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Total questions: 33

Worksheet time: 25mins

Name
Class
Date
1.

The mechanism involved in the anti-seizure activity of carbamazepine is…..

a)

Block of sodium ion channels

b)

Block of calcium ion channels

c)

Facilitation of GABA actions

d)

Glutamate receptor antagonism

e)

Inhibition of GABA transaminase

2.

The mechanism involved in the anti-seizure activity of phenytoin is……

a)

Block of sodium ion channels

b)

Block of calcium ion channels

c)

Facilitation of GABA actions

d)

Glutamate receptor antagonism

e)

Inhibition of GABA transaminase

3.

Which one of the following statements about phenytoin is accurate?

a)

Displaces sulfonamides from plasma proteins

b)

Drug of choice in myoclonic seizures

c)

Half-life is increased if used with phenobarbital

d)

Isoniazid decreases steady state blood levels of phenytoin

e)

Toxicity may occur with only small increments in dose

4.

Which one of the following THREE statements about vigabatrin are ACCURATE? (3 marks)

a)

Causes visual field defects

b)

Blocks neural degradation of GABA

c)

Drug of choice in partial seizures

d)

Blocks neuronal reuptake of GABA

e)

Drug of choice in absence seizures

5.

An intravenous bolus dose of thiopental usually leads to loss of consciousness within 10–15 seconds. If no further drugs are administered, the patient will regain consciousness in just a few minutes. The reason for this, that thiopental is……….

a)

A good substrate for renal tubular secretion

b)

Exhaled rapidly

c)

Rapidly metabolized by hepatic enzymes

d)

Redistributed from brain to other body tissues

e)

Secreted in the bile

6.

Respiratory depression following use of this agent may be reversed by administration of flumazenil

a)

Desflurane

b)

Fentanyl

c)

Ketamine

d)

Midazolam

7.

You have a vial containing 4 mL of a 2% solution of lidocaine. How much lidocaine is present in 1 mL?

a)

2 mg

b)

8 mg

c)

20 mg

d)

80 mg

e)

200 mg

8.

Which one of the following statements about the toxicity of local anesthetics are CORRECT? (4 marks)

a)

Serious cardiovascular reactions are more likely to occur with tetracaine than with bupivacaine

b)

Intravenous injection of LA may stimulate ectopic cardiac pacemaker activity

c)

Serious cardiovascular reactions are more likely to occur with bupivacaine than tetracaine

d)

Allergic reactions are more likely to occur with lidocaine than procaine

e)

Allergic reactions are more likely to occur with procaine than lidocaine

9.

Regarding malignant hyperthermia It is caused by……..

a)

(a) Baclofen

b)

(b) Dantrolene

c)

(c) Haloperidol

d)

(d) Halothane

e)

(e) Vecuronium

10.

Which one of the following is most effective in its management……

a)

(a) Baclofen

b)

(b) Dantrolene

c)

(c) Haloperidol

d)

(d) Halothane

e)

(e) Vecuronium

11.

A 30-year-old male patient is on drug therapy for a psychiatric problem. He complains that he feels “flat”. He has been gaining weight and has lost his sex drive. As he moves his hand, you notice a slight tremor. He tells you that since he has been on medication he is always thirsty and frequently has to urinate. The drug he is most likely to be taking is

a)

(a) Clonazepam

b)

(b) Clozapine

c)

(c) Haloperidol

d)

(d) Lithium

e)

(e) Trifluoperazine

12.

Concerning the proposed mechanisms of action of antidepressant drugs, which one of the following statements is accurate? (3 marks)

a)

Escitalopram is a selective inhibitor of 5-HT reuptake

b)

Bupropion is an effective inhibitor of NE and 5-HT transporters

c)

Chronic treatment with an antidepressant often leads to the up-regulation of adrenoceptors

d)

MAO inhibitors used as antidepressants selectively decrease the metabolism of norepinephrine

e)

Elevation in amine metabolites in CSF is characteristic of most depressed patients prior to drug therapy

13.

Which one of the following effects is LEAST LIKELY to occur during treatment with amitriptyline? (2 marks)

a)

Mydriasis

b)

Elevation of the seizure threshold

c)

Alpha adrenoceptor blockade

d)

DA receptor blockade

e)

Sedation

14.

Which one of the following drugs is most likely to increase plasma levels of alprazolam?

a)

Desipramine

b)

Floxetine

c)

Imipramine

d)

Nefazodone

e)

Venlafaxine

15.

This agent is currently used in the management of absence seizures as well as partial, primary generalized, and tonic-clonic seizures.

a)

Carbamazepine

b)

Clonazepam

c)

Ethosuximide

d)

Phenytoin

e)

Valproic acid

16.

If one patient is taking amitriptyline and another patient is taking chlorpromazine, they are both likely to experience

a)

Excessive salivation

b)

Extrapyramidal dysfunction

c)

Gynecomastia

d)

Increased gastrointestinal motility

e)

Postural hypotension

17.

Name the receptor responsible for your choice in 16. Above.

4 lines
18.

Which one of the following agents used in hypertension is a prodrug that is converted to its active form in the brain?

a)

Clonidine

b)

Doxazosin

c)

Methyldopa

d)

Nitroprusside

e)

Verapamil

19.

The brain-stem centers affected most strongly by barbiturates are the…………………

a)

Respiratory centers

b)

Vasomotor centers

c)

Cardioinhibitory centers

d)

Cardioacceleratory centers

e)

None of the above

20.

Which is the drug of choice for trigeminal neuralgia?

a)

Carbamazepine

b)

Phenytoin

c)

Fluoxetine

d)

Diazepam

e)

Trimethadione

21.

The characteristic feature of phenytoin pharmacokinetics is

a)

High first pass metabolism

b)

Zero order kinetics of metabolism

c)

First order kinetics of metabolism

d)

Capacity limited metabolism

e)

Extrahepatic metabolism

22.

Sodium valproate has been shown to.................. (2 marks)

a)

Inhibit degradation of GABA

b)

Act as a GABAA agonist

c)

Attenuate ‘T’ type Ca2+ current in neurons

d)

Enhance GABA release

e)

Prolong neuronal Na+ channel inactivation

23.

Gabapentin acts

a)

As GABAA agonist

b)

As precursor of GABA

c)

By enhancing GABA release

d)

By GABA independent mechanism

24.

The dopamine D2 receptor has the following feature. It is…….. (2 marks)

a)

excitatory in nature

b)

positively coupled to adenylyl cyclase

c)

negatively coupled to adenylyl cyclase

d)

selectively blocked by chlorpromazine

e)

stimulated by metoclopramide

25.

Which statement concerning the pharmacokinetics of anti-seizure drugs is ACCURATE?

a)

Administration of phenytoin to patients in methadone maintenance programs can led to symptoms of opioid overdose

b)

Although ethosuximide has a half-life of approximately 40 h, the drug is usually taken twice a day

c)

At high doses, phenytoin elimination follows first-order kinetics

d)

Valproic acid may increase the synthesis of porphyrins

e)

Treatment with vigabatrin reduces the effectiveness of oral contraceptives

26.

Which statement concerning anesthetic MAC value is accurate?

a)

Anesthetics with low MAC value have low potency

b)

MAC values increase in elderly patients

c)

MAC values give information about the slope of the dose-response curve

d)

Methoxyflurane has an extremely low MAC value

e)

Simultaneous use of opioid analgesics increases the MAC for inhaled anesthetics

27.

To be effective in breast cancer, tamoxifen must be converted to an active form by CYP2D6. Cases of inadequate treatment of breast cancer have occurred when tamoxifen was administered to patients who were being treated with

a)

Amitriptyline

b)

Clomipramine

c)

Fluoxetine

d)

Imipramine

e)

Eszopiclone

28.

Regarding the clinical use of antidepressant drugs, which statement is accurate?

a)

Chronic use of antidepressants increases the activity of hepatic drug metabolizing enzymes

b)

In treatment of depressive disorders, sertraline is usually more effective than fluoxetine

c)

Tricyclics are highly effective in depressions with attendant anxiety and phobic features

d)

Weight is unaffected in patients taking paroxetine

29.

The following anti-depressant is effective in attenuating nicotine withdrawal symptoms?

a)

venlafaxine

b)

mianserin

c)

bupropion

d)

trazodone

30.

A 30-year-old male patient is on drug therapy for a psychiatric problem. He complains that he feels “flat” and that he gets confused at times. He has been gaining weight and has lost his sex drive. As he moves his hands, you notice a slight tremor. He tells you that since he has been on medication he is always thirsty and frequently has to urinate. The drug he is most likely to be taking is…………….

a)

Carbamazepine

b)

Clozapine

c)

Fluphenazine

d)

Lithium

e)

Valproic acid

31.

A 45-year-old female patient presents with severe mood swings and irritability. She has a history of depression and is currently on medication. She reports feeling restless and has difficulty sleeping. Which medication is most likely contributing to her symptoms?

a)

(c) Paroxetine

b)

(d) Venlafaxine

c)

(b) Sertraline

d)

(e) Bupropion

e)

(a) Fluoxetine

32.

Which of the following medications is primarily used for the management of acute mania in bipolar disorder?

a)

Olanzapine

b)

Carbamazepine

c)

Valproic acid

d)

Quetiapine

e)

Lamotrigine

33.

Which one of the following statements about the pharmacodynamics of SSRIs is accurate?

a)

SSRIs can lead to significant weight loss in most patients

b)

SSRIs primarily block the reuptake of norepinephrine

c)

SSRIs have a rapid onset of action compared to tricyclics

d)

SSRIs selectively inhibit serotonin reuptake

e)

SSRIs are associated with a high risk of sedation

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