Deck 6: Central Nervous System Agents

Question 1

Which of the following is FALSE regarding phentermine?

A) Contraindicated use with MAO inhibitors
B) Decreases blood pressure
C) Avoid late night dosing
D) Contraindicated in patients with a history of drug abuse

Answer 1

B

Question 2

Which of the following is the active metabolite of oxcarbazepine?

A) 10-monohydroxy metabolite
B) 10,11-epoxide
C) Carbamazepine
D) Epoxide hydrolase

Answer 2

B

Question 3

The target blood concentrations for phenobarbital are:

A) 10-20 mcg/ml
B) 4-12 mcg/ml
C) 10-40 mcg/ml
D) 50-100 mcg/ml

Answer 3

C

Question 4

The following are all black box warnings for valproate/divalproex medications, EXCEPT:

A) Pancreatitis
B) Hepatotoxicity
C) Teratogenicity
D) Rash

Question 5

Which of the following is NOT a Schedule C-II controlled substance?

A) Methylphenidate
B) Amphetamine/ dextroamphetamine
C) Modafanil
D) Lisdexamfetamine

Question 6

Which of the following is an indication for buspirone?

A) Seizure disorder
B) Generalized anxiety disorder
C) Binge eating disorder
D) Bipolar disorder

Question 7

Which medication should be avoided in patients with known serious structural cardiac abnormalities, coronary artery disease, or other serious cardiac abnormalities due to an increased risk of sudden death?

A) Methocarbamol
B) Escitalopram
C) Memantine
D) Lisdexamfetamine

Question 8

Sumatriptan is contraindicated for use in patients with:

A) Seizure disorder
B) Ischemic heart disease
C) Gout
D) Renal impairment

Question 9

Which of the following represents the most common adverse reaction seen with donepezil?

A) Weight gain
B) Rash
C) Gastrointestinal symptoms (nausea, vomiting, diarrhea)
D) Somnolence

Question 10

Carisoprodol should not be given concurrently with:

A) Aspirin
B) Metoprolol
C) Meprobamate
D) Phenytoin

Question 11

Mr. Jones was helping his daughter move into her college dorm over the weekend and is now complaining of muscle spasm and lower back pain. His PCP has prescribed metaxolone and ibuprofen. Which of the following statements is correct?

A) Metaxalone is safe to use in end-stage liver disease.
B) The usual dose is 800 mg every 6-8 hours.
C) Hemolytic anemia is one of the most common side effects seen with this drug.
D) The mechanism of action of this agent is due to a direct effect on skeletal muscle.

Question 12

Your patient presents with a prescription for Zanaflex 2 mg po q8h as needed. He reports that his job requires a lot of heavy lifting and his back has been bothering him for a few days. All of the following counseling points are correct, EXCEPT:

A) Encourage him to rise slowly from a lying or seated position.
B) Consider recommending a lumbar back support at work for relief of symptoms.
C) Moderate alcohol consumption is reasonable while taking this drug.
D) He should use no more than 3 doses in a 24-hour period.

Question 13

All of the following statements regarding carbidopa/levodopa are correct, EXCEPT:

A) Parcopa is an extended-release formulation.
B) Some patients may require QID dosing or use of more than one dosage strength for adequate control.
C) Therapeutic effects may take weeks to months to achieve.
D) Use of concurrent MAO inhibitors is contraindicated with carbidopa/levodopa.

Question 14

Significant drug-drug interactions with Requip include:

A) CYP1A2 inhibitors can increase the effect of Requip.
B) CYP1A2 inhibitors can decrease the effect of Requip.
C) CYP1A2 inducers can increase the effect of Requip.
D) CYP1A2 inducers have no effect on Requip.

Question 15

Which of the following is an example of a tricyclic antidepressant?

A) Escitalopram
B) Mirtazapine
C) Ziprasidone
D) Nortriptyline

Question 16

Therapy for a first episode of depression should continue for how long, once a patient has had adequate control of their symptoms?

A) At least 2 years
B) 18 months
C) At least 6-9 months
D) Stop drug when depression remits

Question 17

Medications that can increase the risk for serotonin syndrome when used with antidepressants include:

A) Triptans
B) Linezolid
C) Dextromethorphan
D) All of the above

Question 18

Nefazodone is structurally related to trazodone but does not share which of the following rarely seen adverse reaction caused by trazodone?

A) Nausea
B) Priapism
C) Lenticular atrophy
D) Homonymous hemianopsia

Question 19

Which of the following is considered an "atypical antipsychotic agent"?

A) Quetiapine
B) Olanzapine
C) Clozapine
D) All of the above

Question 20

There is an FDA black box warning that states there is an increased risk of suicidal thinking and behavior in children, adolescents, and young adults (18-24 years of age) for which class of drugs?

A) Anti-anxiety agents, including benzodiazepines
B) Antidepressants
C) Antipsychotic agents, especially the newer ones
D) None of the above

Question 21

In which of the following dosage forms is Imitrex not available?

A) Oral tablet
B) Subcutaneous injection
C) Sublingual tablet
D) Nasal spray

Question 22

What is the starting dose of Aricept?

A) 20 mg/day
B) 10 mg/day
C) 5 mg/day
D) 2.5 mg/day

Question 23

When should dopamine agonists be taken if a patient experiences dry mouth?

A) Before meals
B) After meals
C) With meals
D) At bedtime

Question 24

What is the maximum daily dosage of Sinemet?

A) 10 tablets
B) 8 tablets
C) 6 tablets
D) 4 tablets

Question 25

What is the recommended maximum duration of use for cyclobenzaprine?

A) 2-3 weeks
B) 4-6 weeks
C) 2-3 months
D) 6-12 months

Question 26

Which of the following skeletal muscle relaxants may be used for trigeminal neuralgia?

A) Cyclobenzaprine
B) Carisoprodol
C) Metaxalone
D) Tizanidine

Question 27

Memantine is effective in moderate to severe Alzheimer's dementia via which mechanism?

A) Acetylcholinesterase inhibition
B) N-methyl-D-aspartate (NMDA) receptor antagonism
C) Dopamine receptor agonist
D) Serotonin reuptake inhibition

Question 28

All of the following statements are correct regarding Exelon, EXCEPT:

A) The oral solution and capsules may be interchanged at equal doses.
B) Oral Exelon should be taken on an empty stomach.
C) Adverse effects such as nausea and vomiting may be related to elevated plasma concentrations.
D) The transdermal system is worn continuously for 24 hours.

Question 29

Which of the following is contraindicated for use with ciprofloxacin due to CYP1A2 inhibition?

A) Fexmid
B) Zanaflex
C) Flexeril
D) Maxalt

Question 30

What is NOT a contraindication to using phenetamine?

A) History of cardiovascular disease
B) Hypothyroidism
C) Glaucoma
D) Concurrent use with monoamine oxidase inhibitors

Question 31

Which of the following has a warning against concomitant use with opioids, as this may result in profound sedation, respiratory depression, coma, and death?

A) Phenytoin
B) Lorazepam
C) Amphetamine/dextroamphetamine
D) Modafinil

Question 32

Which of the following benzodiazepines is formulated as a rectal gel?

A) Diazepam
B) Lorazepam
C) Clonazepam
D) Temazepam

Question 33

All of the following statements are true regarding benzodiazepines, EXCEPT:

A) Benzodiazepines should be used cautiously in older adult patients due to an increased risk in falls.
B) Temazepam is the only benzodiazepine that is not a Schedule C-IV medication.
C) The parenteral formulation of lorazepam has a risk of propylene glycol toxicity especially when utilized as a continuous IV infusion.
D) Abrupt discontinuation should be avoided and a tapering strategy should be utilized with benzodiazepines, especially in patients with pre-existing seizure disorders.

Question 34

Which counseling point regarding antipsychotic therapy is FALSE?

A) Most agents are stimulating and should therefore be taken in the morning.
B) Glucose, weight, and lipids must be monitored with all atypical agents.
C) There is a black box warning for all agents that patients with dementia-related behavioral disorders treated with antipsychotics are at an increased risk of death compared to placebo.
D) If a patient misses a dose, they should not double up the next day.

Question 35

Which antipsychotic is approved for the treatment of MDD as an adjunctive agent?

A) Zyprexa
B) Geodon
C) Haldol
D) Abilify