Chapter10:DrugTherapyforMentalHealth

Chapter10:DrugTherapyforMentalHealth Visovsky:IntroductiontoClinicalPharmacology,9thEdition
MULTIPLECHOICE
1.Whichdrugcategoryisusefulinpromotingsleepamongpatientswithinsomnia?
a.Sedatives
b.ACEinhibitors
c.Atypicalantipsychotics
d.Selectiveserotoninreuptakeinhibitors
ANS: A
Sedativesaredrugsthathavethemainpurposeofpromotingsleepbychangingsignalsinthecentraln
ervoussystemandreducingresponsestostimulation.
DIF:CognitiveLevel:Knowing REF:p.184
2.
YouarepreparingtogivethebenzodiazepineValiumtoapatientasapremedicationbeforesurgery.T hepatientasksyouhowthisdrugworks.Whatisyourbestresponse?
a.“ThisdrugworksbybindingtoreceptorsactingwithGABAtoinducesleep.”
b.“Thisdrugisactsbypreventingbindingtothebenzodiazepinereceptors.”
c.“ThisdrugactsbyinhibitingGABAresponsestorelaxmuscles.”
d.“Thisdrugactsbybindingtoopioidreceptors.”
ANS: A
BenzodiazepinesaresedatinghypnoticdrugsthatdepresstheCNSbybindingtobenzodiazepine(B
NZ)receptorsthatactwithgamma-
aminobutyricacid(GABA)receptorstoenhanceGABAeffects,resultingsleepandmusclerelaxati
on.
DIF:CognitiveLevel:Applying REF:p.186
3.
Youarecaringforapatientintheclinicsettingwhohasbeentakingabenzodiazepinealprazolam(Xan ax)foranxiety.Whatpotentialproblemshouldyouobservethispatientfor?
a.Seizureactivity
b.Addiction
c.Insomnia
d.Anorexia
ANS: B
Thebenzodiazepineshaveahigherriskforaddictionanddependencythandothenonbenzodiazepin
es.Theyalsocarryablackboxwarningforcentralnervoussystemdepression.Overdosesarepossibl
eandserious.
DIF:CognitiveLevel:Understanding REF:p.185
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Whichdrugwouldyouanticipatewillbegiventoapatientwhoexperiencedanoverdoseofabenzodia zepine?
a.Rifampin
b.Naloxone
c.Flumazenil
d.Epinepherine
ANS: C
Thedrugflumazenil(Romazicon)isabenzodiazepinereceptorantagonistandisanantidoteusedtor
everseanoverdoseofeitherabenzodiazepinesedativeoranonbenzodiazepinesedative.Foradults,i
tisgivenintravenouslywithaninitialdoseof0.2mg.Ifthereisnoresponseafter45seconds,thedosec
anberepeated.Afterthat,itcanberepeatedeveryminuteforatotalof4doses.
DIF:CognitiveLevel:Knowing REF:p.187
5.Forwhichpatientwouldbenzodiazepinesbecontraindicated?
a.Afemalewithbreastcancer.
b.Awomanwhois20weekspregnant.
c.Amalewhohasahistoryofsmoking.
d.Amalewhoisabouttoundergosurgery.
ANS: B
Pregnancyisanabsolutecontraindicationforthebenzodiazepinesbecausetheyhaveahighriskforc
ausingbirthdefects.Althoughthechemicalstructureofthenonbenzodiazepines(benzodiazepinea
gonists)isdifferent,thesedrugsbindtothesamereceptorsandhavesimilaractions.Asaresult,theyar
enotrecommendedduringpregnancy.
DIF:CognitiveLevel:Applying REF:p.185
6.
Whatspecificinformationshouldbepartoftheteachingplanforapatienttakinganonbenzodiazepin esedative?
a.Thesedrugscaninteractwithmanyfoodsandbeverages.
b.Thesedrugscancauseyoutobephysicallyactiveatnight.
c.Thesedrugsmustbetakesforatleast6weekstoseeanyeffects.
d.Excesscaffeineintakecanworktoincreasetheeffectivenessofthesedrugs.
ANS: B
Whentakinganonbenzodiazepine(benzodiazepineagonist),beawarethatdrugsfromthisclasscan
causeyoutobephysicallyactiveatnight,evengoingforadrive,withoutyourknowledgeormemoryo
ftheevent.Itisbesttohaveafamilymemberorfriendwatchoutfortheseeffectswhenyoufirststarttaki
ngthedrug.
DIF:CognitiveLevel:Applying REF:p.186
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