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Pharm II Exam II

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CNS
Diana Flores
Quiz by Diana Flores, updated more than 1 year ago
Diana Flores
Created by Diana Flores almost 9 years ago
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Resource summary

Question 1

Question
Which of the following is NOT a general mechanism utilized to treat epilepsy?
Answer
  • GABA receptor antagonist activity
  • Inhibiting calcium channels
  • Activating potassium channels
  • Blocking sodium channels

Question 2

Question
How does antagonizing glutamate receptors help in treating epilepsy?
Answer
  • 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

Question 3

Question
Which of the following is NOT a side effect of benzodiazepines?
Answer
  • Cardiovascular effects in healthy patients receiving dose causing hypnosis
  • Anterograde amnesia
  • Delirium (mostly in ICU sedation)
  • Slight depression of alveolar ventilation

Question 4

Question
Which of the following is correct regarding Z compounds?
Answer
  • 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

Question 5

Question
Choose the broad spectrum AED
Answer
  • Phenytoin
  • Lamotrigine
  • Levetiracetam
  • Topiramate
  • Valproic acid
  • Oxcarbezepine

Question 6

Question
Benzodiazepines can be used for long-term use as an anticonvulsant
Answer
  • True
  • False

Question 7

Question
Which of the following is the safest to use during pregnancy?
Answer
  • Topiramate
  • Phenobarbital
  • Valproic acid
  • Levetiracetam

Question 8

Question
Which of the following drugs are preferred for status epilepticus?
Answer
  • Diazepam
  • Lorazapam
  • Phenobarbital
  • Clobazam

Question 9

Question
Diazepam can be given IM
Answer
  • True
  • False

Question 10

Question
Which of the followings is NOT a side effect of phenytoin?
Answer
  • Megaloblastic anemia
  • Elevated liver enzymes
  • Steven-Johnsons syndrome
  • Rare aplastic anemia

Question 11

Question
Which of the following is NOT a side effect of carbamezapine
Answer
  • Hyponatremia
  • Idiosyncratic blood dyscrasias
  • Sedation
  • Suicidality

Question 12

Question
Which of the following is NOT a side effect of eslicarbazepine acetate?
Answer
  • Hyponatremia
  • Vomiting
  • Eosinophilia
  • Renal calculi

Question 13

Question
Which of the following is NOT a side effect of Lamotrigine?
Answer
  • 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

Question 14

Question
Which of the following is NOT a side effect of lacosamide?
Answer
  • Euphoria
  • Diplopia
  • Dizziness
  • Skin rash

Question 15

Question
Zonisamide can cause renal calculi
Answer
  • True
  • False

Question 16

Question
Which of the following can cause suicidality?
Answer
  • Zonisamide
  • Rufinamide
  • Levetiracetam
  • Vigabatrin

Question 17

Question
Which of the following causes behavioral changes and extrapyramidal reactions?
Answer
  • Lamotrigine
  • Ethosuximide
  • Vigabatrin
  • Rufinamide

Question 18

Question
Which of the following can cause significant cognitive impairment?
Answer
  • Phenobarbital
  • Phenytoin
  • Lamotrigine
  • Felbamate

Question 19

Question
Which of the following has an effect on though processes and level of consciousness?
Answer
  • Vigabatrin
  • Tiagabine
  • Benzodiazepines
  • Carbamezapine

Question 20

Question
Which of the following AED causes retinal dysfunction?
Answer
  • Vigabatrin
  • Tiagabine
  • Gabapentin
  • Pregabalin

Question 21

Question
Keppra has more milder CNS effects than Gabapentin.
Answer
  • True
  • False

Question 22

Question
Which of the following drugs has a risk of causing GI effects and liver toxicity in patients younger than two years old?
Answer
  • Topomax
  • Valproic Acid
  • Phenytoin
  • Phenobarbital

Question 23

Question
Which of the following drugs has an important adverse effect that is similar to that of Zonisamide, along with dose-related cognitive effects?
Answer
  • Valproic acid
  • Topomax
  • Phenobarbital
  • Carbamazepine

Question 24

Question
Which of the following drugs has a side effect of aplastic anemia and acute hepatic failure and therefore is rarely used?
Answer
  • Peramanel
  • Felbamate
  • Topomax
  • Ethosuximide

Question 25

Question
Which of the following has risk of causing neuropsychiatric events such as aggression, anger, irritability, agitation, and mental status changes?
Answer
  • Perampanel
  • Felbamate
  • Pregabalin
  • Ezogabine

Question 26

Question
Which of the following is NOT true regarding Ramelteon?
Answer
  • 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

Question 27

Question
Which of the following is a characteristic of tolerance?
Answer
  • 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

Question 28

Question
Which of the following could give a patient, who is allergic to sulfa drugs, a reaction?
Answer
  • Zonisamide
  • Ezogabine
  • Tigabatrin
  • Gabapentin

Question 29

Question
Which of the following is NOT true regarding dexmedetomidine?
Answer
  • It is a nonBZD hypnotic
  • It is a selective alpha2 receptor agonist with sedative properties
  • It causes tachycardia and hypertension
  • Used in ICU setting

Question 30

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

Question 31

Question
Which of the following does NOT cause cognitive effects?
Answer
  • Primidone
  • Phenobarbital
  • Topomax
  • Valproic acid

Question 32

Question
Which of the following is NOT excreted renally/ requires adjustment in patients with renal dysfunction?
Answer
  • Gabapentin/Pregabalin
  • Levetiracetam
  • Valproic acid
  • Topiramate

Question 33

Question
Which of the following does NOT have a GI side effect?
Answer
  • Ethosuximide
  • Valproic acid
  • Perampanel
  • Lacosomide

Question 34

Question
Ethosuximide and Perampanel have behavioral side effects
Answer
  • True
  • False

Question 35

Question
Which of the following mechanisms is correct for amphetamines?
Answer
  • 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

Question 36

Question
What is the clinical use for amphetamines?
Answer
  • ADHD
  • Narcolepsy
  • Obesity
  • All of the above

Question 37

Question
Which of the following is NOT a side effect of amphetamines?
Answer
  • Increase suicidal ideation
  • Decrease fatigue
  • Anorexia
  • Increase blood pressure

Question 38

Question
Methohexital can cause the following EXCEPT
Answer
  • Hypotension
  • Porphyria
  • Respiratory depression
  • Bronchospams

Question 39

Question
Which of the following is a side effect of propofol?
Answer
  • Increased cerebral metabolic rate
  • Hypertension
  • Anti-emetic action
  • All of the above

Question 40

Question
Which of the following is a side effect of Etomidate?
Answer
  • Electrolyte imbalance
  • Hypertension
  • Tachycardia
  • Anti-emetic activity

Question 41

Question
Which of the following is NOT a side effect of Ketamine?
Answer
  • Cataleptic state
  • Post-op disorientation
  • Analgesic properties
  • Decrease in cerebral blood flow

Question 42

Question
Drugs such as Benztropine, Oxybutynin, Antivert, and Tolterodine add synergistic effects to oral CheI
Answer
  • True
  • False

Question 43

Question
Which of the following best describes the mechanism of oral ChEI?
Answer
  • They inhibit the reuptake of Ach
  • They block ChE, preventing further breakdown of Ach
  • Block reuptake of DA
  • None of the above

Question 44

Question
ChEI are used for symptomatic improvements of dementia, not slow the progression of the disease
Answer
  • True
  • False

Question 45

Question
ChEI are used for moderate to severe dementia
Answer
  • True
  • False

Question 46

Question
Which of the following is NOT a side effect of ChEI?
Answer
  • GI
  • Tachycardia
  • Urinary obstruction
  • Asthma

Question 47

Question
Which of the following is NOT true regarding Memantine?
Answer
  • 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

Question 48

Question
Which of the following statements is FALSE?
Answer
  • 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

Question 49

Question
Which of the following is NOT true regarding ethanol?
Answer
  • 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

Question 50

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

Question 51

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

Question 52

Question
Which of the following is NOT a side effect of use of fomepizole in treatment of methanol toxicity?
Answer
  • Agitation
  • Dizziness
  • Eosinophilia
  • Retinal and optic-nerve damage

Question 53

Question
Which of the following is NOT a side effect of use of ethanol to treat methanol toxicity?
Answer
  • Pancreatitis
  • Hypoglycemia
  • Mental status change
  • Eosinophilia

Question 54

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

Question 55

Question
Which of the following is a side effect of atomoxetine (Strattera)
Answer
  • Suicidal ideation
  • Increased appetite
  • Hypotension
  • Headache

Question 56

Question
Which of the following is true regarding malignant hyperthermia?
Answer
  • Caused by increase release of Ca2+ from the sarcoplasmic reticulum
  • Worsens with use of Dantrolene
  • Treated with Desflurane
  • Does not have a genetic disposition

Question 57

Question
Which of the following is true regarding Chantix?
Answer
  • 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

Question 58

Question
Which of the following is NOT a side effect of Chantix?
Answer
  • Nausea
  • Suicidal ideation
  • Cardiovascular events in patients with cardiovascular disease
  • Physical dependence

Question 59

Question
Which of the following is NOT possible side effect of Pancurinium?
Answer
  • Atrophy
  • Myalgia
  • Increase in HR/BP
  • Accumulation of laudanosine

Question 60

Question
Choose the Antispasm centrally-acting muscle relaxants
Answer
  • Diazepam
  • Baclofen
  • Tizanidine
  • Carisoprodol (SOMA)
  • Chlorzoxazone
  • Cyclobenzaprine
  • Metaxalone
  • Methocarbamol
  • Orphenadrine
  • Dantrolene

Question 61

Question
Choose ALL of the following Antispasm drugs that have anticholinergic side effects
Answer
  • Carisoprodol
  • Chlorzoxazone
  • Cyclobenzaprine
  • Metaxalone
  • Methocarbaol
  • Orphenadrine

Question 62

Question
Which of the following is true in regards to Levodopa and its use?
Answer
  • It can cross the BBB, which is not true about DA
  • Should be taken with food
  • No development of tolerance
  • These are all true

Question 63

Question
Which of the following extrapyramidal symptoms is NOT reversible?
Answer
  • Tardive dyskinesia
  • Dystonias
  • Parkinson-like symptoms
  • Akathisia

Question 64

Question
Which of the following is NOT used for management of EPS?
Answer
  • Anticholinergic drugs
  • Antihistamine with anticholinergic activity
  • Trihexyphenidyl
  • All are used for management

Question 65

Question
Which of the following is an anticholinergic side effect?
Answer
  • Bradycardia
  • Wakefulness
  • Salivation
  • Urinary retention

Question 66

Question
Atypical antipsychotics have anticholinergic side effects
Answer
  • True
  • False

Question 67

Question
Which of the following is a side effect of TCA?
Answer
  • Orthostatic hypotension
  • Bradycardia
  • Wakefulness
  • Diarrhea

Question 68

Question
Which of the following is NOT true regarding Antipsychotics and their side effects?
Answer
  • 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)

Question 69

Question
Atypical antipsychotics cause less TD
Answer
  • True
  • False

Question 70

Question
Which of the following is NOT a side effect of Parkinson's drugs
Answer
  • Orthostatic hypotension
  • Hallucinations
  • Dyskinesia
  • Anxiety

Question 71

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

Question 72

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

Question 73

Question
Which of the following is a side effect of lithium?
Answer
  • GI distress
  • Hypothyroidism
  • Renal failure
  • All are side effects of lithium

Question 74

Question
Rasagiline forms toxic metabolites, whereas Selegiline does not
Answer
  • True
  • False

Question 75

Question
Choose ALL of the following that cause weight gain
Answer
  • SNRI
  • SSRI
  • Wellbutrin
  • TCA
  • Mirtazepine
  • Vortioxetine
  • MAOIs
  • Levomilnacipram

Question 76

Question
Which of the following is a side effect of serotonin agonists?
Answer
  • Decrease in blood pressure
  • Coronary vasospasm
  • Constipation
  • Discontinuation syndrome

Question 77

Question
Which of the following is a side effect of serotonin antagonists?
Answer
  • Sexual dysfunction
  • Serotonin syndrome
  • Suicidal ideation
  • QT interval prolongation

Question 78

Question
Which of the following is true regarding Vilazodone?
Answer
  • 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

Question 79

Question
Which of the following is true regarding Vortioxetine?
Answer
  • 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

Question 80

Question
Parkinson's drugs typically cause hallucinations
Answer
  • True
  • False

Question 81

Question
Which of the following causes psychosis?
Answer
  • MAOI
  • Opioids
  • Anticholinergics
  • These all cause psychosis

Question 82

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

Question 83

Question
Which of the following does NOT cause serotonin syndrome?
Answer
  • Serotonin antagonists
  • SSRIs
  • Vilazodone
  • Dextromethorphan

Question 84

Question
Which of the following best describes serotonin syndrome?
Answer
  • 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

Question 85

Question
Which of the following drugs inhibits reuptake of 5-HT and NE?
Answer
  • Escitalopram
  • Desipramine
  • Levodopa
  • Sumatriptan

Question 86

Question
Which of the following drugs inhibits reuptake of ONLY 5-HT?
Answer
  • Nortriptyline
  • Duloxetine
  • Paroxetine
  • Selegiline

Question 87

Question
Which of the following drugs is used to treat migraine by stimulating 5-HT1D receptors, causing cranial vasoconstriction?
Answer
  • Ondansetron
  • Sertraline
  • Almotriptan
  • These are all 5-HT1d stimulants

Question 88

Question
Which of the following drugs acts as an anti-emetic by antagonizing 5-HT3 receptors?
Answer
  • Vortioxetine
  • Vilazodone
  • Palonosetron
  • Duloxetine

Question 89

Question
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?
Answer
  • Vilazodone
  • Vortioxetine
  • Paroxetine
  • Trazodone

Question 90

Question
Which of the following drugs has 5-HT1A agonistic activity and 5-HT3 antagonistic activity?
Answer
  • Vortioxetine
  • Paroxetine
  • Fluoxetine
  • Granisetron

Question 91

Question
Typical antipsychotics, such as Chlorpromazine, are more potent in inhibiting 5-HT2 receptors than D2 receptors
Answer
  • True
  • False

Question 92

Question
Atypical antipsychotics, such as Clozapine, are more potent in inhibiting 5-HT2 receptors than D2 receptors
Answer
  • True
  • False

Question 93

Question
Which of the following drugs is NOT used to inhibit the breakdown of L-DOPA or DA?
Answer
  • Carbidopa
  • Selegiline
  • Tolcapone
  • Levommilnacipran

Question 94

Question
Which of the following drugs is NOT an SNRI?
Answer
  • Venlafaxine
  • Milnacipran
  • Duloxetine
  • Fluoxetine

Question 95

Question
Which of the following drugs is NOT an SSRI?
Answer
  • Sertraline
  • Citalopram
  • Paroxetine
  • Vortioxetine

Question 96

Question
Which of the following does NOT have anticholinergic side effects?
Answer
  • TCA
  • Diphenydramine
  • Benztropine
  • Alosetron

Question 97

Question
Which of the following is more commonly seen with typical antipsychotics?
Answer
  • QTc prolongation
  • EPS/TD
  • Weight gain
  • Sedation

Question 98

Question
Which of the following is NOT typically seen with use of atypical antiopsychotics (except for paliperidone and risperidone)
Answer
  • Weight gain
  • Prolactin elevation
  • Sedation
  • Orthostatic hypotension

Question 99

Question
Clozapine is seen to having the following effects, except for
Answer
  • Sedation
  • Anticholinergic effects
  • Orthostatic hypotension
  • Prolactin elevation

Question 100

Question
Which of the following classes of antidepressants can cause suicidal ideation?
Answer
  • SSRI-like antidepressants
  • SSRI
  • SNRI
  • Trazadone

Question 101

Question
Which of the following antidepressants causes increase in blood pressure and heart rate?
Answer
  • TCA
  • SsRI
  • SSRI-related
  • SNRI

Question 102

Question
Which of the following antidepressants does NOT cause discontinuation syndrome?
Answer
  • SSRI
  • SSRI-related
  • SNRI
  • TCA
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