Deck 17: Drugs for the Treatment of Central Nervous System Disorders

Question 1

Which of the following second-generation antipsychotics is associated with agranulocytosis?

A) Aripiprazole
B) Clozapine
C) Quetiapine
D) Risperidone
E) Ziprasidone

Answer 1

Clozapine

Question 2

Which of the following are adverse reactions associated with selective serotonin reuptake inhibitors (SSRIs)?

A) Central nervous system (CNS)depression
B) Nausea and diarrhea in approximately 15% to 30% of patients
C) Xerostomia in 10% to 15% of the population
D) Both a and b
E) Both b and c

Answer 2

Both b and c

Question 3

The amount of any drug prescribed for a depressed patient should not exceed a _____-day supply.

A) 1
B) 3
C) 7
D) 14

Answer 3

7

Question 4

In general, lower potency first-generation antipsychotic agents such as chlorpromazine (Thorazine)will have more of which of the following effects in contrast to the higher potency first-generation antipsychotic agents such as haloperidol (Haldol): (1)sedation, (2)orthostatic hypotension, (3)autonomic effects, (4)extrapyramidal effects?

A) 1, 2, 3, 4
B) 1, 2, 3
C) 2, 3, 4
D) 1, 2
E) 3, 4

Question 5

Which of the following agents is classified as an antipsychotic?

A) Celexa
B) Cephalexin
C) Zyprexa
D) Lexapro
E) Bextra

Question 6

Which of the following choices is recommended to counteract the anticholinergic effects of first-generation antipsychotics?

A) Caffeine-containing beverages
B) Alcohol-containing mouth rinses
C) Sugarless products or artificial saliva
D) Sugar-containing candy

Question 7

First-generation antipsychotic therapy must often be combined with _____ drugs such as benztropine to control excessive extrapyramidal stimulation.

A) adrenergic
B) antiadrenergic
C) cholinergic
D) anticholinergic

Question 8

First-generation antipsychotics would have little effect on which of the following symptoms of psychosis?

A) Delusions
B) Unwanted thoughts
C) Flat affect
D) Agitation
E) Disorganized behavior

Question 9

All of the following symptoms are "negative" (passive)symptoms of psychoses except for which one?

A) Flat affect
B) Vocalization of feelings of superhuman strength
C) Abstract thinking difficult
D) Social withdrawal
E) Thought and speech impaired

Question 10

Which antidepressant is least likely to cause xerostomia?

A) Bupropion
B) Sertraline
C) Chlorpromazine
D) Amitriptyline
E) Trazodone

Question 11

The type of depression that exhibits alternating periods of depression and excitation have a(n)_____ disorder.

A) endogenous
B) exogenous
C) manic-depressive
D) reactive

Question 12

Epinephrine should not be used to treat vasomotor collapse in patients taking first-generation antipsychotics because the first-generation antipsychotics are:

A) a-adrenergic stimulators.
B) a-adrenergic blockers.
C) b-adrenergic stimulators.
D) b-adrenergic blockers.

Question 13

Tardive dyskinesia is characterized by:

A) increased compulsive motor activity.
B) resting tremor and rigidity.
C) akinesia.
D) involuntary, repetitive body movements involving the tongue, lips, face, and jaw.

Question 14

Abrupt withdrawal of serotonin norepinephrine reuptake inhibitors (SNRIs)can lead to symptoms of:

A) urinary retention.
B) anxiety.
C) tachycardia.
D) sweating.

Question 15

First-generation antipsychotics are primarily _____ antagonists.

A) acetylcholine
B) norepinephrine
C) dopamine
D) serotonin (5-hydroxytryptamine)

Question 16

Phenothiazines cause orthostatic hypotension by blocking which receptor?

A) a-Adrenergic
B) b-Adrenergic
C) Dopamine
D) Acetylcholine

Question 17

Which of the following psychiatric disorders involves a loss of the perception of reality?

A) Bipolar affective disorder
B) Schizophrenia
C) Panic disorder
D) Obsessive-compulsive disorder

Question 18

Extrapyramidal reactions such as an acute spasm of the mandible caused by first-generation antipsychotics such as phenothiazines:

A) can be treated with anticholinergic agents.
B) are disorders of muscle control.
C) include akathisia.
D) All of the above are correct.

Question 19

Patients taking first-generation antipsychotics can experience severe intermittent temporomandibular joint (TMJ)pain. This pain is a consequence of:

A) hyperalgesia produced by a-adrenergic blockade.
B) anticholinergic side effects.
C) dislocation of the mandible.
D) extrapyramidal side effects.

Question 20

Which of the following are anticholinergic effects that may be associated with tricyclic antidepressants?

A) Xerostomia
B) Bradycardia
C) Urination
D) Both a and b
E) Both b and c

Question 21

All antidepressants will carry a boxed warning about the potential for patient suicide.

Question 22

Interaction of monoamine oxidase inhibitors (MAOIs)with many drugs such as amphetamines, and with foods such as wines, cheese, and fish, can precipitate:

A) hair loss.
B) hypertensive crisis.
C) gout.
D) dysgeusia.

Question 23

Dental local anesthetic with vasoconstricting agents must be limited to the cardiac dose for patients taking:

A) selective serotonin reuptake inhibitors (SSRIs).
B) serotonin norepinephrine reuptake inhibitors (SNRIs).
C) tricyclic antidepressants (TCAs).
D) trazodone (Desyrel).

Question 24

Which antidepressant drug carries a "black box" warning regarding its potential to cause life-threatening liver failure?

A) Imipramine
B) Bupropion
C) Nefazodone
D) Mirtazapine
E) Venlafaxine

Question 25

The chemoreceptor trigger zone (CTZ)is a site of action for prochlorperazine and promethazine.

Question 26

Which of the following side effects is the most serious peripheral side effect associated with the use of tricyclic antidepressants?

A) Orthostatic hypotension
B) Cardiac toxicity
C) Urination
D) Bradycardia

Question 27

Which of the following types of dental medicaments must be administered with caution to patients taking tricyclic antidepressants?

A) Fluoride
B) Antibiotics
C) Anesthetics
D) Analgesics

Question 28

Force should be exerted to open the patient's mouth if muscle spasm is present as a result of tardive dyskinesia.

Question 29

Of the tricyclic antidepressants listed, which one is most sedating?

A) Imipramine
B) Nortriptyline
C) Protriptyline
D) Desipramine
E) Amitriptyline

Question 30

Intractable hiccups have been successfully treated with first-generation antipsychotics.

Question 31

Serotonin norepinephrine reuptake inhibitors (SNRIs): (Select all that apply.)

A) are considered first line therapy for the treatment of depression.
B) are considered superior to selective serotonin reuptake inhibitors (SSRIs).
C) can induce withdrawal symptoms is abruptly discontinued.
D) are antipsychotic agents.

Question 32

Which of the following are true of second-generation antipsychotics in contrast to first-generation antipsychotics? (Select all that apply.)

A) Second-generation antipsychotics are used more frequently than first-generation antipsychotics.
B) Second-generation antipsychotics are better tolerated than first-generation antipsychotics.
C) Second-generation antipsychotics are more effective against the negative effects of psychosis than first-generation antipsychotics.
D) Second-generation antipsychotics are primarily dopamine antagonists, whereas first-generation antipsychotics were dopamine agonists.

Question 33

Second-generation antipsychotics have fewer side effects than first-generation antipsychotics.

Question 34

SSRIs tend to produce CNS stimulation rather than CNS depression.

Question 35

Bupropion is reserved for patients who are not responsive to other agents because of a potential for:

A) cardiac arrhythmias.
B) seizures.
C) retinopathy.
D) glaucoma.

Question 36

Patients undergoing lithium therapy should be observed for signs of overdose toxicity, including:

A) hyperpyrexia.
B) constipation.
C) muscle rigidity and fasciculations.
D) loquacious speech.

Question 37

Which of the following categories of medications has recently been approved for the treatment of bipolar disorder?

A) High-potency first-generation antipsychotics
B) Second-generation antipsychotics
C) SSRIs
D) MAOIs

Question 38

Which of the following medications is used to treat bipolar depression?

A) Haloperidol
B) Lithium
C) Clozapine
D) Paroxetine