問題一覧
1
Which one of the following combinations of antiparkin- sonian drugs is an appropriate treatment plan? A. Amantadine, carbidopa, and entacapone. B. Levodopa, carbidopa, and entacapone. C. Pramipexole, carbidopa, and entacapone. D. Ropinirole, selegiline, and entacapone. E. Ropinirole, carbidopa, and selegiline.
B. Levodopa, carbidopa, and entacapone.
2
Peripheral adverse effects of levodopa, including nausea, hypotension, and cardiac arrhythmias, can be diminished by including which of the following drugs in the therapy? A. Amantadine. B. Ropinirole. C. Carbidopa. D. Tolcapone. E. Pramipexole.
C. Carbidopa
3
Which of the following antiparkinsonian drugs may cause vasospasm? A. Amantadine. B. Bromocriptine. C. Carbidopa. D. Entacapone. E. Ropinirole.
B. Bromocriptine
4
Modest improvement in the memory of patients with Alzheimer’s disease may occur with drugs that increase transmission at which of the following receptors? A. Adrenergic. B. Cholinergic. C. Dopaminergic. D. GABAergic. E. Serotonergic.
B. Cholinergic
5
Whichmedicationisaglutamatereceptorantagonistthat can be used in combination with an acetylcholinesterase inhibitor to manage the symptoms of Alzheimer’s disease? A. Rivastigmine. B. Ropinirole. C. Fluoxetine. D. Memantine. E. Donepezil.
D. Memantine
6
Which of the following agents is available as a patch for once-daily use and is likely to provide steady drug levels to treat Alzheimer’s disease? A. Rivastigmine. B. Donepezil. C. Memantine. D. Galantamine. E. Glatiramer
A. Rivastigmine
7
Which of the following is the only medication that is approved for the management of amyotrophic lateral sclerosis? A. Pramipexole. B. Selegiline. C. Galantamine. D. Riluzole. E. Glatiramer.
D. Riluzole
8
Which of the following medications reduces immune system–mediated inflammation via inhibition of pyrimidine synthesis to reduce the number of activated lymphocytes in the CNS? A. Riluzole. B. Rotigotine. C. Teriflunomide. D. Dexamethasone.
C. Teriflunomide
9
Which of the following agents may cause tremors as a side effect and, thus, should be used with caution in patients with Parkinson’s disease, even though it is also indicated for the treatment of dementia associated with Parkinson’s disease? A. Benztropine. B. Rotigotine. C. Rivastigmine. D. Dimethyl fumarate.
C. Rivastigmine
10
Which of the following agents exerts its therapeutic effect in multiple sclerosis via potassium channel blockade? A. Dalfampridine. B. Donepezil. C. Riluzole. D. Bromocriptine.
A. Dalfampridine
11
Which one of the following statements is correct regarding benzodiazepines? A. Benzodiazepines directly open chloride channels. B. Benzodiazepines show analgesic actions. C. Clinical improvement of anxiety requires 2 to 4 weeks of treatment with benzodiazepines. D. All benzodiazepines have some sedative effects. E. Benzodiazepines, like other CNS depressants, readily produce general anesthesia.
D. All benzodiazepines have some sedative effects.
12
Which one of the following is a short-acting hypnotic? A. Phenobarbital. B. Diazepam. C. Chlordiazepoxide. D. Triazolam. E. Flurazepam.
D. Triazolam
13
Which one of the following statements is correct regarding the anxiolytic and hypnotic agents? A. Phenobarbital shows analgesic properties. B. Diazepam and phenobarbital induce the cytochrome P450 enzyme system. C. Phenobarbital is useful in the treatment of acute intermittent porphyria. D. Phenobarbital induces respiratory depression, which is enhanced by the consumption of ethanol. E. Buspirone has actions similar to those of the benzodiazepines.
D. Phenobarbital induces respiratory depression, which is enhanced by the consumption of ethanol.
14
A 45-year-old man who has been injured in a car accident is brought into the emergency room. His blood alcohol level on admission is 275 mg/dL. Hospital records show a prior hospitalization for alcohol-related seizures. His wife confirms that he has been drinking heavily for 3 weeks. What treatment should be provided to the patient if he goes into withdrawal? A. None. B. Lorazepam. C. Pentobarbital. D. Phenytoin. E. Buspirone.
B. Lorazepam
15
Which one of the following is a short-acting hypnotic and better for sleep induction compared to sleep maintenance? A. Temazepam. B. Flurazepam. C. Zaleplon. D. Buspirone. E. Escitalopram.
C. Zaleplon
16
Which of the following agents has a rapid anxiolytic effect and would be best for the acute management of anxiety? A. Buspirone. B. Venlafaxine. C. Lorazepam. D. Escitalopram. E. Duloxetine.
C. Lorazepam
17
Which of the following sedative–hypnotic agents utilizes melatonin receptor agonism as the mechanism of action to induce sleep? A. Zolpidem. B. Eszopiclone. C. Estazolam. D. Ramelteon. E. Diphenhydramine.
D. Ramelteon
18
All of the following agents for the management of insomnia are controlled substances and may have a risk for addiction or dependence except: A. Zaleplon. B. Flurazepam. C. Doxepin. D. Zolpidem. E. Triazolam.
C. Doxepin
19
All of the following agents may cause cognitive impairment, including memory problems when used at recommended doses except: A. Diphenhydramine. B. Zolpidem. C. Alprazolam. D. Phenobarbital. E. Ramelteon.
E. Ramelteon
20
Which agent is best used in the Emergency Room setting for patients who are believed to have received too much of a benzodiazepine drug or taken an overdose of benzodiazepines? A. Diazepam. B. Ramelteon. C. Flumazenil. D. Doxepin. E. Naloxone.
C. Flumazenil
21
A 55-year-old teacher began to experience changes in mood. He was losing interest in his work and lacked the desire to play his daily tennis match. He was preoccupied with feelings of guilt, worthlessness, and hopelessness. In addition to the psychiatric symptoms, the patient complained of muscle aches throughout his body. Physical and laboratory tests were unremarkable. After 6 weeks of therapy with fluoxetine, his symptoms resolved. However, the patient complains of sexual dysfunction. Which of the following drugs might be useful in this patient? A. Fluvoxamine. B. Sertraline. C. Citalopram. D. Mirtazapine. E. Lithium.
D. Mirtazapine
22
A 25-year-old woman has a long history of depressive symptoms accompanied by body aches and pain secondary to a car accident 2 years earlier. Physical and laboratory tests are unremarkable. Which of the following drugs might be useful in this patient? A. Fluoxetine. B. Sertraline. C. Phenelzine. D. Mirtazapine. E. Duloxetine.
E. Duloxetine
23
A 51-year-old woman with symptoms of major depression also has angle-closure glaucoma. Which of the following antidepressants should be avoided in this patient? A. Amitriptyline. B. Sertraline. C. Bupropion. D. Mirtazapine. E. Fluvoxamine.
A. Amitriptyline
24
A 36-year-old man presents with symptoms of compulsive behavior. If anything is out of order, he feels that “work will not be accomplished effectively or efficiently.” He realizes that his behavior is interfering with his ability to accomplish his daily tasks but cannot seem to stop himself. Which of the following drugs would be most helpful to this patient? A. Imipramine. B. Fluvoxamine. C. Amitriptyline. D. Tranylcypromine. E. Lithium.
B. Fluvoxamine
25
Which antidepressant has, as its two proposed principle mechanisms of action, 5-HT1a receptor partial agonism and 5-HT reuptake inhibition? A. Fluoxetine. B. Aripiprazole. C. Maprotiline. D. Vilazodone. E. Mirtazapine.
D. Vilazodone
26
Which antidepressant is the most sedating? A. Fluoxetine. B. Duloxetine. C. Nortriptyline. D. Citalopram. E. Venlafaxine.
C. Notriptyline
27
Which mood stabilizer is completely renally eliminated and may be beneficial for patients with hepatic impairment? A. Valproic acid. B. Carbamazepine. C. Lithium. D. Risperidone. E. Aripiprazole.
C. Lithium
28
Which antidepressant has, as its two principle mechanisms of action, 5-HT2A receptor antagonism and α2 receptor antagonism? A. Fluoxetine. B. Doxepin. C. Maprotiline. D. Mirtazapine. E. Selegiline.
D. Mirtazapine
29
Which agent is best known to have the side effect of decreasing the thyroid function of the patient being chronically treated with this agent? A. Carbamazepine. B. Lithium. C. Valproic acid. D. Chlorpromazine. E. Lurasidone.
B. Lithium
30
Which agent would be a poor choice in a 70-year- old elderly female with depressive symptoms due to the drug having significant α1 receptor antagonism and thus a higher risk for falls due to orthostatic hypotension? A. Lithium. B. Bupropion. C. Escitalopram. D. Imipramine. E. Sertraline.
D. Imipramine
31
An adolescent male is newly diagnosed with schizo- phrenia. Which of the following antipsychotic agents may have the best chance to improve his apathy and blunted affect? A. Chlorpromazine. B. Fluphenazine. C. Haloperidol. D. Risperidone. E. Thioridazine.
D. Risperidone
32
Which one of the following antipsychotics has been shown to be a partial agonist at the dopamine D2 receptor? A. Aripiprazole. B. Clozapine. C. Haloperidol. D. Risperidone. E. Thioridazine.
A. Aripiprazole
33
A 21-year-old male has recently begun pimozide therapy for Tourette disorder. His parents bring him to the emergency department. They describe that he has been having “different-appearing tics” than before, such as prolonged contraction of the facial muscles. While being examined, he experiences opisthotonos (type of extrapyramidal spasm of the body in which the head and heels are bent backward and the body is bowed forward). Which of the following drugs would be beneficial in reducing these symptoms? A. Benztropine. B. Bromocriptine. C. Lithium. D. Prochlorperazine. E. Risperidone.
A. Benztropine
34
A 28-year-old woman with schizoaffective disorder (combination of mood and psychotic symptoms) reports difficulty falling asleep. Which of the following would be most beneficial in this patient? A. Lithium. B. Chlorpromazine. C. Haloperidol. D. Paliperidone. E. Ziprasidone.
D. Paliperidone
35
Which of the following antipsychotic agents is con- sidered to be the most potent and, thus, have the highest risk of extrapyramidal symptoms? A. Thioridazine. B. Fluphenazine. C. Quetiapine. D. Chlorpromazine. E. Clozapine.
B. Fluphenazine
36
Which antipsychotic has the most sedative potential and is sometimes questionably used as a hypnotic agent in certain clinical settings? A. Fluphenazine. B. Thiothixene. C. Quetiapine. D. Haloperidol. E. Iloperidone.
C. Quetiapine
37
A 30-year-old male patient who is treated with halo- peridol for his diagnosis of schizophrenia is considered to be well-managed symptomatically for his psychotic symptoms. However, he is reporting restlessness, the inability to sit still at the dinner table, and his family notices that he is pacing up and down the hallway frequently. Of the following, which is the best medication to treat this antipsychotic-induced akathisia? A. Benztropine. B. Dantrolene. C. Amoxapine. D. Bromocriptine. E. Propranolol.
E. Propanolol
38
Which of the following antipsychotic agents is available in a LAI formulation that may be useful for patients with difficulty adhering to therapy? A. Asenapine. B. Chlorpromazine. C. Clozapine. D. Quetiapine. E. Risperidone.
E. Risperidone
39
Which of the following antipsychotic agents is most associated with the possibility of a hematological dyscrasia such as agranulocytosis in a patient being treated for schizophrenia? A. Chlorpromazine. B. Buspirone. C. Lithium. D. Clozapine. E. Asenapine.
D. Clozapine
40
Which antipsychotic agent has been most associated with significant QT interval prolongation and should be used with caution in patients with preexisting arrhythmias or patients taking other drugs associated with QT prolongation? A. Thioridazine. B. Risperidone. C. Asenapine. D. Lurasidone. E. Aripiprazole.
Thioridazine