Exam 1 practice Flash Flashcards
Which of the following patients should not use l-dopa/carbidopa?
a. Psychotic patient
b. Closed-angle glaucoma patient
c. Patient treated with phenelzine
d. Malignant melanoma patient
e. All of the above
All of the above
Which of the following is true regarding Parkinson’s disease?
a. Selegiline improves symptoms by inhibition of MAO-B
b. Haloperidol treatment will improve symptoms
c. Donezepil treatment will improve symptoms
d. L-dopa induced nausea and vomiting is treated with bromocriptine
Selegiline improves symptoms by inhibition of MAO-B
Which of the following will increase the toxicity of lithium?
a. Loss of sodium
b. Diazepam
c. Fluoxetine
d. Risperidone
Loss of sodium
Which drug is best for a woman that complains of antipsychotics induced lactation.
a. Quetiapine
b. Chlorpromazine
c. Haloperidol
d. Risperidone
e. Olanzapine
Quetiapine
Which drug is associated with the development of hyperglycemia and Type 2 Diabetes?
a. Olanzapine
b. Risperidone
c. Haloperidol
d. Aripiprazole
e. Valproic acid
Olanzapine
An alcoholic with liver damage is discharged from the hospital following alcohol withdrawal. Which antidepressant should be avoided in this patient?
a. Duloxetine
b. Buspirone
c. Citalopram
d. Zolpidem
e. Paroxetine
Duloxetine
Which drug is least likely to produce weight gain?
a. Bupropion
b. Lithium
c. Olanzapine
d. Amitriptyline
e. Duloxetine
Bupropion
How does duloxetine and tricyclic antidepressants treat chronic pain?
a. Blocking NE re-uptake
b. Blocking Serotonin re-uptake
c. Increasing dopamine release
d. Blocking GABA receptors
e. Stimulating NMDA receptors
Blocking NE re-uptake
What is the site of action for alcohol, barbiturates and benzodiazepines?
a. GABA-A receptors
b. GABA-B receptors
c. NMDA receptors
d. D2 receptors
e. 5HT-A receptor
GABA-A receptors
What is true regarding NMDA receptors
a. Overstimulation may cause neurotoxicity
b. Chlorine channels cause hyperpolarization
c. Receptors are Gs receptors
d. Inhibit spinal cord pain transmission
e. Stimulation blocks memory formation
Overstimulation may cause neurotoxicity
Which of the following is an ionotropic receptor?
a. GABA-A
b. M1
c. D2
d. Beta adrenergic
e. 5HT-2A
GABA-A
Which drug used to treat Parkinson’s disease can cause the feet to get red, hot and swollen after walking?
a. Bromocriptine
b. Benztropine
c. Selegiline
d. Ropinirole
Bromocriptine
How are the effects of Risperidone different from those of Chlorpromazine?
a. Risperidone is used for negative symptoms
b. Risperidone blocks D2 receptors and is selective for positive symptoms
c. Risperidone doesn’t block D2 receptors and doesn’t increase prolactin release
d. Risperidone doesn’t cause postural hypotension
e. Risperidone inhibits NE re-uptake
Risperidone is used for negative symptoms
Chronic alcohol abuse may cause all of the following except:
a. Increased hemoglobin and hematocrit
b. Gynecomastia
c. Peripheral neuropathy
d. Cardiomyopathy
e. Hypertension
Increased hemoglobin and hematocrit
Which drug will produce a rapid relief of symptoms?
a. Bupropion
b. Buspirone
c. Risperidone- per Eric Huish
d. Lithium
e. Fluoxetine
Bupropion
What is true regarding lithium?
a. Produces antiemetic effect
b. Produces polyuria and polydypsia- per Eric Huish
c. Produces weight loss
d. Sudden withdrawal will cause delirium tremens
e. Produces abnormal enzymes on liver function tests
Produces polyuria and polydypsia- per Eric Huis
You treat a patient with chronic anxiety with a drug that does not cause sedation nor impairs memory. Which of the following is true regarding this drug?
a. It’s effects will take 2-3 weeks
b. It will cause euphoria
c. It will prevent alcohol withdrawal symptoms
d. It will be a benzodiazepine
It’s effects will take 2-3 weeks
A patient is being treated for Parkinson’s disease. He also has signs of dementia, agitation and delusional thinking. Which drug will help this patient without worsening the Parkinson’s disease?
a. Aripiprazole
b. Haloperidol
c. Chlorpromazine
d. Lithium
e. Amphetamine
Aripiprazole
Which drug is least likely to cause sedation?
a. Sertraline
b. Amitriptyline
c. Diazepam
d. Zolpidem
e. Chlorpromazine
Sertraline
What is least likely to occur if a patient that is being treated with chlorpromazine attempts suicide by taking 10 pills of amitripyline?
a. Severe hypertensive crisis
b. Tachycardia
c. Seizures
d. Torsades de pointes
e. Hypotension
Severe hypertensive crisis
Which drug is least likely to cause seizures?
a. Citalopram
b. Bupropion
c. Amitriptyline
d. Clozapine
e. Chlorpromazine
Citalopram
A patient with difficult to control hypertension develops depression. Which drug should be avoided in this patient?
a. Venlafaxine
b. Nortriptyline
c. Bupropion
d. Citalopram
e. Fluoxetine
Venlafaxine
Which drug can reverse the effects of midazolam?
a. Flumazenil
b. Naltrexone
c. Lorazepam
d. Fomepizole
Flumazenil
Which sedative-hypnotic drug does not interact with the receptors for benzodiazepines?
a. Ramelteon
b. Zolpidem
c. Diazepam
d. Triazolium
Ramelteon
A 40 year old male with difficulty sleeping is given a drug with a short half life. One month later he has gained 15 pounds and his wife notes he has been eating in the middle of the night but later the next day he doesn’t remember eating anything. Which drug is he taking?
a. Zolpidem
b. Amitriptyline
c. Diazepam
d. Fluoxetine
Zolpidem
A patient successfully treated with chlorpromazine for schizophrenia begins abusing barbiturates to get high. Three weeks later the patient begins having recurrent attacks of schizophrenia. What beset explains why this patient is experiencing schizophrenic episodes?
a. Barbiturates induce cytochrome P450 thereby decreasing chlorpromazine levels
b. Barbiturates inhibit reuptake of dopamine thereby causing psychosis
c. Barbiturates block the effects of chlorpromazine on serotonin receptors
Barbiturates induce cytochrome P450 thereby decreasing chlorpromazine levels
A patient is treated with a drug for chronic pain and difficulty sleeping. This drug may also cause postural hypotension and SIADH syndrome. What drug is it?
a. Amitriptyline
b. Trazodone
c. Citalopram
d. Diazepam
e. Fluoxetine
Amitriptyline
A patient taking citalopram complains of sexual dysfunction and incomplete relief from depression. Which drug could be added to his regimen?
a. Bupropion
b. Amitriptyline
c. Phenelzine
d. Fluoxetine
Bupropion
Why is Naltrexone helpful in recovery from alcoholism?
a. Decreases alcohol craving by blocking opiod receptors
b. Prevents delirium tremens by acting on GABA-A receptors
c. Blocks the reuptake of serotonin and NE
Decreases alcohol craving by blocking opiod receptors
How does Disulfiram work?
Inhibits aldehyde dehydrogenase
Which drug helps alcoholics maintain abstinence by restoring the balance between GABA and glutamate activity?
a. Acamprosate
b. Buspirone
c. Naltrexone
Acamprosate
Which drug may increase the QT interval?
a. Risperidone
b. Diazepam
c. Buspirone
d. Valproic acid
Risperidone
Which drug works at the GABA-B receptor?
Baclofen
Arist with acute intermittent porphyria what do you not give them?:
Barbiturates (Phenobarbital)
This drug is rapidly acting, causes blackouts, little effect on REM and can have sleep eating?
Zolpidem Zaleplon
What sleep aid doesn’t work on GABA receptors?
Ramelteon
What is the first step in alcohol metabolism?
Ethanol yields NADH
What is DOC for alcohol withdrawl syndrome?
Benzodiapenes
Patient complains of “visual snowstorm” how do you treat it?
Fomepizole
Person is taking a drug, complains of dry mouth and sedation, so you prescribe an active metabolite of the drug, the person has less dry mouth and less sedation
Nortriptyline
Person who is treated with depression that “doesn’t respond to other drugs” (last try) goes to a party and drinks alcohol and takes amphetamines, crashes out, so you give them Propranol and Phenolamine to treat them, they live.. What drug were they prescribed for depression?
Two part question: You give them an SSRI, what happens to them?
Phenelzine
Serotonin syndrome
Two different questions where person had no symptoms on drug X, and then they added another drug to the mix and then got symptoms 2-3 weeks later, why?
Basically its because of Fluoxetine being a CYP inhibitor.
Basically asked which drug produces the fewest side effects of all the choices:
CItalopram or Escitalopram
Person has a BMI of 40 and drinks alcohol, what drug do you take if you don’t want sexual side effects?
Buproprion
Person takes drug and gets priapism, what drug is it?
Trazodone (trazoBONE ahhah)
Person starts getting acute dsytonia after starting a drug for psychosis, how do you treat it?
Benzotroprine (anti-cholingerics)
Chart drugs A,B,C,D with + and - for stimulating various receptors (Alpha, Beta, NE, etc). Asked which one causes EPS symptoms:
It was the one with most Beta blockage
What is a difference between TCAs and SSRIs?
TCAs don’t inc prolactin
Person starts getting muscle rigidity and a temperature of 40celisus, what is the mechanism for the drug that can treat him?
Blocks Ca2+ release from sarcoplasmic reticulum. (it was dantrolene)
Kid takes his grandpa’s phenothiazines trying to get high, what does he experience?
Sedation
Which drug causes Jaundice?
Chlorpromazine
Which drug causes Agranulocytosis?
Clozapine
Which drug causes hyperglycemia, T2D, and weight gain?
Olanzapine
Person has an increased QT interval, drug?
Risperidone
Which drug is the best choice for not increasing prolactin levels?
Quetiapine
Person takes a drug that causes esophageal motility problems, drug?
Aripiprazole
Person is taking a drug that increases their TSH levels, what drug is it?
Lithium
Person is taking lithium, what should they not also take?
NSAIDS
Person drinks 4-5 drinks a day regularly, what should they not take?
Acetaminophen
Person is being treated for absent seizures and myclonic ones, The drug has side effects, how should you test for them?
Liver enzyme panel (it was valproic acid)
Person with peripheral neuropathy, how do you treat?
Gabapentin
Child suddenly starts staring off into the distance for 20-30 seconds, what is the mechanism by which a drug would treat this?
Blockade of T-Type Ca2+ channels
What drug causes gingival hyperplasia
Phenytoin
What is the mechanism by which Tizanidine and some other drug work?
A2 receptor agonist
Person suffers stroke and gets a muscle spasm, how does the drug that treats this work?
Inhibits ACh release
What is the mechanism by which Amphetamines work?
Cause the release of catecholamines from the synaptic vesicle
How does carbidopa work?
Inhibits that CONVERSION of L-dopa to DA in the periphery (NOT THE METABOLISM)
Person with Parkinson’s gets psychosis, how do you treat it?
Atypical antispychotics
What do you use for a person who is experiencing Parkinon’s On-Off phenomenon?
Use Apomorphine and you get On-Off bc of dropping levels of L-dopa/Carbidopa
What is the mechanism by which Donepezil works?
Cholinesterase inhibitor
You’re treating a recovering alcoholic for sleep deprivation. Which of the following drugs could be used and is non-habit forming?
Ramelton
Which of the following is used to restore GABA/Glutamate balance in a recovering alcoholic?Which of the following is used to restore GABA/Glutamate balance in a recovering alcoholic?
venlafaxine
You prescribe an anti-psychotic drug and the pt later reports esophageal dysmotility. Which receptor does this drug act on?
Blocks 5HT-2A (Drug in question is Ariprazole)Blocks 5HT-2A (Drug in question is Ariprazole)
A pt being reated for bipolar disease with a certain drug andis experiencing polydipsia and polydipsea. What could be used to treat the toxicity of this drug?
Amiloride
You’re treating a pt who suffers from both absence as well as tonic-clonic seizures with the DOC. What’s a possible side effect?
Hepatotoxicity
artist is psychotic and has Porpheria, which drug would be contra indicated to treat his depression?
Phenobarbital
This is the DOC of concomitant absence seizures and general tonic clonic seizures what is associated?
A)hepatotoxic
b)sedation
c) hypotension
?
this drug is used to treat absence seizures what is it Mechanism of action?
A) block T type Ca channels
B) prolonged inactivation of Na channels
?
carbemazepine works by
and that it’s the drug that should be tested
to make sure they don’t get
inhibiting sodium channels
HLA- genes
Stevens Johnson
Case of a boy who is 17 years old and gets mania for a bit, he is treated with a drug, then he develops symptoms of extra pyramidal syndromes like rocking, akathesia, etc. What drug caused it?
Haloperidol
fluoxetine is a potent inhibitor of
CYPs
antipsychotic used when the patient is complaining about having hyperprolactinemia
Olanzepine
side effects of a drug that is responsible for treating absence and partial seizures
either nausea vomiting or weight gain
Kid takes a phenylthiazine and the question asks what the side effect of the drug was
Kid takes a phenylthiazine and the question asks what the side effect of the drug was
the benefit of taking Selegiline (MAO-B inhibitor)
selegieline doesn’t work in the periphery for stopping MAO from action
Which neurotransmitter is not a target of drugs used to treat depression?
a. NE
b. 5-HT
c. Ach
d. DA
Ach
Following an accident a patient is seen in the ER. He says he has been drinking plenty of water but not urinating. Lab tests show decreased serum Na+. What drug might have caused his symptoms?
amitriptyline
This drug is commonly added to OTC preparations because it cures headaches by constricting cerebral blood vessels
caffeine
16 year old boy overdoses on a barbituate what is the appropriate treatment? a. provide stimulants bdiuresis and alkalination of urine c. ethanol d. iv diazepam e. cociaine
diuresis and alkalination of urine
Donepezil:
a. alpha blocker
b. d2 receptor agonist
c. cholinesterase inhibitors
d. adenosine inhibitor
cholinesterase inhibitors
A 15 year old with a known psychiatric disorder was riding a horse and fell off. His friends were worried about his head and took hime to the hospital. The scans were negative and blood test reveled decreased sodium. The also said that he had not been urinating frequently what drug was he taking for his illness?
a. amytriptyline
b. diazepam
c. lithium
d. phenylzine
amytriptyline
Which drug causes retinal deposits a amytriptyline bthioridazine c clozapine d fluphenazine
thioridazine
Buproprion (wellbutrin) +
increases dopamine available
Fewer sexual side effects than other antidepressants
Dereases cravings (smoking cessation)
Weight loss
Buproprion (wellbutrin) -
anxiety, insomnia, psychosis
Seizures (don’t combine with TCA)
Tachycardia
Rash
Mirtazapine
not an uptake inhibitor
Blocks pre-syn a2 receptors
Blocks 5HT2a and 5HT3 receptors
(reduce anxiety, insomnia, nausea, sexual problems)
Antihistamine (sedation)
(weight gain but treats insomnia
NE reuptake
Atomoxetine
Amoxapine
(blocks D receptors, used in schiz w/ depression
Trazadone
sedation and PRIAPISM
St Johns Wort interactions
prolongs anesthesia
Serotonin syndrome
Induces P450:
Inhibits OC
Digoxin, warfarin
SIADH
ADH causes too much water reabsorption in collecting duct
Dopamine hypothesis of schizophrenia
blocking DA receptors is antipsychotic
Where should dopamine be blocked?
the mesolimbic pathway
Side effect is Parkinsons-like symptoms
(substantia niagra)
Increases prolactin synth
+ schiz
- schiz
positive: overactive mesolimbic path
Negative: underactive mesocortical pathway
5HT2a blocks
Blocking D2 receptors in schiz:
helps pychosis, not depression
Blocking 5HT2a receptors in schiz:
treats negative symptoms (mesocortical)
And prevents overactivity of mesolimbic
prevents + symptoms
Extrapyramidal symptoms
Parkinsons like
Akastheisia (pacing)
Dystonia (spasms)
Rigidity
Blocking acetylcholine (muscarinic blocker) helps balance
Neuroleptic Malignant Syndrome
increase body tem, rigitidity
Tx: dantroleme, benzo
