neuropharmacology

Question 1

The new onset of pathological gambling, increased libido, and hypersexuality in a patient with Parkinson disease is likely to be secondary to: (3x)

Answer 1

PRAMIPEXOLE

Question 2

First line treatment of vocal tics in Tourette syndrome: (2x)

Answer 2

ALPHA 2 ADRENERGIC AGONIST

Question 3

Which drug for the Tx of parkinsonism has been associated with sudden sleep attacks? (2x)

Answer 3

ROPINIROLE

Question 4

2nd generation with the lowest D2 affinity

Answer 4

QUETIAPINE

Question 5

What medicine interferes with efficacy of Donepezil?

Answer 5

OXYBUTYNIN

Question 6

A condition with increased frequency in pts with HIV on long term HAART:

Answer 6

HEPATOTOXICITY

Question 7

Inhibitors of enzyme catechol-O-methyl transferase are used in Parkinson disease to address which disease-associate problem?

Answer 7

WEARING OFF OF LEVODOPA EFFECT

Question 8

33 y/o with insomnia, fatigue, nervousness, irritability, and depressed mood. Has scaly dermatitis in sun-exposed areas, apathy, and mild memory impairment. Which vitamin is pt deficient in?

Answer 8

NIACIN

Question 9

Which medication reduces accumulation of plaques and disability in pt’s with relapsing remitting MS?

Answer 9

INTERFERON BETA-1 A

Question 10

What cognitive enhancer is an NMDA receptor antagonist?

Answer 10

MEMANTINE

Question 11

Medication helpful in early HIV dementia but is potentially toxic later in the disease?

Answer 11

METHYLPHENIDATE

Question 12

Acamprosate works through which neurotransmitter system?

Answer 12

GLUTAMATE

Question 13

Neuronal enzyme that is the target of drugs to treat Alzheimer’s i.e. galantamine and rivastigmine

Answer 13

ACETYLCHOLINESTERASE

Question 14

Pharmacologic mechanisms of topiramate include: inhibition of firing of voltage- dependent sodium channels, antagonism of kainite binding to the alpha-amino-3- hydroxy-5-methyl-4- isoxazole propionic acid (AMPA) receptor & potentiation at which receptor?

Answer 14

GABA-A

Question 15

A medication to treat MS is an integrin antagonist that primarily acts by blocking lymphocytes and monocytes adhesion to the endothelial cells:

Answer 15

NATALIZUMAB

Question 16

Medication for restless leg syndrome:

Answer 16

BROMOCRIPTINE

Question 17

A 73 yo M pt is seen for follow up treatment for a seizure disorder. On examination the pt is found to have gum hypertrophy, cerebellar ataxia and hirsutism. Which of the following medication is the pt taking (most likely)?

Answer 17

PHENYTOIN/DILANTIN

Question 18

Restless Legs syndrome 2/2 medication

Answer 18

ANTIDEPRESSANTS

Question 19

62 y/o pt evaluated for frequent falls w/o loss of consciousness. Pt w rigidity, hallucinations. Three episodes of hallucinations resolved w/o sequelae. Cause?

Answer 19

RISPERIDONE

Question 20

Safest heterocyclic antidepressant for 78 y/o w depression, agitation & dementia is:

Answer 20

NORTRIPTYLINE

Question 21

Neuronal damage from excitotoxicity secondary to glutamate sensitivity. Treat with:

Answer 21

MEMANTINE

Question 22

Which medication for insomnia is most likely to cause amnestic cognitive impairment?

Answer 22

TEMAZEPAM

Question 23

Sx most likely related to excessive use of vitamin B12

Answer 23

BURNING SENSATIONS

Question 24

60 y/o F with 10 month hx of apathy and depression has hyperchromic macrocytic anemia. Best test to order next:

Answer 24

VITAMIN B12 LEVEL

Question 25

A pt with EtOH-dependence present to ED with confusion, ataxia, nystagmus and ophthalmologist. High doses of which of the following vitamins could have prevented this syndrome?

Answer 25

VITAMIN B1

Question 26

A derivative of which of the following vitamins is a necessary cofactor for the function of the enzyme glutamic acid decarboxylase?

Answer 26

PYRIDOXINE

Question 27

Which of the following neurohormones is known to modulate immune function, has analgesic properties, is derived from the serotonin molecule, and is a potent antioxidant and free-radical scavenger?

Answer 27

MELATONIN

Question 28

Mirtazapine mediates increased release of NE and and serotonin through what mechanism?

Answer 28

ALPHA-2 ADRENERGIC BLOCKADE

Question 29

Reduces Sxs during acute exacerbation of MS:

Answer 29

METHYLPREDNISONE

Question 30

What occurs when the central nervous system responds to an acute cortical insult?

Answer 30

Microglia processes retract, and the cell body enlarges

Question 31

What drug can reduce psychotic symptoms in parkinson’s disease w/out worsening motor symptoms

Answer 31

Pimavanserin

Question 32

Which medication class exacerbates physiology tremor? Barbiturates, corticosteroids, benzos, CCB’s, Beta blockers

Answer 32

Corticosteroids