Pharmacology Ch. 19&20 Analgesic, sedatives, and hypnotics & Psychotropics, Alcohol, & Drug abuse.

58. Which of the following statements is true of Naltrexone? a. It blocks pleasurable sensations associated with alcohol and opiates. b. It can be used as an aid to therapy in opiate-addicted patients. c. It is more effective than disulfiram (Antabuse) in alcoholics who are still drinking. d. All of the above are true.

a. It blocks pleasurable sensations associated with alcohol and opiates. *Naltrexone

56. Crystal, crank, and ice are all street names for which? a. Methamphetamines b. Cocaine c. Marijuana d. Benzodiazepines

a. Methamphetamines

38. Heterocyclics should be used cautiously in which patient populations? a. Those who exhibit suicidal tendencies, patients with seizure disorders, and those with cardiac problems b. Persons with Parkinson's disease, kidney disorders, and thyroid disease c. Patients with depression, depressed vital signs, and those who operate machinery d. Renal or hepatic impairment

a. Those who exhibit suicidal tendencies, patients with seizure disorders, and those with cardiac problems *Heterocyclics

22. CNS stimulants are used to treat _________. a. central nervous system dysfunction b. types of depression c. bipolar disorders d. anxiety disorders, neuroses, some psychosomatic disorders, and insomnia

a. central nervous system dysfunction Stimulants caffeine citrate - Cafcit amphetamine mixture - Adderall lisdexamfetamine - Vyvanse methylphenidate - Ritalin modafinil - Provigil Nonstimulants atomoxetine Strattera

26. Side effects of controlled CNS stimulants can include _______. a. dilated pupils with photophobia, nervousness b. increased appetite and weight gain, constipation, and urinary retention c. headache, stiff neck, hypertension, or hypertensive crisis d. sexual dysfunction, nausea, anorexia, dizziness, and headache

a. dilated pupils with photophobia, nervousness *CNS stimulants

35. Which list describes relative contraindications or cautions to be observed with tricyclics? a. Hyperthyroidism, history of drug dependence, or eating disorders b. Cardiac, renal, GI, and liver disorders c. Cerebrovascular disease d. Patients who are prone to suicide, diabetics, and those with bipolar disorders

b. Cardiac, renal, GI, and liver disorders *Tricyclics*

47. Treatment of acute alcohol poisoning is ___________. a. vitamin B (thiamine), multiple vitamins, and folic acid b. Close monitoring for respiratory status, prevent aspiration, IV electrolytes, fluids and benzodiazepines if needed c. low-carbohydrate and high-protein diet d. elimination of caffeine

b. Close monitoring for respiratory status, prevent aspiration, IV electrolytes, fluids and benzodiazepines if needed

25. Requiring a larger dose of medication to achieve the same level of effect. a. Tolerance b. Dependence c. Placebo effect d. Paradoxical reaction

b. Dependence

43. Identify the mechanism of action of MAOIs. a. Potentiation of norepinephrine and serotonin activity by blocking their reuptake b. Increasing concentrations of serotonin, norepinephrine, and dopamine by inhibition of monoamine oxidase enzyme c. Selective blockade of serotonin reabsorption, restoring the brain's chemical balance d. Dopamine receptor blockade

b. Increasing concentrations of serotonin, norepinephrine, and dopamine by inhibition of monoamine oxidase enzyme *MAOIs

27. Drugs that enhance analgesic effects of opioids and nonopioids, produce analgesia alone, or reduce the side effects of analgesics are referred to as __________. a. coanalgesics b. adjuvants c. placebos d. tricyclics

b. adjuvants

59. Prolongation of the QT interval caused by the use of certain drugs may result in ________. a. nausea and vomiting b. an increased risk of life-threatening cardiac arrhythmias c. gastrointestinal ulcers d. tardive dyskinesia

b. an increased risk of life-threatening cardiac arrhythmias

31. Side effects of lithium therapy may include __________. a. drowsiness, insomnia, restlessness, agitation, anxiety, impotence, and weight gain. b. cardiac arrhythmia, hypotension, thirst and polyuria, tremors, and thyroid problems. c. depression, hallucination, agitation, bizarre behavior, and extrapyramidal reactions. d. dizziness, drowsiness, headache, and GI effects.

b. cardiac arrhythmia, hypotension, thirst and polyuria, tremors, and thyroid problems. *Animaniacs Agent Lithium (Lithobid, Eskalith)

26. Physical adaptation of the body to a medication with resultant withdrawal symptoms following its abrupt discontinuation is ________. a. tolerance b. dependence c. placebo effect d. paradoxical response

b. dependence

29. Adjuvant analgesics are given to ___________. a. relieve mild to moderate pain, fever, and anti-inflammatory conditions b. enhance analgesic effects of opioids and nonopioids c. promote sedation d. promote sleep

b. enhance analgesic effects of opioids and nonopioids

38. An antipyretic is used to treat ___________. a. pain b. fever c. nausea d. insomnia

b. fever

27. Side effects of tricyclics may include _________. a. dilated pupils with photophobia, nervousness, and tachycardia b. increased appetite and weight gain, postural hypotension, and cardiac arrhythmia c. headache, stiff neck, hypertension, or hypertensive crisis d. sexual dysfunction, anorexia, diarrhea, insomnia, anxiety, nervousness, and fatigue

b. increased appetite and weight gain, postural hypotension, and cardiac arrhythmia *tricyclics amitriptyline (Elavil) desipramine (Norpramin) doxepin (Sinequan) nortriptyline (Pamelor) imipramine (Tofranil)

39. Cautions for the use of lithium include _________. a. patients with seizure disorders, cardiac or liver disorders, or who are more prone to suicide b. patients with seizure disorders, Parkinson's disease, and thyroid disease c. patients who are depressed, who exhibit suicidal tendencies, who have depressed vital signs, and who operate machinery d. patients with renal and hepatic impairment

b. patients with seizure disorders, Parkinson's disease, and thyroid disease *Lithium

49. Drug addiction is defined as __________. a. the use of a drug for other than therapeutic purposes b. physical dependence and withdrawal reaction with physiological effects c. illegal behavior d. a problem with the moral character

b. physical dependence and withdrawal reaction with physiological effects

33. Side effects of salicylate analgesics and anti-inflammatory medications can include __________. a. constipation b. prolonged bleeding time, tinnitus, gastric distress, ulceration, and bleeding c. respiratory depression d. physical and/or emotional dependence

b. prolonged bleeding time, tinnitus, gastric distress, ulceration, and bleeding

50. Drug habituation refers to ___________. a. the use of a drug for other than therapeutic purposes b. tolerance, psychological dependence, physical dependence, and withdrawal reaction with physiological effects c. psychological dependence d. a problem with the moral character

c. psychological dependence

21. Drugs that can exert a therapeutic effect on a person's mental processes, emotions, or behavior are ________. a. addictive b. dependent c. psychotropic d. tricyclics

c. psychotropic

34. Side effects of acetaminophen (Tylenol) can include a. respiratory depression b. prolonged bleeding time c. severe liver toxicity and renal insufficiency d. tinnitus

c. severe liver toxicity and renal insufficiency

36. Patients taking analgesics, sedatives, or hypnotics should be provided all of the following instructions, EXCEPT: a. "Psychotropics, alcohol, muscle relaxants, antihistamines, antiemetics, cardiac medications, and antihypertensives may have serious interactions." b. "Be aware of the potential side effects of these medications." c. "You may experience tolerance to the medications the longer you use them." d. "It is best to use OTC analgesic medications for breakthrough or exacerbations of pain while taking these medications."

d. "It is best to use OTC analgesic medications for breakthrough or exacerbations of pain while taking these medications."

32. Side effects of opioids can include ____________. a. constipation b. respiratory depression c. physical and/or emotional dependence d. All of the above.

d. All of the above

57. Which of the following statements is true regarding Rohypnol? a. It is not approved for use in the United States. b. It is used to counteract effects of cocaine withdrawal. c. It is used as a date-rape drug. d. All of the above are true.

d. All of the above are true. *Rohypnol

41. Contraindications to the use of opioid medications include __________. a. head injury with increased intracranial pressure b. undiagnosed gastrointestinal disease c. pregnancy d. All of the above.

d. All of the above.

55. Which of the following drugs are most often abused by medical personnel? a. Hydrocodone b. Benzodiazepines c. Oxycodone d. All of the above.

d. All of the above.

40. Why do most patients seek medical care? a. Preventive care b. Family history c. Chronic conditions d. Pain

d. Pain

35. Side effects of tramadol (Ultram) include __________. a. physical and/or emotional dependence b. prolonged bleeding time c. liver dysfunction d. Similar list to opioids and possible seizures

d. Similar list to opioids and possible seizures Classification - opiod It can treat moderate to severe pain.

34. Which list describes relative contraindications or cautions to be observed with CNS stimulants? a. Hyperthyroidism, history of drug dependence, alcoholism, or eating disorders b. Renal and GI disorders c. Cerebrovascular disease d. Patients who are prone to suicide, diabetics, and those with bipolar disorders

a. Hyperthyroidism, history of drug dependence, alcoholism, or eating disorders *CNS stimulants

60. Drugs that interact with antipsychotics by prolonging the QT interval fall into which categories? a. Antiarrhythmic agents b. Quinolones c. Phenothiazines d. All of the above.

ANSWER: d

30. Side effects of heterocyclic antidepressants may include ________. a. drowsiness, insomnia, restlessness, anxiety, dry mouth, impotence, and weight gain b. cardiac arrhythmia, hypotension, thirst and polyuria, tremors, and thyroid problems c. depression, hallucination, bizarre behavior, amnesia, and extrapyramidal reactions d. drowsiness, headache, and GI effects

a. drowsiness, insomnia, restlessness, anxiety, dry mouth, impotence, and weight gain *Heterocyclic antidepressants bupropion (Wellbutrin) mirtazapine (Remeron) trazodone

48. Treatment of chronic alcoholism frequently includes ___________. a. elimination of caffeine, and a low-carbohydrate and high-protein diet b. IV "banana bag" c. establishing and maintaining an airway d. preventing aspiration

a. elimination of caffeine, and a low-carbohydrate and high-protein diet

51. Symptoms of chronic amphetamine abuse include ___________. a. emotional lability, anorexia, amnesia, photophobia, and paranoid syndrome b. short-term memory loss, impaired learning, apathy, lethargy, reduced testosterone levels, and sperm count c. euphoria, agitation and excitation, arrhythmia, or cardiac failure d. flashbacks, panic or paranoia, and psychotic episodes

a. emotional lability, anorexia, amnesia, photophobia, and paranoid syndrome *Amphetamines

42. Identify the primary mechanism of action of tricyclic antidepressants _______. a. potentiation of norepinephrine and serotonin activity by blocking their reuptake b. increase concentrations of serotonin, norepinephrine, and dopamine by inhibition of the monoamine oxidase enzyme c. selective blockade of serotonin reabsorption, helping to restore the brain's chemical balance d. dopamine receptor blockade

a. potentiation of norepinephrine and serotonin activity by blocking their reuptake *Tricyclic antidepressants

28. Nonopioid medications are given to ___________. a. relieve mild to moderate pain, fever, and anti-inflammatory conditions b. enhance analgesic effect with opioids and nonopioids c. promote sedation d. promote sleep

a. relieve mild to moderate pain, fever, and anti-inflammatory conditions

54. Side effects of marijuana include _______. a. emotional lability, anorexia, amnesia, photophobia, and paranoid syndrome with hallucinations b. short-term memory loss, impaired learning, apathy, lethargy, reduced testosterone level, and sperm count c. euphoria, agitation and excitation, arrhythmia, or cardiac failure d. flashbacks, panic or paranoia, and psychotic episodes

b. short-term memory loss, impaired learning, apathy, lethargy, reduced testosterone level, and sperm count *Marijuana

23. Something that may only be experienced or perceived by the individual is said to be _________. a. objective b. subjective c. endogenous d. exogenous

b. subjective

23. Antidepressant medications are used primarily to treat _______. a. central nervous system function b. various types of depression c. bipolar disorders d. anxiety disorders, neurosis, some psychosomatic disorders, and insomnia

b. various types of depression Tricyclic antidepressants MAOIs Selective serotonin reuptake inhibitors (SSRIs) Selective norepinephrine reuptake inhibitors (SNRIs), Heterocyclic antidepressants

37. Patients taking analgesics, sedatives, or hypnotics should be instructed that: a. "Psychotropics, alcohol, muscle relaxants, antihistamines, antiemetics, cardiac medications, and antihypertensives mix well with these medications." b. "There are relatively few serious side effects or interactions with other medications." c. "Tolerance may result with prolonged use, with increasingly larger doses being required to achieve the same effect." d. "OTC analgesic combinations in safe levels are not a danger."

c. "Tolerance may result with prolonged use, with increasingly larger doses being required to achieve the same effect."

36. Contraindications for MAOIs include which of the following? a. Hyperthyroidism, cardiovascular disorders, history of drug dependence, or eating disorders b. Cardiac, renal, and GI problems c. Cerebrovascular, heart, and renal disease d. Patients who are prone to suicide, people with diabetes, and those with bipolar disorders

c. Cerebrovascular, heart, and renal disease *MAOIs

44. Which mechanism of action is descriptive of SSRIs? a. Potentiation of norepinephrine and serotonin activity by blocking their reuptake b. Increasing concentrations of serotonin, norepinephrine, and dopamine by monoamine oxidase enzyme inhibition c. Selective blockade of serotonin reabsorption d. Dopamine receptor blockade

c. Selective blockade of serotonin reabsorption *SSRIs

42. What antidote should be considered or kept on hand to treat opioid overdose in a patient who begins to exhibit signs of respiratory arrest? a. Flumazenil b. Administer oxygen c. The opioid antagonist [e.g., Narcan or naloxone] d. Vitamin K

c. The opioid antagonist [e.g., Narcan or naloxone] Naloxone is a medication designed to rapidly reverse opioid overdose. Binds to opioid receptors and can reverse and block the effects of other opioids. It can very quickly restore normal respiration to a person whose breathing has slowed or stopped as a result of overdosing with heroin or prescription opioid pain medications.

24. Lithium salts are used to treat _________. a. central nervous system dysfunction b. various types of depression c. bipolar disorders d. anxiety disorders

c. bipolar disorders

32. Side effects of anxiolytic benzodiazepines may include ________. a. drowsiness, insomnia, restlessness, agitation, dizziness, impotence, and weight gain b. cardiac arrhythmia, hypotension, thirst and polyuria, tremors, and thyroid problems c. depression, hallucination, bizarre behavior, amnesia, ataxia, and extrapyramidal reactions d. dizziness, drowsiness, headache, and GI effects

c. depression, hallucination, bizarre behavior, amnesia, ataxia, and extrapyramidal reactions *anxiolytic benzodiazepines alprazolam (Xanax) chlordiazepoxide (Librium) clorazepate (Tranxene) diazepam (Valium, Diastat) lorazepam (Ativan)

53. Side effects of cocaine can include _________. a. emotional lability, anorexia, amnesia, photophobia, and paranoid syndrome with hallucinations b. short-term memory loss, impaired learning, apathy, lethargy, reduced testosterone levels, and sperm count c. euphoria, agitation and excitation, arrhythmia, stroke, and cardiac failure d. flashbacks, panic or paranoia, and psychotic episodes

c. euphoria, agitation and excitation, arrhythmia, stroke, and cardiac failure *Cocaine

28. Side effects of MAOIs may include _________. a. dilated pupils with photophobia, nervousness, insomnia, and irritability b. increased appetite and weight gain, postural hypotension, cardiac arrhythmia, and palpitation c. headache, stiff neck, hypertension, or hypertensive crisis d. sexual dysfunction, nausea, anorexia, diarrhea, insomnia, anxiety, and drowsiness

c. headache, stiff neck, hypertension, or hypertensive crisis *MAOIs isocarboxazid (Marplan) phenelzine (Mardil) tranylcypromine (Parnate)

40. Benzodiazepines should be used with extreme caution in persons who have _______. a. seizure disorders b. Parkinson's disease and thyroid disease c. mental depression, suicidal tendencies, and those who are older or debilitated d. All of the above.

c. mental depression, suicidal tendencies, and those who are older or debilitated *Benzodiazepines

39. An analgesic would be prescribed to treat ____________. a. fever b. insomnia c. pain d. anxiety

c. pain

30. Sedatives are given to __________. a. relieve mild to moderate pain, fever, and anti-inflammatory conditions b. enhance analgesic effect with opioids and nonopioids c. promote sedation, calm, soothe d. promote sleep

c. promote sedation, calm, soothe

37. SSRIs should be used with caution in which patients? a. Those with hyperthyroidism, cardiovascular disorders, or a history of drug dependence and/or alcoholism b. Patients with cardiac, renal, GI, or liver disorders c. Persons with cerebrovascular and renal disease d. Those who are more prone to suicide, people with diabetes, and patients with bipolar disorders

d. Those who are more prone to suicide, people with diabetes, and patients with bipolar disorders *SSRIs

25. Anxiolytics are used to treat ____________. a. central nervous system dysfunction b. various types of depression c. bipolar disorders d. anxiety disorders, neurosis, some psychosomatic disorders, and insomnia

d. anxiety disorders, neurosis, some psychosomatic disorders, and insomnia

33. Side effects of the anxiolytic buspirone (Buspar) may include _________. a. drowsiness, insomnia, dry mouth, nausea, dizziness, impotence, and weight gain b. cardiac arrhythmia, hypotension, thirst and polyuria, tremors, and thyroid problems c. depression, hallucinations, agitation, bizarre behavior, and extrapyramidal reactions d. dizziness, drowsiness, headache, and GI effects

d. dizziness, drowsiness, headache, and GI effects *anxiolytic buspirone (Buspar)

45. The mechanism of action of phenothiazine antipsychotics involves ___________. a. potentiation of norepinephrine and serotonin activity by blocking their reuptake b. increasing the concentrations of serotonin, norepinephrine, and dopamine by monoamine oxidase enzyme inhibition c. selective blockade of serotonin reabsorption d. dopamine receptor blockade

d. dopamine receptor blockade *phenothiazine antipsychotics

24. Chemicals produced within the brain as a reaction to severe pain or intense exercise are _______. a. exogenous b. placebos c. endogenous d. endorphins

d. endorphins

52. Side effects of hallucinogens may include __________. a. emotional lability, anorexia, amnesia, photophobia, and paranoid syndrome with hallucinations b. short-term memory loss, impaired learning, apathy, lethargy, reduced testosterone levels, and sperm count c. euphoria, agitation and excitation, arrhythmia, or cardiac failure d. flashbacks, panic, and psychotic episodes

d. flashbacks, panic, and psychotic episodes *Hallucinogens

46. Long-term physiological effects of alcohol use include ________. a. excitement, sedation, and anesthesia b. stupor, cerebral edema, and depressed respiration c. decreased control over judgment, memory, and other intellectual and emotional functioning d. liver damage, pancreatitis, esophageal varices, gastritis, ulceration, cardiomyopathy, and hemorrhage.

d. liver damage, pancreatitis, esophageal varices, gastritis, ulceration, cardiomyopathy, and hemorrhage.

31. Hypnotics are used to _________. a. relieve mild to moderate pain, fever, and anti-inflammatory conditions b. enhance analgesic effect with opioids and nonopioids c. promote sedation d. promote sleep

d. promote sleep

41. Caution should be used when buspirone (Buspar) is administered to patients with _________. a. seizure, cardiac, or liver disorders b. Parkinson's and thyroid disease c. suicidal tendencies, depressed vital signs, and persons operating machinery d. renal and hepatic impairment

d. renal and hepatic impairment *Buspar

29. Side effects of the SSRIs may include _________. a. dilated pupils with photophobia, nervousness, tachycardia, and cardiac arrhythmia b. increased appetite and weight gain, cardiac arrhythmia, and palpitation c. headache, stiff neck, hypertension, or hypertensive crisis d. sexual dysfunction, anorexia, diarrhea, sweating, insomnia, anxiety, and dizziness

d. sexual dysfunction, anorexia, diarrhea, sweating, insomnia, anxiety, and dizziness *SSRIs citalopram (Celexa) escitalopram (Lexapro) fluoxetine (Prozac) Paroxetine (Paxil) sertraline (Zoloft)