1. PHARMACOLOGY EXAM 4 – PART 1 BY ALAINA DARBY

2. Which of the following is part of the diencephalon? a. Hypothalamus b. Medulla c. Pons d. Basal ganglia

3. Which of the following is not part of the limbic system? a Amygdala b Mammillary bodies c Substantia nigra d Orbitofrontal cortex

4. Which of the following is properly paired? a. Cingulate cortex – memory b. Hippocampus – autonomic, endocrine c. Nucleus accumbens – spatial memory d. Cingulate cortex – autonomic, attention, cognition

5. Which of the following portions of the brain is responsible for sleep, wakefulness, arousal and eye movements? a. Thalamus b. Hypothalamus c. Midbrain d. Basal ganglia

6. What is the main role of the basal ganglia? a. Emotion b. Learning c. Motor control d. Cognition

7. Which of the following types of channels are not found in neurons? a. Mechanosensitive channels b. Voltage gated channels c. Cyclic nucleotide gated channels d. Ligand gated channels

8. Which of the following is a peptide neurotransmitter? a. Endocannabinoid b. GABA c. Norepinephrine d. Neurotensin

9. Which of the following is true? a. Metabotropic receptors rely on second messengers b. Ionotropic receptors have 7 transmembrane domains c. Metabotropic receptors are transmembrane channels d. Ionotropic receptors open or close in response to ions

10. Which of the following does not directly influence the synthesis or metabolism of dopamine? a. COMT b. Reserpine c. MAO d. L-DOPA

11. Which of the following would be considered a form of neurotransmitter antagonism? a. Black widow spider venom b. Nicotine c. Reserpine d. Cocaine

12. Which of the following would result in neurotransmitter agonism? a. Drug blocks autoreceptors b. Drug inactivates synthetic enzyme c. Drug prevents storage of neurotransmitter in vesicles d. Drug blocks postsynaptic receptors

13. Which of the following is not a primary use of stimulants? a. Anorexic b. Treatment for ADHD c. Antiemetic d. Treatment for narcolepsy

14. Which of the following is true of cocaine? a. Crack is the powder form of the drug b. It can act as a local anesthetic c. It causes hypotension d. It causes the release of neurotransmitter

15. Which of the following is more potent than cocaine? a. Benzoyleconine b. Cocaethylene c. Benzoic acid d. Dexeconine

16. Which of the following is the reward portions of the brain takes over in substance abuse? a. Prefrontal cortex b. Nucleus accumbens c. VTA d. Basal ganglia

17. John is 53 and has just been diagnosed with ADHD. He became addicted to cocaine when he was younger but has since been able to quit. Which of the following drugs is best suited for him? a. Amphetamine b. Methylphenidate c. Atomoxetine d. Lisdexamfetamine

18. Which of the following is a true comparison of mazindol and cocaine? a. Mazindol is more selective for norepinephrine b. Cocaine is more selective for norepinephrine c. Cocaine causes neurotransmitter release while mazindol causes transporter blockade d. Mazindol causes neurotransmitter release while cocaine causes transporter blockade

19. Steve is looking to start taking mazindol for his obesity. Which of his current drugs would not cause an interaction with mazindol? a. Tranylcypromine b. Guanethidine c. Cimetidine d. Amitriptyline

20. Samantha is pregnant. Which of the following stimulants might induce premature labor, if she were to use it? a. Cocaine b. Mazindol c. Amphetamine d. Methylphenidate

21. Which of the following adverse reactions is the most distinguishing for amphetamine among other stimulants? a. Headache b. Confusion c. Neurotoxicity d. Restlessness

22. Which of the following is thought to have the lowest risk of abuse since it causes less of a surge of dopamine? a. Amphetamine b. Methamphetamine c. Lisdexamfetamine d. Methylphenidate

23. Jake is on a high dose of amphetamine for his ADHD and accidentally took his medication three times this morning. Which of the following treatments would he not need to treat the described symptoms from this poisoning? a. Aluminum chloride to increase elimination b. Sedative for the resulting anxiety c. Sodium nitroprusside to reduce hypotension d. Acidification of his urine to neutralize the amphetamine

24. How does methylphenidate differ from amphetamine? a. Side effects b. Abuse potential c. Mechanism of action d. Usefulness for narcolepsy and ADHD

25. Casey needs to lose weight before her wedding in a few weeks and has asked her doctor what she could take to increase her weight loss. Which of the following might he prescribe since she will only be taking it for a short time? a. Modafinil b. Amphetamine c. Phentermine d. Mazindol

26. Which of the following would be effective to treat a narcoleptic that has a history of drug abuse? a. Amphetamine b. Methylphenidate c. Modafinil d. Atomoxetine

27. What might be a reason to select a medication other than modafinil to treat narcolepsy? a. Cardiovascular problems b. GI problems c. Frequent headaches d. Past addiction

28. How does nicotine cause addiction? a. Blocking dopamine reuptake b. Acting on the dopaminergic neurons c. Activating dopamine receptors d. Blocking presynaptic dopamine receptors

29. Which of the following drugs would be least likely to interact with varenicline? a. Insulin b. TCA’s c. Blood thinners d. Asthma medications

30. Which of the following would be most beneficial to someone who is depressed and wants to quit smoking? a. Nicotine patch b. Nicotine gum c. Varenicline d. Buproprion

31. Which is not a mechanism of action for caffeine? a. Blocking dopamine and norepinephrine reuptake b. Adenosine receptor antagonism c. Phosphodiesterase inhibition d. Increasing dopamine and norepinephrine release

32. Which of the following is true of ephedrine? a. It is used for narcolepsy, depression, and as a bronchodilator b. It undergoes extensive metabolism in the liver c. It decreases dopamine and norepinephrine reuptake d. It may cause hypotension and insomnia

33. Which of the following antagonizes the receptor for an inhibitory amino acid neurotransmitter? a. Nicotine b. Modafinil c. Cocaine d. Strychnine

34. How might one treat strychnine poisoning? a. Aluminum chloride b. Diazepam c. Sodium nitroprusside d. Benztropine

35. Which of the following is an example of a negative symptom of psychosis? a. Crawling sensation b. Delusion of grandeur c. Lack of social interest d. Waxy flexibility

36. Which of the following would be an example of disorganized or catatonic behavior? a. Tangentiality of speech b. Inappropriate affect c. Feeling of persecution d. Hearing voices

37. Which of the following is evidence that contradicts with the dopamine hypothesis? a. Dopamine underactivity in the prefrontal cortex causes negative symptoms b. Time delay in reduction of psychotic symptoms after treatment c. Anti-schizophrenic drugs block dopamine receptors d. Amphetamine can induce psychosis

38. Which of the following drugs is used to support the glutamate hypothesis of schizophrenia? a. Amphetamine b. PCP c. Strychnine d. Cocaine

39. Why would targeting mGlu receptors not be a good method of preventing psychosis? a. They can modulate glutamate release b. They can modulate dopamine release c. There are 8 subtypes of the receptors d. Agonism can induce seizures

40. Typical antipsychotics have affinity for all of the following receptors except… a. Muscarinic b. Alpha-adrenergic c. Histamine d. Serotonin e. Dopamine

41. Which of the following groups of typical antipsychotics have the highest potency? a. Phenothiazines with an aliphatic side chain b. Phenothiazines with a piperidine ring in the side chain c. Thioxanthenes d. Phenothiazines with a piperazine group in the side chain

42. Which of the following groups of typical antipsychotics have the lowest potency? a. Phenothiazines with an aliphatic side chain b. Phenothiazines with a piperidine ring in the side chain c. Thioxanthenes d. Phenothiazines with a piperazine group in the side chain

43. Which of the following is true of antipsychotics? a. High potency typicals have a reduced risk of EPS b. Low potency typicals are less efficacious than higher potency antipsychotics c. Atypical antipsychotics have increased affinity for D2 as compared to typical antipsychotics d. Increased anticholinergic activity reduces the risk of EPS

44. Which of the following atypical antipsychotics has an active metabolite that is also marketed? a. Molindone b. Risperidone c. Ziprasidone d. Lurasidone

45. Which of the following antipsychotics reduces the incidence of side effects by only partially antagonizing D2 receptors? a. Aripiprazole b. Asenapine c. Clozapine d. Lurasidone

46. Which of the following has affinity for alpha adrenergic and histamine receptors but low affinity for muscarinic receptors? a. Aripiprazole b. Asenapine c. Clozapine d. Lurasidone

47. Which of the following has a low affinity for muscarinic and histamine receptors but still maintains affinity for alpha adrenergic receptors? a. Iloperidone b. Resperidone c. Molindone d. Lurasidone

48. Which of the following is considered a low potency antipsychotic? a. Fluphenazine b. Loxapine c. Thioridazine d. Pimozide

49. Which of the following is not an atypical antipsychotic? a. Risperidone b. Olanzepine c. Loxapine d. Asenapine

50. Which receptor do all atypical antipsychotics target? a. 5-HT1 b. 5-HT2 c. Alpha adrenergic d. Histamine e. Muscarinic

51. Which of the following would have the least side effects but still has a risk of EPS? a. Lurasidone b. Iloperidone c. Asenapine d. Rispiridone

52. The term “neuroleptic syndrome” is used to describe the therapeutic effects of antipsychotics that can be seen in animals. Which of the following is not one of these effects? a. Supression of spontaneous movements b. Increased initiative and interest in environment c. Decreased manifestations of emotion d. Disappearance of psychotic symptoms

53. Where are the antipsychotic effects thought to occur? a. Cerebral cortex b. Basal ganglia c. Limbic system d. Brainstem

54. Which of the following increases prolactin secretion? a. Lurasidone b. Iloperidone c. Asenapine d. Rispiridone

55. Which of the following antipsychotics is most likely to lower seizure thresholds? a. Olanzapine b. Rispiridone c. Ziprasidone d. Asenapine

56. What portion of the brain is thought to be associated with the EPS effects? a. Cerebral cortex b. Basal ganglia c. Limbic system d. Brainstem

57. Scott has a family history type II diabetes. With this in mind, which of the following antipsychotic would be preferred? a. Clozapine b. Rispiridone c. Thioridazine d. Olanzepine

58. Prolonged QT is most likely to be a problem in which of the following classes of antipsychotics? a. Low potency typicals b. Potent typicals c. Low potency atypicals d. Potent atypicals

59. Which of the following is not true of the pharmacokinetics of antipsychotics? a. Highly protein bound b. Accumulates in high blood supply tissues c. Crosses placental barrier and enters breast milk d. Good oral absorption

60. Which of the following is true of antipsychotics? a. Low therapeutic index b. Abrupt stoppage causes difficulty sleeping c. Addicting d. Most metabolites are active

61. Which of the following is a neurological side effect associated with prolonged use of antipsychotics? a. Acute dystonia b. Neueroleptic malignant syndrome c. Tardive dyskinesia d. Akathesia

62. Which of the following is benztropine not one of the primary methods of treatment? a. Acute dystonia b. Akathesia c. Parkinsonian syndrome d. Neuroleptic malignant syndrome

63. Which of the following is not a risk of taking antipsychotics? a. Type II diabetes b. Weight gain c. Jaundice d. Insomnia

64. Which of the following is most likely to cause blood dyscrasis? a. Clozapine b. Chlorpromazine c. Quentiapine d. Rispiridone

65. Which of the following is most likely to cause drug interactions? a. Thioridazine b. Haloperidol c. Pimozide d. Lurasidone

66. What would not be a strategy for treating psychosis? a. Choose based on side effects b. Target specific symptoms c. Use only in schizophrenia d. Trial and error in drug choice

67. Which would not be a use of antipsychotics? a. Major depression b. Parkinson’s disease c. Nausea and vomiting d. Alcoholic hallucinations