Term
| A new antidepressant is developed based on the monoamine hypothesis. This drug would most likely have which one of the following characteristics? |
|
Definition
| Increases levels of NE (norepinephrine) in synapses |
|
|
Term
| D. Pressed is a 30-year-old female with severe depression; she has also been diagnosed with neuropathic pain. Which one of the following drugs would most likely treat both conditions? |
|
Definition
| Amitriptyline (Elavil®) – a tertiary TCA, also has great sedative effects used for insomnia |
|
|
Term
| The therapeutic effects of Nefazodone (Serzone®) are thought to be a result of the blockade of what? |
|
Definition
| 5-HT2 receptors – Nefazodone is an atypical antidepressant with minimal anticholinergic effects, does have SE of orthostatic hyptension |
|
|
Term
| You are prescribing Lithium (Eskalith®) to a new patient. Which one of the following side effects is a severe symptom suggesting that the individual should seek emergency medical attention? |
|
Definition
| Mental confusion – another common SE of lithium is polyuria and/or polydipsia, this occurs early in Tx and should go away. |
|
|
Term
| The long term treatment of generalized anxiety disorder is best instituted with what? |
|
Definition
| Venlafaxine – a SNRI, both SSRI and SNRI can be used for long term depression |
|
|
Term
| The effects of benzodiazepines can be reversed with what? |
|
Definition
|
|
Term
| Which one of the following drugs used in the treatment of anxiety is a partial 5HT1a agonist? |
|
Definition
|
|
Term
| Which one of the following would NOT be a mechanism that would contribute to a decrease in neuronal activity? |
|
Definition
| Increased sodium influx into the neuron |
|
|
Term
| Which one of the following enzymes is responsible for metabolism of gamma amino butyric acid (GABA) and conversion of alpha-ketoglutarate to Glutamate? |
|
Definition
| GABA transaminase (GABA-T) |
|
|
Term
| Which one of the following enzyme converts dihydroxyphenylalanine (DOPA) to dopamine? |
|
Definition
|
|
Term
| Memantine (Namenda) a NMDA receptor antagonist used in Alzheimer’s disease is thought to reduce neuronal degeneration by? |
|
Definition
| Blocking Na+ and Ca++ influx |
|
|
Term
| Nitrous oxide should not be used in the presence of what injury? |
|
Definition
| Suspected pneumothorax – causes air to expand |
|
|
Term
| Inhaled anesthetics affect the respiratory system by? |
|
Definition
Decreasing minute ventilation
Decreasing the ventilatory response to CO
Depressing mucociliary function in the airway
Influencing bronchial smooth muscle contraction |
|
|
Term
| Which one of the following opioids may cause seizures? |
|
Definition
| Meperidine – does not cause contraction of the sphicnter of Odi, does not cause Miois, also need to avoid this in renal pts |
|
|
Term
| Which of the following local anesthetic is NOT a member of the amino ester group? |
|
Definition
| Bupivacaine – just remember the “I” rule |
|
|
Term
| Which of the following local anesthetic agent is a member of the amino ester class? |
|
Definition
|
|
Term
| Amino amide local anesthetics are metabolized by what? |
|
Definition
| Liver microsomal cytochrome P450 |
|
|
Term
| Which one of the following signaling pathways is predominantly used by opioids? |
|
Definition
|
|
Term
| The actions of opioids can be reversed by what? |
|
Definition
| Naloxone – this comes in IV form, Naltrxone is it’s buddy but it comes in oral form and has a longer half life, Naltrezone is very hepatotoxic |
|
|
Term
| A 6yr old is brought to the pediatrician by his mother. She reports that there are times when the child “abruptly stops playing and stares into space”. One such episode occurs in the physician’s office and the EEG reveals a 3Hz spike & wave discharge. Which one of the following drug is first line therapy for this type of seizure? |
|
Definition
| Ethosuximide (Zarontine) – Etho is only used in absence seizures, nothing else. This is because Etho inhibits T-type Calcium Channels |
|
|
Term
| A 24 yr old woman visits her physician because of “pain in her arm” after spending all day cleaning. X rays reveal a linear fracture of the right radius. She is an epileptic who has been treated for 3 yrs with anti-seizure medication and has been suffering from increasing leg weakness and persistent back pain. Lab tests reveal mildly elevated glucose levels and low levels of vitamin D. DEXA reveals severe bone loss. Further examination reveals overgrown gums & excessive facial hair. Which one of the following anti-epileptic drugs is the cause of the symptoms in this patient? |
|
Definition
| Phenytoin (Dilantin) – see above for the SE |
|
|
Term
| Which one of the following antiepileptic drug potentiates GABA activity by blocking GABA reuptake? |
|
Definition
|
|
Term
| Which one of the following conditions would be a contraindication for the administration of morphine to a patient to alleviate pain? |
|
Definition
| Severe head injury and concussion |
|
|
Term
| A 30 year-old man is being treated with lithium for bipolar disorder. Which one of the following is the most common early sign of lithium toxicity? |
|
Definition
| Gastrointestinal distress |
|
|
Term
| Which one of the following agents would be expected to alleviate insomnia with minimal daytime sedative effects? |
|
Definition
| Zaleplon – Zolpidem too, has fast onset of action, they are benzo agonists |
|
|
Term
| A 57 year old patient has a history of insomnia and because of affordability issues seeks a low-cost non-benzodiazepine drug. Which one of the following would be most appropriate? |
|
Definition
| Diphenhydramine – antihistamine |
|
|
Term
| Which one the following is a G-protein coupled receptor? |
|
Definition
|
|
Term
| Which one of the following enzymes converts glutamate to GABA? |
|
Definition
| Glutamic Acid Decarboxylase (GAD) |
|
|
Term
| Which one of the following is a precursor for Serotonin synthesis? |
|
Definition
|
|
Term
| Panic attacks would best be treated with? |
|
Definition
| Alprazolam – for acute relief of panic symptoms Clonazepam and Alprazolam are the agents of choice |
|
|
Term
| Which one of the following is a direct benzodiazepine receptor agonist? |
|
Definition
|
|
Term
| Which of the following is considered an Opioid Agonist /Antagonist? |
|
Definition
| Nalbuphine, Pentazocine, and Butorphanol are all opoid agonist/antagonists |
|
|
Term
| Which of the following is NOT one of the general indications for opioids? |
|
Definition
|
|
Term
| What is the risk of administering meperidine (Demerol) in a patient with kidney failure? |
|
Definition
|
|
Term
| All of the following are peripheral effects of morphine EXCEPT: |
|
Definition
| Bronchodilation – remember respiratory depression is the #1 cause of death in opiod use |
|
|
Term
| Gingival hyperplasia and hirsutism are adverse effects associated with which one of the following anti-epileptic drugs? |
|
Definition
|
|
Term
| In normal individuals, the depolarizing muscle relaxant succinylcholine performs what action? |
|
Definition
| Acts as a nicotinic agonist at the motor end plate |
|
|
Term
| Dantrolene (Dantrium®) is the drug of choice in the treatment of acute Malignant hyperthermia due to what? |
|
Definition
| It’s ability to prevent calcium release form the sarcoplasmic reticulum |
|
|
Term
| Which one of the following agents is used in the treatment of chronic muscle spasms: |
|
Definition
| Tizanidine (Zanaflex®) – Diazepam, Baclofen, Dantrolene, Botulinum toxin, and Gabapentin are also used |
|
|
Term
| Parkinsons’s disease (PD) is caused by what? |
|
Definition
| Degeneration of dopaminergic neurons in the substantia nigra |
|
|
Term
| Carbidopa is given along with Levodopa for what purpose? |
|
Definition
| Reduce formation of dopamine in the periphery |
|
|
Term
| Which one of the following drugs used in the treatment of parkinson’s disease cannot cross the blood brain barrier? |
|
Definition
| Entacapone (Comtan) – is a COMT inhibitor along with Tolcapone. Difference is that Entacapone is only peripheral COMT inhibition |
|
|
Term
| Which one of the following antidepressant agents has an active metabolite with a half-life of several days? |
|
Definition
| Fluoxetine (Prozac) – an SSRI, the most stimulating of all SSRI’s. has the longest half life because it has Norfluoxetine which is the active metabolite of Fuoxetine |
|
|
Term
| The occurrence of a lethal overdose is more likely with which one of the following antidepressants? |
|
Definition
| Imipramine (Tofranil) – a TCA, effective but dangerous |
|
|
Term
| Which one of the following antidepressants inhibits both norepinephrine and 5HT transporters? |
|
Definition
| Duloxetine (Cymbalta) – an SNRI (they all do the above), in addition Dulozetine can also be used to treat neuropathic pain |
|
|
Term
| Which one of the following classes of antidepressants can cause significant weight gain, lethargy and dry mouth? |
|
Definition
| Tricyclic antidepressants (TCA’s) – most sig side effects here |
|
|
Term
| Which one of the following is considered to be a nondepolarizing muscle relaxant? |
|
Definition
| Vecuronium – all nondepolarizing muscle relaxants end with “ium” except Tugocraruine. Tubocurarine and Pancuronium have the longest acting effect due to being eliminated by the kidney. Pan is the longest acting |
|
|
Term
| What is the MoA of Cyclobenzaprine (Flexeril)? |
|
Definition
| Acts by interfering with polysynaptic reflexes in the brain stem – this is why we see confusion and visual hallucinations as a SE for this drub |
|
|
Term
| Which one of the following is the molecular site of action for the anxiolytic and amnestic actions of midazolam? |
|
Definition
|
|
Term
| Which one of the following agents is most likely to be used in a patient to overcome heroin addiction? |
|
Definition
|
|
Term
| Which general anesthetic is likely to potentiate the muscle relaxant effects of pancuronium? |
|
Definition
|
|
Term
| Which one of the following is an OTC opioid antitussive agent? |
|
Definition
| Dextromethorphan – only used as antitussive, not for pain |
|
|
Term
| The local anesthetic with the shortest duration of action is? |
|
Definition
|
|
Term
| Which one of the following agents would be effective in controlling generalized seizures without causing excessive sedation? |
|
Definition
|
|
Term
| Which one of the following is considered a benzodiazepine receptor agonist and has no anxiolytic properties? |
|
Definition
| Zolpidem – this is why it is used for insomnia, no anxiolytic properties |
|
|
Term
| Immediate treatment of a panic attack would be commenced with? |
|
Definition
| Alprazolam – other choice could have been Clonazepam |
|
|
Term
| A 26-year-old white male is brought to the emergency room having been found unresponsive in the restroom of a nightclub. When EMS arrived at the club, an intravenous line was placed and the patient was given an infusion of normal saline. On physical exam the patient appears disheveled. His blood pressure is 110/70 mmHg, pulse 56/minute, respirations 6/minute and a temperature 98.5 Fahrenheit. The patient has shallow breathing. His heart sounds are normal. There is no evidence of trauma and his head. The patient responds to painful stimuli only and moves all four extremities. The patient's pupils are pinpoint approximately 1 millimeter in diameter bilaterally. Which of the following medications would be most beneficial to this patient at this time? |
|
Definition
|
|
Term
| The rationale for developing Carbidopa/L-Dopa (SINEMET) formulation was to? |
|
Definition
| Reduce side effects associated with peripheral metabolism of L-DOPA |
|
|
Term
| Which one of the following drugs used to treat Parkinson disease (PD) is a selective agonist at D2 family of receptors? |
|
Definition
|
|
Term
| The relative incidence of which of the following side effects is greater with “TYPICAL” antipsychotics? |
|
Definition
| Extrapyramidal symptoms (EPS) |
|
|
Term
| Which one of the following ATYPICAL antipsychotics can cause hyperprolactinemia at doses greater than 8mg/day? |
|
Definition
| Risperidone (Risperdal) – can cuase hyperprolactinemia even at non therapeutic levels |
|
|
Term
| The appearance of extrapyramidal symptoms (EPS) with antipsychotic use is due to? |
|
Definition
| Blockade of D2 receptors in the nigrostriatal pathway |
|
|
Term
| Alcohol withdrawal symptoms would best be treated with? |
|
Definition
|
|
Term
| Which of the following agents has caused hyperkalemia leading to cardiac arrest in patients with undiagnosed muscular dystrophies? |
|
Definition
|
|
Term
| Which of the following agents is used in the treatment of chronic muscle spasms? |
|
Definition
|
|
Term
| Atracurium (Tracrium®) is a nondepolarizing muscle relaxant that is inactivated by what? |
|
Definition
|
|
Term
| Minimal Alveolar Concentration (MAC) is established by: |
|
Definition
| Observing for patient movement at the time of skin incision |
|
|
Term
| Benzodiazepines decrease neuronal excitability by acting at what? |
|
Definition
|
|
Term
| Binding of GABA to GABA-A receptor increases conductance of what? |
|
Definition
|
|
Term
| Binding of GABA to GABA-B receptor increases conductance of what? |
|
Definition
|
|
Term
| Which subtype of the opioid receptor has the greatest affinity for the opioid antagonist naloxone? |
|
Definition
|
|
Term
A 45 year old female presents with severe right upper quadrant abdominal pain that comes and goes. Her vitals are BP140/88, HR 94, Temp 100.9F, Resp
Which of the following is the best pain medication to give to this patient? |
|
Definition
|
|
Term
| An 82-year-old, African-American chronic hypertensive, diabetic male had orthopedic knee surgery three days ago. The orthopedic resident had the patient on meperidine (Demerol) every four hours as needed. As the intern on call, the nurse is calling you because the patient continues to complain of pain. If you were to increase the dosage of meperidine (Demerol), what are you potentially worried about? |
|
Definition
|
|
Term
| What is the MoA of local anesthetics? |
|
Definition
| Reversibly bind to and inactivate voltage-gated channels |
|
|
Term
| Which one of the following antidepressant agents has an active metabolite with a half-life of several days? |
|
Definition
|
|
Term
| Which one of the following is the most bothersome side effects of Selective Serotonin Reuptake Inhibitors (SSRI’s) likely to affect patient compliance? |
|
Definition
|
|
Term
| The occurrence of a lethal overdose is more likely with which one of the following antidepressants? |
|
Definition
|
|
Term
| Phenytoin & Carbamazepine are prescribed for many types of seizures EXCEPT? |
|
Definition
|
|
Term
| Which one of the following antiepileptic drugs inhibits liver P450 enzymes? |
|
Definition
|
|
Term
| Which one of the following antiepileptic agents should not be prescribed to patients with a history of allergic reactions to sulfonamides? |
|
Definition
|
|
Term
| An autosomal dominant genetic disorder of skeletal muscle metabolism that occurs in susceptible individuals undergoing general anesthesia with volatile anesthetics or depolarizing muscle relaxants is what? |
|
Definition
|
|
Term
| Which of the following agents has caused hyperkalemia leading to cardiac arrest in patients with undiagnosed muscular dystrophies? |
|
Definition
|
|
Term
| Memantine (Namenda) a NMDA receptor antagonist used in Alzheimer’s disease is thought to reduce neuronal degeneration by what? |
|
Definition
| Blocking Na+ and Ca++ influx |
|
|
Term
| Which one of the following routes of administration is likely to by pass the first-pass effect and allow for maximum bioavailability? |
|
Definition
|
|
Term
| You are prescribing Lithium (Eskalith®) to a new patient. Which one of the following side effects is a severe symptom suggesting that the individual should seek emergency medical attention? |
|
Definition
|
|
Term
| The long term treatment of generalized anxiety disorder is best instituted with? |
|
Definition
|
|
Term
| 4) Which one of the following processes in the drug distribution phase plays an important role in determining the amount of drug available for action at the target tissue? |
|
Definition
| Binding to plasma proteins |
|
|
Term
| Drug excretion is usually enhanced by the drug being |
|
Definition
|
|
Term
| A new antidepressant is developed based on the monoamine hypothesis. This drug would most likely have which one of the following characteristics? |
|
Definition
| Increases levels of NE (norepinephrine) in synapses |
|
|
Term
| The principal neurotransmitter in the AUTONOMIC GANGLIA is |
|
Definition
|
|
Term
| Which of the following is NOT a parasympathetic effect |
|
Definition
|
|
Term
| Acetylcholine released from the synapse is mainly degraded by |
|
Definition
|
|
Term
| D. Pressed is a 30-year-old female with severe depression; she has also been diagnosed with neuropathic pain. Which one of the following drugs would most likely treat both conditions? |
|
Definition
|
|
Term
| Depolarizing block at the NMJ can be caused by |
|
Definition
| Nicotinic receptor agonists |
|
|
Term
| Skeletal muscle relaxation is produced by all of the following EXCEPT |
|
Definition
Succinylcholine
Pancuronium
Atracurium
Nicotine
---->Trimetaphan<---- |
|
|
Term
| Which one of the following is an Anticholinesterase |
|
Definition
|
|
Term
| The therapeutic effects of Nefazodone (Serzone®) are thought to be a result of the blockade of? |
|
Definition
|
|
Term
| The effects of benzodiazepines can be reversed with? |
|
Definition
|
|
Term
| Which one of the following drugs used in the treatment of anxiety is a partial 5HT1a agonist? |
|
Definition
|
|
Term
| Which one of the following would NOT be a mechanism that would contribute to a decrease in neuronal activity? |
|
Definition
| Increased sodium influx into the neuron |
|
|
Term
| Which one of the following enzymes is responsible for metabolism of gamma amino butyric acid (GABA) and conversion of alpha-ketoglutarate to Glutamate? |
|
Definition
| GABA transaminase (GABA-T) |
|
|
Term
| Which one of the following enzyme converts dihydroxyphenylalanine (DOPA) to dopamine? |
|
Definition
|
|
Term
| Memantine (Namenda) a NMDA receptor antagonist used in Alzheimer’s disease is thought to reduce neuronal degeneration by? |
|
Definition
| Blocking Na+ and Ca++ influx |
|
|
Term
| Inhaled anesthetics affect the respiratory system by? |
|
Definition
Decreasing minute ventilation
Decreasing the ventilatory response to CO
Depressing mucociliary function in the airway
Influencing bronchial smooth muscle contraction |
|
|
Term
| Which one of the following opioids may cause seizures? |
|
Definition
|
|
Term
| Amino amide local anesthetics are metabolized by? |
|
Definition
| Liver microsomal cytochrome P450 |
|
|
Term
| Which one of the following signaling pathways is predominantly used by opioids? |
|
Definition
|
|
Term
| Which one of the following antiepileptic drug potentiates GABA activity by blocking GABA reuptake? |
|
Definition
|
|
Term
| The rationale for developing Carbidopa/L-Dopa (SINEMET) formulation was to? |
|
Definition
| Reduce side effects associated with peripheral metabolism of L-DOPA |
|
|
Term
| Which one of the following drugs used to treat Parkinson disease (PD) is a selective agonist at D2 family of receptors? |
|
Definition
|
|
Term
| The relative incidence of which of the following side effects is greater with “TYPICAL” antipsychotics? |
|
Definition
| Extrapyramidal symptoms (EPS) |
|
|
Term
| Which one of the following ATYPICAL antipsychotics can cause hyperprolactinemia at doses greater than 8mg/day? |
|
Definition
|
|
Term
| The appearance of extrapyramidal symptoms (EPS) with antipsychotic use is due to? |
|
Definition
| Blockade of D2 receptors in the nigrostriatal pathway |
|
|
Term
| Alcohol withdrawal symptoms would best be treated with? |
|
Definition
|
|
Term
| Cocaine may be detected in urine via which metabolite? |
|
Definition
|
|
Term
| Which one of the following drugs of abuse is most likely to directly cause tooth decay? |
|
Definition
|
|
Term
| Which one of the following antidepressant agents has an active metabolite with a half-life of several days? |
|
Definition
|
|
Term
| The occurrence of a lethal overdose is more likely with which one of the following antidepressants? |
|
Definition
|
|
Term
| Which one of the following antidepressants inhibits both norepinephrine and 5HT transporters? |
|
Definition
|
|
Term
| Which one of the following classes of antidepressants can cause significant weight gain, lethargy and dry mouth? |
|
Definition
| Tricyclic antidepressants (TCA’s) |
|
|
Term
| Which one of the following is considered to be a nondepolarizing muscle relaxant |
|
Definition
|
|
Term
| Succinylcholine acts as a depolarizing muscle relaxant by |
|
Definition
| Acting at nicotinic receptors in the motor end plate |
|
|
Term
| Acts by interfering with polysynaptic reflexes in the brain stem |
|
Definition
|
|
Term
| Phenytoin & Carbamazepine are prescribed for many types of seizures EXCEPT? |
|
Definition
|
|
Term
| The primary mode of action of Ethosuximide is? |
|
Definition
| Blockade of T-type calcium channels |
|
|
Term
| Which one of the following antiepileptic drugs inhibits liver P450 enzymes? |
|
Definition
|
|
Term
| Which one of the following antiepileptic agents should not be prescribed to patients with a history of allergic reactions to sulfonamides? |
|
Definition
|
|
Term
| 45 year old obese female presents with sharp right upper quadrant abdominal pain that comes and goes. His vitals are BP 120/78, HR 90, Temp 100.3F, Resp 20. Physical exam is positive for right upper quadrant tenderness, made worse with deep inspiration (Murphy’s sign). Which of the following is the best pain medication to give to this patient for immediate relief of this pain? |
|
Definition
|
|
Term
| What is the potential risk of giving meperidine (Demerol) in patients with renal insufficiency? |
|
Definition
|
|
Term
| Reversibly bind to and inactivate voltage-gated channels |
|
Definition
|
|
Term
| Which one of the following is NOT a factor in the elimination of inhaled volatile anesthetic agents? |
|
Definition
| The use of a “balanced” anesthesia technique |
|
|
Term
| An autosomal dominant genetic disorder of skeletal muscle metabolism that occurs in susceptible individuals undergoing general anesthesia with volatile anesthetics or depolarizing muscle relaxants is: |
|
Definition
|
|
Term
| All of the following are peripheral effects of morphine EXCEPT |
|
Definition
|
|
Term
| Which of the following agents has caused hyperkalemia leading to cardiac arrest in patients with undiagnosed muscular dystrophies |
|
Definition
|
|
Term
| Which of the following agents is used in the treatment of chronic muscle spasms |
|
Definition
|
|
Term
| Atracurium is a nondepolarizing muscle relaxant that |
|
Definition
| Is inactivated by spontaneous breakdown (hoffman’s degradation) |
|
|
Term
| Dantrolene (Dantrium®) is the drug of choice in the treatment of acute Malignant Hyperthermia due to |
|
Definition
| Its ability to prevent calcium release from the sarcoplasmic reticulum |
|
|
Term
| Which of the following is a False statement |
|
Definition
| EPSPs cause hyperpolarization |
|
|
Term
| Which of the following is a False statement |
|
Definition
| Binding of GABA to GABAA receptor increases K+ conductance |
|
|
Term
| Benzodiazepines decrease neuronal excitability by |
|
Definition
|
|
Term
| Binding of GABA to GABAA receptor increases |
|
Definition
|
|
Term
| Binding of GABA to GABAB receptor increases |
|
Definition
|
|
Term
| Which one of the following statements concerning mechanisms of action of anticonvulsant drugs is FALSE |
|
Definition
| Ethosuximide selectively blocks K channels in thalamic neurons (actually blocks T-type calcium channels) |
|
|
