Which of the following is NOT a general mechanism utilized to treat epilepsy?
GABA receptor antagonist activity
Inhibiting calcium channels
Activating potassium channels
Blocking sodium channels
How does antagonizing glutamate receptors help in treating epilepsy?
Glutamate is an inhibitory neurotransmitter and therefore inhibiting its receptor can inhibit neurotransmission
Glutamate is an excitatory neurotransmitter and therefore inhibiting its receptor can inhibit neurotransmission
Inhibiting Glutamate channels cause an excitatory response
Inhibiting Glutamate channels causes a positive membrane potential
Which of the following is NOT a side effect of benzodiazepines?
Cardiovascular effects in healthy patients receiving dose causing hypnosis
Anterograde amnesia
Delirium (mostly in ICU sedation)
Slight depression of alveolar ventilation
Which of the following is correct regarding Z compounds?
They are more specific for sedation
They have more side effects than benzodiazepines
They are more effective as anticonvulsants than benzodiazepines
They have more potential for abuse
Choose the broad spectrum AED
Phenytoin
Lamotrigine
Levetiracetam
Topiramate
Valproic acid
Oxcarbezepine
Benzodiazepines can be used for long-term use as an anticonvulsant
Which of the following is the safest to use during pregnancy?
Phenobarbital
Which of the following drugs are preferred for status epilepticus?
Diazepam
Lorazapam
Clobazam
Diazepam can be given IM
Which of the followings is NOT a side effect of phenytoin?
Megaloblastic anemia
Elevated liver enzymes
Steven-Johnsons syndrome
Rare aplastic anemia
Which of the following is NOT a side effect of carbamezapine
Hyponatremia
Idiosyncratic blood dyscrasias
Sedation
Suicidality
Which of the following is NOT a side effect of eslicarbazepine acetate?
Vomiting
Eosinophilia
Renal calculi
Which of the following is NOT a side effect of Lamotrigine?
Decreased plasma levels with use of valproic acid
Decreased plasma levels with use of phenobarbital
Stevens-Johnson syndrome at high doses
Decreased half-life with use of phenytoin
Which of the following is NOT a side effect of lacosamide?
Euphoria
Diplopia
Dizziness
Skin rash
Zonisamide can cause renal calculi
Which of the following can cause suicidality?
Zonisamide
Rufinamide
Vigabatrin
Which of the following causes behavioral changes and extrapyramidal reactions?
Ethosuximide
Which of the following can cause significant cognitive impairment?
Felbamate
Which of the following has an effect on though processes and level of consciousness?
Tiagabine
Benzodiazepines
Carbamezapine
Which of the following AED causes retinal dysfunction?
Gabapentin
Pregabalin
Keppra has more milder CNS effects than Gabapentin.
Which of the following drugs has a risk of causing GI effects and liver toxicity in patients younger than two years old?
Topomax
Valproic Acid
Which of the following drugs has an important adverse effect that is similar to that of Zonisamide, along with dose-related cognitive effects?
Carbamazepine
Which of the following drugs has a side effect of aplastic anemia and acute hepatic failure and therefore is rarely used?
Peramanel
Which of the following has risk of causing neuropsychiatric events such as aggression, anger, irritability, agitation, and mental status changes?
Perampanel
Ezogabine
Which of the following is NOT true regarding Ramelteon?
It is a non-benzodiazepine hypnotic
It is selective for MT1 and MT2 receptors
Has has higher risk for addiction
It is less efficacious than benzodiazepines as a hypnotic
Which of the following is a characteristic of tolerance?
Exposure to a drug induces changes that result in decrease of the drug's effects over time
Manifests by a specific withdrawal syndrome
Compulsive use
Produced by abrupt cessation
Which of the following could give a patient, who is allergic to sulfa drugs, a reaction?
Tigabatrin
Which of the following is NOT true regarding dexmedetomidine?
It is a nonBZD hypnotic
It is a selective alpha2 receptor agonist with sedative properties
It causes tachycardia and hypertension
Used in ICU setting
What is the difference between dalfampridine and Dimethyl Fumarate when treating MS?
Dalfampridine is a DMT and Dimethyl Fufurate is for symptom management
Dalfampridine is for symptom management and Dimethyl Fufurate is a DMT
Dalfampridine is an anti-inflammatory and Dimethyl Fufurate is a DMT
There is no difference
Which of the following does NOT cause cognitive effects?
Primidone
Which of the following is NOT excreted renally/ requires adjustment in patients with renal dysfunction?
Gabapentin/Pregabalin
Which of the following does NOT have a GI side effect?
Lacosomide
Ethosuximide and Perampanel have behavioral side effects
Which of the following mechanisms is correct for amphetamines?
Selectively inhibits the reuptake of NE
They are taken up into the cell and interfere with vesicular monoamine transporter, depleting stores and stimulating release of these NT
Selectively inhibit reuptake of DA
Mechanism is unknown
What is the clinical use for amphetamines?
ADHD
Narcolepsy
Obesity
All of the above
Which of the following is NOT a side effect of amphetamines?
Increase suicidal ideation
Decrease fatigue
Anorexia
Increase blood pressure
Methohexital can cause the following EXCEPT
Hypotension
Porphyria
Respiratory depression
Bronchospams
Which of the following is a side effect of propofol?
Increased cerebral metabolic rate
Hypertension
Anti-emetic action
Which of the following is a side effect of Etomidate?
Electrolyte imbalance
Tachycardia
Anti-emetic activity
Which of the following is NOT a side effect of Ketamine?
Cataleptic state
Post-op disorientation
Analgesic properties
Decrease in cerebral blood flow
Drugs such as Benztropine, Oxybutynin, Antivert, and Tolterodine add synergistic effects to oral CheI
Which of the following best describes the mechanism of oral ChEI?
They inhibit the reuptake of Ach
They block ChE, preventing further breakdown of Ach
Block reuptake of DA
None of the above
ChEI are used for symptomatic improvements of dementia, not slow the progression of the disease
ChEI are used for moderate to severe dementia
Which of the following is NOT a side effect of ChEI?
GI
Urinary obstruction
Asthma
Which of the following is NOT true regarding Memantine?
Prevents futher neurodegeneration caused by excitotoxic reactions by blocking NMDA receptors
Used for moderate to severe Alzheimers
May need dose adjustment in older patients due to renal excretion
GI is the most common side effect
Which of the following statements is FALSE?
ChEI, such as Neostigmine and Pyridostimine, can be used as reversal agents for non-depolarizing neuromuscular blockers
Succinylcholine requires a reversal agent due to its onset of action
Naltrexone can reverse the effects of opioids
Which of the following is NOT true regarding ethanol?
It enhances GABA-mediated inhibition and blocks NMDA receptors
90-95% is metabolized in the liver into acetic acid
Can cause euphoric effects a low-moderate doses
Acute effects, such as increased risk for cancer occurs
Which of the following is NOT used for treatment of ethanol toxicity?
Disulfram, to inhibit aldehyde dehydrogenase
Naltrexone, which acts as opiate antagonist to produce positive effects in alcohol
Acamprosate, which acts as a weak glutamate antagonist
Fomepizole, a competitive inhibitor of alcohol dehydrogenase
Which of the following is NOT used as treatment for methanol toxicity?
Ethanol, since it has a higher affinity for alcohol dehydrogenase
Benzodiazepines, for withdrawal symptoms
Alkalinization with sodium bicarbonate to avoid metabolic acidosis
Which of the following is NOT a side effect of use of fomepizole in treatment of methanol toxicity?
Agitation
Retinal and optic-nerve damage
Which of the following is NOT a side effect of use of ethanol to treat methanol toxicity?
Pancreatitis
Hypoglycemia
Mental status change
Which of the following is NOT true regarding Atomoxetine (Strattera)
Effects are not apparent until 2 weeks
Used as 1st line therapy
Used to treat ADHD
Can be used in patients who have a h/o illicit substance abuse or concerns about abuse
Which of the following is a side effect of atomoxetine (Strattera)
Suicidal ideation
Increased appetite
Headache
Which of the following is true regarding malignant hyperthermia?
Caused by increase release of Ca2+ from the sarcoplasmic reticulum
Worsens with use of Dantrolene
Treated with Desflurane
Does not have a genetic disposition
Which of the following is true regarding Chantix?
It is a nicotine-based therapy
It is a partial agonist and antagonist, to cause partial stimulation and suppress withdrawal
It is started the same day patient quits smoking
More effective as monotherapy than in combination with other nicotine0based therapies
Which of the following is NOT a side effect of Chantix?
Nausea
Cardiovascular events in patients with cardiovascular disease
Physical dependence
Which of the following is NOT possible side effect of Pancurinium?
Atrophy
Myalgia
Increase in HR/BP
Accumulation of laudanosine
Choose the Antispasm centrally-acting muscle relaxants
Baclofen
Tizanidine
Carisoprodol (SOMA)
Chlorzoxazone
Cyclobenzaprine
Metaxalone
Methocarbamol
Orphenadrine
Dantrolene
Choose ALL of the following Antispasm drugs that have anticholinergic side effects
Carisoprodol
Methocarbaol
Which of the following is true in regards to Levodopa and its use?
It can cross the BBB, which is not true about DA
Should be taken with food
No development of tolerance
These are all true
Which of the following extrapyramidal symptoms is NOT reversible?
Tardive dyskinesia
Dystonias
Parkinson-like symptoms
Akathisia
Which of the following is NOT used for management of EPS?
Anticholinergic drugs
Antihistamine with anticholinergic activity
Trihexyphenidyl
All are used for management
Which of the following is an anticholinergic side effect?
Bradycardia
Wakefulness
Salivation
Urinary retention
Atypical antipsychotics have anticholinergic side effects
Which of the following is a side effect of TCA?
Orthostatic hypotension
Diarrhea
Which of the following is NOT true regarding Antipsychotics and their side effects?
Atypical agents cause weight gain more, except for aripirazole.
Typical agents cause more prolactin elevation and EPS/TD, except paliperidone and risperidone (Atypical agents)
QTc prolongation is seen with the use of chlorpromazine (typical AP)
Risk of sedation, Anticholinergic side effects, and Orthostatic Hypotension is low with aripiprazole (atypical AP)
Atypical antipsychotics cause less TD
Which of the following is NOT a side effect of Parkinson's drugs
Hallucinations
Dyskinesia
Anxiety
Which of the following is the correct reasoning for giving Carbidopa with Levodopa?
To inhibit the conversion of Levodopa into DA in the periphery, thus allowing levodopa to cross the BBB
So that carbidopa crosses the BBB and prevents breakdown in the CNS
Inhibit MAO-B to prevent breakdown of DA
To inhibit COMT and thus prevent breakdown of DA
Which of the following is correct regarding the On-Off phenomenon?
It occurs at the very first administration of levodopa
"On" periods occur as levodopa levels decline
"Off" periods occur shortly after bolus of Levodopa is given
Described as fluctuations of rigidity and normal/dyskinetic movements
Which of the following is a side effect of lithium?
GI distress
Hypothyroidism
Renal failure
All are side effects of lithium
Rasagiline forms toxic metabolites, whereas Selegiline does not
Choose ALL of the following that cause weight gain
SNRI
SSRI
Wellbutrin
TCA
Mirtazepine
Vortioxetine
MAOIs
Levomilnacipram
Which of the following is a side effect of serotonin agonists?
Decrease in blood pressure
Coronary vasospasm
Constipation
Discontinuation syndrome
Which of the following is a side effect of serotonin antagonists?
Sexual dysfunction
Serotonin syndrome
QT interval prolongation
Which of the following is true regarding Vilazodone?
Should be avoided with food
Has antagonistic activity at the 5-HT3 receptor
It is a partial agonist at 5-HT1A receptor, which speeds up the onset of action and possibly augments the anxiolytic effects
Superior to other antidepressants
Which of the following is true regarding Vortioxetine?
Efficacy is seen at higher doses
Has an advantage over other antidepressants
It has anti-emetic effects due to antagonistic activity at the 5-HT3 receptor
It causes weight gain
Parkinson's drugs typically cause hallucinations
Which of the following causes psychosis?
MAOI
Opioids
Anticholinergics
These all cause psychosis
Which of the following is a difference between SSRIs and SNRIs?
SSRIs cause weight gain, whereas SNRIs can cause decrease in appetite
SSRIs cause increase in blood pressure and heart rate
SNRIs cause urinary retention
SNRIs cause dose-related GI symptoms that resolve after 2 weeks
Which of the following does NOT cause serotonin syndrome?
Serotonin antagonists
SSRIs
Vilazodone
Dextromethorphan
Which of the following best describes serotonin syndrome?
Fluctuations in motor function with periods of stiffness/rigidity and periods of normal or dyskinetic movements
It occurs when there is an overdose with a single drug, or concurrent use of several drugs that results in excess serotonergic activity
Includes side effects such as dizziness, nausea, weakness, HA, anxiety, irritability, and insomnia
Includes side effects such as hypothermia, hypotension, bradycardia, and dyskinesia
Which of the following drugs inhibits reuptake of 5-HT and NE?
Escitalopram
Desipramine
Levodopa
Sumatriptan
Which of the following drugs inhibits reuptake of ONLY 5-HT?
Nortriptyline
Duloxetine
Paroxetine
Selegiline
Which of the following drugs is used to treat migraine by stimulating 5-HT1D receptors, causing cranial vasoconstriction?
Ondansetron
Sertraline
Almotriptan
These are all 5-HT1d stimulants
Which of the following drugs acts as an anti-emetic by antagonizing 5-HT3 receptors?
Palonosetron
Which of the following drugs is a partial agonist at 5-HT1A receptor, which speeds up the onset of action and possibly augments the anxiolytic effects?
Trazodone
Which of the following drugs has 5-HT1A agonistic activity and 5-HT3 antagonistic activity?
Fluoxetine
Granisetron
Typical antipsychotics, such as Chlorpromazine, are more potent in inhibiting 5-HT2 receptors than D2 receptors
Atypical antipsychotics, such as Clozapine, are more potent in inhibiting 5-HT2 receptors than D2 receptors
Which of the following drugs is NOT used to inhibit the breakdown of L-DOPA or DA?
Carbidopa
Tolcapone
Levommilnacipran
Which of the following drugs is NOT an SNRI?
Venlafaxine
Milnacipran
Which of the following drugs is NOT an SSRI?
Citalopram
Which of the following does NOT have anticholinergic side effects?
Diphenydramine
Benztropine
Alosetron
Which of the following is more commonly seen with typical antipsychotics?
QTc prolongation
EPS/TD
Weight gain
Which of the following is NOT typically seen with use of atypical antiopsychotics (except for paliperidone and risperidone)
Prolactin elevation
Clozapine is seen to having the following effects, except for
Anticholinergic effects
Which of the following classes of antidepressants can cause suicidal ideation?
SSRI-like antidepressants
Trazadone
Which of the following antidepressants causes increase in blood pressure and heart rate?
SsRI
SSRI-related
Which of the following antidepressants does NOT cause discontinuation syndrome?
