Chapter 12. Drugs Affecting the Central Nervous System
Multiple Choice
Identify the choice that best completes the statement or answers thequestion.
1. Sarah, a 42-year-old female, requests a prescription for an anorexiant to treat her obesity. A trial of
phentermine is prescribed. Prescribing precautions include:
1. Understanding that obesity is a contraindication to prescribing phentermine
2. Anorexiants may cause tolerance and should only be prescribed for 6 months
3. Patients should be monitored for postural hypotension
4. Renal function should be monitored closely while on anorexiants
2. Before prescribing phentermine to Sarah, a thorough drug history should be taken including
assessing for the use of serotonergic agents such as selective serotonin reuptake inhibitors (SSRIs)
and St John’s wort due to:
1. Additive respiratory depression risk
2. Additive effects affecting liver function
3. The risk of serotonin syndrome
4. The risk of altered cognitive functioning
, 3. Antonia is a 3-year-old child who has a history of status epilepticus. Along with her routine
antiseizure medication, she should also have a home prescription for to be used for
an episode of status epilepticus.
1. IV phenobarbital
2. Rectal diazepam (Diastat)
3. IV phenytoin (Dilantin)
4. Oral carbamazepine (Tegretol)
4. Rabi is being prescribed phenytoin for seizures. Monitoring includes assessing:
1. For phenytoin hypersensitivity syndrome 3 to 8 weeks after starting treatment
2. For pedal edema throughout therapy
3. Heart rate at each visit and consider altering therapy if heart rate is less than 60
bpm
4. For vision changes, such as red-green blindness, at least annually
5. Dwayne has recently started on carbamazepine to treat seizures. He comes to see you and you note
that while his carbamazepine levels had been in the therapeutic range, they are now low. The
possible cause for the low carbamazepine levels include:
1. Dwayne hasn’t been taking his carbamazepine because it causes insomnia.
2. Carbamazepine auto-induces metabolism, leading to lower levels in spite of good
compliance.
3. Dwayne was not originally prescribed the correct amount of carbamazepine.
4. Carbamazepine is probably not the right antiseizure medication for Dwayne.
6. Carbamazepine has a Black Box Warning due to life-threatening:
1. Renal toxicity, leading to renal failure
2. Hepatotoxicity, leading to liver failure
3. Dermatologic reaction, including Steven’s Johnson and toxic epidermal necrolysis
Multiple Choice
Identify the choice that best completes the statement or answers thequestion.
1. Sarah, a 42-year-old female, requests a prescription for an anorexiant to treat her obesity. A trial of
phentermine is prescribed. Prescribing precautions include:
1. Understanding that obesity is a contraindication to prescribing phentermine
2. Anorexiants may cause tolerance and should only be prescribed for 6 months
3. Patients should be monitored for postural hypotension
4. Renal function should be monitored closely while on anorexiants
2. Before prescribing phentermine to Sarah, a thorough drug history should be taken including
assessing for the use of serotonergic agents such as selective serotonin reuptake inhibitors (SSRIs)
and St John’s wort due to:
1. Additive respiratory depression risk
2. Additive effects affecting liver function
3. The risk of serotonin syndrome
4. The risk of altered cognitive functioning
, 3. Antonia is a 3-year-old child who has a history of status epilepticus. Along with her routine
antiseizure medication, she should also have a home prescription for to be used for
an episode of status epilepticus.
1. IV phenobarbital
2. Rectal diazepam (Diastat)
3. IV phenytoin (Dilantin)
4. Oral carbamazepine (Tegretol)
4. Rabi is being prescribed phenytoin for seizures. Monitoring includes assessing:
1. For phenytoin hypersensitivity syndrome 3 to 8 weeks after starting treatment
2. For pedal edema throughout therapy
3. Heart rate at each visit and consider altering therapy if heart rate is less than 60
bpm
4. For vision changes, such as red-green blindness, at least annually
5. Dwayne has recently started on carbamazepine to treat seizures. He comes to see you and you note
that while his carbamazepine levels had been in the therapeutic range, they are now low. The
possible cause for the low carbamazepine levels include:
1. Dwayne hasn’t been taking his carbamazepine because it causes insomnia.
2. Carbamazepine auto-induces metabolism, leading to lower levels in spite of good
compliance.
3. Dwayne was not originally prescribed the correct amount of carbamazepine.
4. Carbamazepine is probably not the right antiseizure medication for Dwayne.
6. Carbamazepine has a Black Box Warning due to life-threatening:
1. Renal toxicity, leading to renal failure
2. Hepatotoxicity, leading to liver failure
3. Dermatologic reaction, including Steven’s Johnson and toxic epidermal necrolysis
