3 Flashcards

(116 cards)

1
Q

Which antidepressant’s mechanism of action includes only serotonin reuptake inhibition?
a. Fluoxetine (Prozac)
b. Bupropion (Wellbutrin)
c. Venlafaxine (Effexor)
d. Mirtazapine (Remeron)

A

a. Fluoxetine (Prozac)

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2
Q

Which antidepressant has the lowest risk of weight gain and sexual dysfunction?

a. Fluoxetine (Prozac)
b. Bupropion (Wellbutrin)
c. Venlafaxine (Effexor)
d. Mirtazapine (Remeron)

A

B

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3
Q

What is the risk associated with using a monoamine oxidase inhibitor antidepressant with an over the counter cold preparation
containing pseudoephedrine?

A

A

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4
Q

What is the risk associated with using a monoamine oxidase inhibitor antidepressant with any of the following medications:
dextromethorphan, meperidine, tramadol, or methadone?
a. Serotonin syndrome
b. QT prolongation
c. Seizures
d. Hypertensive crisis

A

A

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5
Q

Which antidepressant has the highest risk of mortality associated with an overdose?
a. Sertraline (Zoloft)
b. Duloxetine (Cymbalta)
c. Mirtazapine (Remeron)
d. Amitriptyline (Elavil)

A

D

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6
Q

Which statement is true regarding the efficacy of antidepressants?
a. SSRI antidepressants are recommended first line based on superior efficacy
b. SNRI antidepressants are recommended first line based on superior efficacy
c. Current evidence suggests all antidepressants demonstrate similar efficacy
d. Remission rates are approximately 70% for all antidepressants

A

C

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7
Q

Which benzo has the shortest duration of action?
a. Alprazolam (Xanax)
b. Chlordiazepoxide (Librium)
c. Clonazepam (Klonopin)
d. Diazepam (Valium)

A

A

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8
Q

Which medication would have the fastest onset of efficacy for the treatment of acute anxiety?
a. Buspirone (Buspar)
b. Lorazepam (Ativan)
c. Sertraline (Zoloft)
d. Venlafaxine (Effexor)

A

B

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9
Q

What mechanism of action do risperidone and ziprasidone have in common for treating schizophrenia?
a. D2 agonist
b. D2 antagonist
c. D2 partial agonist
d. D2/5HTA2 antagonist

A

D

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10
Q

Which antipsychotic has the greatest risk of metabolic side effects such as weight gain, hyperglycemia, and hyperlipidemia?
a. Aripiprazole (Abilify)
b. Haloperidol (Haldol)
c. Olanzapine (Zyprexa)
d. Risperidone (Risperdal)

A

C

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11
Q

Which antipsychotic has the greatest risk of EPS disorders/tardive dyskinesia?
a. Quetiapine (Seroquel)
b. Clozapine
c. Haloperidol (Haldol)
d. Risperidone (Risperdal)

A

C

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12
Q

What is the proposed mechanism of action of haloperidol and chlorpromazine for treating schizophrenia?
a. D2 agonist
b. D2 antagonist
c. D2 partial agonist
d. D2/5HTA2 antagonist

A

A

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13
Q

Based on treatment guidelines, which antipsychotic would be considered first line therapy in a patient newly diagnosed with
schizophrenia?
a. Aripiprazole (Abilify)
b. Clozapine
c. Haloperidol
d. Chlorpromazine

A

A

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14
Q

What is the max recommended daily dose for acetaminophen?
a. < 3 grams/day for adults and 2-3 grams/day for children

a. < 3 grams/day for adults and 2-3 grams/day for elderly
b. < 5 gms/day for aults and <4 gm/day for elderly
c. < 13gm/day for adults and <12-13/day for elderly
d. < 15gm/day for adults nad <14 gm/day for elderly

A

A

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15
Q

What patient risk factors are important to asses when considering treating pain with NSAIDs?
a. History of GI problems and GI risk factors
b. Cardiovascular conditions and CV risk factors
c. Renal dysfunction
d. A&B
e. E. all of the above

A

E

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16
Q

TT is a 66 year old patient with post extraction pain. His primary care physician does not want him to take NSAIDs because the patient
is on warfarin. You have prescribed him 2 days of opioid therapy. TT should be educated to monitor for which common adverse
effect?
a. Diarrhea
b. Headache
c. Constipation
d. Insomnia

A

C

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17
Q
  1. What is the problem when you have a diet high on Tyramine?
A

a. Hypertensive Crisis

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18
Q
  1. If you take Prozac and you combine it with another drug that
    has Seritonin what happens?
A

a. Seritonin Syndrome

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19
Q
  1. Which antidepressant has the highest risk of mortality
    associated with an overdose?
A
  1. Which antidepressant has the highest risk of mortality
    associated with an overdose?
    a. Amitriptyline (TCA)
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20
Q

Which of the following medications is the first line of treatment

A

a. Answer Sertraline (SSRI)

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21
Q

What are the main side effects for a patient on an SSRI?

A

are the main side effects for a patient on an SSRI?
a. Nausea, vomiting, diarrhea

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22
Q
  1. What is the common drug for GAD (generalized Anxiety
    disorder), SAD (social), panic disorder?
A

a. Answer is SSRI (Fluxetine, Prozac)

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23
Q
  1. Which drug has both Seritonin and NE reuptake inhibition?
    a. Venlafaxine (Effexor) SNRI
    b. Prozac (SSRI)
    c. Celexa (SSRI)
    d. Wellbutrin (NDRI)
A

A

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24
Q

What is a 5HT alpha 1 partial agonist?

A

a. a. buspar

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25
The recommended length of time for someone that has experience depression for the first time is? a. 9-­--12 Mo after remission b. 5 years
A
26
The first symptom that is seen on someone who starts taking an antidepressant is? a. Decreased anxiety, improvement of sleep and improvement of appetite b. Energy levels
A
27
11. What is the mechanism of action of Buspar?
a. 5HT1A partial agonist
28
Benzodizepines are given for a parson that is going through? a. Alcohol withdrawal – if acute b. Depression c. Seizures d. All of the above
C and A i think
29
14. Which of the following is true about Benzodizepine? a. Quick onset b. Long half life
A
30
Which drug is associated with tardive dyskinesia?
a. Haloperidol (HALDOL)
31
All benzodiazepines have the potential for? Quick onset Not the potential for abuse Short dosages Long half life
Quick onset
32
Pathway involved with Proactolemia ?
a. a. Tuberoinfundibular
33
Which antipsychotic has the greatest risk of tardive dyskinesia?
a. Haloperidol (Haldol)
34
Muscarinic M1 receptor is involved with?
a. Urinary retention, decreased cognition, tachycardia, dry mouth, blurred vision, constipation
35
20. Patient presents with the symptoms of extreme motor restlessness, inability to sit still?
a. Akathisia (we are confused between the answer choice being TD or Akathisia)
36
25. What causes Agrunolocytosis?
a. Clozapine
37
What is a treatment of choice for refactory schizophrenia?
a. Clozapine
38
What drug causes excess of weight gain?
a. Olanzapine
39
These drugs have decrease incidences of EPS?
Lorazpan
40
Which ONE of the following antiepileptic medications should be discontinued if a rash develops? a. Phenobarbital b. Levetiracetam (Keppra) c. Lamotrigine (Lamictal) d. Topiramate (Topamax)
C
41
Which ONE of the following antiepileptic medications is associated with the development of gingival hyperplasia? a. Phenytoin (Dilantin) b. Iamotrigine (Lamictal) c. Divalproex (Depakote) d. Carbamazepine (Tegretol)
A
42
Which ONE of the following antiepileptic medications would be most likely to contribute to a potential drug interaction with oral contraceptive medications resulting in a decreased level of effectiveness of the contraceptive? a. Lamotrigine (Lamictal) b. Carbamazepine (Tegretol) c. Levetiracetam (Keppra) d. Alprazolam (Xanax)
B
43
A medication that causes dry mouth, dry eyes, and constipation is likely to exhibit which one of the following receptor activities? a. Dopamine blockade b. Inhibition of serotonin reuptake c. Alpha-1 receptor blockade d. Anticholinergic/antimuscarinic
D
44
The antiepileptic that is most often associated with concerns about cognitive impairment and requires a gradual dosage titration in part for this reason is which one of the following? a. Topiramate (Topamax) b. Zonisamide (Zonegran) c. Divalproex (Depakote) d. Oxcarbazepine (Trileptal)
A
45
What is the max recommended daily dose for acetaminophen? a. < 3 grams/day for adults and 2-3 grams/day for elderly b. < 5 gms/day for adults and < 4 gm/day for elderly c. < 13 gm/day for adults and < 12-13 gm/day for elderly d. < 15 gm/day for adults and < 14 gm/day for elderly
A
46
What patient risk factors are important to asses when considering treating pain with NSAIDs? a. History of GI problems and GI risk factors b. Cardiovascular conditions and CV risk factors c. Renal dysfunction d. all of the above
D
47
AK is a 22 year old scheduled to have an impacted third molar removed next week in the reduced cost dental clinic in which you are working. He reports he is otherwise healthy and denies any prescription or OTC medications. He denies allergies to medications. He is currently reporting a constant aching pain due to the impacted molar. He states the pain then causes him to have daily headaches. He rates this pain as mild to moderate but it is interfering with his ability to concentrate at work and in his everyday tasks. He states he doesn’t currently have any prescription drug insurance because he just started a new job and won’t receive benefits for another 60 days. Considering cost and the patient’s condition, which of the following treatment options would be the best choice for this patient’s pain? a. Celecoxib b. Oxycodone c. Ibuprofen (Naproxen) d. Hydrocodone/APAP
C
48
AK is a 22 year old scheduled to have an impacted third molar removed next week in the reduced cost dental clinic in which you are working. He reports he is otherwise healthy and denies any prescription or OTC medications. He denies allergies to medications. He is currently reporting a constant aching pain due to the impacted molar. He states the pain then causes him to have daily headaches. He rates this pain as mild to moderate but it is interfering with his ability to concentrate at work and in his everyday tasks. He states he doesn’t currently have any prescription drug insurance because he just started a new job and won’t receive benefits for another 60 days. AK returned and had his impacted third molar extracted. He calls you after using ibuprofen 400 mg and APAP 650 mg q 6 hours for 24 hours and is reporting severe pain post-extraction. What is the best treatment option to treat his severe pain? a. Add oxycodone 10 mg q 6 hrs for 24-48 hrs to the ibuprofen/APAP regimen b. Discontinue ibuprofen/APAP regimen and start hydrocodone/APAP 5/325 mg q 6 hrs for 3 days c. Discontinue ibuprofen/APAP regimen and start tramadol 50 mg q 6 hrs d. Add a fentanyl patch 25mcg/72 hrs to the ibuprofen/APAP regimen
A
49
10. TT is a 66-year-old patient with post extraction pain. His primary care physician does not want him to take NSAIDs because the patient is on warfarin. You have prescribed him 2 days of opioid therapy. TT should be educated to monitor for which common adverse effect? a. Diarrhea b. Headache c. Insomnia d. Constipation
D
50
Which antidepressant’s mechanism of action includes only serotonin reuptake inhibition? a. Fluoxetine (Prozac) - SSRI b. Buproprion (Wellbutrin) - DNRI c. Venlafaxine (Effexor) - SNRI d. Mirtazapine (Remeron) – alpha 2 antagonist
A
51
Which antidepressant has the lowest risk of weight gain and sexual dysfunction? 1. Fluoxetine (Prozac) 2. Buproprion (Wellbutrin) 3. Venlafaxine (Effexor) 4. Mirtazapine (Remeron)
2
52
Which antidepressant has the highest risk of mortality associated with an overdose? 1. Sertraline (Zoloft) 2. Duloxetine (Cymbalta) 3. Mirtazapine (Remeron) 4. Amitriptyline (Elavil) - TCA
4
53
Which statement is true regarding the efficacy of antidepressants? 1. SSRI antidepressants are recommended first line based on superior efficacy 2. SNRI antidepressants are recommended first line based on superior efficacy 3. Current evidence suggests all antidepressants demonstrate similar efficacy (70%) 4. Remission rates are approximately 70% for all antidepressants
3
54
What is the proposed mechanism of action of risperidone for treating schizophrenia? 1. D2 agonist 2. D2 antagonist 3. D2 partial agonist 4. D2/5HT2A antagonist
4
55
Which antipsychotic has the greatest risk of tardive dyskinesia? 1. Quetiapine (Seroquel) 2. Clozapine (Clozapine) 3. Haloperidol (Haldol) à FGA 4. Risperidone (Risperdal)
3
56
Which antipsychotic has the greatest risk of metabolic side effects such as weight gain, hyperglycemia, and hyperlipidemia? 1. Aripiprazole (Abilify) 2. Haloperidol (Haldol) 3. Olanzapine (Zyprexa) 4. Risperidone (Risperdal)
3
57
Which benzodiazepine has the shortest duration of action? 1. Alprazolam (Xanax) – short(rapid onset) 2. Chlordiazpexoide (Librium)- long (slow onset) 3. Clonazepam (Klonopin) – long (slow onset) 4. Diazepam (Valium) – long (quick onset)
2
58
Which medication would have the fastest onset of efficacy for the treatment of acute anxiety? 1. Buspirone (Buspar)- 5HT1A partial agonist 2. Lorazepam (Ativan) - benzo 3. Setraline (Zoloft)- SSRI 4. Venlafaxine (Effexor) - SNRI
2
59
Mechanism of action for Buspirone?
(5HT1A) Serotonin 1-alpha partial agonist
60
Beginning anti-depressants could cause increased suicidality in which age group?
Children, teens, young adults
61
13. Foods containing tyramine should be avoided when taking MOA’s because they could cause what?
Hypertensive crisis
62
14. Side effects of antagonizing muscarinic receptors?
Dry mouth, constipation, blurred vision
63
Side effects of SSRI’s?
Headache, insomnia, nausea, vomiting, diarrhea
64
Side effects of antagonizing alpha 1 receptors, such as Risperidone?
Orthostatic hypotension
65
Taking Prozac (SSRI) with other serotonin containing drugs could cause what?
1. Serotonin syndrome
66
18. Which antidepressant can be used for tx of general anxiety disorder, panic disorder, and social anxiety disorder?
Sertraline (Zoloft) – bc it’s SSRI
67
Which of the following drugs has a serotonin reuptake inhibitor as its mechanism of action ?
Sertraline (Zoloft)
68
Which drug has a mechanism of action that includes serotonin and norepinephrine reuptake inhibition?
Venlafaxine
69
First to be affected when starting an antidepressant? 1. Sleep/appetite 2. We see increased activity after a couple of weeks 3. Last thing to improve is mood and decreased thoughts of suicide
1
70
Patient presents with first episode of depression. How long would you give this pt antidepressant?
9-12 months – after remission
71
Which tract effects prolactin levels?
1. Tuberoinfundibular tract
72
What do Haloperidol and Chlorpromazine have in common?
Both are D2 antagonists – non selective
73
Which drug causes risk of developing agranulocytosis and requires regular blood tests?
Clozapine
74
Mechanism of action for Aripiprazole?
Partial D2 agonist, 5HT2A antagonist
75
What would you prescribe a pt who just experienced their first schizophrenic episode?
Aripiprazole
76
Which drug is well suited for treating refractory schizophrenia?
Clozapine
77
What is the primary advantage of using a second generation antipsychotic over first generation?
No/low risk of EPS
78
What receptor does Lorazepam (benzo) act on?
No/low risk of EPS
79
What receptor does Lorazepam (benzo) act on?
GABA-A
80
Which of the following has not been shown to be effective with the use of benzo? 1. Acute panic attacks- not panic disorder 2. Short-term anxiety short term tx only 3. Seizures ??? 4. Depression ??? 5. Acute alcohol withdrawal 6. Insomnia 7. Muscle relaxant 8. Acute mania 9. Acute agitation 10. PRN before med procedure
Which of the following has not been shown to be effective with the use of benzo? 1. Acute panic attacks- not panic disorder 2. Short-term anxiety short term tx only 3. Seizures ??? 4. Depression ??? 5. Acute alcohol withdrawal 6. Insomnia 7. Muscle relaxant 8. Acute mania 9. Acute agitation 10. PRN before med procedure
81
Which of following characteristics of drugs make them more prone to abuse?
Shorter onset of action
82
Which antidepressant has the highest risk of mortality associated with an overdose?
Amitriptyline (Elavil) - TCAs
83
Which statement is true regarding the efficacy of antidepressants?
Current evidence suggest all antidepressants demonstrate similar efficacy
84
What is the risk associated with using a MAOI antidepressant with an over-the-counter cold preparation containing pseudoephedrine?
Hypertensive crisis
85
Which antidepressant has the lowest risk of weight gain and sexual dysfunction?
Buproprion (Wellbutrin)
86
Which antidepressant’s mechanism of action includes only serotonin reuptake inhibition?
Fluoxetine (Prozac)
87
Which ONE of the following antiepileptic medications should be discontinued if a rash develops? . Phenobarbital a. Levetiracetam (Keppra) b. Lamotrigine (Lamictal) c. Topiramate (Topamax) 3. Which ONE of the following antiepileptic medications is associated with the development of gingival hyperplasia?
B
88
3. Which ONE of the following antiepileptic medications is associated with the development of gingival hyperplasia? 1. Phenytoin (Dilantin) 2. Iamotrigine (Lamictal) 3. Divalproex (Depakote) 4. Carbamazepine (Tegretol)
1
89
Which ONE of the following antiepileptic medications would be most likely to contribute to a potential drug interaction with oral contraceptive medications resulting in a decreased level of effectiveness of the contraceptive? 1. Lamotrigine (Lamictal) 2. Carbamazepine (Tegretol) 3. Levetiracetam (Keppra) 4. Alprazolam (Xanax)
2
90
A medication that causes dry mouth, dry eyes, and constipation is likely to exhibit which one of the following receptor activities? 1. Dopamine blockade 2. Inhibition of serotonin reuptake 3. Alpha-1 receptor blockade 4. Anticholinergic/antimuscarinic
4
91
The antiepileptic that is most often associated with concerns about cognitive impairment and requires a gradual dosage titration in part for this reason is which one of the following? 1. Topiramate (Topamax) 2. Zonisamide (Zonegran) 3. Divalproex (Depakote) 4. Oxcarbazepine (Trileptal)
1
92
What is the max recommended daily dose for acetaminophen? 1. < 3 grams/day for adults and 2-3 grams/day for elderly 2. < 5 gms/day for adults and < 4 gm/day for elderly 3. < 13 gm/day for adults and < 12-13 gm/day for elderly 4. < 15 gm/day for adults and < 14 gm/day for elderly
1
93
What patient risk factors are important to asses when considering treating pain with NSAIDs?
All
94
AK is a 22 year old scheduled to have an impacted third molar removed next week in the reduced cost dental clinic in which you are working. He reports he is otherwise healthy and denies any prescription or OTC medications. He denies allergies to medications. He is currently reporting a constant aching pain due to the impacted molar. He states the pain then causes him to have daily headaches. He rates this pain as mild to moderate but it is interfering with his ability to concentrate at work and in his everyday tasks. He states he doesn’t currently have any prescription drug insurance because he just started a new job and won’t receive benefits for another 60 days. Considering cost and the patient’s condition, which of the following treatment options would be the best choice for this patient’s pain? 1. Celecoxib 2. Oxycodone 3. Ibuprofen (Naproxen) 4. Hydrocodone/APAP
3
95
AK is a 22 year old scheduled to have an impacted third molar removed next week in the reduced cost dental clinic in which you are working. He reports he is otherwise healthy and denies any prescription or OTC medications. He denies allergies to medications. He is currently reporting a constant aching pain due to the impacted molar. He states the pain then causes him to have daily headaches. He rates this pain as mild to moderate but it is interfering with his ability to concentrate at work and in his everyday tasks. He states he doesn’t currently have any prescription drug insurance because he just started a new job and won’t receive benefits for another 60 days. AK returned and had his impacted third molar extracted. He calls you after using ibuprofen 400 mg and APAP 650 mg q 6 hours for 24 hours and is reporting severe pain post-extraction. What is the best treatment option to treat his severe pain? 1. Add oxycodone 10 mg q 6 hrs for 24-48 hrs to the ibuprofen/APAP regimen 2. Discontinue ibuprofen/APAP regimen and start hydrocodone/APAP 5/325 mg q 6 hrs for 3 days 3. Discontinue ibuprofen/APAP regimen and start tramadol 50 mg q 6 hrs 4. Add a fentanyl patch 25mcg/72 hrs to the ibuprofen/APAP regimen
1
96
TT is a 66-year-old patient with post extraction pain. His primary care physician does not want him to take NSAIDs because the patient is on warfarin. You have prescribed him 2 days of opioid therapy. TT should be educated to monitor for which common adverse effect? 1. Diarrhea 2. Headache 3. Insomnia 4. Constipation
4
97
Each of the following patients is experiencing moderate dental pain from a root canal. Which patient would NOT be a good candidate for a non-steroidal anti-inflammatory agent? 1. A 38 year old patient with a urinary tract infection and history of migraines 2. A 63 year old patient with osteoporosis and gout 3. A 30 year old patient with a fractured tibia and allergic rhinitis 4. A 52 year old patient with a history of a myocardial infarction and chronic kidney disease
4
98
ST, a 24 year old WM was given hydrocodone/acetaminophen after having his 3rd molars removed. Before ST leaves the office you should educate him/his caregiver on which common side effect? 1. Constipation 2. Diarrhea 3. Tremor 4. Sweating
1
99
In the case of an inadvertent opioid overdose occurring in the recovery area after a dental surgery or procedure, which medication should be kept in the emergency kit to reverse opioid effects? 1. Glucagon 2. Naloxone 3. Acetylcysteine 4. Hydrocodone
2
100
GABA-A is coupled to what channels and is the mechanistic target for the therapeutic benefits of benzodiazepines? 1. NMDA 2. Potassium 3. Sodium 4. Chloride 16. Which of the following medications has been
4
101
Which of the following medications has been associated with the development of seizures? 1. Clozapine 2. Carbamazepine 3. Buproprion 4. All of the above
All
102
The seizure medication that is most commonly associated with gingival hyperplasia is which one of the following? 1. Carbamazepine (tegretol) 2. Phenytoin (Dilantin) 3. Divalproex (Depakote) 4. Phenobarbital (luminal)
2
103
What is the maximum recommended over the counter daily dose of acetaminophen? 1. 1.5 g per day 2. 3 g per day 3. 5 g per day 4. 7.5 g per day
2
104
Ions may cross cellular membranes by one of the three mechanisms which includes ion pumps, ligand-gated channels, and which one of the following? 1. Potentiation of GABA 2. Selective serotonin reuptake inhibition 3. Voltage gated channels 4. Glutamate channel blockage
4
105
The seizure medication that patients should be encouraged to maintain adequate hydration with in order to prevent nephrolithiasis is which one of the following? 1. Topiramate (topomax) 2. Tiagabine (gabitril) 3. Carbamazepine (tegretol) 4. Ethosuximide (zarontin)
1
106
The action potential depolarization phase begins with the influx of which one of the following? 1. Potassium 2. Chloride 3. Sodium 4. Magnesium
3
107
At what dose is a patient considered to be opioid tolerant? 1. 5 mg of morphine or equivalent dose for 10 days 2. 40 mg of morphine or equivalent for 3 days 3. 60 mg of morphine or equivalent for 7 days 4. All of the above
3
108
The seizure medication that should not be used in patients with an allergy to sulfa is which one of the following? 1. Zonisamide (zonegran) 2. Lamotrigine (lamictal) 3. Topiramate (Topamax) 4. Oxcarbazepine (trileptal)
1
109
WK is a 62 year old female who is undergoing an extraction. You anticipate she will have moderate to severe pain. Based on systematic review data on the number-needed to treat to obtain on additional patient achieving at least 50 percent maximum pain relief over 4- 6 hours compared with placebo, which option is the best choice to provide for analgesic efficacy? 1. Codeine 60mg with acetaminophen 1000mg 2. Ibuprofen 200mg with acetaminophen 500mg 3. Ibuprofen 400mg 4. Acetaminophen 1000mg
3
110
The seizure medication that is most commonly associated with a rash and requires a conservative gradual dose titration when used with enzyme inhibitors or valproic acid? 1. Levetiracetam (keppra) 2. Zonisamide (zonegran) 3. Lamotrigine (lamictal) 4. Gabapentin (Neurontin)
3
111
Which of the following adjuvant pain medications is an anticonvulsant often used to treat neuropathic pain? 1. Duloxetine 2. Celecoxib 3. Amitriptyline 4. Gabapentin
4
112
What receptor does Lorazepam act on?
gaba a
113
Mechanism of action for Aripiprazole?
Partial D2 agonist, 5HT2A antagonist
114
What would you prescribe a pt who just experienced their first schizophrenic episode?
Apiprazole
115
Which drug is well suited for treating refractory schizophrenia?
Clozapine
116
What is the primary advantage of using a second generation antipsychotic over first generation?
No risk of EPS