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Pharm II Exam II

Question 1 of 102

1

Which of the following is NOT a general mechanism utilized to treat epilepsy?

Select one of the following:

  • GABA receptor antagonist activity

  • Inhibiting calcium channels

  • Activating potassium channels

  • Blocking sodium channels

Explanation

Question 2 of 102

1

How does antagonizing glutamate receptors help in treating epilepsy?

Select one of the following:

  • Glutamate is an inhibitory neurotransmitter and therefore inhibiting its receptor can inhibit neurotransmission

  • Glutamate is an excitatory neurotransmitter and therefore inhibiting its receptor can inhibit neurotransmission

  • Inhibiting Glutamate channels cause an excitatory response

  • Inhibiting Glutamate channels causes a positive membrane potential

Explanation

Question 3 of 102

1

Which of the following is NOT a side effect of benzodiazepines?

Select one of the following:

  • Cardiovascular effects in healthy patients receiving dose causing hypnosis

  • Anterograde amnesia

  • Delirium (mostly in ICU sedation)

  • Slight depression of alveolar ventilation

Explanation

Question 4 of 102

1

Which of the following is correct regarding Z compounds?

Select one of the following:

  • They are more specific for sedation

  • They have more side effects than benzodiazepines

  • They are more effective as anticonvulsants than benzodiazepines

  • They have more potential for abuse

Explanation

Question 5 of 102

1

Choose the broad spectrum AED

Select one or more of the following:

  • Phenytoin

  • Lamotrigine

  • Levetiracetam

  • Topiramate

  • Valproic acid

  • Oxcarbezepine

Explanation

Question 6 of 102

1

Benzodiazepines can be used for long-term use as an anticonvulsant

Select one of the following:

  • True
  • False

Explanation

Question 7 of 102

1

Which of the following is the safest to use during pregnancy?

Select one of the following:

  • Topiramate

  • Phenobarbital

  • Valproic acid

  • Levetiracetam

Explanation

Question 8 of 102

1

Which of the following drugs are preferred for status epilepticus?

Select one of the following:

  • Diazepam

  • Lorazapam

  • Phenobarbital

  • Clobazam

Explanation

Question 9 of 102

1

Diazepam can be given IM

Select one of the following:

  • True
  • False

Explanation

Question 10 of 102

1

Which of the followings is NOT a side effect of phenytoin?

Select one of the following:

  • Megaloblastic anemia

  • Elevated liver enzymes

  • Steven-Johnsons syndrome

  • Rare aplastic anemia

Explanation

Question 11 of 102

1

Which of the following is NOT a side effect of carbamezapine

Select one of the following:

  • Hyponatremia

  • Idiosyncratic blood dyscrasias

  • Sedation

  • Suicidality

Explanation

Question 12 of 102

1

Which of the following is NOT a side effect of eslicarbazepine acetate?

Select one of the following:

  • Hyponatremia

  • Vomiting

  • Eosinophilia

  • Renal calculi

Explanation

Question 13 of 102

1

Which of the following is NOT a side effect of Lamotrigine?

Select one of the following:

  • Decreased plasma levels with use of valproic acid

  • Decreased plasma levels with use of phenobarbital

  • Stevens-Johnson syndrome at high doses

  • Decreased half-life with use of phenytoin

Explanation

Question 14 of 102

1

Which of the following is NOT a side effect of lacosamide?

Select one of the following:

  • Euphoria

  • Diplopia

  • Dizziness

  • Skin rash

Explanation

Question 15 of 102

1

Zonisamide can cause renal calculi

Select one of the following:

  • True
  • False

Explanation

Question 16 of 102

1

Which of the following can cause suicidality?

Select one of the following:

  • Zonisamide

  • Rufinamide

  • Levetiracetam

  • Vigabatrin

Explanation

Question 17 of 102

1

Which of the following causes behavioral changes and extrapyramidal reactions?

Select one of the following:

  • Lamotrigine

  • Ethosuximide

  • Vigabatrin

  • Rufinamide

Explanation

Question 18 of 102

1

Which of the following can cause significant cognitive impairment?

Select one of the following:

  • Phenobarbital

  • Phenytoin

  • Lamotrigine

  • Felbamate

Explanation

Question 19 of 102

1

Which of the following has an effect on though processes and level of consciousness?

Select one of the following:

  • Vigabatrin

  • Tiagabine

  • Benzodiazepines

  • Carbamezapine

Explanation

Question 20 of 102

1

Which of the following AED causes retinal dysfunction?

Select one of the following:

  • Vigabatrin

  • Tiagabine

  • Gabapentin

  • Pregabalin

Explanation

Question 21 of 102

1

Keppra has more milder CNS effects than Gabapentin.

Select one of the following:

  • True
  • False

Explanation

Question 22 of 102

1

Which of the following drugs has a risk of causing GI effects and liver toxicity in patients younger than two years old?

Select one of the following:

  • Topomax

  • Valproic Acid

  • Phenytoin

  • Phenobarbital

Explanation

Question 23 of 102

1

Which of the following drugs has an important adverse effect that is similar to that of Zonisamide, along with dose-related cognitive effects?

Select one of the following:

  • Valproic acid

  • Topomax

  • Phenobarbital

  • Carbamazepine

Explanation

Question 24 of 102

1

Which of the following drugs has a side effect of aplastic anemia and acute hepatic failure and therefore is rarely used?

Select one of the following:

  • Peramanel

  • Felbamate

  • Topomax

  • Ethosuximide

Explanation

Question 25 of 102

1

Which of the following has risk of causing neuropsychiatric events such as aggression, anger, irritability, agitation, and mental status changes?

Select one of the following:

  • Perampanel

  • Felbamate

  • Pregabalin

  • Ezogabine

Explanation

Question 26 of 102

1

Which of the following is NOT true regarding Ramelteon?

Select one of the following:

  • It is a non-benzodiazepine hypnotic

  • It is selective for MT1 and MT2 receptors

  • Has has higher risk for addiction

  • It is less efficacious than benzodiazepines as a hypnotic

Explanation

Question 27 of 102

1

Which of the following is a characteristic of tolerance?

Select one of the following:

  • Exposure to a drug induces changes that result in decrease of the drug's effects over time

  • Manifests by a specific withdrawal syndrome

  • Compulsive use

  • Produced by abrupt cessation

Explanation

Question 28 of 102

1

Which of the following could give a patient, who is allergic to sulfa drugs, a reaction?

Select one of the following:

  • Zonisamide

  • Ezogabine

  • Tigabatrin

  • Gabapentin

Explanation

Question 29 of 102

1

Which of the following is NOT true regarding dexmedetomidine?

Select one of the following:

  • It is a nonBZD hypnotic

  • It is a selective alpha2 receptor agonist with sedative properties

  • It causes tachycardia and hypertension

  • Used in ICU setting

Explanation

Question 30 of 102

1

What is the difference between dalfampridine and Dimethyl Fumarate when treating MS?

Select one of the following:

  • Dalfampridine is a DMT and Dimethyl Fufurate is for symptom management

  • Dalfampridine is for symptom management and Dimethyl Fufurate is a DMT

  • Dalfampridine is an anti-inflammatory and Dimethyl Fufurate is a DMT

  • There is no difference

Explanation

Question 31 of 102

1

Which of the following does NOT cause cognitive effects?

Select one of the following:

  • Primidone

  • Phenobarbital

  • Topomax

  • Valproic acid

Explanation

Question 32 of 102

1

Which of the following is NOT excreted renally/ requires adjustment in patients with renal dysfunction?

Select one of the following:

  • Gabapentin/Pregabalin

  • Levetiracetam

  • Valproic acid

  • Topiramate

Explanation

Question 33 of 102

1

Which of the following does NOT have a GI side effect?

Select one of the following:

  • Ethosuximide

  • Valproic acid

  • Perampanel

  • Lacosomide

Explanation

Question 34 of 102

1

Ethosuximide and Perampanel have behavioral side effects

Select one of the following:

  • True
  • False

Explanation

Question 35 of 102

1

Which of the following mechanisms is correct for amphetamines?

Select one of the following:

  • Selectively inhibits the reuptake of NE

  • They are taken up into the cell and interfere with vesicular monoamine transporter, depleting stores and stimulating release of these NT

  • Selectively inhibit reuptake of DA

  • Mechanism is unknown

Explanation

Question 36 of 102

1

What is the clinical use for amphetamines?

Select one of the following:

  • ADHD

  • Narcolepsy

  • Obesity

  • All of the above

Explanation

Question 37 of 102

1

Which of the following is NOT a side effect of amphetamines?

Select one of the following:

  • Increase suicidal ideation

  • Decrease fatigue

  • Anorexia

  • Increase blood pressure

Explanation

Question 38 of 102

1

Methohexital can cause the following EXCEPT

Select one of the following:

  • Hypotension

  • Porphyria

  • Respiratory depression

  • Bronchospams

Explanation

Question 39 of 102

1

Which of the following is a side effect of propofol?

Select one of the following:

  • Increased cerebral metabolic rate

  • Hypertension

  • Anti-emetic action

  • All of the above

Explanation

Question 40 of 102

1

Which of the following is a side effect of Etomidate?

Select one of the following:

  • Electrolyte imbalance

  • Hypertension

  • Tachycardia

  • Anti-emetic activity

Explanation

Question 41 of 102

1

Which of the following is NOT a side effect of Ketamine?

Select one of the following:

  • Cataleptic state

  • Post-op disorientation

  • Analgesic properties

  • Decrease in cerebral blood flow

Explanation

Question 42 of 102

1

Drugs such as Benztropine, Oxybutynin, Antivert, and Tolterodine add synergistic effects to oral CheI

Select one of the following:

  • True
  • False

Explanation

Question 43 of 102

1

Which of the following best describes the mechanism of oral ChEI?

Select one of the following:

  • They inhibit the reuptake of Ach

  • They block ChE, preventing further breakdown of Ach

  • Block reuptake of DA

  • None of the above

Explanation

Question 44 of 102

1

ChEI are used for symptomatic improvements of dementia, not slow the progression of the disease

Select one of the following:

  • True
  • False

Explanation

Question 45 of 102

1

ChEI are used for moderate to severe dementia

Select one of the following:

  • True
  • False

Explanation

Question 46 of 102

1

Which of the following is NOT a side effect of ChEI?

Select one of the following:

  • GI

  • Tachycardia

  • Urinary obstruction

  • Asthma

Explanation

Question 47 of 102

1

Which of the following is NOT true regarding Memantine?

Select one of the following:

  • Prevents futher neurodegeneration caused by excitotoxic reactions by blocking NMDA receptors

  • Used for moderate to severe Alzheimers

  • May need dose adjustment in older patients due to renal excretion

  • GI is the most common side effect

Explanation

Question 48 of 102

1

Which of the following statements is FALSE?

Select one of the following:

  • ChEI, such as Neostigmine and Pyridostimine, can be used as reversal agents for non-depolarizing neuromuscular blockers

  • Succinylcholine requires a reversal agent due to its onset of action

  • Naltrexone can reverse the effects of opioids

  • None of the above

Explanation

Question 49 of 102

1

Which of the following is NOT true regarding ethanol?

Select one of the following:

  • It enhances GABA-mediated inhibition and blocks NMDA receptors

  • 90-95% is metabolized in the liver into acetic acid

  • Can cause euphoric effects a low-moderate doses

  • Acute effects, such as increased risk for cancer occurs

Explanation

Question 50 of 102

1

Which of the following is NOT used for treatment of ethanol toxicity?

Select one of the following:

  • Disulfram, to inhibit aldehyde dehydrogenase

  • Naltrexone, which acts as opiate antagonist to produce positive effects in alcohol

  • Acamprosate, which acts as a weak glutamate antagonist

  • Fomepizole, a competitive inhibitor of alcohol dehydrogenase

Explanation

Question 51 of 102

1

Which of the following is NOT used as treatment for methanol toxicity?

Select one of the following:

  • Ethanol, since it has a higher affinity for alcohol dehydrogenase

  • Fomepizole, a competitive inhibitor of alcohol dehydrogenase

  • Benzodiazepines, for withdrawal symptoms

  • Alkalinization with sodium bicarbonate to avoid metabolic acidosis

Explanation

Question 52 of 102

1

Which of the following is NOT a side effect of use of fomepizole in treatment of methanol toxicity?

Select one of the following:

  • Agitation

  • Dizziness

  • Eosinophilia

  • Retinal and optic-nerve damage

Explanation

Question 53 of 102

1

Which of the following is NOT a side effect of use of ethanol to treat methanol toxicity?

Select one of the following:

  • Pancreatitis

  • Hypoglycemia

  • Mental status change

  • Eosinophilia

Explanation

Question 54 of 102

1

Which of the following is NOT true regarding Atomoxetine (Strattera)

Select one of the following:

  • Effects are not apparent until 2 weeks

  • Used as 1st line therapy

  • Used to treat ADHD

  • Can be used in patients who have a h/o illicit substance abuse or concerns about abuse

Explanation

Question 55 of 102

1

Which of the following is a side effect of atomoxetine (Strattera)

Select one of the following:

  • Suicidal ideation

  • Increased appetite

  • Hypotension

  • Headache

Explanation

Question 56 of 102

1

Which of the following is true regarding malignant hyperthermia?

Select one of the following:

  • Caused by increase release of Ca2+ from the sarcoplasmic reticulum

  • Worsens with use of Dantrolene

  • Treated with Desflurane

  • Does not have a genetic disposition

Explanation

Question 57 of 102

1

Which of the following is true regarding Chantix?

Select one of the following:

  • It is a nicotine-based therapy

  • It is a partial agonist and antagonist, to cause partial stimulation and suppress withdrawal

  • It is started the same day patient quits smoking

  • More effective as monotherapy than in combination with other nicotine0based therapies

Explanation

Question 58 of 102

1

Which of the following is NOT a side effect of Chantix?

Select one of the following:

  • Nausea

  • Suicidal ideation

  • Cardiovascular events in patients with cardiovascular disease

  • Physical dependence

Explanation

Question 59 of 102

1

Which of the following is NOT possible side effect of Pancurinium?

Select one of the following:

  • Atrophy

  • Myalgia

  • Increase in HR/BP

  • Accumulation of laudanosine

Explanation

Question 60 of 102

1

Choose the Antispasm centrally-acting muscle relaxants

Select one or more of the following:

  • Diazepam

  • Baclofen

  • Tizanidine

  • Carisoprodol (SOMA)

  • Chlorzoxazone

  • Cyclobenzaprine

  • Metaxalone

  • Methocarbamol

  • Orphenadrine

  • Dantrolene

Explanation

Question 61 of 102

1

Choose ALL of the following Antispasm drugs that have anticholinergic side effects

Select one or more of the following:

  • Carisoprodol

  • Chlorzoxazone

  • Cyclobenzaprine

  • Metaxalone

  • Methocarbaol

  • Orphenadrine

Explanation

Question 62 of 102

1

Which of the following is true in regards to Levodopa and its use?

Select one of the following:

  • It can cross the BBB, which is not true about DA

  • Should be taken with food

  • No development of tolerance

  • These are all true

Explanation

Question 63 of 102

1

Which of the following extrapyramidal symptoms is NOT reversible?

Select one of the following:

  • Tardive dyskinesia

  • Dystonias

  • Parkinson-like symptoms

  • Akathisia

Explanation

Question 64 of 102

1

Which of the following is NOT used for management of EPS?

Select one of the following:

  • Anticholinergic drugs

  • Antihistamine with anticholinergic activity

  • Trihexyphenidyl

  • All are used for management

Explanation

Question 65 of 102

1

Which of the following is an anticholinergic side effect?

Select one of the following:

  • Bradycardia

  • Wakefulness

  • Salivation

  • Urinary retention

Explanation

Question 66 of 102

1

Atypical antipsychotics have anticholinergic side effects

Select one of the following:

  • True
  • False

Explanation

Question 67 of 102

1

Which of the following is a side effect of TCA?

Select one of the following:

  • Orthostatic hypotension

  • Bradycardia

  • Wakefulness

  • Diarrhea

Explanation

Question 68 of 102

1

Which of the following is NOT true regarding Antipsychotics and their side effects?

Select one of the following:

  • Atypical agents cause weight gain more, except for aripirazole.

  • Typical agents cause more prolactin elevation and EPS/TD, except paliperidone and risperidone (Atypical agents)

  • QTc prolongation is seen with the use of chlorpromazine (typical AP)

  • Risk of sedation, Anticholinergic side effects, and Orthostatic Hypotension is low with aripiprazole (atypical AP)

Explanation

Question 69 of 102

1

Atypical antipsychotics cause less TD

Select one of the following:

  • True
  • False

Explanation

Question 70 of 102

1

Which of the following is NOT a side effect of Parkinson's drugs

Select one of the following:

  • Orthostatic hypotension

  • Hallucinations

  • Dyskinesia

  • Anxiety

Explanation

Question 71 of 102

1

Which of the following is the correct reasoning for giving Carbidopa with Levodopa?

Select one of the following:

  • To inhibit the conversion of Levodopa into DA in the periphery, thus allowing levodopa to cross the BBB

  • So that carbidopa crosses the BBB and prevents breakdown in the CNS

  • Inhibit MAO-B to prevent breakdown of DA

  • To inhibit COMT and thus prevent breakdown of DA

Explanation

Question 72 of 102

1

Which of the following is correct regarding the On-Off phenomenon?

Select one of the following:

  • It occurs at the very first administration of levodopa

  • "On" periods occur as levodopa levels decline

  • "Off" periods occur shortly after bolus of Levodopa is given

  • Described as fluctuations of rigidity and normal/dyskinetic movements

Explanation

Question 73 of 102

1

Which of the following is a side effect of lithium?

Select one of the following:

  • GI distress

  • Hypothyroidism

  • Renal failure

  • All are side effects of lithium

Explanation

Question 74 of 102

1

Rasagiline forms toxic metabolites, whereas Selegiline does not

Select one of the following:

  • True
  • False

Explanation

Question 75 of 102

1

Choose ALL of the following that cause weight gain

Select one or more of the following:

  • SNRI

  • SSRI

  • Wellbutrin

  • TCA

  • Mirtazepine

  • Vortioxetine

  • MAOIs

  • Levomilnacipram

Explanation

Question 76 of 102

1

Which of the following is a side effect of serotonin agonists?

Select one of the following:

  • Decrease in blood pressure

  • Coronary vasospasm

  • Constipation

  • Discontinuation syndrome

Explanation

Question 77 of 102

1

Which of the following is a side effect of serotonin antagonists?

Select one of the following:

  • Sexual dysfunction

  • Serotonin syndrome

  • Suicidal ideation

  • QT interval prolongation

Explanation

Question 78 of 102

1

Which of the following is true regarding Vilazodone?

Select one of the following:

  • Should be avoided with food

  • Has antagonistic activity at the 5-HT3 receptor

  • It is a partial agonist at 5-HT1A receptor, which speeds up the onset of action and possibly augments the anxiolytic effects

  • Superior to other antidepressants

Explanation

Question 79 of 102

1

Which of the following is true regarding Vortioxetine?

Select one of the following:

  • Efficacy is seen at higher doses

  • Has an advantage over other antidepressants

  • It has anti-emetic effects due to antagonistic activity at the 5-HT3 receptor

  • It causes weight gain

Explanation

Question 80 of 102

1

Parkinson's drugs typically cause hallucinations

Select one of the following:

  • True
  • False

Explanation

Question 81 of 102

1

Which of the following causes psychosis?

Select one of the following:

  • MAOI

  • Opioids

  • Anticholinergics

  • These all cause psychosis

Explanation

Question 82 of 102

1

Which of the following is a difference between SSRIs and SNRIs?

Select one of the following:

  • SSRIs cause weight gain, whereas SNRIs can cause decrease in appetite

  • SSRIs cause increase in blood pressure and heart rate

  • SNRIs cause urinary retention

  • SNRIs cause dose-related GI symptoms that resolve after 2 weeks

Explanation

Question 83 of 102

1

Which of the following does NOT cause serotonin syndrome?

Select one of the following:

  • Serotonin agonists

  • SSRIs

  • Vilazodone

  • Dextromethorphan

Explanation

Question 84 of 102

1

Which of the following best describes serotonin syndrome?

Select one of the following:

  • Fluctuations in motor function with periods of stiffness/rigidity and periods of normal or dyskinetic movements

  • It occurs when there is an overdose with a single drug, or concurrent use of several drugs that results in excess serotonergic activity

  • Includes side effects such as dizziness, nausea, weakness, HA, anxiety, irritability, and insomnia

  • Includes side effects such as hypothermia, hypotension, bradycardia, and dyskinesia

Explanation

Question 85 of 102

1

Which of the following drugs inhibits reuptake of 5-HT and NE?

Select one of the following:

  • Escitalopram

  • Desipramine

  • Levodopa

  • Sumatriptan

Explanation

Question 86 of 102

1

Which of the following drugs inhibits reuptake of ONLY 5-HT?

Select one of the following:

  • Nortriptyline

  • Duloxetine

  • Paroxetine

  • Selegiline

Explanation

Question 87 of 102

1

Which of the following drugs is used to treat migraine by stimulating 5-HT1D receptors, causing cranial vasoconstriction?

Select one of the following:

  • Ondansetron

  • Sertraline

  • Almotriptan

  • These are all 5-HT1d stimulants

Explanation

Question 88 of 102

1

Which of the following drugs acts as an anti-emetic by antagonizing 5-HT3 receptors?

Select one of the following:

  • Vortioxetine

  • Vilazodone

  • Palonosetron

  • Duloxetine

Explanation

Question 89 of 102

1

Which of the following drugs is a partial agonist at 5-HT1A receptor, which speeds up the onset of action and possibly augments the anxiolytic effects?

Select one of the following:

  • Vilazodone

  • Vortioxetine

  • Paroxetine

  • Trazodone

Explanation

Question 90 of 102

1

Which of the following drugs has 5-HT1A agonistic activity and 5-HT3 antagonistic activity?

Select one of the following:

  • Vortioxetine

  • Paroxetine

  • Fluoxetine

  • Granisetron

Explanation

Question 91 of 102

1

Typical antipsychotics, such as Chlorpromazine, are more potent in inhibiting 5-HT2 receptors than D2 receptors

Select one of the following:

  • True
  • False

Explanation

Question 92 of 102

1

Atypical antipsychotics, such as Clozapine, are more potent in inhibiting 5-HT2 receptors than D2 receptors

Select one of the following:

  • True
  • False

Explanation

Question 93 of 102

1

Which of the following drugs is NOT used to inhibit the breakdown of L-DOPA or DA?

Select one of the following:

  • Carbidopa

  • Selegiline

  • Tolcapone

  • Levommilnacipran

Explanation

Question 94 of 102

1

Which of the following drugs is NOT an SNRI?

Select one of the following:

  • Venlafaxine

  • Milnacipran

  • Duloxetine

  • Fluoxetine

Explanation

Question 95 of 102

1

Which of the following drugs is NOT an SSRI?

Select one of the following:

  • Sertraline

  • Citalopram

  • Paroxetine

  • Vortioxetine

Explanation

Question 96 of 102

1

Which of the following does NOT have anticholinergic side effects?

Select one of the following:

  • TCA

  • Diphenydramine

  • Benztropine

  • Alosetron

Explanation

Question 97 of 102

1

Which of the following is more commonly seen with typical antipsychotics?

Select one of the following:

  • QTc prolongation

  • EPS/TD

  • Weight gain

  • Sedation

Explanation

Question 98 of 102

1

Which of the following is NOT typically seen with use of atypical antiopsychotics (except for paliperidone and risperidone)

Select one of the following:

  • Weight gain

  • Prolactin elevation

  • Sedation

  • Orthostatic hypotension

Explanation

Question 99 of 102

1

Clozapine is seen to having the following effects, except for

Select one of the following:

  • Sedation

  • Anticholinergic effects

  • Orthostatic hypotension

  • Prolactin elevation

Explanation

Question 100 of 102

1

Which of the following classes of antidepressants can cause suicidal ideation?

Select one of the following:

  • SSRI-like antidepressants

  • SSRI

  • SNRI

  • Trazadone

Explanation

Question 101 of 102

1

Which of the following antidepressants causes increase in blood pressure and heart rate?

Select one of the following:

  • TCA

  • SsRI

  • SSRI-related

  • SNRI

Explanation

Question 102 of 102

1

Which of the following antidepressants does NOT cause discontinuation syndrome?

Select one of the following:

  • SSRI

  • SSRI-related

  • SNRI

  • TCA

Explanation