Deck 19: Geriatric Psychopharmacology

Question 1

Based on your knowledge of the cellular basis of Parkinsonism and psychotropic drugs,you would expect drugs used to treat ________ to worsen Parkinson's symptoms.

A)depression
B)anxiety
C)mania
D)schizophrenia

Answer 1

D

Question 2

A major limitation of present-day long-term drug therapy for Parkinsonism is:

A)a high incidence of serious liver toxicity associated with levodopa.
B)a rebound or withdrawal effect following discontinuation of treatment.
C)a sensitization phenomenon wherein less and less drug is needed even as dyskinesia and other
D)decreased responsiveness to levadopa.

Answer 2

D

Question 3

The mainstay of pharmacological treatment for behavioral and psychological symptoms of dementia is:

A)SSRI antidepressants.
B)atypical antipsychotics.
C)Ritalin and/or major CNS stimulants.
D)None of the answers are correct.

Answer 3

B

Question 4

At the cellular level,the biological basis for Parkinsonism is best described as a:

A)hypernoradrenergic state.
B)hyponoradrenergic state.
C)hyperdopaminergic state.
D)hypodopaminergic state.

Question 5

The two main COMT-inhibitory drugs talcapone and entacapone are effective:

A)in the PNS but not CNS.
B)in the CNS but not PNS.
C)in both the PNS and CNS.
D)in neither the PNS nor CNS.

Question 6

The mainstay of therapy for Parkinson's disease is:

A)implementation of dopamine neurons.
B)administration of dopamine.
C)administration of neuroleptics.
D)administration of dopamine precursors.

Question 7

MAO-A is associated with _______; MAO-B is associated with ________.

A)norepinephrine neurons; serotonin neurons
B)serotonin neurons; dopamine neurons
C)dopamine neurons; norepinephrine neurons
D)norepinephrine neurons; dopamine neurons

Question 8

Symptoms of Parkinson's disease are frequently a side effect of:

A)antidepressants.
B)anti-anxiety agents.
C)mood stabilizers.
D)neuroleptics.

Question 9

The new dopamine receptor agonists are _______ in the treatment of Parkinson's disease.

A)highly effective
B)about as effective as levadopa
C)totally ineffective
D)marginally effective

Question 10

The clinical syndrome of Parkinsonism includes all of the following,EXCEPT:

A)slowness/poverty of movement.
B)muscle rigidity.
C)tremor during voluntary movement.
D)impaired postural balance.

Question 11

The precursor of levadopa is:

A)dopamine.
B)dopa decarboxylase.
C)tyramine.
D)tyrosine.

Question 12

Mainstay drug treatments for Parkinsonism target the ________; newer drugs target the ________.

A)postsynaptic receptor; cell body
B)cell body; postsynaptic receptor
C)presynaptic terminal; postsynaptic receptor
D)postsynaptic receptor; presynaptic terminal

Question 13

In your answer above,carbidopa achieves this by virtue of two properties,namely:

A)inhibits the breakdown of dopamine; readily crosses the blood-brain barrier.
B)inhibits the breakdown of dopamine; does not cross the blood-brain barrier.
C)inhibits the breakdown of levadopa; readily crosses the blood-brain barrier.
D)inhibits the breakdown of levadopa; does not cross the blood-brain barrier.

Question 14

Undesirable side effects are minimized by combining levadopa with carbidopa,a drug which acts to:

A)inhibit the breakdown of dopamine.
B)increase the amount of dopamine in the peripheral circulation and the brain.
C)decrease the amount of dopamine in both the peripheral circulation and the brain.
D)decrease the amount of dopamine in the peripheral circulation,but not the brain.

Question 15

The amount of levodopa that crosses the blood-brain barrier is:

A)1 to 5 percent.
B)20 to 30 percent.
C)50 to 60 percent.
D)80 to 90 percent.

Question 16

The enzyme dopa decarboxylase:

A)inhibits the conversion of dopamine to levadopa.
B)inhibits the conversion of levadopa to dopamine.
C)converts dopamine to levadopa.
D)converts levadopa to dopamine.

Question 17

Symptoms of Parkinson's disease reveal themselves when levels of dopamine ________ by ________.

A)increase; 20 percent
B)decrease; 20 percent
C)increase; 80 percent
D)decrease; 80 percent

Question 18

The most undesirable side effects of treatment with levodopa are caused by the buildup of high levels of ________ in the ________.

A)levadopa; brain
B)levadopa; peripheral circulation
C)dopamine; brain
D)dopamine; peripheral circulation

Question 19

All of the following treatments ameliorate parkinsonism symptomatology,EXCEPT:

A)replacement of dopamine.
B)administration of antipsychotics.
C)administration of dopamine agonists.
D)administration of dopamine-breakdown inhibitors.

Question 20

Selegiline ameliorates symptoms of Parkinsonism through a unique mechanism,namely inhibiting:

A)the conversion of levadopa to dopamine.
B)COMT,an enzyme involved in the degradation of dopamine.
C)the reuptake of dopamine into the presynaptic terminal.
D)the breakdown of dopamine by MAO-B.

Question 21

The core symptoms of dementia are markedly reduced through the use of atypical antipsychotics.

Question 22

Patients with severe Alzheimer's disease show acetylcholine levels:

A)10 percent below normal.
B)25 percent below normal.
C)50 percent below normal.
D)75 percent below normal.

Question 23

About 95 percent of levadopa administered orally crosses the blood-brain barrier.

Question 24

The current treatment for delaying the onset of Alzheimer's disease is primarily:

A)blockade of acetylcholine receptors.
B)stimulation of acetylcholine receptors.
C)inhibition of acetylcholine breakdown.
D)potentiation of acetylcholine breakdown.

Question 25

Parkinson's disease is characterized by a blockade of dopamine receptors.

Question 26

Transplantation of DA cells into the brains of persons with Parkinson's disease has been remarkably successful.

Question 27

Levadopa produces undesirable side effects in the peripheral circulation.

Question 28

Carbidopa inhibits the synthesis of dopamine in the systemic,but not central,circulation.

Question 29

The most common neurodegenerative disease is:

A)cardiovascular disease.
B)Parkinson's disease.
C)bipolar disorder.
D)Alzheimer's disease.

Question 30

Dopamine is synthesized in the soma (cell body)of neurons.

Question 31

Memantine's mechanism of action is:

A)blockade of acetylcholine receptors.
B)inhibition of acetylcholine breakdown.
C)blockade of NMDA receptors.
D)inhibition of glutamate breakdown.

Question 32

Drugs to treat Alzheimer's disease work by:

A)increasing acetylcholine levels in the brain.
B)mimicking the effects of acetylcholine in the brain.
C)inhibiting the breakdown of acetylcholine in the brain.
D)blocking acetylcholine receptors in the brain.

Question 33

Inhibitors of dopamine breakdown can restore function in Parkinson's disease.

Question 34

Levadopa is the mainstay of therapy for Parkinson's disease.

Question 35

Loss of motor function in Parkinson's disease can be restored by antipsychotic drugs.

Question 36

Reducing levels of dopamine in the systemic circulation is a major component of the current approach in treating Parkinson's disease.

Question 37

Voluntary tremor is a cardinal symptom of parkinsonism.

Question 38

Dopamine readily crosses the blood-brain barrier.

Question 39

Adults 65 years of age and older account for 20 percent of all suicides in the U.S.

Question 40

In the brain,dopamine is converted into levadopa by decarboxylation.

Question 41

Thus far,drugs that block formation of amyloid plaques have demonstrated significant efficacy in treating Alzheimer's disease.

Question 42

Current treatments for mild to moderate Alzheimer's disease involve primarily inhibitors of acetylcholine.

Question 43

Marked tolerance develops to levadopa.

Question 44

Cholinesterase inhibitors impair cognition in non-Alzheimer's patients

Question 45

Insufficient levels of the neurotransmitter glutamate can lead to neuronal damage via the phenomenon of excitotoxicity.

Question 46

Based on the actions of memantine,low doses of PCP might be expected to enhance memory in Alzheimer's patients.

Question 47

At high doses,the new anti-Alzheimer's drug memantine impairs memory.

Question 48

Currently,no treatment can alter the course of Alzheimer's disease.

Question 49

Alzheimer's disease is a direct result of neurons secreting less Ach than normal.

Question 50

Carbidopa inhibits the conversion of tyrosine to levadopa.