Antipsychotics Flashcards
1
Q
Schizophrenia is caused by:
a. Psychological factors
b. Inherent dysfunction of the brain
c. Environmental factors
d. Nutritional deficiencies
A
The correct answer is: b. Inherent dysfunction of the brain.
2
Q
Which of the following symptoms is NOT commonly associated with schizophrenia?
a. Delusions
b. High fever
c. Hallucinations
d. Speech disturbances
A
The correct answer is: b. High fever.
3
Q
What percentage of the population has schizophrenia?
a. 0.5%
b. 1%
c. 2%
d. 5%
A
The correct answer is: b. 1%.
4
Q
Schizophrenia most commonly affects individuals during:
a. Childhood
b. Middle age
c. Late adolescence or early adulthood
d. Old age
A
The correct answer is: c. Late adolescence or early adulthood.
5
Q
The prevalence of schizophrenia in men compared to women is:
a. Higher in men
b. Higher in women
c. Equal in men and women
d. Unknown
A
The correct answer is: c. Equal in men and women.
6
Q
Schizophrenia is characterized as a:
a. Mild disorder
b. Disabling disorder
c. Temporary disorder
d. Reversible disorder
A
The correct answer is: b. Disabling disorder.
7
Q
Schizophrenia has a strong:
a. Environmental component
b. Genetic component
c. Social component
d. Dietary component
A
The correct answer is: b. Genetic component.
8
Q
Schizophrenia is possibly a dysfunction of the:
a. Mesolimbic or mesocortical dopaminergic neuronal pathways
b. Serotonergic pathways
c. Cholinergic pathways
d. Glutamatergic pathways
A
The correct answer is: a. Mesolimbic or mesocortical dopaminergic neuronal pathways.
9
Q
Which of the following is a positive symptom of schizophrenia?
a. Blunted emotions
b. Hallucinations
c. Anhedonia
d. Lack of feeling
A
The correct answer is: b. Hallucinations.
10
Q
Which of the following is a negative symptom of schizophrenia?
a. Disorganized thought
b. Anhedonia
c. Hallucinations
d. Inappropriate emotions
A
The correct answer is: b. Anhedonia.
11
Q
Cognitive symptoms of schizophrenia include:
a. Social withdrawal
b. New learning and memory difficulties
c. Hallucinations
d. Blunted emotions
A
The correct answer is: b. New learning and memory difficulties.
12
Q
Mood symptoms of schizophrenia include all EXCEPT:
a. Loss of motivation
b. Social withdrawal
c. Insight
d. Hallucinations
A
The correct answer is: d. Hallucinations.
13
Q
Which of the following substances can enhance central dopaminergic neurotransmission and cause psychosis?
a. Antidepressants
b. Amphetamines
c. Antipsychotics
d. Beta-blockers
A
The correct answer is: b. Amphetamines.
14
Q
Low doses of which substance can induce a psychotic reaction in schizophrenics in remission?
a. Cocaine
b. Alcohol
c. Nicotine
d. Amphetamine
A
The correct answer is: d. Amphetamine.
15
Q
Stress is considered a major predisposing factor in:
a. Schizophrenia
b. Diabetes
c. Hypertension
d. Asthma
A
The correct answer is: a. Schizophrenia.
16
Q
Repeated administration of stimulants like amphetamines and cocaine can cause psychosis that resembles:
a. Depression
b. Anxiety
c. Positive symptoms of schizophrenia
d. Negative symptoms of schizophrenia
A
The correct answer is: c. Positive symptoms of schizophrenia.
17
Q
Antipsychotic drugs are also known as:
a. Antidepressants
b. Neuroleptics
c. Anxiolytics
d. Sedatives
A
The correct answer is: b. Neuroleptics.
18
Q
Another term used to describe antipsychotic drugs is:
a. Antidepressants
b. Major tranquilizers
c. Stimulants
d. Analgesics
A
The correct answer is: b. Major tranquilizers.
19
Q
The primary use of antipsychotics is to treat:
a. Depression
b. Anxiety
c. Schizophrenia
d. Bipolar disorder
A
The correct answer is: c. Schizophrenia.
20
Q
True or False: Antipsychotics are curative for schizophrenia.
a. True
b. False
A
The correct answer is: b. False.
21
Q
Antipsychotics do NOT eliminate:
a. Positive symptoms of schizophrenia
b. Fundamental and chronic thoughts
c. Hallucinations
d. Delusions
A
The correct answer is: b. Fundamental and chronic thoughts.
22
Q
Antipsychotics primarily work by:
a. Increasing dopaminergic neurotransmission
b. Increasing serotonergic neurotransmission
c. Decreasing dopaminergic and/or serotonergic neurotransmission
d. Decreasing GABAergic neurotransmission
A
The correct answer is: c. Decreasing dopaminergic and/or serotonergic neurotransmission.
23
Q
The main effect of antipsychotics on schizophrenic symptoms is to:
a. Decrease the intensity of hallucinations and delusions
b. Increase cognitive function
c. Eliminate all symptoms
d. Cure the disease
A
The correct answer is: a. Decrease the intensity of hallucinations and delusions.
24
Q
Antipsychotics represent several diverse, heterocyclic structures with:
a. Uniform potencies
b. Marked different potencies
c. Identical chemical structures
d. No variations in effects
A
The correct answer is: b. Marked different potencies.
25
Antipsychotic drugs are divided into:
a. Low and high potency agents
b. Oral and injectable agents
c. First- and second-generation agents
d. Short- and long-acting agents
The correct answer is: c. First- and second-generation agents.
26
First-generation antipsychotic drugs are further classified as:
a. Short-acting and long-acting
b. Oral and injectable
c. Low potency and high potency
d. Mild and strong
The correct answer is: c. Low potency and high potency.
27
The classification of first-generation antipsychotic drugs is based on their:
a. Clinical effectiveness
b. Affinity for the dopamine D2 receptor
c. Duration of action
d. Metabolic effects
The correct answer is: b. Affinity for the dopamine D2 receptor.
28
The classification of antipsychotic drugs does NOT indicate their:
a. Clinical effectiveness
b. Affinity for receptors
c. Adverse effect profile
d. Mechanism of action
The correct answer is: a. Clinical effectiveness.
29
Which of the following is a high potency first-generation antipsychotic?
a. Chlorpromazine (Thorazine)
b. Haloperidol (Haldol)
c. Fluphenazine (Prolixin)
d. Pimozide (Orap)
The correct answer is: b. Haloperidol (Haldol).
30
Which of the following is a high potency first-generation antipsychotic?
a. Thioridazine (Mellaril)
b. Haloperidol (Haldol)
c. Chlorpromazine (Thorazine)
d. Prochlorperazine (Compazine)
The correct answer is: b. Haloperidol (Haldol).
31
Identify the first-generation antipsychotic classified as low potency:
a. Haloperidol (Haldol)
b. Thioridazine (Mellaril)
c. Fluphenazine (Prolixin)
d. Thiothixene (Navane)
The correct answer is: b. Thioridazine (Mellaril).
32
Identify the first-generation antipsychotic classified as high potency:
a. Prochlorperazine (Compazine)
b. Fluphenazine (Prolixin)
c. Thioridazine (Mellaril)
d. Chlorpromazine (Thorazine)
The correct answer is: b. Fluphenazine (Prolixin).
33
The mechanism of action of first-generation antipsychotics is:
a. Competitive blocking of D2 dopamine receptors
b. Inhibition of serotonin reuptake
c. Enhancement of GABAergic transmission
d. Blocking of calcium channels
The correct answer is: a. Competitive blocking of D2 dopamine receptors.
34
First-generation antipsychotics are more likely to be associated with:
a. Weight gain
b. Hyperglycemia
c. Movement disorders
d. Gastrointestinal disturbances
The correct answer is: c. Movement disorders.
35
First-generation antipsychotics that bind tightly to dopaminergic neuroreceptors are more likely to cause:
a. Movement disorders
b. Sedation
c. Hypertension
d. Hyperlipidemia
The correct answer is: a. Movement disorders.
36
Which of the following drugs is more likely to be associated with movement disorders due to tight binding to dopaminergic neuroreceptors?
a. Haloperidol
b. Chlorpromazine
c. Thioridazine
d. Prochlorperazine
The correct answer is: a. Haloperidol.
37
Which of the following drugs binds weakly to dopaminergic neuroreceptors and is less likely to cause movement disorders?
a. Haloperidol
b. Chlorpromazine
c. Fluphenazine
d. Pimozide
The correct answer is: b. Chlorpromazine.
38
True or False: No one first-generation antipsychotic drug is clinically more effective than another.
a. True
b. False
The correct answer is: a. True.
39
Second-generation antipsychotics are also known as:
a. Neuroleptics
b. Atypical antipsychotics
c. Major tranquilizers
d. Mood stabilizers
The correct answer is: b. Atypical antipsychotics.
40
Compared to first-generation antipsychotics, second-generation antipsychotics have:
a. Higher incidence of movement disorders
b. Fewer extrapyramidal symptoms (EPS)
c. Increased sedation
d. More severe gastrointestinal side effects
The correct answer is: b. Fewer extrapyramidal symptoms (EPS).
41
Second-generation antipsychotics have a higher risk of:
a. Extrapyramidal symptoms
b. Metabolic side effects
c. Neurological symptoms
d. Cardiovascular side effects
The correct answer is: b. Metabolic side effects.
42
Metabolic side effects associated with second-generation antipsychotics include:
a. Diabetes, hypercholesterolemia, and weight gain
b. Hypertension, hyperkalemia, and weight loss
c. Hyperthyroidism, anemia, and dehydration
d. Asthma, COPD, and bronchitis
The correct answer is: a. Diabetes, hypercholesterolemia, and weight gain.
43
Which generation of antipsychotic agents is commonly used to minimize the risk of debilitating movement disorders?
a. First-generation agents
b. Third-generation agents
c. Second-generation agents
d. Non-specific agents
The correct answer is: c. Second-generation agents.
44
The selection of antipsychotic drugs often depends on:
a. Cost of the medication
b. Availability of the drug
c. Individual patient response and comorbid conditions
d. Color of the pill
The correct answer is: c. Individual patient response and comorbid conditions.
45
True or False: Second-generation drugs are considered interchangeable for all patients.
a. False
b. True
The correct answer is: a. False.
46
Why should second-generation antipsychotic drugs not be considered interchangeable?
a. Due to differences in cost
b. Because they all have the same side effects
c. Patients may respond differently to each drug in this class
d. Due to availability issues
The correct answer is: c. Patients may respond differently to each drug in this class.
47
Which factor is NOT commonly considered when selecting an antipsychotic drug?
a. The brand name of the drug
b. Individual patient response
c. Comorbid conditions
d. The generation of the drug
The correct answer is: a. The brand name of the drug.
48
The primary mechanism of action for antipsychotics involves:
a. Dopamine receptor–blocking activity in the brain
b. Inhibition of serotonin reuptake
c. Enhancement of GABAergic transmission
d. Blocking of calcium channels
The correct answer is: a. Dopamine receptor–blocking activity in the brain.
49
How many types of dopamine receptors are there in the brain?
a. Three
b. Four
c. Five
d. Six
The correct answer is: c. Five.
50
Which dopamine receptors are excitatory?
a. D2 and D3
b. D3 and D4
c. D1 and D5
d. D2 and D4
The correct answer is: c. D1 and D5.
51
Which dopamine receptors are inhibitory?
a. D1 and D5
b. D2, D3, and D4
c. D1 and D3
d. D4 and D5
The correct answer is: b. D2, D3, and D4.
52
The neuroleptic drugs bind to dopamine receptors:
a. To varying degrees
b. Uniformly
c. Equally
d. Exclusively to D2
The correct answer is: a. To varying degrees.
53
All first-generation and most second-generation antipsychotics block:
a. Serotonin receptors
b. Dopamine receptors
c. GABA receptors
d. Glutamate receptors
The correct answer is: b. Dopamine receptors.
54
The ability to block which receptor is linked to the clinical efficacy of antipsychotics?
a. D1 receptor
b. D3 receptor
c. D4 receptor
d. D2 receptor
The correct answer is: d. D2 receptor.
55
Which drug is 100 times more potent toward the D2 receptor than chlorpromazine?
a. Clozapine
b. Risperidone
c. Haloperidol
d. Olanzapine
The correct answer is: c. Haloperidol.
56
Which atypical antipsychotic has a higher affinity for the D4 receptor and lower affinity to D2?
a. Haloperidol
b. Clozapine
c. Aripiprazole
d. Quetiapine
The correct answer is: b. Clozapine.
57
The actions of antipsychotic drugs are antagonized by:
a. Levodopa, amphetamines, bromocriptine
b. Serotonin reuptake inhibitors
c. Benzodiazepines
d. Beta-blockers
The correct answer is: a. Levodopa, amphetamines, bromocriptine.
58
Second-generation antipsychotics exert part of their unique effect by inhibiting:
a. Dopamine D2 receptors
b. GABA receptors
c. Serotonin receptors (5-HT)
d. Glutamate receptors
The correct answer is: c. Serotonin receptors (5-HT).
59
Which serotonin receptor is particularly inhibited by most second-generation antipsychotics?
a. 5-HT1A
b. 5-HT1B
c. 5-HT2B
d. 5-HT2A
The correct answer is: d. 5-HT2A.
60
Clozapine has a high affinity for which receptors?
a. D2, D3, 5-HT1A, muscarinic
b. D1, D4, 5-HT2, muscarinic, α-adrenergic
c. D2, D4, 5-HT3, cholinergic
d. D3, D5, 5-HT4, nicotinic
The correct answer is: b. D1, D4, 5-HT2, muscarinic, α-adrenergic.
61
Clozapine is also known to be a:
a. Strong dopamine D2-receptor agonist
b. Weak dopamine D2-receptor antagonist
c. Strong dopamine D1-receptor antagonist
d. Weak dopamine D1-receptor agonist
The correct answer is: b. Weak dopamine D2-receptor antagonist.
62
Risperidone primarily blocks which receptors?
a. 5-HT2A > D2 receptor
b. D2 > 5-HT2A receptor
c. D1 > 5-HT2A receptor
d. 5-HT1A > D2 receptor
The correct answer is: a. 5-HT2A > D2 receptor.
63
Aripiprazole acts as a:
a. Partial agonist at D2 and 5-HT1A receptors and a blocker of 5-HT2A receptors
b. Full agonist at D2 and 5-HT1A receptors
c. Partial antagonist at D2 and 5-HT2A receptors
d. Full antagonist at D2 and 5-HT1A receptors
The correct answer is: a. Partial agonist at D2 and 5-HT1A receptors and a blocker of 5-HT2A receptors.
64
Quetiapine blocks which receptors more effectively?
a. D2 receptors > 5-HT2A receptors
b. 5-HT2A receptors > D2 receptors
c. D1 receptors > 5-HT2A receptors
d. 5-HT1A receptors > D2 receptors
The correct answer is: a. D2 receptors > 5-HT2A receptors.
65
Antipsychotic actions are due to:
a. Blockade at histamine receptors.
b. Blockade at dopamine and/or serotonin receptors.
c. Blockade at acetylcholine receptors.
d. Blockade at GABA receptors.
Correct answer: b. Blockade at dopamine and/or serotonin receptors.
66
Antipsychotics reduce:
a. Negative symptoms only.
b. Positive symptoms only.
c. Both hallucinations and delusions (positive symptoms).
d. Cognitive symptoms only.
Correct answer: c. Both hallucinations and delusions (positive symptoms).
67
To a lesser extent, antipsychotics reduce:
a. Positive symptoms.
b. Negative symptoms.
c. Physical symptoms.
d. Autonomic symptoms.
Correct answer: b. Negative symptoms.
68
Negative symptoms reduced by antipsychotics include:
a. Blunted affect.
b. Euphoria.
c. Hyperactivity.
d. Insomnia.
Correct answer: a. Blunted affect.
69
The time for antipsychotic effects to take effect is usually:
a. Immediate.
b. Several hours.
c. Several days to weeks.
d. Several months.
Correct answer: c. Several days to weeks.
Correct answer: c. Several days to weeks.
70
The therapeutic effects of antipsychotics are related to:
a. Primary changes in the frontal cortex.
b. Secondary changes in the corticostriatal pathway.
c. Primary changes in the cerebellum.
d. Secondary changes in the hypothalamus.
Correct answer: b. Secondary changes in the corticostriatal pathway.
71
Second-generation antipsychotics such as clozapine:
a. Worsen negative symptoms.
b. Ameliorate negative symptoms to some extent.
c. Do not affect negative symptoms.
d. Only treat positive symptoms.
Correct answer: b. Ameliorate negative symptoms to some extent.
72
Antipsychotics have what additional effect?
a. Increase physical movement.
b. Have a calming effect and reduce spontaneous physical movement.
c. Increase intellectual functioning.
d. Have no effect on physical movement.
Correct answer: b. Have a calming effect and reduce spontaneous physical movement.
73
In contrast to CNS depressants, antipsychotics:
a. Depress the intellectual functioning of the patient.
b. Do not depress the intellectual functioning of the patient as much.
c. Cause severe motor coordination difficulties.
d. Have no effect on intellectual functioning.
Correct answer: b. Do not depress the intellectual functioning of the patient as much.
74
Extrapyramidal effects include:
a. Dystonias.
b. Euphoria.
c. Hyperactivity.
d. Somnolence.
Correct answer: a. Dystonias.
75
Sustained contraction of muscles leading to twisting and distorted postures is termed:
a. Akathisia.
b. Tardive dyskinesia.
c. Dystonias.
d. Parkinsonism.
Correct answer: c. Dystonias.
76
Parkinson-like symptoms in antipsychotic use include:
a. Tremors.
b. Blunted affect.
c. Involuntary movements of the tongue.
d. Twisting of muscles.
Correct answer: a. Motor restlessness.
Correct answer: a. Tremors.
77
Blocking of dopamine receptors in the nigrostriatal pathway probably causes:
a. Euphoria.
b. Unwanted movement symptoms.
c. Cognitive improvement.
d. Calming effect.
Correct answer: b. Unwanted movement symptoms.
78
Second-generation antipsychotics exhibit:
a. Higher incidence of extrapyramidal symptoms.
b. Lower incidence of extrapyramidal symptoms.
c. No effect on extrapyramidal symptoms.
d. Similar incidence of extrapyramidal symptoms as first-generation antipsychotics.
Correct answer: b. Lower incidence of extrapyramidal symptoms.
79
Antiemetic effects of antipsychotics exclude:
a. Aripiprazole and thioridazine.
b. Clozapine and haloperidol.
c. Risperidone and olanzapine.
d. Quetiapine and ziprasidone.
Correct answer: a. Aripiprazole and thioridazine.
80
Antiemetic effects are due to blocking:
a. D1 dopaminergic receptors in the chemoreceptor trigger zone of the medulla.
b. D2 dopaminergic receptors in the chemoreceptor trigger zone of the medulla.
c. Serotonin receptors in the chemoreceptor trigger zone of the medulla.
d. Histamine receptors in the chemoreceptor trigger zone of the medulla.
b. D2 dopaminergic receptors in the chemoreceptor trigger zone of the medulla.
81
Anticholinergic effects include:
a. Enhanced salivation.
b. Blurred vision and dry mouth.
c. Increased sweating.
d. Muscle twitching.
Correct answer: b. Blurred vision and dry mouth.
82
The exception to the anticholinergic effect of dry mouth is:
a. Haloperidol.
b. Clozapine.
c. Risperidone.
d. Olanzapine.
Correct answer: b. Clozapine.
83
Inhibition of gastrointestinal and urinary tract smooth muscle by antipsychotics leads to:
a. Diarrhea.
b. Constipation and urinary retention.
c. Increased urination.
d. Weight loss.
Correct answer: b. Constipation and urinary retention.
84
Drugs exhibiting anticholinergic effects include:
a. Haloperidol, risperidone, and ziprasidone.
b. Thioridazine, chlorpromazine, clozapine, and olanzapine.
c. Quetiapine, aripiprazole, and ziprasidone.
d. Haloperidol, risperidone, and clozapine.
Correct answer: b. Thioridazine, chlorpromazine, clozapine, and olanzapine.
85
Orthostatic hypotension and light-headedness are due to the blockade of:
a. Beta receptors.
b. Alpha receptors.
c. Dopamine receptors.
d. Serotonin receptors.
Correct answer: b. Alpha receptors.
86
Alteration in temperature regulating mechanism by antipsychotics produces:
a. Hyperthermia.
b. Hypothermia.
c. Poikilothermia.
d. Normothermia.
Correct answer: c. Poikilothermia.
87
Poikilothermia is a condition in which:
a. Body temperature remains constant regardless of the environment.
b. Body temperature varies with the environment.
c. Body temperature is always higher than normal.
d. Body temperature is always lower than normal.
Correct answer: b. Body temperature varies with the environment.
88
Increase in prolactin release due to antipsychotics is caused by the blockade of:
a. D1 receptors.
b. D2 receptors in the pituitary gland.
c. Alpha receptors.
d. Beta receptors.
Correct answer: b. D2 receptors in the pituitary gland.
89
Sedation caused by antipsychotics is due to the antagonism of:
a. Dopamine receptors.
b. Serotonin receptors.
c. Histamine receptors.
d. Alpha receptors.
Correct answer: c. Histamine receptors.
90
Antipsychotics such as chlorpromazine, olanzapine, and clozapine are known to cause:
a. Euphoria.
b. Sedation.
c. Hyperactivity.
d. Anxiety.
Correct answer: b. Sedation.
91
Sexual dysfunction is a common side effect of:
a. Antihistamines.
b. Antipsychotics.
c. Antibiotics.
d. Antidepressants.
Correct answer: b. Antipsychotics.
92
Not all people who take antipsychotics:
a. Respond.
b. Comply.
c. Relapse.
d. Recover.
Correct answer: a. Respond.
93
Complete normalization of behavior when using antipsychotics is:
a. Often achieved.
b. Seldom achieved.
c. Easily achieved.
d. Never achieved.
Correct answer: b. Seldom achieved.
94
First-generation antipsychotics more alleviate:
a. Negative symptoms.
b. Cognitive symptoms.
c. Positive symptoms.
d. Motor symptoms.
Correct answer: c. Positive symptoms.
95
Second-generation antipsychotics more alleviate:
a. Cognitive symptoms.
b. Motor symptoms.
c. Positive symptoms.
d. Negative symptoms (but not consistent).
Correct answer: d. Negative symptoms (but not consistent).
96
Second-generation antipsychotics are used for patients:
a. Resistant to first-generation.
b. Responding well to first-generation.
c. With mild symptoms.
d. Without any symptoms.
Correct answer: a. Resistant to first-generation.
97
Clozapine is reserved for treatment of individuals who are:
a. Responded to other neuroleptics.
b. Not responded to other neuroleptics.
c. Responded partially to other neuroleptics.
d. Completely normalized by other neuroleptics.
Correct answer: b. Not responded to other neuroleptics.
98
Clozapine is associated with:
a. Low side effects.
b. High efficacy.
c. Blood dyscrasia and other severe side effects.
d. Mild sedation.
Correct answer: c. Blood dyscrasia and other severe side effects.
99
The most commonly used drug for severe drug-induced nausea is:
a. Promethazine.
b. Prochlorperazine.
c. Haloperidol.
d. Risperidone.
Correct answer: b. Prochlorperazine.
100
Nausea arising from motion should be treated with:
a. Powerful antipsychotic drugs.
b. Sedatives, antihistamines, and anticholinergics.
c. Neuroleptics.
d. Antidepressants.
Correct answer: b. Sedatives, antihistamines, and anticholinergics.
101
Antipsychotics are used as:
a. Sedatives.
b. Tranquilizers.
c. Analgesics.
d. Antidepressants.
Correct answer: b. Tranquilizers.
102
Antipsychotics are used in combination with narcotic analgesics for:
a. Mild pain.
b. Chronic pain with severe anxiety.
c. Acute pain.
d. No pain.
Correct answer: b. Chronic pain with severe anxiety.
103
Chlorpromazine is used to treat:
a. Nausea.
b. Vomiting.
c. Intractable hiccups.
d. Headache.
Correct answer: c. Intractable hiccups.
104
Promethazine is not a good antipsychotic drug but is used in the treatment of:
a. Anxiety.
b. Insomnia.
c. Pruritis due to its antihistamine effect.
d. Depression.
Correct answer: c. Pruritis due to its antihistamine effect.
105
Pimozide and haloperidol are used for:
a. Nausea.
b. Tourette disorder (motor and phonic tics).
c. Insomnia.
d. Chronic pain.
Correct answer: b. Tourette disorder (motor and phonic tics).
106
Risperidone and aripiprazole are used for:
a. Depression.
b. Anxiety.
c. Disruptive behavior and irritability secondary to autism.
d. Insomnia.
Correct answer: c. Disruptive behavior and irritability secondary to autism.
107
The absorption of antipsychotics is:
a. Consistent.
b. Variable.
c. Rapid.
d. Minimal.
Correct answer: b. Variable.
108
Antipsychotics readily pass into the:
a. Liver.
b. Kidneys.
c. Brain.
d. Lungs.
Correct answer: c. Brain.
109
Antipsychotics have a:
a. Small volume of distribution.
b. Medium volume of distribution.
c. Large volume of distribution.
d. Fixed volume of distribution.
Correct answer: c. Large volume of distribution.
110
Long-acting injectable (LAI) formulations of antipsychotics have a duration of up to:
a. 1 week.
b. 2 to 4 weeks.
c. 6 weeks.
d. 8 weeks.
Correct answer: b. 2 to 4 weeks.
111
LAI formulations of antipsychotics are often used to treat:
a. Inpatients who are compliant with medications.
b. Outpatients who are noncompliant with oral medications.
c. Patients with acute symptoms.
d. Patients with chronic pain.
Correct answer: b. Outpatients who are noncompliant with oral medications.
112
LAI formulations of antipsychotics are associated with:
a. Higher extrapyramidal symptoms.
b. Lower extrapyramidal symptoms.
c. Increased physical dependence.
d. Severe sedation.
Correct answer: b. Lower extrapyramidal symptoms.
113
LAI formulations of antipsychotics exhibit:
a. High physical dependence.
b. Little physical dependence.
c. No dependence.
d. Severe dependence.
Correct answer: b. Little physical dependence.
114
Which adverse effect is experienced by all patients taking antipsychotics?
a. Urinary retention
b. Sedation
c. Adverse effects occur in all patients
d. Seizure
The correct answer is: c. Adverse effects occur in all patients.
115
What percentage of patients experience significant adverse effects from antipsychotics?
a. 50 percent
b. 60 percent
c. 70 percent
d. 80 percent
The correct answer is: d. 80 percent.
116
Despite the array of side effects, what is the therapeutic index of antipsychotics?
a. Low
b. Medium
c. High
d. Variable
The correct answer is: c. High.
117
Which of the following is a common adverse effect of antipsychotics?
a. Urinary retention
b. Increased appetite
c. Hypertension
d. Hyperactivity
The correct answer is: a. Urinary retention.
118
Which adverse effect is characterized by involuntary muscle movements?
a. Extrapyramidal symptoms
b. Postural hypotension
c. Sexual dysfunction
d. Dry mouth
The correct answer is: a. Extrapyramidal symptoms.
119
What is a potential cardiovascular adverse effect of antipsychotics?
a. Arrhythmias and sudden cardiac death
b. Hypertension
c. Bradycardia
d. Hypotension
The correct answer is: a. Arrhythmias and sudden cardiac death.
120
What adverse effect involves a decrease in blood pressure upon standing?
a. Seizure
b. Postural hypotension
c. Sedation
d. Weight gain
The correct answer is: b. Postural hypotension.
121
Which adverse effect is associated with antipsychotics leading to dry mucous membranes?
a. Dry mouth
b. Hyperhidrosis
c. Constipation
d. Nausea
The correct answer is: a. Dry mouth.
122
What balances the inhibitory effects of dopaminergic neurons in the striatum?
a. Serotonergic neurons
b. GABAergic neurons
c. Cholinergic neurons
d. Glutamatergic neurons
The correct answer is: c. Cholinergic neurons.
123
Blocking which receptors causes a relative excess of cholinergic influence, leading to extrapyramidal motor effects?
a. Serotonin receptors
b. Dopamine receptors
c. GABA receptors
d. NMDA receptors
The correct answer is: b. Dopamine receptors.
124
What results from the blocking of dopamine receptors in the striatum?
a. Decreased cholinergic influence
b. Increased dopaminergic activity
c. Relative excess of cholinergic influence
d. Increased serotonin levels
The correct answer is: c. Relative excess of cholinergic influence.
125
The risk of movement disorders from antipsychotics is dependent on what factors?
a. Age and gender
b. Time and dose
c. Diet and exercise
d. Genetics and environment
The correct answer is: b. Time and dose.
126
What is the time frame for the appearance of dystonias?
a. Weeks to months
b. Days to weeks
c. Few hours to days
d. Months to years
The correct answer is: c. Few hours to days.
127
Akathisias typically appear within what time frame?
a. Days to weeks
b. Weeks to months
c. Few hours to days
d. Months to years
The correct answer is: a. Days to weeks.
128
Parkinson-like symptoms of bradykinesia, rigidity, and tremor can develop over what period?
a. Weeks to months
b. Few hours to days
c. Days to weeks
d. Months to years
The correct answer is: a. Weeks to months.
129
Tardive dyskinesia may develop over what period?
a. Few hours to days
b. Days to weeks
c. Weeks to months
d. Months to years
The correct answer is: d. Months to years.
130
What is the effect of blocking cholinergic activity on extrapyramidal effects?
a. Extrapyramidal effects are enhanced
b. Extrapyramidal effects remain the same
c. Extrapyramidal effects are minimized
d. Extrapyramidal effects are unrelated
The correct answer is: c. Extrapyramidal effects are minimized.
131
Which drug can minimize extrapyramidal effects by blocking cholinergic activity?
a. Benztropine
b. Haloperidol
c. Risperidone
d. Clozapine
The correct answer is: a. Benztropine.
132
Which atypical antipsychotics have a lower potential for causing extrapyramidal symptoms?
a. Clozapine and risperidone
b. Haloperidol and chlorpromazine
c. Fluphenazine and thioridazine
d. Aripiprazole and quetiapine
The correct answer is: a. Clozapine and risperidone.
133
What is the effect of 5-HT2A antagonizing action in atypical antipsychotics?
a. Increases extrapyramidal symptoms
b. Lowers potential for causing extrapyramidal symptoms and tardive dyskinesia
c. Increases the risk of weight gain
d. Lowers therapeutic index
The correct answer is: b. Lowers potential for causing extrapyramidal symptoms and tardive dyskinesia.
134
Which atypical antipsychotic is used as the first-line treatment?
a. Clozapine
b. Risperidone
c. Olanzapine
d. Quetiapine
The correct answer is: b. Risperidone.
135
For which patients is clozapine reserved?
a. First-line treatment patients
b. Patients with mild symptoms
c. Patients refractory to traditional therapy
d. Pediatric patients
The correct answer is: c. Patients refractory to traditional therapy.
136
What severe side effect does clozapine induce that requires monitoring?
a. Bone marrow suppression leading to severe agranulocytosis
b. Weight gain
c. Sedation
d. Hyperglycemia
The correct answer is: a. Bone marrow suppression leading to severe agranulocytosis.
137
Tardive dyskinesia typically occurs after what duration of neuroleptic drug treatment?
a. Short-term treatment
b. Long-term treatment
c. Intermittent treatment
d. Initial dose
The correct answer is: b. Long-term treatment.
138
What are common symptoms of tardive dyskinesia?
a. Involuntary movements, including bilateral and facial jaw movements and "fly-catching" motions of the tongue
b. Weight gain
c. Increased appetite
d. Nausea
The correct answer is: a. Involuntary movements, including bilateral and facial jaw movements and "fly-catching" motions of the tongue.
139
What happens to tardive dyskinesia symptoms after a prolonged holiday from the drug?
a. Symptoms worsen
b. Symptoms diminish in months (reversible toxicity)
c. Symptoms remain unchanged
d. Symptoms immediately disappear
The correct answer is: b. Symptoms diminish in months (reversible toxicity).
140
In some cases, what is the nature of tardive dyskinesia after discontinuing the drug?
a. Irreversible and may not be diminished
b. Always reversible
c. Symptoms transfer to other body parts
d. Symptoms transform into different side effect
The correct answer is: a. Irreversible and may not be diminished.
141
Tardive dyskinesia is a compensatory response to what type of treatment?
a. Short-term neuroleptic treatment
b. Intermittent treatment
c. Long-term neuroleptic treatment
d. Irregular dosing
The correct answer is: c. Long-term neuroleptic treatment.
142
What happens to dopamine receptors in tardive dyskinesia?
a. Increased number of dopamine receptors
b. Decreased sensitivity of receptors
c. Dopamine receptors remain the same
d. Dopamine receptors are blocked permanently
The correct answer is: a. Increased number of dopamine receptors.
143
How do neurons respond to increased dopamine receptors in tardive dyskinesia?
a. Neurons become supersensitive
b. Neurons decrease in number
c. Neurons become less sensitive
d. Neurons stop functioning
The correct answer is: a. Neurons become supersensitive.
144
What is the overall result of the increased sensitivity and overpower of cholinergic input in tardive dyskinesia?
a. Excess movement
b. Muscle paralysis
c. Decreased movement
d. Unchanged movement
The correct answer is: a. Excess movement.
145
What is the severity of antipsychotic malignant syndrome?
a. Mild
b. Moderate
c. Potentially fatal
d. Self-limiting
The correct answer is: c. Potentially fatal.
146
Which symptom is characterized by muscle rigidity and fever in antipsychotic malignant syndrome?
a. Muscle rigidity and fever
b. Weight loss
c. Hyperactivity
d. Increased appetite
The correct answer is: a. Muscle rigidity and fever.
147
What mental status changes occur in antipsychotic malignant syndrome?
a. Increased alertness
b. Altered mental status and stupor
c. Euphoria
d. Depression
The correct answer is: b. Altered mental status and stupor.
148
What cardiovascular symptom is associated with antipsychotic malignant syndrome?
a. Unstable blood pressure
b. Bradycardia
c. Stable blood pressure
d. Hypertension only
The correct answer is: a. Unstable blood pressure.
149
What causes myoglobinemia in antipsychotic malignant syndrome?
a. Increased glucose levels
b. Muscle damage leading to myoglobin release into the blood
c. Increased fat metabolism
d. Decreased protein synthesis
The correct answer is: b. Muscle damage leading to myoglobin release into the blood.
150
What is the immediate treatment step for antipsychotic malignant syndrome?
a. Increase drug dosage
b. Discontinue the drug
c. Decrease drug dosage
d. Maintain current dosage
The correct answer is: b. Discontinue the drug.
151
Which medications may be helpful in treating antipsychotic malignant syndrome?
a. Dantrolene or bromocriptine
b. Haloperidol or risperidone
c. Clozapine or olanzapine
d. Diazepam or lorazepam
The correct answer is: a. Dantrolene or bromocriptine.
152
What causes drowsiness in patients taking antipsychotics?
a. Anticholinergic effect
b. Antihistamine effect
c. Antidopaminergic effect
d. Antimuscarinic effect
The correct answer is: b. Antihistamine effect.
153
Which cognitive effect can be caused by antipsychotics?
a. Increased focus
b. Confusion
c. Enhanced memory
d. Improved concentration
The correct answer is: b. Confusion.
154
Which antimuscarinic activity effects are associated with antipsychotics?
a. Increased salivation
b. Dry mouth, urinary retention, constipation, and loss of accommodation
c. Diarrhea
d. Increased urination
The correct answer is: b. Dry mouth, urinary retention, constipation, and loss of accommodation.
155
What is the cardiovascular effect of alpha-adrenergic blockade caused by antipsychotics?
a. Increased blood pressure
b. Lowered blood pressure and orthostatic hypotension
c. Bradycardia
d. Tachycardia
The correct answer is: b. Lowered blood pressure and orthostatic hypotension.
156
Which reproductive effects can be caused by antipsychotics affecting the hypothalamus?
a. Increased fertility
b. Amenorrhea, galactorrhea, gynecomastia, infertility, and impotence
c. Enhanced libido
d. Decreased breast size
The correct answer is: b. Amenorrhea, galactorrhea, gynecomastia, infertility, and impotence.
157
How does weight gain from antipsychotics affect patient compliance?
a. Improves compliance
b. Results in noncompliance
c. Has no effect on compliance
d. Decreases compliance temporarily
The answer is: b. Results in noncompliance.
158
What metabolic changes can antipsychotics induce?
a. Decrease in blood glucose
b. Decrease in triglycerides
c. Increase in blood glucose (DM) and triglycerides
d. Increase in protein synthesis
The correct answer is: c. Increase in blood glucose (DM) and triglycerides.
159
How can antipsychotics affect patients experiencing withdrawal from alcohol or other drugs?
a. May aggravate acute agitation
b. Decrease withdrawal symptoms
c. Have no effect on withdrawal symptoms
d. Enhance sedative effects
The correct answer is: a. May aggravate acute agitation.
160
What is a general precaution for all antipsychotics regarding seizure threshold?
a. Increase seizure threshold
b. Lower the seizure threshold
c. No effect on seizure threshold
d. Prevent seizures
The correct answer is: b. Lower the seizure threshold.
161
What should be done when using antipsychotics in patients with seizure disorders?
a. No special precautions needed
b. Use cautiously
c. Increase the dosage
d. Discontinue the drug
The correct answer is: b. Use cautiously.
162
Which antipsychotic drug is specifically associated with agranulocytosis?
a. Risperidone
b. Haloperidol
c. Clozapine
d. Olanzapine
The correct answer is: c. Clozapine.
163
How many psychotic episodes indicate the need for maintenance therapy?
a. One
b. Two or more
c. Three or more
d. Continuous episodes
The correct answer is: b. Two or more.
164
What is the recommended duration for maintenance therapy after multiple psychotic episodes?
a. 1 year
b. 3 years
c. At least 5 years
d. Lifetime
The correct answer is: c. At least 5 years.
165
How do higher doses of antipsychotics affect relapse rates?
a. Increase relapse rates
b. Lower relapse rates
c. No effect on relapse rates
d. Varying effect on relapse rates
The correct answer is: b. Lower relapse rates.
166
Which generation of antipsychotics is associated with lower relapse rates?
a. First generation
b. Second generation
c. Both generations equally
d. Neither generation
The correct answer is: b. Second generation.
167
Which drug shows fewer relapses in patients with schizophrenia?
a. Risperidone
b. Haloperidol
c. Clozapine
d. Olanzapine
The correct answer is: a. Risperidone.
