dopamine receptor-blocking drugs are used to alleviate psychotic symptoms in parkisonian patients
C. Drug-induced psychosis can occur without activation of brain dopamine receptors
D. The clinical potency of clozapine correlates well with its dopamine receptor-blocking activity

A

C. Drug-induced psychosis can occur without activation of brain dopamine receptors

57
Q 
An adolescent male is newly diagnosed with schizophrenia. Which of the following antipsychotic agents may have the best chance to improve his apathy and blunted affect?
A. Lithium
B. Chlorpromazine
C. Haloperidol
D. Clozapine
A

D. Clozapine

58
Q

Positive symptoms of schizophrenia (hallucinations, delusions) are believed to result from:
A. Overactivity of dopamine neurons in the mesolimbic system
B. Underactivity of norepinephrine neurons in the cortex
C. Underactivity of dopamine neurons in the nigra-striatal pathway
Overactivity of cholinergic neurons in the cortex

A

A. Overactivity of dopamine neurons in the mesolimbic system

59
Q

In comparing first and second generation antipsychotic drugs, which of the following is true?
A. Frist gen agents are less likely to cause tardive dyskinesias (extrapyramidal toxicity)
B. Controlled trials have generally found second gen drugs to be more effective
C. Second gen drugs are more expensive
D. All of the above

A

C. Second gen drugs are more expensive

60
Q

Which of the following therapeutic actions or side effects of antipsychotic agents does not result from blockage of dopamine receptors? (multiple correct)
A. Anti-emetic action
B. Xerostomia
C. Hyperprolactinemia
D. Parkinson-like rigidity
E. Alleviation of hallucinations and delusions
F. Orthostatic hypotension

A

B. Xerostomia

F. Orthostatic hypotension

61
Q 
Which of the following antipsychotics is considered to be the most potent and thus have the highest risk of extrapyramidal symptoms?
A. Chlorpromazine
B. Haloperidol
C. Clozapine
D. Olanzapine
A

B. Haloperidol

62
Q 
Second gen agents are more likely than first gen agents to cause: 
A. Anticholinergic effects
B. Metabolic syndrome
C. Extrapyramidal symptoms
D. Neuroleptic malignant syndrome
E. All of the above
A

B. Metabolic syndrome

63
Q 
A 28y/o female patient presents to the ED with an acute dystonic reaction. She had initiated therapy with a typical high-potency antipsychotic agent 3 days earlier. If the dystonia is drug induced, what is the best immediate course of action?
A. Administer levodopa
B. Add clozapine to the drug regimen
C. Administer an antimuscarinic agent
D. Administer intravenous flumazenil
A

C. Administer an antimuscarinic agent

64
Q 
Agranulocytosis (low WBC count) can predispose patients to infection. Which of the following agents used in the pharmacotherapy of mental illnesses is associated with the highest incidence of agranulocytosis as a side effect?
A. Chlorpromazine
B. Clozapine
C. Fluoxetine
D. Haloperidol
A

B. Clozapine

65
Q 
An adolescent male is newly diagnosed with schizophrenia. Which of the following antipsychotic agents may have the best chance to improve his apathy and blunted affect?
A. Lithium
B. Chlorpromazine
C. Haloperidol
D. Clozapine
A

D. Clozapine

66
Q

Diazepam resembles other general CNS depressant drugs in:
A. Promoting psychological dependence
B. Leading to development of seizures on sudden withdrawal after long-term treatment with large doses
C. Demonstrating a pattern of cross-dependence to alcohol
D. All of the above

A

D. All of the above

67
Q

Benzodiazepines and barbiturates share which of the following pharmacologic properties? (multiple correct)
A. Enhance GABA action at the GABA receptor-chloride channel complex at low doses
B. Ability to maintain surgical anesthesia (stage III) when administered intravenously
C. Efficacy in the treatment of seizure disorders
D. High therapeutic index
E. Agonist action at benzodiazepine receptors

A

A. Enhance GABA action at the GABA receptor-chloride channel complex at low doses
C. Efficacy in the treatment of seizure disorders

68
Q

Which of the following properties is shared by both inhalation general anesthetics and oral benzodiazepine anti-anxiety agents?
A. Maintenance of Stage III surgical anesthesia
B. Potentiation of GABAa receptor activity
C. Low margin of safety
D. Relatively low potency
E. Inhibition of excitatory synaptic transmission

A

B. Potentiation of GABAa receptor activity

69
Q 
The primary route of elimination for benzodiazepines is hepatic metabolism. If metabolism is impaired due to liver disease or advancing age, benzos may accumulate in the plasma and tissues and their potential for adverse reaction will increase. Glucuronidation metabolic pathways are affected least by aging or liver disease, thus benzos eliminated entirely by this pathway are preferred in these patients. Such benzos include: 
A. Alprazolam (xanax)
B. Diazepam (valium)
C. Oxazepam (serax)
D. Triazolam (halcion)
A

C. Oxazepam (serax)

70
Q

Side effects associated with the use of benzos in treatment of anxiety disorders could include all of the following except:
A. Development of physical dependence
B. Development of psychological dependence
C. Ataxia and risk of falls in the elderly
D. Retrograde amnesia
E. Excessive daytime drowsiness
F. Impaired judgement

A

D. Retrograde amnesia

71
Q 
This drug used in the management of insomnia facilitates the inhibitory action of GABA, but it lacks anticonvulsant or muscle-relaxing properties and has minimal effect on sleep architecture. Its actions are antagonized by flumazenil. 
A. Busprione
B. Flurazepam
C. Ramelteon
D. Zolpidem
E. Triazolam
A

D. Zolpidem

72
Q

Administration of which of the following classes of psychoactive agents is most likely to produce memory disturbances such as anterograde amnesia?
A. Benzodiazepines
B. Serotonin selective reuptake inhibitors
C. Tricyclic antidepressants
D. CNS stimulants
E. Monoamine oxidase inhibitors

A

A. Benzodiazepines

73
Q 
Which of the following agents has a rapid onset of action and would be best for acute management of anxiety?
A. Buspirone
B. Vanlafaxine
C. Escitalopram
D. Duloxetine
E. Alprazolam
A

E. Alprazolam

74
Q

A 24y/o stockbroker has developed a “nervous disposition”. He is easily startled, worried about inconsequential matters, and sometimes complains of stomach cramps. At night, he grinds his teeth in his sleep. There is no history of drug abuse. Diagnosed as suffering from generalized anxiety disorder, he is prescribed buspirone. The patient should be informed to anticipate:
A. Need to continually increase drug dosage because of tolerance
B. Significant effect of the drug on memory
C. Additive CNS depression with alcoholic beverages
D. That the drug is likely to take a week of longer to begin working
E. That if he stops taking the drug abruptly, he will experience withdrawal signs

A

D. That the drug is likely to take a week of longer to begin working

75
Q

Benzos are preferred over barbiturates when use of a sedative-hypnotic agent is needed in sedation procedures. Reasons for this preference include:
A. Barbiturates have a much lower therapeutic index than benzos
B. Barbs (schedule II) have a higher abuse potential than benzos (schedule IV)
C. Barbs are classic inducers of cytochrome P450 enzymes with a greater potential for drug-drug interactions
D. Barb overdose is more likely to result in death by respiratory depression than is benzo overdose
E. All of the above

A

E. All of the above

76
Q 
Which of the following anxiolytic agents is least sedating, will not potentiate the effects of ethanol, and has no appreciable dependence liability?
A. Chlodiazepoxide
B. Midazolam
C. Alprazolam
D. Buspirone
A

D. Buspirone

77
Q 
A 40y/o woman has sporadic attacks of intense anxiety with marked physical symptoms, including hyperventilation, tachycardia, and sweating. If she is diagnosed as suffering from a panic disorder, the most appropriate drug to use is: (multiple correct)
A. Alprazolam
B. Paroxetine
C. Lorazepam
D. Propranolol
E. Diazepam
A

A. Alprazolam

C. Lorazepam

78
Q

Alcohol:
A. Has been shown to improve the quality of sleep
B. Disrupts sleep by causing rebound excitation
C. Use as a hypnotic does not lead to alcohol use disorder
D. All of the above

A

B. Disrupts sleep by causing rebound excitation

79
Q

Benzos can:
A. Impair next-day performance, including driving
B. Cause complex sleep-related behaviors without conscious awareness
C. Cause life-threatening withdrawal symptoms if stopped abruptly
D. All of the above

A

D. All of the above

80
Q

Both benzos (temazepam) and non-benzos (zolpidem) are used in the treatment of insomnia. All pharmacologic properties listed below are shared by both classes of drugs, except that only zolpidem:
A. Can have its CNS depressant effects reversed by flumazenil
B. Can cause anterograde amnesia
C. Produces additive CNS depression if taken with ethanol
D. Binds selectively to GABA receptors containing the a1 subunit
E. Can produce tolerance and dependence (controlled substance)

A

D. Binds selectively to GABA receptors containing the a1 subunit

81
Q 
This drug used in the management of insomnia facilitates the inhibitory actions of GABA, but it lacks anticonvulsant or muscle-relaxing properties and has minimal effect on sleep architecture. Its actions are antagonized by flumazenil. 
A. Buspirone
B. Flurazepam
C. Ramelteon
D. Zolpidem
E. Triazolam
A

D. Zolpidem

82
Q

Both benzos and non-benzo receptor agonists:
A. Can impair next-day driving performance
B. Can cause complex sleep-related behaviors
C. Are classified as schedule 4 controlled substances
D. All of the above

A

D. All of the above

83
Q

Antihistamines like diphenhydramine:
A. Are approved by the FDA for sale as OTC sleep aids
B. Can cause anticholinergic effects
C. Can cause next-day impairment of driving
D. All of the above

A

D. All of the above

84
Q 
Use of which of the following agents is NOT associated with cognitive impairment, including memory disturbances, when used at recommended doses?
A. Diphenhydramine
B. Zolpidem
C. Triazolam
D. Alprazolam
E. Ramelteon
A

E. Ramelteon

85
Q 
Which of the following agents utilized in the treatment of insomnia are most likely to cause anticholinergic effects?
A. Diphenhydramine
B. Trazodone
C. Triazolam
D. Zolpidem
E. Ramelteon
A

A. Diphenhydramine

86
Q 
Which of the following psychopharmacological agents would be least likely to lower the seizure threshold and be safest to use in a patient with a seizure disorder?
A. Amitriptyline
B. Bupropion
C. Chlorpromazine
D. Clozapine
E. Sertraline
A

E. Sertraline

87
Q

Which of the following statements regarding treatment of epilepsy is true?
A. It should begin with a single drug
B. The dosage of the drug should be increased rapidly
C. If seizures persist, adding a second drug to the first is preferred to trying an alternative drug
D. All of the above

A

A. It should begin with a single drug

88
Q

Generic antiepilpetic drugs:
A. Are bioequivalent to their brand-name counterparts
B. Are generally less expensive than their brand-name counterparts
C. May differ in appearance from their brand-name counterparts
D. All of the above

A

D. All of the above

89
Q 
A 52y/o man has had several focal complex partial seizures over the last year. Which of the following therapies would be the most appropriate initial therapy for this patient?
A. Lamotrigine plus carbamazepine
B. Levetiracetam
C. Clonazepam
D. Ethosuximide
E. Phenytoin
F. Watchful waiting
A

B. Levetiracetam

90
Q

A 12y/o girl is being treated with levetiracetam for partial seizures. Her mother had similar seizures as a child that were treated successfully with phenytoin and asks why her daughter is being treated with something else. You could tell her that:
A. Phenytoin is no longer effective for partial seizures
B. A large randomized controlled trial found levetiracetam to be more effective
C. Phenytoin is no longer a 1st line drug due to complicated pharmacokinetics, adverse effects, and frequent DDIs
D. All of the above

A

C. Phenytoin is no longer a 1st line drug due to complicated pharmacokinetics, adverse effects, and frequent DDIs

91
Q

Enzyme-inducing anti epileptic drugs such as phenytoin or carbamazepine may:
A. Decrease the risk of osteoporosis
B. Increase the serum concentrations of hepatically metabolized drugs
C. Reduce the efficacy of oral contraceptives
D. All of the above

A

C. Reduce the efficacy of oral contraceptives

92
Q

Which statement about phenytoin is accurate?
A. Drug of choice in myoclonic seizures
B. Can be used as 2nd line alternative for absence seizures
C. Half-life is increased if used in combination with phenobarbital for seizure control
D. Zero order elimination can occur in the therapeutic dosage range

A

D. Zero order elimination can occur in the therapeutic dosage range

93
Q 
A 52y/o man has had several focal complex partial seizures over the last year. Which of the following therapies would be the most appropriate initial therapy for this patient?
A. Lamotrigine plus carbamazepine
B. Lamotrigine
C. Clonazepam
D. Ethosuximide
E. Phenytoin
F. Watchful waiting
A

B. Lamotrigine

94
Q 
The drug of choice for treatment of primary generalized tonic-clonic seizures is: 
A. Lamotrigine
B. Levetiracetam
C. Valproate
D. Any of the above
A

D. Any of the above

95
Q 
A 9y/o child is having learning difficulties at school. He has brief lapses of awareness with eyelid fluttering that occur every 5-10 minutes. EEG studies reveal a brief 3Hz spike and wave discharges appearing synchronously in all fields. Which drug would be effective in this child without the disadvantages of excessive sedation or tolerance development?
A. Clonazepam
B. Diazepam
C. Ethosuximide
D. Phenobarbital
A

C. Ethosuximide

96
Q

An 8y/o girl seeing you for the first time has been taking clonazepam for first-line treatment of absence seizures for 12 months. Her seizures were well controlled on the drug initially, but they have recently begun to occur with greater frequency. Her parents ask if she is taking the right medication. You could tell them that:
A. Development of tolerance to the effects of clonazepam is common
B. Abrupt discontinuation of clonazepam can lead to withdrawal symptoms
C. Ethosuximide and valproate are preferred options for treatment of absence seizures
D. All of the above

A

D. All of the above

97
Q

Which of the following statement about the use of antiepilptic drugs during pregnancy is true?
A. Valproate appears to be the safest drug to take during pregnancy
B. Pregnancy can inhibit the metabolism of lamotrigine
C. The risk to the offspring is generally considered to be less than the risk of seizures during pregnancy
D. All of the above

A

C is true.

Valproate and phenobarb have the highest risk for fetal malformations.
Newer agents like levetiracetam, oxcarbezepine, and gabapentin have lowest rates.

Pregnancy enhances metabolic clearance, especially with lamotrigine.

98
Q

A 25y/o woman with myoclonic seizures is well controlled on valproic acid. She indicates that she is interested in becoming pregnant in the next year. With respect to her anti-epilepsy medication, which of the following should be considered?
A. Leave her on her current therapy
B. Consider switching to levetiracetam
C. Consider adding a second antiseizure medication
D. Decrease her valproate dose

A

B. Consider switching to levetiracetam

RRPA Pharmacology III (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions