EXAM 4 - PAST QUESTIONS

An intravenous bolus of thiopental usually leads to loss of consciousness within 10-15 seconds. If no further drugs are administered, the patient will regain consciousness in just a few minutes. The reason for this is that thiopental is: A. An exceptionally good substrate for renal tubular secretion B. Removed by rapid exhalation C. Rapidly metabolized by hepatic enzyme systems D. Rapidly redistributed from the brain to other body tissues E. Rapidly metabolized by CNS enzymes

D

Aripiprazole (Abilify) functions as a partial agonist at the D2 receptor, which means it has ____________ activity than dopamine at the D2 receptor, which results in _____________ dopaminergic neurotransmission in the mesolimbic pathway. A. more; increased B. more; normalized C. less; increased D. less; normalized E. the same; normalized

D

As a group, benzodiazepines differ from one another significantly only in terms of: A depth of CNS depression. B. pharmacologic actions. C. side effects. D. onset and duration of action.

D

Flunitrazepam (Rohypnol®, roofies) has been used as a "date rape" drug due to which of the following pharmacological properties? A. It produces a "conscious sedation" at higher doses. B. It produces anterograde amnesia at higher doses. C. It has additive or synergistic CNS depressant activities when combined with alcohol. D. All of the above are correct. E. Only two of the above are correct.

D

In some depressed patients there is a ________ of neurons/cells in the ________ area of the brain. Antidepressants are thought to ____________ neurogenesis (birth of new cells) A. gain; striatum; increase B. loss; striatum; decrease C. loss; hippocampus; increase D. there is no such thing as neurogenesis—you are born with all the brain cells you will ever have.

C

Secobarbital A. Binds to the benzodiazepine binding site on its target receptor. B. Has actions very similar to atropine on salivary and lacrimal secretions. C. Increases the potency of GABA at the GABA-A receptor, but is NOT a benzodiazepine. D. Enhances the action of GABA in the synaptic cleft.

C

This SSRI antidepressant , ________________, is less likely to cause a serotonin withdrawal syndrome because it has a ___________________ A. imipramine; short half-life B. Sluoxetine; long half-life C. citalopram; special coating D. venlafaxine; high efficiacy

C

This receptor is not activated upon binding of biogenic amine neurotransmitter or amino acid neurotransmitter. A. D2 receptor B. D1 receptor C. Nicotinic Ach receptor D. Ionotropic GABA receptor E. Histamine H1 receptor

C

Which of the following describes the intravenous drug which would most appropriately be used to hasten recovery from excessive sedative effects of the drug midazolam? A. a competitive benzodiazepine antagonist at the GABA(A) receptor complex. B. an allosteric benzodiazepine agonist at the GABA(A) receptor complex. C. a competitive GABA antagonist at the GABA(A) receptor complex. D. an allosteric benzodiazepine antagonist at the GABA(B) receptor complex. E. a CNS stimulant such as amphetamine.

C

Which of the following receptor-mediated intracellular signaling events should we expect to be excitatory to a neuron? (Select all from the list that apply) 1. ⬆ cAMP 2. ⬆ Na+ conductance 3. ⬆ IP3/DAG/Ca2+ 4. ⬆ Cl- conductance 5. ⬇ cAMP 6. ⬆ K+ conductance A. 1, 2, 3, 4 & 6 B. 1, 2, 3 & 6 C. 1, 2 & 3 D. 4, 5 & 6 E. 2, 4 & 6

C

Which of the following would most appropriately be used to prepare a patient before an outpatient procedure such as a colonoscopy? A. diazepam B. imipramine C. midazolam D. chlordiazepoxide =E. flunitrazepam

C

According to the biogenic amine hypothesis of depression, which of the following statements is true? A. Norepinephrine is elevated in depressed individuals B. Monoamine oxidase levels are increased in depressed individuals C. Tyramine levels are increased in depressed individuals D. Serotonin levels are decreased in depressed individuals E. Antidepressants primary mechanism of action is through dopamine receptor blockade.

D

After receiving lidocaine during nerve-block local anesthesia, the patient's pulse became irregular and slow. The correct analysis of this finding is: a. The lidocaine may have caused cardiac toxicity. b. There may have been excessive epinephrine in the anesthetic. c. The patient is now pain free, so the pulse rate is slower. d. This is a normal response when lidocaine is used for nerve block local anesthesia.

D

29. Which of the following statements is FALSE? i. D2 agonism and subsequent increases in prolactin in the tuberoinfundibular dopamine pathway may lead to gynecomastia. ii. An antipsychotic with high 5HT2A and lower D2 is more likely to be efficacious for negative and cognitive symptoms. iii. Antipsychotics with higher D2 than 5-HT2A affinities are more likely to result in extrapyramidal symptoms iv. Affinity at adrenergic receptors are likely responsible for side effects involving hypotension. A. i B. ii C. iii D. iv E. none of the above

A

Clozapine: A. Antagonist at 5-HT type 2A receptors B. Reversible inhibitor of MAO type A C. Serotonin type 3 receptor antagonist D. 5-HT type 1D receptor agonist

A

D2 receptor antagonism is an activity primarily found only in typical antipsychotics compared to atypical agents. A. True B. False

A

In treating insomnia, those with delayed onset of sleep should be prescribed a sleep agent/benzodiazepine with ________________, while those who wake up early in the morning (a.m. hours) should be prescribed sleep agents/benzodiazepine with _________________ . A. a short half-life, a long half-life B. a long half-life, a short half-life C. low affinity of a1 subunits at GABAa receptors, activity at GABAb receptors D. activity at GABAa receptors, activity at GABAb receptors E.both A and D

A

Local anesthetics act on the target molecule located on the intracellular surface of the nerve fiber. A. True B. False

A

Under most conditions, the benzodiazepines are much safer to use than the barbiturates. In part, this can be explained at the drug-receptor level based on the fact that ... A. benzodiazepines and barbiturates bind to different allosteric sites on the GABA(A) receptor complex, and barbiturates can exhibit a much greater maximum effect. B. benzodiazepines share an allosteric binding site with the barbiturates on the GABA(A) receptor complex, but have higher affinity than barbiturates. C. benzodiazepines bind exclusively to GABA(A) receptors, whereas barbiturates bind to both GABA(A) and GABA(B) receptors. D. benzodiazepines bind to allosteric sites on GABA(A) receptors, and barbiturates bind to allosteric sites on GABA(B) receptors. E. benzodiazepines share an allosteric binding site with barbiturates on the GABA(A) receptor complex but have a shorter half-life than barbiturates.

A

When comparing the actions of barbiturates to benzodiazepines, the barbiturates: A. Can directly activate the GABA-A receptor, while the benzodiazepines will not. B. Have a lesser potential for drug-drug interactions. C. Have a broader therapeutic index. D. Are safer to use long term for insomnia. E. Almost always have a longer duration of action.

A

Which of the following statements is TRUE? A. High D2 receptor occupancy by antipsychotic agents is more likely to cause extrapyramidal symptoms (EPS). B. The therapeutic response of schizophrenic patients to antipsychotics is highly predictable if the antipsychotic agents don't produce EPS. C. The dopamine hypothesis of schizophrenia indicates that positive and negative symptoms are associated with increased DA neurotransmission on the four dopamine pathways. D. Tardive dyskinesia is a rare side effect that occurs shortly after starting a first generation antipsychotic and can be quickly alleviated by lowering the dose.

A

A male patient complains of pain in his chest and discharge from his nipples. This is most likely due to activity of his antipsychotic medication on the mesolimbic dopamine pathway. A. True B. False

B

Barbiturates are antagonists at GABAa receptors. A. True B. False

B

Benzodiazepines with higher affinity for the α1 subunit of GABAa receptors are better anxiolytics. A. True B. False

B

The _________________ of schizophrenia include ________________, and are associated with _______________ pathway. A. Cognitive symptoms; decreased executive function; hyperfunction of the tuberoinfundibular B. Positive symptoms; delusions and hallucinations; hyper function of the mesolimbic C. Negative symptoms; apathy and anhedonia; hyperfunction of the mesocortical D. Positive symptoms; apathy and anhedonia; hyperfunction of the mesocortical E. Negative symptoms; Flattened affect; hypofunction of the striatonigral

B

A family pharmacist advising a single mother on administering medicines to her young child was CORRECT in which of the following statements? A. "Remember that a child's metabolism is faster than that of an adult; thus give the child a slightly larger dose." B. "Remember that a child's metabolism is slower than that of an adult; thus give the child a slightly lower dose." C. "When your physician prescribes a drug, she takes into account that the blood brain barrier of the child is not fully developed." D. "Remember that children have more baby fat than muscle."

C

Alosetron: A. Antagonist at 5-HT type 2A receptors B. Reversible inhibitor of MAO type A C. Serotonin type 3 receptor antagonist D. 5-HT type 1D receptor agonist

C

Compared to typical antipsychotic drugs, which of the following characteristics are more likely to be found in atypical antipsychotic drugs? A. Have more block of the nigrostriatal pathway B. Have less effect on mesocortical pathways C. Blocks serotonin effects more than dopamine effects D. Blocks both D1 and D2 receptors E. Have less of an effect on the negative symptoms of schizophrenia

C

In comparing typical and atypical antipsychotics, which of the following attributes best describes typical agent class? A. block serotonin 5-HT2A as much as dopamine D2 receptors B. activate D2 receptors more than 5-HT2A C. have more extrapyramidal side effects D. are less effective at treating positive symptoms of schizophrenia E. are more effective at treating the cognitive symptoms of schizophrenia

C

Symptoms for major depression typically do NOT include which of the following? A. Depressed or irritable mood B. Anhedonia C. Increased involvement in pleasurable activities with a high potential for negative consequences D. Changes in sleep patterns (e.g. hypo or hyper insomnia) E. More than one of the above is a correct response.

C

The monoamine hypothesis of depression in part is based on a serendipitous finding that the drug reserpine: A. Can induce depression because it inhibits NET and DAT, causing a depletion of CNS monoamines. B. Can reduce depression because it inhibits NET and DAT, causing an increase in synaptic levels of monoamines. C. Can induce depression because it inhibits VMAT, causing a depletion of CNS monoamines. D. Can reduce depression because it inhibits VMAT, causing an increase in synaptic release of monoamines. E. None of the above are correct, because being an antihypertensive drug, reserpine action is restricted to the periphery.

C

Which one of the following statements concerning benzodiazepines is false? A. benzodiazepines have a very low therapeutic index B. benzodiazepines can function as muscle relaxants C. shorter half-life - benzodiazepines are preferentially used for treatment of insomnia D. disinhibition can be an important side-effect of the benzodiazepine drugs E. All of the above are false statements

C

Approved therapeutic applications for diazepam do NOT include: A. short-term anxiolytic. B. sedation. C. general anesthetic. D. insomnia. E. All of the above are applications

C/D

Activation of this receptor represents the major mechanism for inhibitory neurotransmission in the CNS. A. D2 receptor B. D1 receptor C. Nicotinic Ach receptor D. Ionotropic GABA receptor E. Histamine H1 receptor

D

Which one of the following CNS receptors has an integral ion channel so that the effects of its activation do not typically involve second messenger systems? A. m-Ach - acetylcholine B. GABA-B - GABA C. D2A-dopamine D. 5-HT3 - serotonin E. 5-HT2 - serotonin

D

Which statement regarding SSRIs is true? A. Their primary mechanism of action is through blocking the dopamine transporter (DAT) B. They alleviate depressive symptoms within 120 minutes of acute administration C. SSRIs include each of the following agents: Sluoxetine, citalopram, escitalopram, and duloxetine D. They have the potential to inhibit the conversion of codeine to morphine, thereby reducing the analgesic efficacy of codeine

D

A 46-year-old woman visits her podiatrist to have several bunions removed from her right foot. She chooses conscious sedation rather than general anesthesia for this procedure. She is given IV midazolam to supplement the local anesthetics that are injected into her foot. Midway through the surgery, she suddenly becomes agitated and combative and exhibits involuntary movements. The anesthesiologist determines that she is having a paradoxical reaction to the midazolam. Which should be administered? A. flumazenil B. picrotoxin C. selegiline D. fluoxetine E. buspirone

A

A middle-aged woman arrives to see her physician complaining of moderate anxiety. Which of the following drugs will help relieve her anxiety with the least risk of unwanted drowsiness side effects? A. Buspirone B. Chlordiazepoxide C. Haloperidol D. Zolpidem E. Phenobarbital

A

A patient is taking a benzodiazepine to relieve anxiety. Which of the following should the doctor consider? i. The patient may have more anxiety if the drug is suddenly stopped. ii. The benzodiazepine should be given as long as the patient feels anxiety, unless it produces a linear dose-effect curve. iii. The patient should be warned to stop taking the drug immediately if it becomes less effective in treating their anxiety. iv. A z-drug should be considered if the benzodiazepine does not work. A. i only B. ii only C. iii only D. iv only E. ii and iv

A

At the drug-receptor level, the clinical safety advantage of benzodiazepines over barbiturates can best be explained by the fact that: A. benzodiazepines and barbiturates bind to different allosteric sites on the GABA(A) receptor complex, but only barbiturates also act as direct agonists. B. benzodiazepines share an allosteric binding site with barbiturates on the GABA(A) receptor complex but have lower affinity than barbiturates. C. benzodiazepines bind exclusively to GABA(A) receptors, whereas barbiturates bind to both GABA(A) and GABA(B) receptors. D. benzodiazepines bind to allosteric sites on GABA(A) receptors, and barbiturates bind to the GABA sites on GABA(A) receptors. E. benzodiazepines share an allosteric binding site with barbiturates on the GABA(A) receptor complex but typically have a longer half-life than barbiturates.

A

Blurred vision, dry mouth, and constipation are side effects of many antidepressant drugs. These are a result of: A. anticholinergic effect. B. beta-1 receptor blockade. C. neuroleptic effect. D. sympathomimetic effect. E. None of the above

A

Classify the following drugs in order pharmacologically (1 to 4) 1) Fluoxetine (Prozac®) 2) Citalopram (Celexa®) 3) Duloxetine (Cymbalta®) 4) Imipramine (Tofranil®) A) SSRI, SSRI, SNRI, TCA B) SSRI, MAOI, SNRI, SNRI C) SSRI, SNRI, TCA, SSRI D) TCA, SSRI, Atypical, TCA

A

Compared to typical antipsychotic drugs, which of the following characteristics are more likely to be found in atypical antipsychotic drugs? A. less nigrostriatal blockade B. blocks dopamine receptor activity and more than serotonin receptor activity C. less effect on the negative symptoms of schizophrenia D. less effect on mesocortical pathways E. blocks both D1 and D2 receptors

A

In comparing typical and atypical antipsychotics, which of the following attributes best describes the atypical agents? A. block serotonin 5-HT2A proportionally more than dopamine D2 receptors B. activate D2 receptors more than 5-HT2A C. have more extrapyramidal side effects D. have little impact on negative symptoms E. produce cognitive symptoms by activating glutamate receptors

A

In patients afflicted with bipolar disorder; treatment with mood stabilizers such as lithium as are less effective in the reduction of __________ . A. depressive symptoms B. reducing mania C. mood swings D. sleep disturbances

A

Lithium has a low therapeutic index and blood levels should be monitored closely. A. True B. False

A

Opisthotonus following ingestion of strychnine reflects which one of the following phenomena? A. Excessive excitatory neurotransmission B. Excessive inhibitory neurotransmission C. Blockade of excitatory neurotransmission D. Blockade of inhibitory neurotransmission E. Both C and D

A

Patient NK was recently diagnosed with schizophrenia and is currently being treated with clozapine. During his last visit to the psychiatrist he complains of weight gain, and the psychiatrist notices that NK has low blood pressure and dizziness when standing. Which of the following treatment options is most likely to help NK? i. Switch from the original drug, to drug A with an affinity profile of α2>>D2>>5- HT2A ii. Switch from the original drug B with an affinity profile of 5-HT2A>D2 with high affinity for H1 iii. Switch from the original drug C with an affinity profile of 5-HT2A>D2 with no affinity for α2 and low affinity for H1 iv. Switch to a recently approved antipsychotic agent that has less activity in the tuberoinfundibular pathway A. i only B. ii only C. iii only D. i and iv E. ii and iv

A

Some positive symptoms of schizophrenia include hallucinations, disorganized speech and delusions. A. True B. False

A

The actions of benzodiazepines include which of the following findings? (Select all from the list that apply.) 1. Sleep deprivation 2. Acute relief of general anxiety 3. Suppression of seizures and/or seizure activity 4. Development of tardive dyskinesia 5. Increase in muscle spasms or tics A. 2 & 3 B. 1, 2 & 3 C. 2, 3 & 5 D. 1 & 2

A

A patient suffering from generalized anxiety disorder (GAD) has a history of drug dependence that includes the illicit use of secobarbital ("reds") and a variety of other drugs. Psychotherapy is indicated, but the physician also prescribes a drug that can be helpful in GAD and that has the advantage of no abuse liability. The drug prescribed was most likely to have been ... A. diazepam B. buspirone C. baclofen D. vigabatrine E. phenobarbital

B

A schizophrenic patient has gained 100 lbs in the past year while under drug treatment. His doctor should consider switching him to an antipsychotic drug with less H1 receptor affinity. A. True B. False

B

Activation of this receptor is predicted to increase production of cAMP. A. D2 receptor B. D1 receptor C. Nicotinic Ach receptor D. Ionotropic GABA receptor E. Histamine H1 receptor

B

Assuming a standard length of sleep, 6-9 hours, which of the following statements is true? i. Most REM sleep occurs at the beginning of a sleep session ii. Sleep occurs in repetitive cycles, with deep sleep occurring less frequently as the night progresses. iii. Alcohol promotes restorative REM sleep. iv. On average, the elderly sleep less every night but spend more time in deep sleep and wake up less frequently. A. i only B. ii only C. i and iii D. ii and iv E. ii and iii

B

Extrapyramidal side effects occur when high α2 receptor occupancy occurs. A. True B. False

B

High blood/gas partition coefficient for an inhalation general anesthetic means a fast rise in arterial anesthetic tension. A. True B. False

B

It is safe to rapidly stop taking the drug venlafaxine (Effexor) because it has a very long half life in the body. A. True B. False

B

Local anesthetics selectively block nerve conduction in sensory neurons without affecting motor neurons. A. True B. False

B

Schizophrenia is associated with hyperfunction in both mesocortical and mesolimbic pathways. A. True B. False

B

The monoamine hypothesis of depression in part is based on a finding that ________ given before reserpine prevented the breakdown of _____________ (correctly fill in the blanks) A. cocaine; dopamine B. MAO-Inhibitors; 5HT and norepinephrine C. MAO-Inhibitors;glutamate D. Bupropion (Wellbutrin®); Norepinephrine

B

Which of the following describes the intravenous drug which would most appropriately be used to hasten recovery from the sedation effects of midazolam? A. a competitive GABA antagonist at the GABA(A) receptor complex. B. an antagonist at the benzodiazepine site of the GABA(A) receptor complex. C. a dopamine receptor agonist. D. an allosteric benzodiazepine agonist at the GABA(A) receptor complex. E. a dopamine receptor antagonist.

B

Patient LK has been successfully treated with a first generation antipsychotic drug for years. However, on a recent visit, his psychiatrist noticed that LK appeared less interactive. He avoided questions and did not respond as on prior visits. With further questioning he admitted that he has not been participating in social events and normal activities that he previously expressed great interest in. His doctor is considering altering his medications, including switching to newly approved drugs. Which of the following treatments should be best to consider? i. New Drug A: D1>D2>>H1 (refers to order of receptor activity) ii. New Drug B: 5-HT2A>D2>>H1 (refers to order of receptor activity) iii.Switching to an antipsychotic drug with more alpha-1 and less H1 activity. iv. Giving an anticholinergic drug in addition to the first generation antipsychotic. v. Prescribing an antidepressant drug instead of the first generation antipsychotic. vi.Prescribing a drug that has recently been shown to normalize mesocortical activity in schizophrenics . vii. Prescribing a drug that has recently been shown to normalize nigrostriatal activity in schizophrenics. A. i or iv B. v only C. ii or vii D. ii or vi E. i or iii

D

Reserpine inhibits ____________, which leads to a depletion of norepinephrine and 5HT, an effect that can be attenuated by the prior administration of _________________ A. SERT; Sluoxetine B. VMAT; ketamine C. 5-HT3 receptors; SSRIs D. VMAT; MAOIs

D

Sleep is thought to be an active process for each of the following reasons EXCEPT: A. Sleep occurs both with REM and NREM sleep. B. Sleep can be induced upon electrical stimulation of certain parts of the brain. C. Chronic insomnia can be induced upon lesions of other brain regions. D. Barbiturates, benzodiazepines and alcohol can facilitate sleep. E. ALL of the above are correct.

D

The Neurotrophin/Neurogenesis model of depression states that in both human and rodent models of depression there is a(n) __________ in cell number in the _______________ and this is ___________________ by antidepressants. Choose the item with the 3 terms that correctly completes in the 3 blanks. A) increase, cerebellum, worsened B) increase, hippocampus, reversed C) decrease, prefrontal cortex, unaffected by D) decrease, hippocampus, reversed

D

The best treatment strategies for Bipolar depression usually recommend: A) telling the patient to get over it already, AKA the "Buck Up" approach B) mainly a typical antipsychotic agent combined with an anti-anxiety drug if necessary C) a mood stabilizer, usually used alone to avoid dangerous serotonin-related drug interactions D) a mood stabilizer + an antidepressant + an antipsychotic + psychotherapy E) There are no effective pharmacological treatments for bipolar disorders

D

The blood brain barrier: A. Permits entry into the brain of lipid soluble drugs B. Excludes from the brain lipid soluble drugs C. Excludes from the brain drugs bound to proteins and ionized drugs D. Both A and C E. Both B and C

D

The negative symptoms of schizophrenia are, according to the dopamine theory, attributable to alteration of dopamine actions in which one of the following pathways: A. Tuberoinfundibular pathway B. Nigrostriatal pathway C. Mesocortical pathway D. Mesolimbic pathway E. None of the above

D

The signal cascade triggered by gamma-aminobutyric acid-mediated activation of GABA(A) receptors includes the: A. opening of a chloride channel and subsequent depolarization of the postsynaptic membrane. B. interaction with heterotrimeric G proteins and subsequent inhibition of adenylyl cyclase. C. interaction with heterotrimeric G proteins and subsequent activation of potassium channels. D. opening of a chloride channel and subsequent hyperpolarization of the postsynaptic membrane. E. opening of a chloride channel and subsequent opening of voltage-gated Ca2+ channels.

D

Which of the following receptor-mediated signaling events should we expect to be inhibitory to a neuron? (Select all from the list that apply) 1. ⬆ cAMP 2. ⬆ Na+ conductance 3. ⬆ IP3/DAG/Ca2+ 4. ⬆ Cl- conductance 5. ⬇ cAMP 6. ⬆ K+ conductance A. 1,2,3,4&6 B. 1,2,3&6 C. Only 5 D. 4,5&6 E. 4&6

D

Which of these are both biogenic amines AND are neurotransmitters in the central nervous system? (Select all from the list that apply) 1. Serotonin 2. L-dopa 3. Acetylcholine 4. Dopamine 5. Glutamate A. 1, 2, 3 & 4 B. 1, 2 & 4 C. 1, 3, & 5 D. 1 & 4

D

________ class of antidepressants are therapeutically effective in some individuals but have side effects including dangerous interactions with dietary amines leading to life threatening hypertensive events. (Find all that can correctly fill in the blank) A. Selective Serotonin Reuptake Inhibitors B. Citalopram C. Tricyclics D. Monoamine Oxidase Inhibitors

D

A disadvantage of barbiturates relative to the use of benzodiazepines is (are): (If all are correct then select E.) A. Upon discontinuation, barbiturates cause REM rebound, benzodiazepines do not. B. At therapeutic doses barbiturates can produce all degrees of CNS depression, from sedation to anesthesia; benzodiazepines do not. C. Barbiturates can produce profound respiratory depression, benzodiazepines do not. D. Barbiturates induce drug metabolizing enzymes, benzodiazepines do not. E. ALL of the above are correct responses.

E

A man is taking phenelzine for atypical depression. He goes to a party and consumes a few bottles of beer and some aged cheese and crackers. Later that evening, he develops a headache so severe he needs to go to the hospital. He is found to have a blood pressure of 210/100 mm Hg. The emergency room physician explains to him that because he is taking this medication, he should not have consumed those particular foods at the party because they contain which of the following types of substances? A. A direct-acting sympathomimetic B. A false transmitter C. A muscarinic agonist D. A neuronal uptake inhibitor E. An indirect-acting sympathomimetic

E

A patient with a history of depression enters the ER in a highly agitated state complaining of tremors, a fever and muscle spasms. The patient has been taking fluoxetine (Prozac) for over a year and had recently started taking paroxetine (Paxil) as well. Given the new symptoms, which of the following treatments should be avoided? A. paroxetine B. fluoxetine C. meperidine (Demerol) D. desipramine (Norpramin) E. all of the above

E

Benzodiazepines are _________________; they work primarily by ________________ neurons; and they _______________ neuronal firing. A. GABAa agonists; depolarizing; enhance B. GABAa antagonists; hyperpolarizing; enhance C. GABAa agonists; hyperpolarizing; inhibit D. GABAa positive allosteric modulators; depolarizing; enhance E. GABAa positive allosteric modulators; hyperpolarizing; inhibit

E

Benzodiazepines are thought to cause sedative and/or anxiolytic effects by A. increasing functional activity at GABAB receptors B. enhancing the actions of dopamine C. blocking the NMDA glutamate receptor subtype D. acting as a partial agonist at 5-HT receptors E. facilitating GABA-mediated increases in chloride ion conductance

E

Patient NK was recently diagnosed with schizophrenia and is currently being treated with haloperidol. During his last visit to the psychiatrist he complains of shaking hands, muscle aches and weight gain. His doctor is considering a number of options including the following treatments. Which treatment regimen from the listing (i-iv) are most likely to help NK? i. New drug A with an affinity profile of D1>>D2>>5-HT2A ii. New drug B with an affinity profile of 5-HT2A> D2 with no affinity for α2 iii. adding an anticholinergic to the treatment regimen iv. switching to a recently approved antipsychotic that has less activity in the tuberoinfundibular pathway A. i only B. ii only C. i and iii D. i and iv E. ii and iii

E

The CNS depressant actions of alcohol will be exacerbated by the co-use of which of the following agents? A. Diazepam B. Phenobarbital C. Chlorpromazine D. Zolpidem E. All of the above

E

Vasoconstrictors may be combined with local anesthetics for which reason(s)? A. Decrease the risk of toxicity. B. Prevent bradycardia. C. Prolong the duration of anesthesia. D. Both A and B. E Both A and C

E

Which of the following drugs bind at the α1 subunit of the GABA-A receptor? (If all are correct then select E.) A. Zolpidem B. Diazepam C. Triazolam D. Flurazepam E. All are correct

E

Which of the following statements is true? If ALL are true, then select E. i. Suddenly stopping a benzodiazepine after prolonged use may result in insomnia. ii. As compared with benzodiazepines, barbiturates also block AMPA receptors leading to increased CNS depression. iii. Barbiturates are most frequently abused/used recreationally in combination with other drugs. iv. Benzodiazepines are less likely than barbiturates to cause anesthesia, coma and death. A. i only B. ii only C. i and ii D. ii and iv E. ALL of the above are true

E