Gvsu Pharm Exam 2

Front 1

This traditional anti-epileptic drug (AED) is inactive against tonic-clonic, simple partial, and complex partial seizures. However, it is a drug of choice for absence seizures. Absence seizures are abolished in 60% of patients by inhibiting calcium currents known as T currents. Which one is it?

Back 1

Ethosuximide (Zarontin)

Front 2

Which of the following acts directly on skeletal muscle to suppress release of calcium from the sarcoplasmic reticulum (SR)? Fortunately, therapeutic doses only have minimal effects on smooth and cardiac muscle. Dose-related liver damage is the most serious adverse effect. In addition to treating spasm and spasticity, this drug is also used for malignant hyperthermia.

Back 2

Dantrolene (Dantrium)

Front 3

Which of the following is a local anesthetic characterized by an amide bond, has a very low incidence of allergic reactions & is metabolized by hepatic enzymes? This drug can also be used to treat cardiac dysrhythmias.

Back 3

Lidocaine (Xylocaine, others)

Front 4

Almost all patients undergoing general anesthesia receive this to supplement the analgesic effects of the primary anesthetic. In certain settings, such as dentistry or during delivery, this drug may be used alone to block pain. At therapeutic doses, this drug has no serious adverse effects. Which is it?

Back 4

Nitrous oxide

Front 5

Which of the following is a strong opioid analgesic with high milligram potency? This drug is available for parenteral, transdermal, and transmucosal administration. All preparations are regulated under Schedule II of the Controlled Substances Act.

Back 5

Fentanyl

Front 6

The drugs that are used for preventive therapy of migraine headache were discussed in class and are listed in Table 30-5 of the text. Which of the following drugs are the preferred drugs for migraine prevention? These drugs can reduce the number and intensity of attacks in 70% of patients.

Back 6

Beta-blockers

Front 7

Sumatriptan (Imitrex) was the first triptan available for aborting an on-going migraine attack. This drug can be administered by mouth, nasal inhalation, or subQ injection. How do the triptans work? What is their mechanism of action?

Back 7

Serotonin receptor agonists

Front 8

Which of the following is considered the prototype of the high-potency neuroleptics? This conventional anti-psychotic belongs to the butyrophenone family of compounds. Early extrapyramidal reactions occur frequently, whereas sedation, hypotension and anticholinergic effects are uncommon. This drug is also available in an IM or subQ depot preparation.

Back 8

Haloperidol (Haldol)

Front 9

Which of the following is the prototype of the antidepressants that block neuronal reuptake of two monoamine neurotransmitters? The nucleus of this drug consists of 3 rings, hence the classification of tricyclic antidepressant. The most common adverse effects are orthostatic hypotension, sedation and anticholinergic effects. The most serious adverse effect is cardiotoxicity.

Back 9

Imipramine (Tofranil)

Front 10

Which of the following is used as a mood stabilizer in bipolar disorder? The exact mechanism of action of this drug is not known. Toxicity can occur at blood levels only slightly higher than therapeutic levels. With increasing blood levels, effects can range from nausea & vomiting to convulsions & death.

Back 10

Lithium

Front 11

This drug was not approved by the FDA until 2005, even though it was used for years in Canada and Europe. It interacts with the benzodiazepine receptor like other drugs, but has no limitation on how long it can be used. This hypnotic is generally well tolerated and features a large moth against the night sky in advertisements. Which is it?

Back 11

Eszopiclone (Lunesta)

Front 12

This drug is considered ‘first-line’ therapy in the treatment of generalized anxiety disorder. It falls under the ‘Other’ category in Table #35-1 and is not a CNS depressant. It does not cause sedation, has no abuse potential and does not intensify the effects of CNS depressants. Which is it?

Back 12

Buspirone (BuSpar)

Front 13

A child is diagnosed with ADHD and it is decided to start him on the medication that over 70% of ADHD children receive. This drug is considered a non-amphetamine chemically, but shares the same mechanism of action, adverse effects and abuse potential as amphetamines. This drug comes in 3 formulations. Which drug is it?

Back 13

Methylphenidate (Ritalin)

Front 14

There has been discussion lately of changing the classification of marijuana to a less restricted classification. Marijuana is currently listed under the most restricted class, which class is it?

Back 14

Schedule I drugs

Front 15

An alcoholic patient reports for a follow-up visit after starting a drug to maintain abstinence. He states that the drug decreases the ‘high’ associated with alcohol. Which drug is a pure opioid antagonist that decreases the craving for alcohol and blocks alcohol’s ‘pleasurable’ effects?

Back 15

Naltrexone (ReVia)

Front 16

A patient is trying to quit smoking. She wants to try the ‘new’ medication that uses a tortoise and hare in their advertisements. You warn the patient about recent adverse effects associated with this drug. These include reports of mental confusion and dizziness with airline pilots. Which drug?

Back 16

Varenicline (Chantix)

Front 17

Which of the following stimulates decarboxylase activity and can accelerate decarboxylation of levodopa? As a result, therapeutic effects of levodopa can be reduced. Parkinson’s patients should be warned of this interaction.

Back 17

Pyridoxine (vitamin B6)

Front 18

Which of the following is a local anesthetic characterized by an ester bond, has a low incidence of allergic reactions & is metabolized by plasma esterases? Once popular in dentistry, use of this drug has declined drastically with the development of newer agents.

Back 18

Procaine (Novocain)

Front 19

Which of the following reduces the symptoms of Parkinson’s disease by promoting synthesis of dopamine? This drug is considered the most effective for PD and has been a cornerstone of therapy since the 1960s. It enters the brain through an active transport system.

Back 19

Levodopa

Front 20

Which of the following is a cholinesterase inhibitor used in the treatment of Alzheimer’s disease? There are several cholinesterase inhibitors, but this one is considered the drug of choice due to once-a-day dosing & being better tolerated. Which one?

Back 20

Donepezil (Aricept)

Front 21

There are a limited number of ways that drugs can treat the symptoms of Alzheimer’s disease. What is the mechanism of action of Memantine (Namenda)? In other words, how does it work?

Back 21

Blocks NMDA receptors

Front 22

The precise mechanism by which this naturally occurring glycoprotein suppresses the autoimmune destruction of myelin in multiple sclerosis is unknown. Adverse effects include: flu-like reactions, hepatotoxicity, myelosuppression and injection-site reactions. Which one is it?

Back 22

Interferon Beta

Front 23

This traditional anti-epileptic drug (AED) is effective, inexpensive and can be administered just once a day. This drug suppresses seizures by potentiating the effects of GABA. Adverse effects include: lethargy, depression, learning impairment & physical dependence. Which one of the following?

Back 23

Phenobarbital

Front 24

This newer anti-epileptic drug was introduced in 1993 and has a wide spectrum of anti-seizure activity. Its precise mechanism of action is unknown, but it appears to enhance GABA release. Unlike most AEDs, it is very well tolerated and devoid of significant drug interactions. Which is it?

Back 24

Gabapentin (Neurontin)

Front 25

Which of the following is used to treat muscle spasm and spasticity, but has no direct effect on skeletal muscle? This drug is a structural analog of GABA & may mimic the effects of GABA on spinal neurons. Administration must be carefully monitored as there is no antidote for overdose.

Back 25

Baclofen (Lioresal)

Front 26

Which drug was our first local anesthetic? It is used for anesthesia of the ear, nose and throat. It should be avoided in individuals with cardiovascular complications as it stimulates the heart and causes vasoconstriction. This drug must be dispensed in accord with the Controlled Substances Act.

Back 26

Cocaine

Front 27

There are numerous neurotransmitters in the central nervous system (CNS), many more than in the periphery. We discussed these in class & they are listed in Table #20-1. Which of the following is NOT considered a neurotransmitter of the CNS?

Back 27

Trick question, all are CNS neurotransmitters

Front 28

Some drugs alleviate the symptoms of Parkinson’s disease by blocking muscarinic receptors in the striatum. These are most appropriate for younger patients who can tolerate the CNS side-effects. Which is an example of these anti-cholinergics used for PD?

Back 28

Benztropine (Cogentin)

Front 29

This drug is considered one of the most widely used traditional anti-epileptic drugs (AEDs). It slows the recovery of sodium channels from the inactive state back to the active. It has ‘tricky’ kinetics, a narrow therapeutic index and various adverse effects. There is an IV formulation that is used following Diazepam (Valium) after a ‘status epilepticus’ seizure. Which is it?

Back 29

Phenytoin (Dilantin)

Front 30

COMT inhibitors are used for Parkinson’s disease. Benefits derive from inhibiting metabolism of levodopa in the periphery. This increases the time levodopa is available to the brain. Which is it?

Back 30

Entacapone (Comtan)

Front 31

The American Academy of Neurology (AAN) issued guidelines for the treatment of Alzheimer’s disease in 2001. They acknowledge that depression can occur with AD patients. Which of the following would be recommended for treating depression in AD patients according to their guidelines?

Back 31

Fluoxetine (Prozac)

Front 32

Which drug is a polypeptide composed of a random sequence of 4 amino acids? This drug is similar in structure to myelin basic protein and is believed to inhibit the immune response in multiple sclerosis. This drug is well tolerated except for some short-lasting post-injection reactions.

Back 32

Glatiramer (Copaxone)

Front 33

Which of the drugs for multiple sclerosis requires: complete blood counts at baseline and prior to each dose, liver function tests at baseline and prior to each dose, a pregnancy test prior to each dose & periodic determination of ‘left ventricular ejection fraction’ (LVEF)?

Back 33

Mitoxantrone (Novantrone)

Front 34

This drug is considered a traditional anti-epileptic drug (AED). In addition to epilepsy, it is used in bipolar disorder and trigeminal & glossopharyngeal neuralgias. Main adverse effects include: neurologic effects, hematologic effects, birth defects, hypo-osmolarity & dermatologic effects. Which drug?

Back 34

Carbamazepine (Tegretol)

Front 35

Which of the following is our most widely used inhalation anesthetic? This drug is potent (MAC = 1.15%) with an induction of anesthesia that is smooth and rapid. Like other volatile liquids, this drug causes respiratory depression and hypotension.

Back 35

Isoflurane

Front 36

Which of the following is potent hypnotic agent used for the induction of surgical anesthesia? This drug has no analgesic actions. There are several adverse effects with this drug, but it is preferred for patients with cardiovascular disorders instead of using barbiturates.

Back 36

Etomidate (Amidate)

Front 37

Which of the following are NOT associated with the use of morphine?

Back 37

Diarrhea

Front 38

Which of the following was the first opioid agonist/antagonist available? It is indicated for mild to moderate pain & is much less effective against severe pain than morphine. However, it produces little to no euphoria & has a limit to respiratory depression (compared to morphine).

Back 38

Pentazocine (Talwin)

Front 39

This ‘migraine-specific’ drug is used to about an ongoing migraine attack. The actions of this drug are complex and the precise mechanism of action is unknown. It is well tolerated at usual therapeutic doses, but can trigger nausea & vomiting in addition to the migraine itself. This drug has multiple delivery modes. Which one is it?

Back 39

Ergotamine (Ergomar, Ergostat)

Front 40

Which of the following would be considered the most common form of headache? These headaches are characterized by moderate, non-throbbing pain usually located in a “head band” distribution. They have minimal impact on daily life and patients should be taught how to manage stress.

Back 40

Tension headache

Front 41

This specific extrapyramidal effect is characterized by pacing and squirming brought about by an uncontrollable need to be in motion. This profound sense of restlessness can be very disturbing. This usually develops with the first 2 months of treatment with typical antipsychotics. What is this EPS effect?

Back 41

Akathisia

Front 42

Which of the following is a new hypnotic with a new mechanism of action, activation of melatonin receptors? This drug is very well tolerated. It is not regulated under the Controlled Substances Act since there is no evidence of physical dependence or abuse. The commercials for this drug feature Abraham Lincoln and a ground hog.

Back 42

Ramelteon (Rozerem)

Front 43

A judge is reviewing the rehabilitation of a person convicted of drunk driving. He orders that for the next month the person report to a clinic and be medicated with a substance that will make him ill if he consumes alcohol. Which of the following medications is probably the ordered substance?

Back 43

Disulfiram (Antabuse)

Front 44

Which of the following was the first modern conventional anti-psychotic? It is considered a low-potency neuroleptic and belongs to the phenothiazine family of compounds. The most common adverse effects are sedation, orthostatic hypotension and anticholinergic effects.

Back 44

Chlorpromazine (Thorazine)

Front 45

Which of the following is the prototype of the antidepressants that block monoamine oxidase? Monoamine oxidase inhibitors are as effective as other antidepressants, but they can be hazardous. Because of numerous adverse effects, drug & food interactions they are normally reserved for patients

Back 45

Isocarboxazid (Marplan)

Front 46

The selective serotonin reuptake inhibitors (SSRIs) have become the most widely prescribed group of antidepressants. These drugs are safer and better tolerated than the other classes of antidepressants. However, there is a side effect that occurs in about 70% of patients. What is that side effect?

Back 46

Sexual dysfunction

Front 47

Which of the following is a competitive benzodiazepine receptor antagonist? This drug can reverse the sedative effects of benzodiazepines. It is approved for benzodiazepine overdose and for reversing the effects of benzodiazepines following general anesthesia.

Back 47

Flumazenil (Romazicon)

Front 48

Which of the following is a unique drug in that it is the first non-stimulant approved for ADHD? It has no potential for abuse and therefore is not regulated as a controlled substance. It is only one of two drugs approved for ADHD in adults. It is a selective inhibitor of norepinephrine reuptake.

Back 48

Atomoxetine (Strattera)

Front 49

Which of the following is a unique non-amphetamine stimulant that is approved for promoting wakefulness with excessive sleepiness (ES)? Exactly how this drug works is unknown. An advertisement was posted on Black Board about using this drug with ES due to obstructive sleep apnea.

Back 49

Modafinil (Provigil)

Front 50

An alcoholic patient reports feeling of tension and anxiety while trying to maintain abstinence. It is decided to give this patient a drug that reduces these unpleasant feelings. It is not known exactly how this drug works, but it is generally well tolerated. Which of the following is it?

Back 50

Acamprosate (Campral)