Basic Clinical Pharmacology Questions With 100% Correct Solutions

What is the main neurotransmitter of the parasympathetic nervous system? Select one: a. Epinephrine b. Norepinephrine c. Dopamine d. Acetylcholine e. Serotonin - ANSWER- Acetylcholine Which antipsychotic requires regular monitoring for agranulocytosis? Select one: a. Olanzapine (Zyprexa) b. Risperidone (Risperdal) c. Clozapine (Clozaril) d. Aripiprazole (Abilify) e. Quetiapine (Seroquel) - ANSWER- Clozapine (Clozaril) Which skeletal muscle relaxant is structurally similar to amitriptyline and therefore has pronounced anticholingeric effects? Select one: a. Carisoprodol (Soma) b. Cyclobenzaprine (Flexeril) c. Methocarbamol (Robaxin) d. Orphenadrine (Norflex) e. Tizanidine (Zanaflex) - ANSWER- Cyclobenzaprine (Flexeril) Beta-blockers may be clinically useful in the treatment of: Select one: a. Hypertension b. Cardiac dysrhythmias c. Chronic heart failure d. Both A and C e. A, B, and C - ANSWER- A, B, and C Beta-blockers have many cardiovascular clinical indications, including the treatment of hypertension, cardiac dysrhythmias, and chronic heart failure. In each case the slowing of the pumping of the heart is key in bringing about the therapeutic benefit. How is ramelteon (Rozerem) different from Z-drugs? When might it be advantageous? - ANSWER- Ramelteon is a melatonin receptor agonist and has no direct effects on GABA. It affects sleep latency (reducing the amount of time it takes to fall asleep). It is not a controlled substance and abuse potential is low. It might be especially good for people suffering from jet-lag. List 2 non-cardiac indications for beta-blockers. - ANSWER- Migraine headaches and anxiety. Beta-blockers may also be used in the management of essential tremor and as migraine prophylactic agents. They may also be used for stage fright or in hyperthyroidism. Briefly describe the concept of "therapeutic index." What does it mean and how does it relate to the safety and efficacy of the drug in question? - ANSWER- Therapeutic index refers to the difference in dose required to achieve a clinical effect and a toxic effect. If only small doses are required for a clinical effect and very large doses are needed before a drug becomes toxic, then that drug is said to have a wide therapeutic index -- a little is helpful and it takes a lot to be harmful. A narrow therapeutic index drug would be like cancer chemotherapy where the dose that is efficacious is near the same dose that is toxic. Which of the following drugs used for asthma and allergic rhinitis has a black box warning from the FDA regarding serious mental health-related side effects? Select one: a. Albuterol (Ventolin) b. Theophylline (Theo-Dur) c. Fluticasone (Flovent) d. Montelukast (Singulair) e. Chlorpheniramine (Chlor-Trimeton) - ANSWER- Montelukast (Singulair) Which of the following is NOT considered to be both an antiepileptic drug as well as a mood stabilizer? Select one: a. Valproic acid (Depakote) b. Lamotrigine (Lamictal) c. Carbamazepine (Tegretol) d. Pregabalin (Lyrica) e. Topiramate (Topamax) - ANSWER- Pregabalin (Lyrica) What is myasthenia gravis, what type of drug is used to treat it, and how do they work? - ANSWER- Myasthenia gravis is a rare autoimmune condition affecting the neuromuscular junction of skeletal muscles. It is characterized by drooping eyelid, double vision, and generalized muscle weakness. It is treated with acetylcholinesterase inhibitors, such as pyridostigmine to increase cholinergic activity at the motor end plate. Which of the following is a selective serotonin reuptake inhibitor (SSRI)? Select one: a. Duloxetine (Cymbalta) b. Venlafaxine (Effexor) c. Bupropion (Wellbutrin) d. Escitalopram (Lexapro) e. Mirtazapine (Remeron) - ANSWER- Escitalopram (Lexapro) A dry, hacking cough is a common adverse effect of: Select one: a. Propranolol (Inderal) b. Enalapril (Vasotec) c. Losartan (Cozaar) d. Amlodipine (Norvasc) e. Diltiazem (Cardizem) - ANSWER- Enalapril (Vasotec) What are the 4 main pharmacokinetic processes? (and give a one line definition of each) - ANSWER- Absorption -how drugs get into the body through different routes Distribution -for systemic drugs, this is the process of getting an adequate blood level Metabolism -process of biotransformation to change the drug into a form that is excretable Elimination -removal from the body, often via the kidneys What is the difference between delirium and dementia? What drugs can make these conditions worse, which drugs can be helpful and why? - ANSWER- Delirium is an acute change in level of consciousness and cognition and may result from drugs that have CNS depressant effects, such as opioids, GABA-ergic drugs, or anticholinergics. Dementia is a slowly progressive from of cognitive decline. Alzheimer's disease is the most common cause of dementia. It is treated with AChE inhibitor drugs like donepezil (Aricept) or rivastigmine (Exelon) which result in net increases in ACh activity in the synapse. Which of the following antidepressants is LEAST likely to result in sexual dysfunction as an adverse effect? Select one: a. Fluoxetine (Prozac) b. Duloxetine (Cymbalta) c. Citalopram (Celexa) d. Sertraline (Zoloft) e. Bupropion (Wellbutrin) - ANSWER- Bupropion (Wellbutrin) Briefly describe the relationship between the fields of pharmacology, toxicology, and pharmacotherapy. - ANSWER- Pharmacology is the study of drugs, which can include the benefits of drug therapy (pharmacotherapy) and the adverse effects of drugs (toxicity). Most patients with hypertension (HTN) will require more than 1 drug to adequately meet blood pressure goals. Select one: True