Week 3 Quiz - The diffusion of neurotransmitter to nearby neu...

Week 3 Quiz

• Volume neurotransmission refers to?

The diffusion of neurotransmitter to nearby neurons.

• Retrograde neurotransmissions refers to?

The flow of neurotransmitter from postsynaptic neuron to presynaptic neuron

• Use the following CYP450 table to hypothesize drug interactions and their clinical

significance for a patient on clozapine who carbamazepine, a mood stabilizer?Clozapine levels would decrease, placing the patient at risk for re-emergence of psychotic symptoms.

• In ligand-gated ion channels, an?

Antagonist, in the presence of an agonist, can return a channel to resting state.

• Which of the following statements about drug absorption is trued?

Concurrent use of some medications can slow absorption.

• A neurotransmitter binds to a receptor, causing electrical impulses to travel the neuron’s

axon; it eventually releases the neurotransmitter and repeats the process with a postsynaptic neuron. Which type of neurotransmission does this describe?Classic synaptic neurotransmission

• Which of the following statements is true about drug distribution?

Protein binding of psychotropic drugs can impact their availability at receptor sites.

• Which of the following statements is true about neuronal gene expression?

Environmental factors can alter a neuron’s gene expression.

• First pass effect refers to the?

Metabolism of the drug in the liver, prior to reaching systemic circulation

• Matching the following.

Pharmacodynamics- Action of drugs on the body Pharmacokinetics- Action of the body on the drugs Axon- The fiber-like part of the neuron that sends information to receiving neurons Ionic filter- Regulates the flow of ions in ligand-gated channels Excitation-secretion coupling- The conversion of an electrical signal to a chemical signal Dendrite- The point of contact for receiving information from neurons in the classical neurotransmission

• Use the following CYP450 table to hypothesize drug interactions and their clinical

significance for a patient on haloperidol, a conventional antipsychotic, who is prescribed paroxetine, an antidepressant?Haloperidol levels would increase, placing the patient at risk for antipsychotic side effects.

• Elimination of a drug can be impacted by all of the following scenarios except?

A Mediterranean diet.

• Which of the following statements is true about ligand-gated ion channels?

Allosteric modulators can enhance or inhibit ion channels when in the presence of neurotransmitter.

• Pharmacokinetics involves consideration all of the following except the?

Receptor binding site of the drug

• The direct role of transcription factors is to?

Influence gene expression

• Second messengers are?

Intracellular messengers activated by extracellular messengers.

• Which of the following statements about pharmacokinetics is true?

Accumulation of psychotropic drugs occurs faster in the brain then adipose tissue.

• G-linked proteins?

Bind enzymes that synthesize second messengers.

• Carbamazepine has a half-life of approximately 12 hours. The clinical implications of this

are?Therapeutic blood monitoring of carbamazepine should not occur before 2 ½ days of starting the medication.

• When an inverse agonist binds to a G-protein linked receptor, signal transduction is?

Inactivated.

• When an antagonist binds to a G-protein-linked receptor, signal transduction is?

Unchanged.

• Which of the following statements is true about concentration-time curve of medication

absorption?Steady-state refers to the point at which blood level fluctuations are mild and not clinically significant.

• When an agonist binds to a G-protein-linked receptor, signal transduction is?

Fully enhanced.

• The two main targets of signal transduction cascades are?

Gene expression and phosphoproteins.

• Which of the following methods of drug delivery is slowest to reach the bloodstreams?

Oral pills.

• When a partial agonist binds to a G-protein-linked receptor, signal transduction is?

Partially enhanced.

• When comparing phase I and phase II metabolism which of the following statements is

true?Phase I metabolism refers to CYP450 enzyme activity whereas Phase II metabolism refers to conjugation of drug.

• Enzyme inhibition as a target of drug therapies is?

A means of preventing the degradation of neurotransmitters.

Week 4 Quiz

• When prescribing atypical antipsychotic medications, it is important to consider which

of the following?Atypical antipsychotics are not approved for the treatment of geriatric dementia-related psychosis and carry increased risk of mortality in this population.

• Atypical antipsychotics, also known as second-generation antipsychotics, are related to

as atypical because?They have the clinical profile of equal positive symptom antipsychotic actions but low extrapyramidal symptoms and less hyperprolactinemia compared to conventional antipsychotics.

• Which of the following statement is true regarding cognitive symptoms of psychosis?

Cognitive symptoms are the strongest correlate of real-world functioning in schizophrenia.

• Match the following?

Muscarinic anticholinergic receptor blockade- Constipation, blurred vision, dry mouth, and drowsiness.Histamine H1 receptor blockade- Weight gain and drowsiness Alpha-1 adrenergic receptor blockade- Orthostatic hypotension and drowsiness.

• Which of the following statement is true about conventional antipsychotics?

Conventional antipsychotics are thought to block dopamine at the D2 receptor equally in dopamine neural circuits.

• Which of the following statement is true about tardive dyskinesia?

Elderly patients may develop tardive dyskinesia sooner in treatment than younger patients.

• When considering metabolic risk associated with atypical antipsychotics which of the

following statements is true?Patients taking atypical antipsychotics are at increased risk for diabetes and cardiovascular disease.

• Which of the following statements best describes the nigrostriatal dopamine pathway?

Chronic blockade of D2 receptors in the nigrostriatal dopamine pathway may result in tardive dyskinesia.

• Which of the following statements is true about dopamine?

Tyrosine is a precursor to dopamine.

• Which of the following statement is true when switching antipsychotics?

For antipsychotics with high anticholinergic, antihistaminergic and anti-alpha 1 adrenergic side effects, it is best to taper slowly to minimize withdrawal effects.

• Which of the following statement is true about the development of schizophrenia is

true?Stress from the environment can cause abnormal expression or abnormal silencing of normal genes which are associated with schizophrenia.

• Failure to give with about a 500 calorie meal can result in lowering oral absorption by

half and inconsistent efficacy for which medication?Ziprasidone.

• Which of the following statement about long-acting injectable (LAI) antipsychotics is

true?Patients with a history of neuroleptic malignant syndrome should not be initiated on LAI antipsychotics.

• Which of the following statements about metabolic syndrome is true?

Diet and lifestyle education should be included as a strategy for reducing risk of metabolic syndrome.

• Which of the following statements best describes the mesolimbic dopamine pathway?

Hyperactivity of the mesolimbic dopamine pathway may account for positive symptoms of schizophrenia.

• Which of the following is true when you consider EPS and Tardive dyskinesia as

antipsychotic side effect?EPS and Tardive dyskinesia are the result of dopamine blockade in the nigrostriatal pathway.

• Which antipsychotic carries a risk of QTc prolongation?

Ziprasidone.

• Which of the following antipsychotics is least likely to cause significant weight gain?

Ziprasidone.

• Which of the following statements best describes the mesocortical dopamine pathway?

Hypoactivity of the mesocortical dopamine pathway is thought to be associated with negative and cognitive symptoms of schizophrenia.

• Which of the following statements best describes the tuberoinfundibular dopamine

pathway?Inhibition of dopaminergic neurons in the nigrostriatal dopamine pathway leads to increased prolactin levels.

• Which atypical antipsychotic carries the highest risk of EPS?

Risperidone.

• Which of the following antipsychotics is least likely to cause sedation?

Aripiprazole.

• A 28 year old man has been diagnosed with schizophrenia at age 19. He has a body mass

index of 30, fasting triglycerides of 220 mg/dL, and fasting glucose of 114 mg/dL. Which of the following is most likely to worsen his metabolic profile?Clozapine.

• A patient on aripiprazole complains that they cannot sit still. They fidget throughout

their appointment and state that they feel like they are crawling out of their skin.Assessment is consistent with akathisia.These symptoms would best respond to a beta blocker.

• Which of the following statement is true about adverse antipsychotic side effects?

Neuroleptic malignant syndrome could be mistaken for another side effect early in its progression.FYI: Ingrezza (valbenazine) is now approved or the treatment of tardive dyskinesia (TD), FYI: Dentrolene is for (NMS) Neuroleptic malignant Syndrome – s/s confusion/agitation/high temp/seizures, for patients who are placed on a 1st or generation aka typical antipsychotic.

FYI: For acute dysyonia use Benadryl / Akathisia use BB propanolol