Exam 1 practice Flash Flashcards by Scott Gunderson

Which of the following patients should not use l-dopa/carbidopa?

a. Psychotic patient
b. Closed-angle glaucoma patient
c. Patient treated with phenelzine
d. Malignant melanoma patient
e. All of the above

All of the above

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Which of the following is true regarding Parkinson’s disease?

a. Selegiline improves symptoms by inhibition of MAO-B
b. Haloperidol treatment will improve symptoms
c. Donezepil treatment will improve symptoms
d. L-dopa induced nausea and vomiting is treated with bromocriptine

Selegiline improves symptoms by inhibition of MAO-B

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Which of the following will increase the toxicity of lithium?

a. Loss of sodium
b. Diazepam
c. Fluoxetine
d. Risperidone

Loss of sodium

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Which drug is best for a woman that complains of antipsychotics induced lactation.

a. Quetiapine
b. Chlorpromazine
c. Haloperidol
d. Risperidone
e. Olanzapine

Quetiapine

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Which drug is associated with the development of hyperglycemia and Type 2 Diabetes?

a. Olanzapine
b. Risperidone
c. Haloperidol
d. Aripiprazole
e. Valproic acid

Olanzapine

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An alcoholic with liver damage is discharged from the hospital following alcohol withdrawal. Which antidepressant should be avoided in this patient?

a. Duloxetine
b. Buspirone
c. Citalopram
d. Zolpidem
e. Paroxetine

Duloxetine

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Which drug is least likely to produce weight gain?

a. Bupropion
b. Lithium
c. Olanzapine
d. Amitriptyline
e. Duloxetine

Bupropion

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How does duloxetine and tricyclic antidepressants treat chronic pain?

a. Blocking NE re-uptake
b. Blocking Serotonin re-uptake
c. Increasing dopamine release
d. Blocking GABA receptors
e. Stimulating NMDA receptors

Blocking NE re-uptake

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What is the site of action for alcohol, barbiturates and benzodiazepines?

a. GABA-A receptors
b. GABA-B receptors
c. NMDA receptors
d. D2 receptors
e. 5HT-A receptor

GABA-A receptors

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What is true regarding NMDA receptors

a. Overstimulation may cause neurotoxicity
b. Chlorine channels cause hyperpolarization
c. Receptors are Gs receptors
d. Inhibit spinal cord pain transmission
e. Stimulation blocks memory formation

Overstimulation may cause neurotoxicity

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Which of the following is an ionotropic receptor?

a. GABA-A
b. M1
c. D2
d. Beta adrenergic
e. 5HT-2A

GABA-A

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Which drug used to treat Parkinson’s disease can cause the feet to get red, hot and swollen after walking?

a. Bromocriptine
b. Benztropine
c. Selegiline
d. Ropinirole

Bromocriptine

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How are the effects of Risperidone different from those of Chlorpromazine?

a. Risperidone is used for negative symptoms
b. Risperidone blocks D2 receptors and is selective for positive symptoms
c. Risperidone doesn’t block D2 receptors and doesn’t increase prolactin release
d. Risperidone doesn’t cause postural hypotension
e. Risperidone inhibits NE re-uptake

Risperidone is used for negative symptoms

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Chronic alcohol abuse may cause all of the following except:

a. Increased hemoglobin and hematocrit
b. Gynecomastia
c. Peripheral neuropathy
d. Cardiomyopathy
e. Hypertension

Increased hemoglobin and hematocrit

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Which drug will produce a rapid relief of symptoms?

a. Bupropion
b. Buspirone
c. Risperidone- per Eric Huish
d. Lithium
e. Fluoxetine

Bupropion

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What is true regarding lithium?

a. Produces antiemetic effect
b. Produces polyuria and polydypsia- per Eric Huish
c. Produces weight loss
d. Sudden withdrawal will cause delirium tremens
e. Produces abnormal enzymes on liver function tests

Produces polyuria and polydypsia- per Eric Huis

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You treat a patient with chronic anxiety with a drug that does not cause sedation nor impairs memory. Which of the following is true regarding this drug?

a. It’s effects will take 2-3 weeks
b. It will cause euphoria
c. It will prevent alcohol withdrawal symptoms
d. It will be a benzodiazepine

It’s effects will take 2-3 weeks

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A patient is being treated for Parkinson’s disease. He also has signs of dementia, agitation and delusional thinking. Which drug will help this patient without worsening the Parkinson’s disease?

a. Aripiprazole
b. Haloperidol
c. Chlorpromazine
d. Lithium
e. Amphetamine

Aripiprazole

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Which drug is least likely to cause sedation?

a. Sertraline
b. Amitriptyline
c. Diazepam
d. Zolpidem
e. Chlorpromazine

Sertraline

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What is least likely to occur if a patient that is being treated with chlorpromazine attempts suicide by taking 10 pills of amitripyline?

a. Severe hypertensive crisis
b. Tachycardia
c. Seizures
d. Torsades de pointes
e. Hypotension

Severe hypertensive crisis

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Which drug is least likely to cause seizures?

a. Citalopram
b. Bupropion
c. Amitriptyline
d. Clozapine
e. Chlorpromazine

Citalopram

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A patient with difficult to control hypertension develops depression. Which drug should be avoided in this patient?

a. Venlafaxine
b. Nortriptyline
c. Bupropion
d. Citalopram
e. Fluoxetine

Venlafaxine

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Which drug can reverse the effects of midazolam?

a. Flumazenil
b. Naltrexone
c. Lorazepam
d. Fomepizole

Flumazenil

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Which sedative-hypnotic drug does not interact with the receptors for benzodiazepines?

a. Ramelteon
b. Zolpidem
c. Diazepam
d. Triazolium

Ramelteon

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A 40 year old male with difficulty sleeping is given a drug with a short half life. One month later he has gained 15 pounds and his wife notes he has been eating in the middle of the night but later the next day he doesn’t remember eating anything. Which drug is he taking? a. Zolpidem b. Amitriptyline c. Diazepam d. Fluoxetine

Zolpidem

A patient successfully treated with chlorpromazine for schizophrenia begins abusing barbiturates to get high. Three weeks later the patient begins having recurrent attacks of schizophrenia. What beset explains why this patient is experiencing schizophrenic episodes? a. Barbiturates induce cytochrome P450 thereby decreasing chlorpromazine levels b. Barbiturates inhibit reuptake of dopamine thereby causing psychosis c. Barbiturates block the effects of chlorpromazine on serotonin receptors

Barbiturates induce cytochrome P450 thereby decreasing chlorpromazine levels

A patient is treated with a drug for chronic pain and difficulty sleeping. This drug may also cause postural hypotension and SIADH syndrome. What drug is it? a. Amitriptyline b. Trazodone c. Citalopram d. Diazepam e. Fluoxetine

Amitriptyline

A patient taking citalopram complains of sexual dysfunction and incomplete relief from depression. Which drug could be added to his regimen? a. Bupropion b. Amitriptyline c. Phenelzine d. Fluoxetine

Bupropion

Why is Naltrexone helpful in recovery from alcoholism? a. Decreases alcohol craving by blocking opiod receptors b. Prevents delirium tremens by acting on GABA-A receptors c. Blocks the reuptake of serotonin and NE

Decreases alcohol craving by blocking opiod receptors

How does Disulfiram work?

Inhibits aldehyde dehydrogenase

Which drug helps alcoholics maintain abstinence by restoring the balance between GABA and glutamate activity? a. Acamprosate b. Buspirone c. Naltrexone

Acamprosate

Which drug may increase the QT interval? a. Risperidone b. Diazepam c. Buspirone d. Valproic acid

Risperidone

Which drug works at the GABA-B receptor?

Baclofen

Arist with acute intermittent porphyria what do you not give them?:

Barbiturates (Phenobarbital)

This drug is rapidly acting, causes blackouts, little effect on REM and can have sleep eating?

Zolpidem Zaleplon

What sleep aid doesn’t work on GABA receptors?

Ramelteon

What is the first step in alcohol metabolism?

Ethanol yields NADH

What is DOC for alcohol withdrawl syndrome?

Benzodiapenes

Patient complains of “visual snowstorm” how do you treat it?

Fomepizole

Person is taking a drug, complains of dry mouth and sedation, so you prescribe an active metabolite of the drug, the person has less dry mouth and less sedation

Nortriptyline

Person who is treated with depression that “doesn’t respond to other drugs” (last try) goes to a party and drinks alcohol and takes amphetamines, crashes out, so you give them Propranol and Phenolamine to treat them, they live.. What drug were they prescribed for depression? Two part question: You give them an SSRI, what happens to them?

Phenelzine Serotonin syndrome

Two different questions where person had no symptoms on drug X, and then they added another drug to the mix and then got symptoms 2-3 weeks later, why?

Basically its because of Fluoxetine being a CYP inhibitor.

Basically asked which drug produces the fewest side effects of all the choices:

CItalopram or Escitalopram

Person has a BMI of 40 and drinks alcohol, what drug do you take if you don’t want sexual side effects?

Buproprion

Person takes drug and gets priapism, what drug is it?

Trazodone (trazoBONE ahhah)

Person starts getting acute dsytonia after starting a drug for psychosis, how do you treat it?

Benzotroprine (anti-cholingerics)

Chart drugs A,B,C,D with + and - for stimulating various receptors (Alpha, Beta, NE, etc). Asked which one causes EPS symptoms:

It was the one with most Beta blockage

What is a difference between TCAs and SSRIs?

TCAs don’t inc prolactin

Person starts getting muscle rigidity and a temperature of 40celisus, what is the mechanism for the drug that can treat him?

Blocks Ca2+ release from sarcoplasmic reticulum. (it was dantrolene)

Kid takes his grandpa’s phenothiazines trying to get high, what does he experience?

Sedation

Which drug causes Jaundice?

Chlorpromazine

Which drug causes Agranulocytosis?

Clozapine

Which drug causes hyperglycemia, T2D, and weight gain?

Olanzapine

Person has an increased QT interval, drug?

Risperidone

Which drug is the best choice for not increasing prolactin levels?

Quetiapine

Person takes a drug that causes esophageal motility problems, drug?

Aripiprazole

Person is taking a drug that increases their TSH levels, what drug is it?

Lithium

Person is taking lithium, what should they not also take?

NSAIDS

Person drinks 4-5 drinks a day regularly, what should they not take?

Acetaminophen

Person is being treated for absent seizures and myclonic ones, The drug has side effects, how should you test for them?

Liver enzyme panel (it was valproic acid)

Person with peripheral neuropathy, how do you treat?

Gabapentin

Child suddenly starts staring off into the distance for 20-30 seconds, what is the mechanism by which a drug would treat this?

Blockade of T-Type Ca2+ channels

What drug causes gingival hyperplasia

Phenytoin

What is the mechanism by which Tizanidine and some other drug work?

A2 receptor agonist

Person suffers stroke and gets a muscle spasm, how does the drug that treats this work?

Inhibits ACh release

What is the mechanism by which Amphetamines work?

Cause the release of catecholamines from the synaptic vesicle

How does carbidopa work?

Inhibits that CONVERSION of L-dopa to DA in the periphery (NOT THE METABOLISM)

Person with Parkinson’s gets psychosis, how do you treat it?

Atypical antispychotics

What do you use for a person who is experiencing Parkinon’s On-Off phenomenon?

Use Apomorphine and you get On-Off bc of dropping levels of L-dopa/Carbidopa

What is the mechanism by which Donepezil works?

Cholinesterase inhibitor

You're treating a recovering alcoholic for sleep deprivation. Which of the following drugs could be used and is non-habit forming?

Ramelton

Which of the following is used to restore GABA/Glutamate balance in a recovering alcoholic?Which of the following is used to restore GABA/Glutamate balance in a recovering alcoholic?

venlafaxine

You prescribe an anti-psychotic drug and the pt later reports esophageal dysmotility. Which receptor does this drug act on?

Blocks 5HT-2A (Drug in question is Ariprazole)Blocks 5HT-2A (Drug in question is Ariprazole)

A pt being reated for bipolar disease with a certain drug and is experiencing polydipsia and polydipsea. What could be used to treat the toxicity of this drug?

Amiloride

You're treating a pt who suffers from both absence as well as tonic-clonic seizures with the DOC. What's a possible side effect?

Hepatotoxicity

artist is psychotic and has Porpheria, which drug would be contra indicated to treat his depression?

Phenobarbital

This is the DOC of concomitant absence seizures and general tonic clonic seizures what is associated? A)hepatotoxic b)sedation c) hypotension

this drug is used to treat absence seizures what is it Mechanism of action? A) block T type Ca channels B) prolonged inactivation of Na channels

carbemazepine works by and that it's the drug that should be tested to make sure they don't get

inhibiting sodium channels HLA- genes Stevens Johnson

Case of a boy who is 17 years old and gets mania for a bit, he is treated with a drug, then he develops symptoms of extra pyramidal syndromes like rocking, akathesia, etc. What drug caused it?

Haloperidol

fluoxetine is a potent inhibitor of

CYPs

antipsychotic used when the patient is complaining about having hyperprolactinemia

Olanzepine

side effects of a drug that is responsible for treating absence and partial seizures

either nausea vomiting or weight gain

Kid takes a phenylthiazine and the question asks what the side effect of the drug was

the benefit of taking Selegiline (MAO-B inhibitor)

selegieline doesn't work in the periphery for stopping MAO from action

Which neurotransmitter is not a target of drugs used to treat depression? a. NE b. 5-HT c. Ach d. DA

Ach

Following an accident a patient is seen in the ER. He says he has been drinking plenty of water but not urinating. Lab tests show decreased serum Na+. What drug might have caused his symptoms?

amitriptyline

This drug is commonly added to OTC preparations because it cures headaches by constricting cerebral blood vessels

caffeine

``` 16 year old boy overdoses on a barbituate what is the appropriate treatment? a. provide stimulants b diuresis and alkalination of urine c. ethanol d. iv diazepam e. cociaine ```

diuresis and alkalination of urine

Donepezil: a. alpha blocker b. d2 receptor agonist c. cholinesterase inhibitors d. adenosine inhibitor

cholinesterase inhibitors

A 15 year old with a known psychiatric disorder was riding a horse and fell off. His friends were worried about his head and took hime to the hospital. The scans were negative and blood test reveled decreased sodium. The also said that he had not been urinating frequently what drug was he taking for his illness? a. amytriptyline b. diazepam c. lithium d. phenylzine

amytriptyline

``` Which drug causes retinal deposits a amytriptyline b thioridazine c clozapine d fluphenazine ```

thioridazine

Buproprion (wellbutrin) +

increases dopamine available Fewer sexual side effects than other antidepressants Dereases cravings (smoking cessation) Weight loss

Buproprion (wellbutrin) -

anxiety, insomnia, psychosis Seizures (don't combine with TCA) Tachycardia Rash

Mirtazapine

not an uptake inhibitor Blocks pre-syn a2 receptors Blocks 5HT2a and 5HT3 receptors (reduce anxiety, insomnia, nausea, sexual problems) Antihistamine (sedation) (weight gain but treats insomnia

NE reuptake

Atomoxetine Amoxapine (blocks D receptors, used in schiz w/ depression

Trazadone

sedation and PRIAPISM

St Johns Wort interactions

prolongs anesthesia Serotonin syndrome Induces P450: Inhibits OC Digoxin, warfarin

SIADH

ADH causes too much water reabsorption in collecting duct

Dopamine hypothesis of schizophrenia

blocking DA receptors is antipsychotic

Where should dopamine be blocked?

the mesolimbic pathway Side effect is Parkinsons-like symptoms (substantia niagra) Increases prolactin synth

+ schiz - schiz

positive: overactive mesolimbic path | Negative: underactive mesocortical pathway 5HT2a blocks

Blocking D2 receptors in schiz:

helps pychosis, not depression

Blocking 5HT2a receptors in schiz:

treats negative symptoms (mesocortical) | And prevents overactivity of mesolimbic prevents + symptoms

Extrapyramidal symptoms

Parkinsons like Akastheisia (pacing) Dystonia (spasms) Rigidity Blocking acetylcholine (muscarinic blocker) helps balance

Neuroleptic Malignant Syndrome

increase body tem, rigitidity Tx: dantroleme, benzo