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PHCOL 402 > Final > Flashcards

Final Flashcards

1
Q 
Which of the following is the more potent narcotic analgesic?
A. fentanyl
B. codeine
C. morphine 
D. oxycodone
A

A. fentanyl

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2
Q 
A major target of NSAIDS is which enzyme? 
A. monoamine oxidase
B. tyrosine hydroxylase
C. phospholipase A2
D. cyclooxygenase
A

D. cyclooxygenase

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3
Q 
Which of the following is an opioid receptor antagonist?
A. naltrexone
D. oxycodone
C. acetaminophen 
D. phenytoin
A

A. naltrexone

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4
Q 
Which of the following is in the Acetic Acid class of NSAIDs? 
A. ibuprofen
B. aspirin
C. ketorolac
D. acetaminophen
A

C. ketorolac

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5
Q 
Methadone is typically used to treat what disorder? 
A. inflammation
B. opioid addiction
C. Parkinson’s
D. epilepsy
A

B. opioid addiction

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6
Q 
Ethosuximide targets what protein? 
A. sodium channels
B. potassium channels
C. glutamate receptors
D. T-type calcium channels
A

D. T-type calcium channels

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7
Q 
What are the side effects of Benztropine?
A. tachycardia
B. somnolence 
C. hallucinations 
D. seizure
A

A. tachycardia

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8
Q 
At high does aspirin can cause which of the following? 
A. respiratory alkalosis
B. metabolic acidosis
C. tinnitus
D. all of the above
A

D. all of the above

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9
Q 
Carbamazepine is effective for which of the following? 
A. absence seizures
B. myoclonic seizures
C. atonic seizures
D. simple partial seizures
A

D. simple partial seizures

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10
Q 
Pentazocine is classified as a?
A. mixed agonist/antagonist
B. strong agonist
C. strong antagonist 
D. moderate agonist
A

A. mixed agonist/antagonist

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11
Q 
A potentially lethal side effect of clozapine is? 
A. respiratory suppression
B. agranulocytosis
C. arrhythmia
D. seizure
A

B. agranulocytosis

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12
Q 
Haldol is an antagonist for which receptor? 
A. dopamine D1
B. kappa-opiod
C. dopamine D2
D. GABA-A
A

C. dopamine D2

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13
Q 
Imipramine is used for the treatment of?
A. depression
B. psychosis 
C. epilepsy
D. Parkinson’s
A

A. depression

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14
Q 
Which of the following is NOT a nociceptive nerve fiber?
A. A-alpha
B. A-delta 
C. C
D. b and c
A

A. A-alpha

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15
Q 
Sinemet is a combination of which drugs? 
A. entacapone and L-DOPA
B. L-DOPA and Carbidopa
C. Carbidopa and tolcapone
D. L-DOPA and amantadine
A

B. L-DOPA and Carbidopa

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16
Q 
The ‘MAC’ is inversely proportional to?
A. potency
B. efficacy
C. protein binding 
D. all of the above
A

A. potency

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17
Q 
Ketamine is used primarily as a?
A. anesthetic
B. anti-psychotic 
C. anti-arrhythmic 
D. anti-convulsant
A

A. anesthetic

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18
Q 
Tardive dyskinesia is a major side effect of which of the following?
A. anti-psychotics
B. anti-depressants 
C. anti-Parkinson’s 
D. anesthetics
A

A. anti-psychotics

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19
Q 
Phenytoin acts on which sodium channel state? 
A. activated
B. resting
C. inactivated
D. both a and b
A

C. inactivated

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20
Q 
The principle function of anti-Parkinson’s drugs are to?
A. increase dopamine
D. decrease dopamine 
C. increase glutamate 
D. reduce GABA
A

A. increase dopamine

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21
Q 
Ibuprofen is a member of which class of NSAIDs: 
A. salicylate
B. Cox-2 selective inhibitor 
C. acetic acid
D. propionic acid
A

D. propionic acid

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22
Q 
Alters gene expression by inhibiting glycogen synthase kinase (GSK3) signaling:
A. Lithium
B. Lamotrigine
C. Valproic Acid
D. Sodium Oxybate 
E. Modafinil
A

A. Lithium

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23
Q 
Decreases action potential firing by increasing action of hyperpolarization-activated (h) channels:
A. Lithium
B. Lamotrigine
C. Valproic Acid
D. Sodium Oxybate 
E. Modafinil
A

B. Lamotrigine

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24
Q 
Decreases signal transduction by decreasing the action of receptors that activate Phospoholipase C:
A. Lithium
B. Lamotrigine
C. Valproic Acid
D. Sodium Oxybate 
E. Modafinil
A

A. Lithium

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25
Q 
Decreases nerve signaling during rapid firing by prolonging the recovery of sodium channels after opening:
A. Lithium
B. Lamotrigine
C. Valproic Acid
D. Sodium Oxybate 
E. Modafinil
A

C. Valproic Acid

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26
Q 
Increases nervous system excitation by inhibiting adenosine receptors:
A. Barbiturates
B. Benzodiazepines
C. Caffeine
D. Sodium Oxybate 
E. Modafinil
A

C. Caffiene

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27
Q 
Leads to decreased nervous system activity by increasing the probability of GABAᴬ channel opening after binding GABA:
A. Barbiturates
B. Benzodiazepines
C. Caffeine
D. Sodium Oxybate 
E. Modafinil
A

B. Benzodiazepines

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28
Q 
Decreases nervous system activity by acting as an agonist at GABA gated ion channels:
A. Barbiturates
B. Benzodiazepines
C. Caffeine
D. Sodium Oxybate 
E. Modafinil
A

A. Barbiturates

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29
Q 
Inhibits the dopamine reuptake transporter:
A. Barbiturates
B. Benzodiazepines
C. Caffeine
D. Sodium Oxybate 
E. Modafinil
A

E. Modafinil

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30
Q 
Acts as agonist at GABAʙ receptors
A. LSD
B. Amphetamines
C. Sodium Oxybate 
D. PCP
E. Cannabinoids
A

C. Sodium Oxybate

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31
Q 
Activates a unique class of neurotransmitter receptor:
A. LSD
B. Amphetamines
C. Sodium Oxybate 
D. PCP
E. Cannabinoids
A

E. Cannabinoids

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32
Q 
Selectively activates a subclass of serotonin receptors:
A. LSD
B. Amphetamines
C. Sodium Oxybate 
D. PCP
E. Cannabinoids
A

A. LSD

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33
Q 
Inhibits the dopamine reuptake transporter:
A. LSD
B. Amphetamines
C. Sodium Oxybate 
D. PCP
E. Cannabinoids
A

B. Amphetamines

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34
Q 
Which endogenous opioid receptor is the principle site of narcotic opioid analgesics?
A. μ1 opioid receptors 
B. μ2 opioid receptors 
C. κ opioid receptors
D. δ opioid receptors
A

A. μ1 opioid receptors

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35
Q

What is the major substrate of cyclooxygenase enzymes? A. prostaglandin G2 (PGG2)
B. prostaglandin H2 (PGH2)
C. thromboxane
D. arachidonic acid

A

D. arachidonic acid

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36
Q 
Which of the following is NOT a strong opioid receptor agonist? 
A. morphine
B. naltrexone
C. oxycodone 
D. fentanyl
A

B. naltrexone

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37
Q 
Chlorpromazine is most effective for treating which of the following? 
A. resting tremor
B. flattened affect (loss of motivation)
C. delusions
D. ataxia
A

C. delusions

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38
Q 
A side effect of aripiprazole is: 
A. hyperthermia
B. constipation
C. tardive dyskinesia
D. gastrointestinal bleeding
A

C. tardive dyskinesia

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39
Q 
Buprenorphine is typically used to treat:
A. opioid addiction
B. inflammation
C. neuropathic pain
D. serotonin syndrome
A

A. opioid addiction

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40
Q 
At low doses aspirin inhibits: 
A. cyclooxygenase 2 
B. phospholipase A2
C. cyclooxygenase 1
D. arachidonate 5-lipoxygenase
A

C. cyclooxygenase 1

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41
Q 
Phenytoin is an effective: 
A. local anesthetic
B. anticonvulsant
C. analgesic
D. general anesthetic
A

B. anticonvulsant

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42
Q 
Agranulocytosis is a side effect associated with:
A. clozapine
B. olanzapine
C. chlorpromazine 
D. Risperidone
A

A. clozapine

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43
Q 
Activation of μ1 opioid receptors by morphine: 
A. opens of sodium channels
B. increases cAMP
C. opens potassium channels
D. opens chloride channels
A

C. opens potassium channels

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44
Q 
Ibuprofen is a member of which class of NSAIDs: 
A. salicylate
B. Cox-2 selective inhibitor 
C. acetic acid
D. propionic acid
A

D. propionic acid

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45
Q 
Efficacy of Typical antipsychotics is directly proportional to: 
A. Dopamine D2 receptor activation
B. Dopamine D2 receptor antagonism
C. muscarinic M1 receptor antagonism
D. alpha-1 adrenoreceptor antagonism
A

B. Dopamine D2 receptor antagonism

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46
Q 
Which class of myelinated nerve fibers is blocked at low concentrations of local anesthetic? 
A. Aβ
B. Aα 
C. Aδ 
D. C
A

C. Aδ

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47
Q

Dual dependence of local anesthetics and sodium channels refers to:
A. protonated state of anesthetics and resting or inactivated state of sodium channel
B. protonated state of anesthetics and resting or open state of sodium channel
C. protonated state of anesthetics and open or inactivated state of sodium channel
D. esterified state of anesthetics and open or inactivated state of sodium channel

A

C. protonated state of anesthetics and open or inactivated state of sodium channel

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48
Q 
Pramipexole is a strong agonist for which receptor? 
A. Serotonin 5HT-1A
B. Dopamine D2
C. Muscarinic M1 
D. Dopamine D1
A

B. Dopamine D2

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49
Q 
Amitriptyline has strong effects on the blockade of:
A. Serotonin transporters
B. Dopamine transporters
C. Vesicular monoamine transporters 
D. Norepinephrine transporters
A

A. Serotonin transporters

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50
Q 
Carbamazepine is a ‘first choice’ drug for the treatment of: 
A. Absence Seizures
B. Myoclonic Seizures
C. Simple Partial Seizures
D. Atonic Seizures
A

C. Simple Partial Seizures

51
Q 
Rapid escalation in SSRI dose can lead to: 
A. Discontinuation Syndrome
B. Tardive Dyskinesia
C. Tyramine Reaction
D. Serotonin Syndrome
A

D. Serotonin Syndrome

52
Q 
Entacapone is in which class of drugs?
A. COMT inhibitor
B. MAOI
C. SSRI
D. Barbiturate
A

A. COMT inhibitor

53
Q 
In general anesthetics the ‘MAC’ refers to: 
A. Maximum Alveolar Concentration 
B. Minimum Alveolar Concentration 
C. Maximum Airway Constriction
D. Minimum Airway Constriction
A

B. Minimum Alveolar Concentration

54
Q

Motor symptoms associated with Parkinson’s disease are associated with the selective loss of:
A. Dopamine neurons of the Substantia Nigra
B. Dopamine neurons of Cerebellar Crus 1
C. Serotonin neurons of the Dorsal Raphe
D. Dopamine neurons of the Ventral Tegmental Area

A

A. Dopamine neurons of the Substantia Nigra

55
Q 
Phenobarbital selectively targets:
A. Voltage-gated sodium channels 
B. NMDA-type glutamate receptors 
C. Voltage gated sodium channels 
D. GABA-A receptors
A

D. GABA-A receptors

56
Q

Lithium:
A) Inhibits inositol phosphate phosphatase, thus affecting Gq signaling
B) Inhibits adenosine receptors, blocking inhibitory neurotransmission mediated by adenosine
C) Alters gene expression
D) Affects membrane depolarization in the dendrites of neurons
E) blocks calcium influx though NMDA-sensitive glutamate-gated ion channels

A

A) Inhibits inositol phosphate phosphatase, thus affecting Gq signaling

57
Q

Valproic Acid:
A) Inhibits inositol phosphate phosphatase, thus affecting Gq signaling
B) Inhibits adenosine receptors, blocking inhibitory neurotransmission mediated by adenosine
C) Alters gene expression
D) Affects membrane depolarization in the dendrites of neurons
E) blocks calcium influx though NMDA-sensitive glutamate-gated ion channels

A

C) Alters gene expression

58
Q

Lamotrigine:
A) Inhibits inositol phosphate phosphatase, thus affecting Gq signaling
B) Inhibits adenosine receptors, blocking inhibitory neurotransmission mediated by adenosine
C) Alters gene expression
D) Affects membrane depolarization in the dendrites of neurons
E) blocks calcium influx though NMDA-sensitive glutamate-gated ion channels

A

D) Affects membrane depolarization in the dendrites of neurons

59
Q 
Barbiturates:
A) antagonist at serotonin 2 receptor 
B) agonist at serotonin 1 receptor
C) agonist at GABAA receptor
D) blocks glutamate receptors
E) inhibitor at adenosine receptor
A

C) agonist at GABAA receptor

60
Q 
Axipirones:
A) antagonist at serotonin 2 receptor 
B) agonist at serotonin 1 receptor
C) agonist at GABAA receptor
D) blocks glutamate receptors
E) inhibitor at adenosine receptor
A

B) agonist at serotonin 1 receptor

61
Q 
Methylxanthines:
A) antagonist at serotonin 2 receptor 
B) agonist at serotonin 1 receptor
C) agonist at GABAA receptor
D) blocks glutamate receptors
E) inhibitor at adenosine receptor
A

E) inhibitor at adenosine receptor

62
Q

Amphetamines:
A) blocks the uptake of monoamines into synaptic vesicles
B) blocks voltage dependent sodium channels in peripheral nerves
C) inhibits the breakdown of cyclic AMP
D) inhibits serotonin gated ion channels
E) selectively increases norepinephrine-mediated synaptic transmission

A

A) blocks the uptake of monoamines into synaptic vesicles

63
Q

Cocaine:
A) blocks the uptake of monoamines into synaptic vesicles
B) blocks voltage dependent sodium channels in peripheral nerves
C) inhibits the breakdown of cyclic AMP
D) inhibits serotonin gated ion channels
E) selectively increases norepinephrine-mediated synaptic transmission

A

B) blocks voltage dependent sodium channels in peripheral nerves

64
Q

Ephedrine:
A) blocks the uptake of monoamines into synaptic vesicles
B) blocks voltage dependent sodium channels in peripheral nerves
C) inhibits the breakdown of cyclic AMP
D) inhibits serotonin gated ion channels
E) selectively increases norepinephrine-mediated synaptic transmission

A

E) selectively increases norepinephrine-mediated synaptic transmission

65
Q

LSD:
A) acts at inverse agonist at GABA receptors
B) acts as agonist at a family of G protein coupled receptors
C) acts as antagonist at serotonin 1A receptors
D) binds inside and blocks of a subset of glutamate gated ion channels
E) acts as agonists at selected serotonin

A

E) acts as agonists at selected serotonin

66
Q

Phencyclidine:
A) acts at inverse agonist at GABA receptors
B) acts as agonist at a family of G protein coupled receptors
C) acts as antagonist at serotonin 1A receptors
D) binds inside and blocks of a subset of glutamate gated ion channels
E) acts as agonists at selected serotonin

A

D) binds inside and blocks of a subset of glutamate gated ion channels

67
Q

Tetrahydrocnnabinol:
A) acts at inverse agonist at GABA receptors
B) acts as agonist at a family of G protein coupled receptors
C) acts as antagonist at serotonin 1A receptors
D) binds inside and blocks of a subset of glutamate gated ion channels
E) acts as agonists at selected serotonin

A

B) acts as agonist at a family of G protein coupled receptors

68
Q

Which opioid receptor is the principal site of analgesia?

a. mu receptor
b. kappa receptor
c. gamma receptor
d. delta receptor

A

a. mu receptor

69
Q

Which is a strategy for controlling the abnormal synchronized firing of neurons in epilepsy?

a. increase feedforward excitation
b. increase feedforward inhibition
c. increase intrinsic excitability
d. all of the above
e. none of the above

A

b. increase feedforward inhibition

70
Q

Which NSAID specifically inhibits COX-2?

a. naproxen
b. aspirin
c. celecoxib
d. ibuprofen

A

c. celecoxib

71
Q

Anti-epileptic drugs that inactivate Na+ channels do so by:

a. preventing Na+ channel conversion from the resting state to the activated state
b. preventing Na+ channel conversion from the activated state to the inactivated state
c. preventing Na+ channel conversion from the inactivated state to the resting state
d. all of the above
e. none of the above

A

c. preventing Na+ channel conversion from the inactivated state to the resting state

72
Q

Opioid binding to opioid receptors causes which of the following to occur?

a. cAMP production is reduced
b. Ca2+ entry is blocked
c. K+ channels open
d. all of the above
e. none of the above

A

d. all of the above

73
Q

NSAIDs can be used to treat:

a. fever
b. moderate pain
c. inflammation
d. all of the above
e. none of the above

A

d. all of the above

74
Q

Which is a mechanism of anticonvulsant drug action?

a. T-type Ca2+ channel activation
b. GABA potentiation
c. increased excitatory transmission
d. none of the above e. all of the above

A

b. GABA potentiation

75
Q

Which receptors are paired with their major endogenous opioid peptide ligands:

a. mu receptor - enkephalins
b. kappa receptor - dynorphins
c. delta receptor – beta-endorphins
d. all of the above
e. none of the above

A

d. all of the above

76
Q

Inhibition of cyclo-oxygenases blocks the production of which molecules?

a. leukotrienes
b. bradykinins
c. prostaglandins
d. all of the above
e. none of the above

A

c. prostaglandins

77
Q

Opioid withdrawal results from cells compensating and making more of which enzyme?

a. adenylate cyclase
b. phosphodiesterase
c. protein kinase a
d. all of the above
e. none of the above

A

a. adenylate cyclase

78
Q

Some analogs of local anesthetics have a quaternary amine group as their hydrophilic group. Thus, they are essentially always charged at physiological pH. You would predict that these molecules:

a. have very rapid onset of action
b. have reduced affinity for voltage gated sodium channels
c. have very little ability to cross neuronal cell membranes
d. have greater activity on motor than sensory fibers

A

c. have very little ability to cross neuronal cell membranes

79
Q

You have a local anesthetic with fast onset but short duration of action, and low potency. As you expect, its important features include:

a. A low pKa
b. A highly hydrophobic aromatic group
c. Central amide bond
d. Intrinsic vasoconstrictor activity

A

a. A low pKa

80
Q

Primary mode of action known to be antagonism of NMDA glutamate receptors

a. propofol
b. etomidate
c. halothane
d. ketamine

A

d. ketamine

81
Q

All the following are true regarding inhalational general anesthetics except:

a. Higher lipophilicity (oil/gas partition coefficient) tends to mean higher potency
b. Higher MAC tends to mean lower lipophilicity (oil/gas partition coefficient)
c. Higher potency tends to mean more rapid induction
d. Depth of anesthesia at a given inhaled concentration is positively correlated with anesthetic solubility in blood

A

d. Depth of anesthesia at a given inhaled concentration is positively correlated with anesthetic solubility in blood

82
Q

All the following are deliberately inhibited or antagonized in the treatment of Parkinson’s Disease except:

a. L-aromatic amino acid transporter
b. Catechol-O-methyltransferase
c. Monoamine Oxidase B
d. NMDA receptors

A

a. L-aromatic amino acid transporter

83
Q

Good penetration of blood brain barrier:

a. Dopamine
b. Pramipexole
c. Carbidopa
d. Entacapone

A

b. Pramipexole

84
Q

Antiparkinsons therapy

a. Aimed at preventing further neurodegeneration.
b. May exploit modulation of the glutamatergic output of the basal ganglia to the - thalamus.
c. Can utilize muscarinic antagonists
d. Usually employs single therapeutic agents at a time

A

c. Can utilize muscarinic antagonists

85
Q

Known or proposed therapeutic mechanisms in the treatment of schizophrenia include all except:
a. Antagonism of 5-HT2A type serotonin receptors with increase in mesocortical dopamine release.
b. Antagonism at NMDA type glutamate receptors
c. Antagonism at D2 type dopamine receptors in the mesolimbic areas
d. Antagonism of muscarinic receptors resulting in reduction in some side effects of antipsychotic
drugs

A

b. Antagonism at NMDA type glutamate receptors

86
Q

Evidence supporting the ‘monoamine theory of depression’ includes:

a. Oral tryramine supplementation can sometimes used to augment antidepressant response.
b. Many drugs that increase synaptic concentrations of NE and 5-HT are effective antidepressants.
c. Tricyclic antidepressants block reuptake of the monoamine neurotransmitters norepinephrine, serotonin, and dopamine at clinically effective doses.
d. The timecourse for tricyclic antidepressant-induced effects on central nervous system monoamines closely parallels the timecourse of their therapeutic effects.

A

b. Many drugs that increase synaptic concentrations of NE and 5-HT are effective antidepressants.

87
Q

Corticotropin-releasing factor (CRF):
a. is generally found in significantly lower concentrations in key brain areas in untreated major depression
b. release from the hypothalamus is regulated by input from hippocampus, an area involved in emotion
c. regulated by feedback via cortisol released by the anterior pituitary
d. release from the paraventricular nucleus is increased by serotonin selective reuptake inhibitors
(SSRIs)

A

b. release from the hypothalamus is regulated by input from hippocampus, an area involved in emotion

88
Q

Which is NOT a known or suspected mechanism of antidepressant action?

a. Alpha2-adrenergic antagonism
b. Norepinephrine transporter blockade
c. Vesicular amine transporter blockade
d. Non-selective MAO inhibition

A

c. Vesicular amine transporter blockade

89
Q

Bupropion:

a. specific and potent DA reuptake blocker
b. enhances Vesicular Monoamine Transporter-2 (VMAT2) activity
c. nAchR neuronal nicotinic receptor agonism useful for smoking cessation
d. Alpha2 antagonism probably contributes to therapeutic effect

A

b. enhances Vesicular Monoamine Transporter-2 (VMAT2) activity

90
Q

Lithium affects the signaling of receptors that couple to Gq by:

a. blocking phospholipase C hydrolysis of PIP2
b. decreasing inositol biosynthesis
c. stimulating inositol lipid production
d. inhibiting inositol phosphate degradation by inositol phosphate phosphatase
e. all of the above

A

d. inhibiting inositol phosphate degradation by inositol phosphate phosphatase

91
Q

A drug that acts selectively on GABA channels that contain alpha-2 subunits has been approved by the FDA. What do you predict it will be prescribed for?

a. short term treatment of sleep disorders
b. anxiety
c. chronic treatment of epilepsy
d. muscle spasms
e. A and D

A

b. anxiety

92
Q

What mechanism of action of phencyclidine (PCP) suggests that it might be useful in preventing seizure-induced brain damage?

a. PCP binds sites near opioid receptors in the CNS and facilitates the action of opioids
b. PCP blocks activity-dependent calcium influx though NMDA-sensitive ion channels
c. PCP is a D2 dopamine receptor agonist specific for synapses in the striatum
d. PCP blocks activity-dependent sodium influx through AMPA-sensitive channels
e. PCP inhibits potassium channel conductance in the cortex

A

b. PCP blocks activity-dependent calcium influx though NMDA-sensitive ion channels

93
Q

Which is a strategy for controlling the abnormal synchronized firing of neurons in epilepsy?

a. increase feedforward inhibition
b. decrease feedforward excitation
c. increase feedback inhibition
d. all of the above
e. none of the above

A

d. all of the above

94
Q

Which is true about GABAᴬ receptor potentiation?

a. Benzodiazepines delay channel closing
b. Barbiturates increase the frequency of channel opening
c. Gabapentin increases GABA binding
d. all of the above
e. none of the above

A

e. none of the above

95
Q

Which is a mechanism of anticonvulsant drug action?

a. T-type Ca2+ channel activation
b. K+ channel potentiation
c. Na2+ channel inactivation
d. none of the above
e. all of the above

A

c. Na2+ channel inactivation

96
Q

Which enzyme is inactivated by opioid binding to opioid receptors?

a. adenylate cyclase
b. lipoxygenase
c. phospholipase A d. all of the above
e. none of the above

A

a. adenylate cyclase

97
Q

Which is a natural opioid peptide?

a. endorphin
b. enkephalin
c. dynorphin
d. all of the above
e. none of the above

A

d. all of the above

98
Q

Inhibition of cyclo-oxygenases blocks the production of which molecules?

a. Endoperoxides
b. Prostacyclins
c. Prostaglandins
d. all of the above
e. none of the above

A

d. all of the above

99
Q

Which NSAID irreversible inhibits cyclo-oxygenase?

a. naproxen
b. aspirin
c. diclofenac
d. ibuprofen

A

b. aspirin

100
Q

NSAIDs can be used to treat:

a. gout
b. moderate pain
c. rheumatoid arthritis
d. all of the above
e. none of the above

A

d. all of the above

101
Q

A characteristic of selective serotonin reuptake inhibitors (SSRI’s) that is related to their increased use relative to tricyclic antidepressants:

a. Relative absence of 5-HT3 receptor mediated effects
b. Stimulation of the HPA axis via increase in hypothalamic CRF
c. Generally superior efficacy in major depression
d. Relative absence of quinidine-like antiarrythmic actions
e. Essentially no risk of the “tyramine reaction”

A

d. Relative absence of quinidine-like antiarrythmic actions

102
Q

Which is NOT a known or suspected mechanism of antidepressant action?

a. Alpha2-adrenergic antagonism
b. CRF-1 receptor agonism
c. Enhanced Vesicular Monoamine Transporter-2 (VMAT2) activity
d. Norepinephrine transporter blockade
e. Non-selective MAO inhibition

A

b. CRF-1 receptor agonism

103
Q

A full understanding of major depression and antidepressant mechanisms will need to account for:
a. Ketamine and other select NMDA antagonist’s ability to mimic clinical depression
b. Lack of efficacy of some agents that do acutely increase norepinephrine and/or serotonin synaptic
activity
c. Immediate effects on monoamines but delayed clinical effects by several classes of antidepressants
d. Antidepressant activity of selegiline via monoamine oxidase A inhibition
e. Loss of hippocampal neurons in chronic depression

A

a. Ketamine and other select NMDA antagonist’s ability to mimic clinical depression

104
Q

Which pairing is WRONG?

a. Mesocortical dopamine system – motivation and reward
b. Tuberoinfundibular dopamine system – arcuate nucleus of the hypothalamus
c. Mesolimbic dopamine system - hyperprolactinemia
d. Substantia nigra degeneration – Parkinsons’s disease
e. Nucleus accumbens – antipsychotic drug target

A

c. Mesolimbic dopamine system - hyperprolactinemia

105
Q

Features of atypical antipsychotic drugs compared with typical antipsychotic drugs generally include all EXCEPT:

a. Little incidence of anticholinergic side effects
b. Increased efficacy for positive and negative symptoms of schizophrenia
c. Lower risk of hyperprolactinemia
d. Lower incidence of extrapyramidal side effects
e. Higher 5-HT2A receptor affinity or occupancy

A

a. Little incidence of anticholinergic side effects

106
Q

The blood brain barrier generally:

a. Allows dopamine and levodopa, but not carbidopa to pass
b. Allows carbidopa and levodopa, but not dopamine to pass
c. Allows levodopa to pass, but not carbidopa or dopamine
d. Allows carbidopa and dopamine to pass, but only in combination
e. Allows all to pass, but carbidopa and dopamine compete for uptake sites

A

c. Allows levodopa to pass, but not carbidopa or dopamine

107
Q

All are deliberately inhibited in the treatment of Parkinson’s disease EXCEPT:

a. Aromatic L-amino acid decarboxylase
b. Monoamine Oxidase B
c. Ubiquitin C-terminal hydrolase L1
d. NMDA receptors
e. Muscarinic cholinergic receptors

A

c. Ubiquitin C-terminal hydrolase L1

108
Q

Which pair does NOT go together?

a. Alpha-synuclein - Lewy bodies
b. Appearance of Parkinson’s symptoms - loss of more than 60% of substantia nigra neurons
c. Pyramidal motor system – voluntary, conscious movement
d. Identified mutations in ubiquitin-proteasome pathway – idiopathic Parkinson’s
e. Parkinsonian symptoms - state of cholinergic excess

A

d. Identified mutations in ubiquitin-proteasome pathway – idiopathic Parkinson’s

109
Q

In general, what would be a better choice for a local anesthetic for a patient where you would like to minimize availability of the drug to the heart?

a. A lipophilic amide-type agent
b. A non-lipophilic amide-type agent.
c. A lipophilic ester-type agent
d. A non-lipophilic ester-type agent

A

c. A lipophilic ester-type agent

110
Q

The halogenated inhalational anesthetics differ from nitrous oxide in having:

a. Higher lipophilicity and higher MAC
b. Relatively greater effect on NMDA conductance
c. Multiple channels as sites of actions
d. Stereospecific interactions with membrane components
e. Inhibitory actions at GABA-A channels

A

d. Stereospecific interactions with membrane components

111
Q

Which is TRUE about a partial seizure?

a. They begin in a localized region of the brain
b. They can evolve to secondarily generalized seizures c. They can be associated with psychic symptoms
d. all of the above
e. none of the above

A

d. all of the above

112
Q

Which is not a treatment strategy for seizures?

a. antiepileptic drugs
b. hypnosis
c. surgery
d. ketogenic diet
e. vagus nerve stimulation

A

b. hypnosis

113
Q

Which is a mechanism for anticonvulsant drug action?

a. Na+ channel inactivation
b. GABA potentiation
c. T-type Ca2+ channel blockade
d. all of the above
e. none of the above

A

d. all of the above

114
Q

Which is a strategy for controlling the abnormal synchronized firing of neurons in epilepsy?

a. decrease intrinsic excitability
b. decrease feedforward excitation
c. increase feedback inhibition
d. all of the above
e. none of the above

A

d. all of the above

115
Q

Which downstream effect is caused by opioid binding to opioid receptors?

a. cAMP synthesis is inhibited
b. adenylate cyclase is activated
c. K+ channels are closed
d. Ca2+ entry is increased
e. none of the above

A

a. cAMP synthesis is inhibited

116
Q

Which is TRUE about pain signal transduction in the dorsal horn?

a. Ad or C primary afferents release glutamate and substance P
b. serotonin released by descending pain tracts stimulates enkephalin neurons
c. enkephalins inhibit Ad or C primary afferents
d. all of the above
e. none of the above

A

d. all of the above

117
Q

Which is FALSE about opioids?

a. changing the hydroxyl groups in morphine to acetyl esters facilitates crossing the BBB
b. changing the substituents on the nitrogen of morphine can improve agonist activity
c. opioids differ only in potency, not efficacy
d. changing the substituents on the nitrogen of morphine can create antagonists
e. more potent antagonists can be made by incorporating changes from more potent agonists

A

c. opioids differ only in potency, not efficacy

118
Q

Why is low-dose aspirin anti-thrombolytic?

a. platelets express only COX-1
b. platelets express only COX-2
c. platelets express both COX-1 and COX-2
d. platelets do not express either COX-1 or COX-2
e. none of the above

A

a. platelets express only COX-1

119
Q

Isoflurane, an inhalational anesthetic

a. provides better analgesia compared to the older agent, nitrous oxide
b. block C-fibers more rapidly than A-ɑ fibers
c. enhances GABA-A receptor mediated responses in brain
d. has both high potency and fast onset of action

A

c. enhances GABA-A receptor mediated responses in brain

120
Q

In general, what type of local anesthetic will have least availability to the heart?

a. A lipophilic ester-type agent
b. A lipophilic amide-type agent
c. A non-lipophilic ester-type agent
d. A non-lipophilic amide-type agent.
e. Cocaine

A

a. A lipophilic ester-type agent

121
Q

In pregnancy, drugs cross from maternal to fetal circulation (and vice versa) primarily by passive diffusion. Ionized molecules cannot easily cross the placenta in either direction. Fetal pH is normally lower than maternal pH. Keeping all this in mind, which of the following statements regarding actions of local anesthetics in pregnant women is true?

a. fetal exposure is minimized due to the unfavorable maternal-to-fetus drug concentration gradient
b. local anesthetics become more ionized on the fetal side of the placenta and are thus partly trapped there, exposing the fetus to higher drug levels
c. At steady state, the concentration of non-ionized local anesthetic is greater in the fetus than in the mother
d. fetal acidosis (a lowering of fetal pH under stress) will decrease steady state concentrations of drug in fetal circulation

A

b. local anesthetics become more ionized on the fetal side of the placenta and are thus partly trapped there, exposing the fetus to higher drug levels

122
Q

Therapy of Parkinson’s disease may employ inhibition of:

a. muscarinic receptors
b. D2 dopamine receptors
c. Monoamine oxidase A
d. Tyrosine hydroxylase

A

a. muscarinic receptors

123
Q

All are true regarding Parkinson’s disease EXCEPT ONE:

a. Lewy bodies are a hallmark of the disease
b. > 60% of DA neurons in substantia nigra disappear before symptoms are apparent
c. dyskinesias are caused by loss of dopamine stimulation
d. most cases have no currently identifiable genetic cause

A

c. dyskinesias are caused by loss of dopamine stimulation

PHCOL 402 (5 decks)

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