COMLEX LEVEL 1 FINAL EXAM SCRIPT 2026
COMPLETE QUESTIONS AND SOLUTIONS
◉ Drugs used for hypertensive emergency . Answer: Nitroprusside
Fenoldopam
labetalol
clevidipine
nicardipine
◉ MOA of nitroprusside . Answer: short acting vasodilator that
increases cGMP by directly releasing NO from the endothelium
◉ AE of nitroprusside . Answer: cyanide toxicity
◉ What's the foal of treatment of hypertensive emergencies? . Answer:
Lower BP by 25% and maintain diastolic BP at no less than 100-110
mmHg
,◉ Names of bisphosphonate drugs . Answer: "-onates"
Alendronate
ibandronate
ridedronate
zoledronate
◉ MOA of bisphosphonates . Answer: Bind calcium (hydroxyapetite) in
bone AND inhibit osteoclast activity
◉ Clinical use of bisphosphonates . Answer: Osteoporosis,
hypercalcemia, Paget disease of bone, metastatic bone disease,
osteogenesis imperfecta
◉ AEs of bisphosphonates . Answer: Esophagitis
**if take orally, stay upright for 30 min and take fasted in the AM with
water only
◉ Indication for typical antipsychotics . Answer: Schizophrenia
Bipolar
Tourrettes
OCd
Huntington's
,◉ Names of typical antipsychotics . Answer: Haloperidol
Chlorpromazine ("-azines")
◉ MOA of typical antipsychotic medications . Answer: Potent D2
(dopamine) receptor blockers
Increase cAMP
◉ Main AEs of typical antipsychotics . Answer: Hyperprolactinemia -->
galactorhhea, oligomenorrhea, gynecomastia
QT prolongation
ADAPT:
Acute dystonia (muscle spasms or stiffness)
Akasthisia (restless, uncontrollable need to move)
Parkinsonism (bradykinesia, mask-like facies, drooling, tremor)
Tardive Dyskinesia (involuntary twisting, worm like movements,
disabling, irreversible -- late effect)
*Neuroleptic Malignant Syndrome*
, ◉ What is Neuroleptic Malignant Syndrome . Answer: fever, muscles
rigid, confusion, dysrhythmias, BP fluctuation
stop drug ASAP
happens bc of typical antipsychotic haloperidol --> blocking D2 receptor
induces massive glutamate release @ synapse --> catatonia,
neurotoxicity, myotoxicity
◉ Atypical antipsychotics & their MOA . Answer: -apines
-idones
Clozapine, Aripiprazole, Asenapine, Lurasidone
Potent blocker of 5-HT2A and partial blocker of D2 receptor
◉ AEs of atypical antipsychotics . Answer: Hyperprolactinemia
Increase markers and risk of diabetes, obesity, dyslipidemia, metabolic
syndrome
Clozapine - agranulocytosis (blood cell count must be monitored)
COMPLETE QUESTIONS AND SOLUTIONS
◉ Drugs used for hypertensive emergency . Answer: Nitroprusside
Fenoldopam
labetalol
clevidipine
nicardipine
◉ MOA of nitroprusside . Answer: short acting vasodilator that
increases cGMP by directly releasing NO from the endothelium
◉ AE of nitroprusside . Answer: cyanide toxicity
◉ What's the foal of treatment of hypertensive emergencies? . Answer:
Lower BP by 25% and maintain diastolic BP at no less than 100-110
mmHg
,◉ Names of bisphosphonate drugs . Answer: "-onates"
Alendronate
ibandronate
ridedronate
zoledronate
◉ MOA of bisphosphonates . Answer: Bind calcium (hydroxyapetite) in
bone AND inhibit osteoclast activity
◉ Clinical use of bisphosphonates . Answer: Osteoporosis,
hypercalcemia, Paget disease of bone, metastatic bone disease,
osteogenesis imperfecta
◉ AEs of bisphosphonates . Answer: Esophagitis
**if take orally, stay upright for 30 min and take fasted in the AM with
water only
◉ Indication for typical antipsychotics . Answer: Schizophrenia
Bipolar
Tourrettes
OCd
Huntington's
,◉ Names of typical antipsychotics . Answer: Haloperidol
Chlorpromazine ("-azines")
◉ MOA of typical antipsychotic medications . Answer: Potent D2
(dopamine) receptor blockers
Increase cAMP
◉ Main AEs of typical antipsychotics . Answer: Hyperprolactinemia -->
galactorhhea, oligomenorrhea, gynecomastia
QT prolongation
ADAPT:
Acute dystonia (muscle spasms or stiffness)
Akasthisia (restless, uncontrollable need to move)
Parkinsonism (bradykinesia, mask-like facies, drooling, tremor)
Tardive Dyskinesia (involuntary twisting, worm like movements,
disabling, irreversible -- late effect)
*Neuroleptic Malignant Syndrome*
, ◉ What is Neuroleptic Malignant Syndrome . Answer: fever, muscles
rigid, confusion, dysrhythmias, BP fluctuation
stop drug ASAP
happens bc of typical antipsychotic haloperidol --> blocking D2 receptor
induces massive glutamate release @ synapse --> catatonia,
neurotoxicity, myotoxicity
◉ Atypical antipsychotics & their MOA . Answer: -apines
-idones
Clozapine, Aripiprazole, Asenapine, Lurasidone
Potent blocker of 5-HT2A and partial blocker of D2 receptor
◉ AEs of atypical antipsychotics . Answer: Hyperprolactinemia
Increase markers and risk of diabetes, obesity, dyslipidemia, metabolic
syndrome
Clozapine - agranulocytosis (blood cell count must be monitored)
