Test Bank For Lehnes Pharmacology for Nursing Care 11th
Edition Chapter 1-112 | 9780323825221 | All Chapters with
Answers and Rationals
true of false: we understand with precision how CNS drugs produce their effects - ANSWER: false
the ______ can protect the CNS from toxic substances, but can also block entry of medications into
the CNS - ANSWER: blood brain barrier
the CNS often goes through _____ changes during prolonged drug exposure. The result can be _____
therapeutic effects, ______ side effects, ______, and physical _______ - ANSWER: adaptive,
increased, decreased, tolerance, dependence
Parkinson's Disease is a neurodegenerative disorder that produces characteristic motor symptoms:
tremor at rest, _______, postural _______, and ______ - ANSWER: rigidity, instability, and
bradykinesia
In addition to motor symptoms, PD can cause nonmotor symptoms, including autonomic dysfunction,
sleep disturbances, ________, psychosis, and ______ - ANSWER: depression and dementia
the primary pathology in PD is..... - ANSWER: degeneration of neurons in the substantia nigra that
supply dopaime to the striatium
the result of PD is.... - ANSWER: imbalance between dopamine and ACh
motor symptoms of PD are primarily treated with drugs that.... - ANSWER: directly or indirectly
activate dopamine receptors, but drugs that block cholinergic receptors can also be used
what drug is the most effective drug for treatment of motor symptoms of parkinson's disease? -
ANSWER: levodopa (combined with carbidopa)
levodopa relieves motor symptoms by undergoing conversion to ______ in surviving nerve terminals
in the ______ - ANSWER: dopamine and striatum
the enzyme that converts levodopa to dopamine is called a______ - ANSWER: decarboxylase
acute loss of response to levodopa occurs in two patterns: - ANSWER: gradual wearing off- which
develops at the end of the dosing interval AND abrupt loss of effect ("on-off" phenomenon) that can
occur at any time during the dosing interval
the principal adverse effects of levodopa are.... - ANSWER: nausea, dyskinesias, hypotension, and
psychosis
first generation antipsychotic drugs effect on levodopa - ANSWER: block doapmine receptors in the
striatum and can thereby negate the effects of levodopa
second generation antipsychotic drugs effect on levodopa - ANSWER: clozapine and quetiapine do not
block dopamine receptors in the striatum, and hence can be used safely to treat levodopa-induced
psychosis
combining levodopa with a nonselective _______ can result in a hypertensive crisis - ANSWER: MAO
inhibiter
, because _____ compete with levodopa from absorption from the intestine and for transport across
the BBB, _____ meals can reduce therapeutic effects - ANSWER: amino acids, high protein
carbidopa enhances the effects of levodopa by preventing.... - ANSWER: decarboxylation of levodopa
in the intestine and peripheral tissues
Can carbidopa cross the BBB? - ANSWER: no! this is why it does not prevent the conversion of
levodopa to dopamine in the brain
pramipexole is a _________ for motor symptoms. It can be used ____ in early PD or ______ in
advanced PD - ANSWER: first line drug, alone, combined with levodopa
pramipexole and other dopamine agonists relieve motor symptoms by causing _______ of dopamine
receptors in the striatum - ANSWER: direct activation
the major adverse effects of pramipexole are..... and they result from excessive activation of
dopamine receptors - ANSWER: nausea
dyskinesia (when combined with levodopa)
postural hypotension (when combined with levodopa)
hallucinations
entacapone, a COMT inhibitor, is combined with levodopa to ______ levodopa's effect. the drugs
______ the metabolism of levodopa by COMT in the ______ and ______, thereby making ____
levodopa available to the brain - ANSWER: enhance, inhibits, peripheral tissues and intestine, more
selegiline enhances responses to levodopa by __________, the brain enzyme that inactivated
dopamine - ANSWER: inhibiting MAO-B
anticholinergic drugs can do what for PD patients? - ANSWER: relieve symptoms by blocking
cholinergic receptors in the striatum
AD is a relentless illness characterized by progressive ______, ______ thinking, neuropsychiatric
symptoms, and inability to perform ______ - ANSWER: memory loss, impaired, routine tasks of daily
living
the histopathology of AD is characterized by neuritic _____, neurofibrillary _____, and degeneration
of cholinergic _______ in the hippocampus and cerebral cortex - ANSWER: plaques, tangles, and
neurons
in patients with AD, _______ is present in high levels and may contribute to neuronal injury -
ANSWER: beta-amyloid
neurofibrillary tangles result from production of a faulty form of ____, a protein that in healthy
neurons serves to maintain the orderly arrangement of neurotubules - ANSWER: tau
the major known risk factor for AD is... - ANSWER: advancing age
AD dementia can be treated with ______ or _____. Although these drugs produced statistically
significant symptomatic improvement in clincial trials, benefits in most patients are marginal -
ANSWER: cholinesterase inhibitors or memantine
_______ increase the availability of acetylcholine at cholinergic synapses, and thereby enhance
transmission by cholinergic neurons that have not yet been destroyed by AD - ANSWER:
cholinesterase inhibitors
______ produce modest improvements in cognition, behavior, and function in 1 out of 12 AD patients
- ANSWER: cholinesterase inhibitors
Edition Chapter 1-112 | 9780323825221 | All Chapters with
Answers and Rationals
true of false: we understand with precision how CNS drugs produce their effects - ANSWER: false
the ______ can protect the CNS from toxic substances, but can also block entry of medications into
the CNS - ANSWER: blood brain barrier
the CNS often goes through _____ changes during prolonged drug exposure. The result can be _____
therapeutic effects, ______ side effects, ______, and physical _______ - ANSWER: adaptive,
increased, decreased, tolerance, dependence
Parkinson's Disease is a neurodegenerative disorder that produces characteristic motor symptoms:
tremor at rest, _______, postural _______, and ______ - ANSWER: rigidity, instability, and
bradykinesia
In addition to motor symptoms, PD can cause nonmotor symptoms, including autonomic dysfunction,
sleep disturbances, ________, psychosis, and ______ - ANSWER: depression and dementia
the primary pathology in PD is..... - ANSWER: degeneration of neurons in the substantia nigra that
supply dopaime to the striatium
the result of PD is.... - ANSWER: imbalance between dopamine and ACh
motor symptoms of PD are primarily treated with drugs that.... - ANSWER: directly or indirectly
activate dopamine receptors, but drugs that block cholinergic receptors can also be used
what drug is the most effective drug for treatment of motor symptoms of parkinson's disease? -
ANSWER: levodopa (combined with carbidopa)
levodopa relieves motor symptoms by undergoing conversion to ______ in surviving nerve terminals
in the ______ - ANSWER: dopamine and striatum
the enzyme that converts levodopa to dopamine is called a______ - ANSWER: decarboxylase
acute loss of response to levodopa occurs in two patterns: - ANSWER: gradual wearing off- which
develops at the end of the dosing interval AND abrupt loss of effect ("on-off" phenomenon) that can
occur at any time during the dosing interval
the principal adverse effects of levodopa are.... - ANSWER: nausea, dyskinesias, hypotension, and
psychosis
first generation antipsychotic drugs effect on levodopa - ANSWER: block doapmine receptors in the
striatum and can thereby negate the effects of levodopa
second generation antipsychotic drugs effect on levodopa - ANSWER: clozapine and quetiapine do not
block dopamine receptors in the striatum, and hence can be used safely to treat levodopa-induced
psychosis
combining levodopa with a nonselective _______ can result in a hypertensive crisis - ANSWER: MAO
inhibiter
, because _____ compete with levodopa from absorption from the intestine and for transport across
the BBB, _____ meals can reduce therapeutic effects - ANSWER: amino acids, high protein
carbidopa enhances the effects of levodopa by preventing.... - ANSWER: decarboxylation of levodopa
in the intestine and peripheral tissues
Can carbidopa cross the BBB? - ANSWER: no! this is why it does not prevent the conversion of
levodopa to dopamine in the brain
pramipexole is a _________ for motor symptoms. It can be used ____ in early PD or ______ in
advanced PD - ANSWER: first line drug, alone, combined with levodopa
pramipexole and other dopamine agonists relieve motor symptoms by causing _______ of dopamine
receptors in the striatum - ANSWER: direct activation
the major adverse effects of pramipexole are..... and they result from excessive activation of
dopamine receptors - ANSWER: nausea
dyskinesia (when combined with levodopa)
postural hypotension (when combined with levodopa)
hallucinations
entacapone, a COMT inhibitor, is combined with levodopa to ______ levodopa's effect. the drugs
______ the metabolism of levodopa by COMT in the ______ and ______, thereby making ____
levodopa available to the brain - ANSWER: enhance, inhibits, peripheral tissues and intestine, more
selegiline enhances responses to levodopa by __________, the brain enzyme that inactivated
dopamine - ANSWER: inhibiting MAO-B
anticholinergic drugs can do what for PD patients? - ANSWER: relieve symptoms by blocking
cholinergic receptors in the striatum
AD is a relentless illness characterized by progressive ______, ______ thinking, neuropsychiatric
symptoms, and inability to perform ______ - ANSWER: memory loss, impaired, routine tasks of daily
living
the histopathology of AD is characterized by neuritic _____, neurofibrillary _____, and degeneration
of cholinergic _______ in the hippocampus and cerebral cortex - ANSWER: plaques, tangles, and
neurons
in patients with AD, _______ is present in high levels and may contribute to neuronal injury -
ANSWER: beta-amyloid
neurofibrillary tangles result from production of a faulty form of ____, a protein that in healthy
neurons serves to maintain the orderly arrangement of neurotubules - ANSWER: tau
the major known risk factor for AD is... - ANSWER: advancing age
AD dementia can be treated with ______ or _____. Although these drugs produced statistically
significant symptomatic improvement in clincial trials, benefits in most patients are marginal -
ANSWER: cholinesterase inhibitors or memantine
_______ increase the availability of acetylcholine at cholinergic synapses, and thereby enhance
transmission by cholinergic neurons that have not yet been destroyed by AD - ANSWER:
cholinesterase inhibitors
______ produce modest improvements in cognition, behavior, and function in 1 out of 12 AD patients
- ANSWER: cholinesterase inhibitors
