Module 7 Flashcards

0
Q

combining fluoxetine and imipramine may lead to

a. dec levels of imipramine
b. inc levels of imipramine
c. dec levels of fluoxetine
d. inc levels of fluoxetine

A

b

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1
Q
Describe the dose response curve of phenobarbital with regards to its CNS effects and dose 
A. Hyperbolic 
B. Sigmoidal 
C. Linear 
D. Parabolic
A

C

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2
Q
Mu receptor that may induce vasodilation 
A. Mu 1 
B. Mu 2 
C. Mu 3 
D. Mu 4
A

c

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3
Q

prototype of TCA

a. fluoxetine
b. imipramine
c. trazodone
d. mirtazepine

A

b

fluoxetine - prototype of SSRI

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4
Q
Patient a is to undergo MRI for the first time. He told you that he was not able to sleep last night because he is very anxious about the procedure. What drug will you give your patient? 
A. Milk 
B. Midazolam 
C. Paraldehyde 
D. Phenobarbital
A

B

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5
Q

browning of vision due to retinal damage is prominent with the use of

a. thioridazine
b. haloperidol
c. clozapine
d. chlorpromazine

A

a

chlorpromazine - corneal and lens deposits

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6
Q
Flumazenil is a/an 
A. Barbiturate agonist 
B. Barbiturate antagonist 
C. Benzodiazepine agonist 
D. Benzodiazepine antagonist
A

D

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7
Q

Fluvoxamine inihibits

a. CYP 2D6
b. CYP 3A4
c. CYP 2B6
d. CYP 1A2

A

b

CYP2D6 - fluoxetine

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8
Q

which of the ff has the shortest duration of action?

a. pentobarbital
b. phenobarbital
c. secobarbital
d. thiopental

A

d- ultra short acting

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9
Q

how will phenobarbital’s be terminated?

a. physical redistribution
b. hepatic metabolism
c. urinary excretion
d. NOTA

A

c. -long acting barbiturates
physical redistribution- short acting
hepatic metabolism - intermediate acting

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10
Q

which of the ff serotonin receptor is inhibitory?

a. 5HT 1A
b. 5HT 1b
c. 5HT2
d. 5HT5

A

a

others are excitatory

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11
Q

which of the ff antipsychotic is related to highest incidence of EPS?

a. thoridazine
b. lithium
c. haloperidol
d. clozapine

A

c

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12
Q

which of the ff benzodiazepines does not affect the REM sleep?

a. fludrocortisone
b. fluconazole
c. flurazepam
d. flumazenil

A

c

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13
Q
which of the ff SSRI has prominent weight gain as its side effect? 
a. citalopram
b. lithium
c. paroxetine
d, selegiline
A

c

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14
Q
Which of the ff benzodiazepine is used for status epilepticus? 
A. Phenobarbital 
B. Lorazepam 
C. Alprazolam
D. Zolpidem 
E. Chloral hydrate
A

B

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15
Q

which of the ff typical antipsychotic medication is closely related to weight gain?

a. chlorpromazine
b. haloperidol
c. lithium
d. olanzapine

A

a

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16
Q

which of the ff antipsych will produce hypotension most?

a. aripriprazole
b. chlorpromazine
c. olanzapine
d. ziprasidone

A

b

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17
Q

the ff are inhibitory except

a. NE on beta 2 receptor
b. histamine
c. glutamate at ACPD receptor
d. opioids

A

b

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18
Q

1st: Phenobarbital - increases frequency of chloride channel opening
2nd: Diazepam - increases duration of chloride channel opening
Which of the ff statement is correct?
A. B only
B. A only
C. Both
D. None

A

D.
Diazepam - inc frequency
Phenobarbital- inc duration

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18
Q

which of the ff barbiturates is least lipophillic?

a. phenobarbital
b. secobarbital
c. thiopental
d. pentobarbital

A

a- long acting -least lipophilic

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19
Q

which of the ff short acting benzodiazepine is used to counteract panic attacks?

a. lorazepam
b. alprazolam
c. diazepam
d. midazolam

A

b

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20
Q

which of the ff functions as a retrograde synaptic messenger?

a. nitric oxide
b. endocannabinoid
c. serotonin
d. acetylcholine

A

b

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22
Q

typical antipsychotic primarily acts on what receptor?

a. dopamine
b. serotonin
c. glutamine
d. alpha 1

A

a

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23
Q

which of the ff benzodiazepines is used for ethanol withdrawal?

a. clonazepam
b. triamzolam
c. buspirone
d. Chloridazepoxide

A

d

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23
Q

comparing imipramine and desimipramine: the ff statements are correct except

a. desimipramine is more potent
b. imipramine has more anticholinergic effect
c. desimipramine is a potent serotonin reuptake inhibitor
d. all are correct

A

c. - more on NE reuptake inhibitor

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24
Q

the ff describes nefazodone except

a. was withdrawn due to its renal toxicity
b. antagonist of 5HT2
c. its active metabolites are hydroxynefazodone and m-cpp
d. can make a person dependent to it

A

a. withdrawn due to its hepatotoxicity

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25
Q
which of the ff  has no associated sexual side effect? 
a. mirtazepine
b. citalopram
c. imipramine
d, venlafexine
A

a

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27
Q

JA, a newborn baby is noted to have extremely high levels of bilirubin. which of the ff may be used to decrease its level?

a. diazepam
b. phenobarbital
c. zolpidem
d. dexamathasone

A

b

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28
Q

what metabolite is responsible for chloral hydrate’s hypnotic effect?

a. trichloroethanol
b. acetaldehyde
c. acetone
d. methanol

A

a

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29
Q

which of the ff older hypontics may cause metabolic acidosis with high anion gap?

a. chloral hydrate
b. paraldehyde
c. MEPROBAMATE
d. GLUTETHIMIDE

A

b

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32
Q

flumazenil is used an antidote for

a. benzodiazepine overdose
b. TCA overdose
c. both a and b
d. neither a and b

A

c

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34
Q

which the ff antidepressant should the discontinued for 4 weeks before starting selegiline?

a. mirtazepine
b. duloxetine
c. imipramine
d. fluoxetine

A

d. others 2 weeks lng

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35
Q

duloxetine is contraindicated to which of the ff condition

a. CKD
b. liver cirrhosis
c. CHF
d. pulmonary embolism

A

b

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36
Q
The most common cause of confusional states in elderly is 
A. Old age 
B. Use of sedative and hypnotic 
C. Excessive sleeping 
D. Inactive lifestyle
A

B

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37
Q

first line antidepressant

a. TCA
b. 5HT2
c. SSRI
d. unicyclic antidepressant

A

c

37
Q
Which of the ff blocks reuptake of norepinephrine? 
A. Amphetamine
B. Reserpine 
C. Cocaine 
D. Capsaicin
A

C
Reserpine- depletes Intracellular NE stores
Amphetamine - releases NE from adrenergic synapses
Capsaicin- substance P

38
Q

which of the ff undergoes biphasic elimination?

a. venlafaxine
b. trazodone
c. buproprion
d. escitalopram

A

c

38
Q

the ff refers to MAO b except

a. Acts on tyramine,phenylethylamine,benzylamine
b. selegiline
c. found in the placenta
d. seen in serotonergic and histaminergic neurons

A

c

39
Q
General characteristic of sedative and hypnotic drugs except 
A. Lipophobic 
B. Can cross the blood brain barrier 
C. Can cross the placenta 
D. Acts on GABA
A

A. Lipophilic

40
Q
Amino acid precursor of serotonin 
A. Valine 
B. Tyrosine 
C. Tryptophan 
D. Threonine
A

C

41
Q
which the ff TCA has a higher affinity for NET
a, fluoxetine 
b. imipramine 
c, clomipramine 
d. nortriptyline
A

d. NET- nortriptyline/ DEsimipramine

42
Q

buproprion has no effect on

a. NE
b. Dopamine
c. serotonin
d. NOTA

A

c

43
Q
mirtazepine is a
a, agonist of presynaptic alpha 2 
b.  Enhances release of both NE and 5HT
c. Antagonist of 5HT2 and 5HT 3 receptors
d. Potent H1 antagonist
A

a- antagonist dapat

46
Q

EPS seen as ADR of antipsych is due to what dopaminergic pathway?

a. mesolimbic- mesocortical
b. nigrostriatal
c. tuberoinfundibular
d. medullary- periventricular
e. incertihypothalamic

A

b
mesolimbic- mesocortial- behavior and psychose
tuberoinfundibular - inh prolactin
medullary- periventricular - eating behavior
incertihypothalamic - sexual behavior

47
Q

which of the ff has a potent parkinsonism effect?

a. amoxapine
b. selegiline
c. paroxitine
d. venlafexine

A

a

48
Q
Activates Gq except 
A. Histamine 1 
B. Alpha 1 
C. Beta 1 
D. Muscarinic 3 
E. Muscarinic 1
A

C - Gs un beta 1

Gq- IP3/DAG- protein kinase C

49
Q
Amino acid precursor of norepinephrine  
A. Valine 
B. Tyrosine 
C. Tryptophan 
D. Threonine
A

B

50
Q

the average time for relapse of a patient who discontinued his antipsych medication is 6 months, except for

a. chlorpromazine
b. haloperidol
c. phenobarbital
d. clozapine

A

d

51
Q
dopamine levels of  depression and schizophrenia 
a. dec, dec
b. dec, inc 
c inc, dec 
d. inc, inc
A

b

54
Q

combining digoxin with diazepam will result to

a. inc sedative effect
b. dec sedative effect
c. arrythmia
d. tachycardia

A

c

55
Q
most widely used typical antipsychotic belongs to what chemical group? 
a, thioxanthine 
b. butyrophenone 
c. alipathic phenothiazine 
d. piperazine
A

b- haloperidol

56
Q
A patient tries committing suicide by taking a rat poison with stychnine. Knowing your pharmacology. What receptors are blocked by this drug? 
A. GABA - A 
B. GABA - B 
C. Acetylcholine 
D. Glycine
A

d

57
Q
PredominAnt excitatory neurotransmitter 
A. Histamine 
B. Tryptophan 
C. Tyrosine 
D. Glycine 
E. Glutamate
A

e

58
Q

what enzyme is inhibited by lithium?

a. phosphofructokinase
b. glycogen synthase kinase 3
c. lactate dehydrogenase
d. renin

A

b

59
Q

which of the ff neurotransmitter is acted upon by secobarbital?

a. glycine
b. acetylcholine
c. GABA
d. dopamine

A

c

59
Q
Primary inhibitory neurotransmitter in the spinal cord 
A. GABA 
B. Glycine 
C. Serotonin 
D. Acetylcholine 
E. Substance P
A

B

GABA- brain

61
Q

prototype of atypical antipsychotic

a. chlorpromazine
b. valproic acid
c. clozapine
d. risperidone

A

c

chlorpromazine -prototype of typical antipsych

62
Q

which of the ff atypical antipsych is related to both dopamine receptor and serotonin receptor antagonism?

a. olanzapine
b. sulpiride
c. haloperidol
d. carbamazepine

A

b

63
Q
The ff cause sedation except
A. Antihistamine 
B. Benzodiazepine 
C. Barbiturates 
D. Opioids 
E. NOTA
A

E

63
Q
Advantages of benzodiazepine except 
A. Rapid onset of action 
B. Low risk of drug interaction 
C. Narrow therapeutic index 
D. Minimal effects on cardiovascular system 
E. NOTA
A

C. - wide therapeutic index

63
Q

lorazepam is used for what kind of seizure?

a. grand mal
b. petit mal
c. absence
d. status epilepticus

A

d

63
Q

the ff are short acting benzodiazepines except

a. lorazepam
b. midazolam
c. triamzolam
d. diazepam

A

d

63
Q

dopamine receptor most likely involved in schizophrenia

a. D1
b. D2
c. D3
d. D4
e. D5

A

b

64
Q

which of the ff typical antipsych has greater affinity for serotonin than dopamine?

a. thioridazone
b. haloperidol
c. chlorpromazine
d. olanzapine

A

c

65
Q

Why is benzodiazepine overdose rarely fatal?
A. Their hypnotic effect is self limiting
B. Their MOA is prolonging the opening of the chloride channel
C. They are excitatory in very high doses
D. They are excreted unchanged in the stool

A

A

65
Q
which of the ff antimicrobial is also a MAO inhibitor 
a. amoxicillin 
b. azithromycin 
c. vancomycin 
d, linezolid
A

d

66
Q

the ff are enzyme inhibitors except

a. ketoconazole
b. rifampicin
c. fluoxetine
d. grapefruit

A

b- inducer

68
Q

Dopamine 2 receptor uses what kind of G protein

a. Gs
b. Gi
c. Gq
d. G3

A

b

dopamine 1- Gs

68
Q

which of the ff anti psych is used as neuroleptanesthesia?

a. prochlorperazine
b. bupoprion
c. promethazine
d. droperidol

A

d
promethazine - pre op sedative
prochlorperazine- anti emetic

69
Q

EPS start to occur when __% of dopamine receptors are occupied

a. 10%
b. 60%
c. 80%
d. 100%

A

c

60% to have antipsychotic effect

70
Q

which of the ff antipsych has similar affinity for D1 and D2

a. chlorpromazine
b. haloperidol
c. clozapine
d. aripiprazole
e. Quetiepine

A

c

72
Q

tremors associated with lithium use should be treated with

a. digoxin
b. propranolol
c. verapamil
d. losartan

A

b

73
Q

lithium toxicity may lead to

a. diabetes insipidus
b. diabetes mellitus
c. hyperthyroidism
d. pregnancy

A

a- nephrogenic type

74
Q

which of the ff anti depressant is used to help smokers?

a. mirtazapine
b. amitriptylline
c. midazolam
d. bupropion

A

d

75
Q

slope of benzodiazepine and barbiturates respectively

a. linear, linear
b. linear, non linear
c. non linear, linear
d. non linear, non linear

A

c

76
Q

true or false: aripriprazole has the same affinity for dopamine 2 and serotonin

A

true

76
Q

which of the ff is the limiting factor in using clozapine?

a. nausea
b. EPS
c. agranulocytosis
d. enzyme inhibition of CYP450

A

c

78
Q

initial symptom of neuroleptic malignant syndrome

a. fever
b. inc blood pressure
c. muscle rigidity
d. eleveated creatine kinase

A

c

79
Q

neuroprotective agent approved for ALS

a. lamotrigine
b. valproic acid
c. riluzone
d. ketamine

A

c

ketamine- NMDA antagonist

80
Q

Only antipsych associated with dec risk of suicide

a. haloperidol
b. fluphenazine
c. clozapine
d. risperidone

A

c`

81
Q

atypical antipsych causing the least weight gain

a. aripriprazole
b. chlorpromazine
c. olanzapine
d. ziprasidone

A

d

83
Q

combining acetaminophen with diazepam will result to

a. inc sedative effect
b. dec sedative effect
c. inc analgesic effect
d. dec analgesic effect

A

a. - dec excretion of diazepam

83
Q

cardiotoxicity is evident in what anti psych med?

a. thioridazone
b. haloperidol
c. chlorpromazine
d. olanzapine

A

a

83
Q

thioridazine should not be used with group 3 anti arrythmics. which of the ff is an example of group 3 anti arrythmics

a. lidocaine
b. verapamil
c. amiodarone
d. digoxin

A

c

84
Q

a person who has Huntington is said to have decrease levels of :

a. norepinephrine
b. GABA
c. glycine
d. serotonin

A

b