Pharmacology Chapter 14

Select the correct daily dosage range of duloxetine (Cymbalta). A. 40-120 mg PO B. 300-600 mg PO C. 50-200 mg PO D. 225-375 mg PO

A. 40-120 mg PO

Identify the type of depression that originates from within an individual and may not be linked to easily identifiable causes. A. Exogenous depression B. Mania C. Major depressive disorder D. Bipolar mood disorder

A. Exogenous depression

Which of the following groups of drugs has a drug each with low, high, and sedating effects on the CNS? A. Citalopram, lithium, and amitriptyline B. Citalopram, fluoxetine, and fluvoxamine C. Paroxetine, lithium, and fluoxetine D. None of the above

B. Citalopram, fluoxetine, and fluvoxamine

Which of the following pairs of drugs is approved for the treatment of premenstrual dysphoric disorder, where mood disturbances occur in relation to the menstrual cycle? A. Escitalopram and citalopram B. Fluoxetine and sertraline C. Fluoxetine and citalopram D. Sertraline and escitalopram

B. Fluoxetine and sertraline

Identify the mechanism through which lithium decreases nerve conduction. A. Lithium blocks the reuptake of norepinephrine and serotonin back into the neuronal nerve endings. B. Lithium interferes with nerve conduction, resulting in a decrease in the excitability of nerve tissue. C. Lithium stimulates norepinephrine and dopamine receptors, which stimulate the release of norepinephrine and dopamine from nerve endings. D. None of the above are true.

B. Lithium interferes with nerve conduction, resulting in a decrease in the excitability of nerve tissue.

A 45-year-old male has been diagnosed with narcolepsy, a disorder characterized by an uncontrolled tendency to fall asleep. His physician has prescribed a psychomotor stimulant. Select a correct statement about the mechanism of action of the amphetamine class of drugs. A. Amphetamines stimulate the release of epinephrine and acetylcholine from the nerve endings and prevent the reuptake of these back into the nerve endings. B. Amphetamines stimulate the release of serotonin from the nerve endings and increase the reuptake of serotonin back into the nerve endings. C. Amphetamines stimulate the release of norepinephrine and dopamine from the nerve endings and prevent the reuptake of these back into the nerve endings. D. None of the above are correct.

C. Amphetamines stimulate the release of norepinephrine and dopamine from the nerve endings and prevent the reuptake of these back into the nerve endings.

The tricyclics (TCAs) possess significant anticholinergic and alpha-blocking actions. Select the tricyclic agent that causes moderate sedation, moderate anticholinergic effects, and moderate alpha-blocking effect. A. Doxepin B. Amitriptyline C. Nortriptyline D. Imipramine

C. Nortriptyline

Analyze the different FDA pregnancy categories and determine the appropriate category for lithium. A. Pregnancy Category B B. Pregnancy Category C C. Pregnancy Category D D. Pregnancy Category X

C. Pregnancy Category D

Which of the following is true of the use of psychomotor stimulants in the treatment of narcolepsy and hyperactivity? A. Amphetamines have the disadvantage of producing drug tolerance and dependence. B. Psychomotor stimulants decrease the activity of the sympathetic nervous system. C. Toxic doses of psychomotor stimulants may cause cardiac arrhythmias and nephritis. D. All of the above are correct.

A. Amphetamines have the disadvantage of producing drug tolerance and dependence.

Roger, a chain smoker, decides to quit smoking. He experiences severe CNS effects of nicotine withdrawal. Which of the following drugs may be used to treat Roger? A. Bupropion B. Mirtazapine C. Nefazodone D. Trazodone

A. Bupropion

Martina is prescribed isocarboxazid to treat mental depression. Which of the following foods can be included in Martina's diet? A. Fresh meat B. Beer C. Wine D. Old cheese

A. Fresh meat

Linda, a teenager, is slightly depressed after the death of her pet cat. She presents with symptoms such as decreased appetite and shock. What is the most common method of treatment for such depression? A. Love and understanding of family or friends B. Extensive drug therapy C. Psychotherapy D. Tricyclic antidepressant therapy

A. Love and understanding of family or friends

Select the statement that is not consistent with the mechanism of action or adverse effect profile of the SSRI mirtazapine (Remeron). A. Mirtazapine decreases the release of norepinephrine and serotonin. B. Mirtazapine has potent antihistaminic actions. C. Mirtazapine antagonizes serotonin 5HT2 and 5HT3 receptors. D. Mirtazapine use has been associated with weight gain.

A. Mirtazapine decreases the release of norepinephrine and serotonin.

Question 33 Jamie, a 50-year-old man, is prescribed fluvoxamine to treat his obsessive-compulsive disorder (OCD). Fluvoxamine is available as a 100-mg scored tablets. Jamie takes half a tablet each day. After two days, Jamie begins experiencing symptoms of sedation such as drowsiness. What is the most likely explanation for this occurrence? A. One of the effects of fluvoxamine on the central nervous system is sedation. B. Jamie is consuming more than the recommended dosage per day. C. Jamie is consuming less than the recommended dosage per day. D. Fluvoxamine is contraindicated in patients aged over 40 years.

A. One of the effects of fluvoxamine on the central nervous system is sedation.

Which of the following is true of SSRIs? A. SSRIs increase the concentration of serotonin in the synaptic cleft, resulting in increased stimulation of serotonin receptors. B. SSRIs decrease the concentration of serotonin in the synaptic cleft, which contributes to its antidepressant effect. C. SSRIs decrease the concentration of serotonin in the synaptic cleft, resulting in decreased stimulation of serotonin receptors. D. SSRIs decrease the release of and increase the reuptake of norepinephrine and dopamine.

A. SSRIs increase the concentration of serotonin in the synaptic cleft, resulting in increased stimulation of serotonin receptors.

A patient has been taking amitriptyline for 5 to 6 days, but she is still experiencing the feelings of depression. She wants the doctor to change her medication because she feels that the drug is not working. After doing research on amitriptyline, you tell the patient that: A. amitriptyline is working, but the full antidepressant effect can take as long as 2 to 4 weeks to develop. B. amitriptyline is not working and the doctor will change her medication. C. amitriptyline is working, but the full antidepressant effect can take as long as 7 to 10 days to develop. D. None of the above are correct.

A. amitriptyline is working, but the full antidepressant effect can take as long as 2 to 4 weeks to develop.

The common adverse effects of using of psychomotor stimulants are: A. dry mouth, tachycardia, hypertension, and insomnia. B. increased blood pressure, heart rate, and CNS activation. C. constipation, somnolence, and weight gain. D. urinary retention, constipation, blurred vision, and hypotension.

A. dry mouth, tachycardia, hypertension, and insomnia.

Kevin, a 12-year-old boy, grew up with his pet dog, Sparky, who was almost the same age as Kevin. Age-related health complications caused Sparky?s death, following which Kevin was distraught. He was depressed for more than a week and refused to go to school. The type of depression affecting Kevin is termed _____. A. exogenous depression B. major depressive disorder C. mania D. bipolar mood disorder

A. exogenous depression

Due to their alpha-blocking, anticholinergic, and antihistaminic effects, tricyclic antidepressants are contraindicated in patients suffering from: A. glaucoma and prostatic hypertrophy. B. hypertension and tachycardia. C. sexual dysfunction and urinary retention. D. obesity and insomnia.

A. glaucoma and prostatic hypertrophy.

Explain the underlying principle of the Monoamine Theory of Mental Depression. A. Low levels of epinephrine and serotonin, which are referred to chemically as the monoamines, lead to depression. B. Low levels of norepinephrine and serotonin, which are referred to chemically as the monoamines, lead to depression. C. Low levels of norepinephrine and dopamine, which are referred to chemically as the monoamines, lead to depression. D. None of the above are correct.

B. Low levels of norepinephrine and serotonin, which are referred to chemically as the monoamines, lead to depression.

A 50-year-old woman has been diagnosed with major depression. She has no other health issues. Her physician has several choices of drug classes to treat her. Select the drug class from which the physician should prescribe a drug for the patient. A. MAOIs B. SSRIs C. Lithium D. Psychomotor stimulants

B. SSRIs

One of your patients is undergoing MAO inhibitor therapy. You have been asked to explain to the patient the dietary restrictions concerning tyramine. The patient does not know what foods should be avoided. You list the foods to avoid as: A. coffee, chocolate, and cookies. B. beer, wine, herring, and certain cheeses. C. skim milk, cottage cheese, and fresh apples. D. oatmeal, cornflakes, and noodles.

B. beer, wine, herring, and certain cheeses.

Tricyclics interfere with antihistamine and anticholinergic drug agents resulting in _____. A. increased sedation B. dry mouth, constipation, urinary retention, and blurred vision C. increased metabolism of the tricyclics, leading to decreased effectiveness D. increased CNS stimulation, hyperpyrexia, and seizures

B. dry mouth, constipation, urinary retention, and blurred vision

Compare the effects of monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs) on norepinephrine and serotonin. A. MAOIs increase the levels of norepinephrine and serotonin in the brain, and TCAs decrease the levels of norepinephrine and serotonin in the neuronal nerve endings. B. MAOIs increase the levels of norepinephrine and serotonin in the neuronal nerve endings, and TCAs increase the levels of norepinephrine and serotonin in the brain. C. Both MAOIs and TCAs increase the levels of norepinephrine and serotonin in the brain. D. Both MAOIs and TCAs increase the levels of norepinephrine and serotonin in the neuronal nerve endings.

C. Both MAOIs and TCAs increase the levels of norepinephrine and serotonin in the brain.

The adverse effects of SNRIs include: A. increased sedation, insomnia, and nephritis. B. cardiac arrhythmias, seizures, and CNS depression. C. GI disturbances, CNS excitation, and increased blood pressure. D. renal insufficiency, mania, and convulsions.

C. GI disturbances, CNS excitation, and increased blood pressure.

Identify the statement that best explains bipolar mood disorder. A. It is a disorder that entails depression caused by external factors. B. It is depression caused by factors that originate within the patient. C. It is a disorder consisting of alternating periods of depression and mania. D. None of the above are true.

C. It is a disorder consisting of alternating periods of depression and mania.

Identify the type of depression in which there is a period of shock followed by a period of readjustment and resolve that life must go on. A. Exogenous depression B. Mania C. Major depressive disorder D. None of the above

C. Major depressive disorder

Select the statement that is not consistent with the mechanism of action or adverse effect profiles of the atypical SSRIs nefazodone (generic) and trazodone (Desyrel). A. Nefazodone and trazodone are weak reuptake inhibitors of serotonin and norepinephrine. B. Nefazodone and trazodone provide some antidepressant effects. C. Nefazodone and trazodone are prescribed for patients who are trying to quit smoking. D. Nefazodone and trazodone cause sedation, orthostatic hypotension, and liver toxicity.

C. Nefazodone and trazodone are prescribed for patients who are trying to quit smoking.

Describe the type of disorder that responds to lithium treatment. A. Disorders characterized by alternating cycles of depression and mania B. Disorders characterized by hyperactivity and excessive elevation of mood C. Disorders characterized by wide shifts in mood D. All of the above

D. All of the above

You have been asked to explain to tell a patient about the common side effects that he should report while taking SSRIs. Which of the following should be included in the reportable side effects? A. Excessive agitation and seizures B. Loss of appetite and nausea C. Headache and nervousness D. All of the above

D. All of the above

Explain the pharmacologic actions of bupropion (Wellbutrin). A. Bupropion increases the release of norepinephrine and dopamine. B. Bupropion inhibits the reuptake of norepinephrine and dopamine. C. Bupropion has minimal effects to inhibit the reuptake of serotonin. D. All of the above are correct.

D. All of the above are correct.

Identify a difference between secondary amines and tertiary amines. A. Tertiary amines contain three amine substitutions on the nitrogen, whereas secondary amines contain two amine substitutions on the nitrogen. B. Secondary amines mainly increase brain levels of norepinephrine more than serotonin, while the tertiary amines increase brain levels of serotonin more than epinephrine. C. Tertiary amines produce more sedation than do the secondary amines. D. All of the above are correct.

D. All of the above are correct.

Patients taking lithium should be instructed to drink adequate amounts of fluids and take adequate amounts of sodium. Select the reason for this instruction. A. Hyponatremia promotes the retention of lithium, which can lead to toxic levels of lithium in the blood. B. Sodium ions and lithium ions compete against each other for renal elimination. C. Lithium is a salt and leads to an increase in thirst and an increase in the frequency of urination. D. All of the above are correct.

D. All of the above are correct.

Which of the following is a difference between mania and depression? A. Depression is a mental state characterized by feelings of hopelessness, frustration, and depressed mood, whereas mania is characterized by excitement, hyperactivity, and elevated mood. B. Depression is treated with SSRIs, whereas mania is treated with lithium. C. Depression is associated with low levels of norepinephrine and/or serotonin, while high levels of norepinephrine and/or serotonin are involved in mania. D. All of the above are correct.

D. All of the above are correct.

Identify the common symptoms associated with a patient suffering from mania. A. The patient shows signs of hyperactivity. B. The patient is very talkative. C. The patient exhibits unrealistic thoughts. D. All of the above are true.

D. All of the above are true.