Lippincott Illustrated Reviews Pharmacology – CNS

9.1 Which one of the following statements is correct regarding benzodiazepines?
A. Benzodiazepines directly open chloride
channels.
B. Benzodiazepines show analgesic actions.
C. Clinical improvement of anxiety requires 2 to 4
weeks of treatment with benzodiazepines.
D. All benzodiazepines have some sedative effects.
E. Benzodiazepines, like other CNS depressants,
readily produce general anesthesia.
D

9.2 Which one of the following is a short-acting hypnotic?
A. Phenobarbital.
B. Diazepam.
C. Chlordiazepoxide.
D. Triazolam.
E. Flurazepam.
D

9.3 Which one of the following statements is correct regarding the anxiolytic and hypnotic agents?
A. Phenobarbital shows analgesic properties.
B. Diazepam and phenobarbital induce the cytochrome
P450 enzyme system.
C. Phenobarbital is useful in the treatment of acute
intermittent porphyria.
D. Phenobarbital induces respiratory depression, which
is enhanced by the consumption of ethanol.
E. Buspirone has actions similar to those of the
benzodiazepines.
D

9.4 A 45-year-old man who has been injured in a car accident is brought into the emergency room. His blood alcohol level on admission is 275 mg/dL. Hospital records show a prior hospitalization for alcohol-related seizures. His wife confirms that he has been drinking heavily for 3 weeks. What treatment should be provided to the patient if he goes into withdrawal?
A. None.
B. Lorazepam.
C. Pentobarbital.
D. Phenytoin.
E. Buspirone.
B

9.5 Which one of the following is a short-acting hypnotic and better for sleep induction compared to sleep maintenance?
A. Temazepam.
B. Flurazepam.
C. Zaleplon.
D. Buspirone.
E. Escitalopram.
C

9.6 Which of the following agents has a rapid anxiolytic effect and would be best for the acute management of anxiety?
A. Buspirone.
B. Venlafaxine.
C. Lorazepam.
D. Escitalopram.
E. Duloxetine.
C

9.7 Which of the following sedative-hypnotic agents utilizes melatonin receptor agonism as the mechanism of action to induce sleep?
A. Zolpidem.
B. Eszopiclone.
C. Estazolam.
D. Ramelteon.
E. Diphenhydramine.
D

9.8 All of the following agents for the management of insomnia are controlled substances and may have a risk for addiction or dependence except:
A. Zaleplon.
B. Flurazepam.
C. Doxepin.
D. Zolpidem.
E. Triazolam.
C

9.9 All of the following agents may cause cognitive
impairment, including memory problems when used at recommended doses except:
A. Diphenhydramine.
B. Zolpidem.
C. Alprazolam.
D. Phenobarbital.
E. Ramelteon.
E

9.10 Which agent is best used in the Emergency Room setting for patients who are believed to have received too much of a benzodiazepine drug or taken an overdose of benzodiazepines?
A. Diazepam.
B. Ramelteon.
C. Flumazenil.
D. Doxepin.
E. Naloxone.
C

12.1 A 9-year-old boy is sent for neurologic evaluation because of episodes of apparent inattention. Over the past year, the child has experienced episodes during which he develops a blank look on his face and his eyes blink for 15 seconds. He immediately resumes his previous activity. Which one the following best describes
this patient’s seizures?
A. Simple partial.
B. Complex partial.
C. Tonic-clonic.
D. Absence.
E. Myoclonic.
D

12.2 A child is experiencing absence seizures that interrupt his ability to pay attention during school and activities. Which of the following therapies would be most appropriate for this patient?
A. Ethosuximide.
B. Carbamazepine.
C. Diazepam.
D. Carbamazepine plus primidone.
E. Watchful waiting.
A

12.3 Which of the following drugs is most useful for the treatment of absence seizures?
A. Topiramate.
B. Tiagabine.
C. Levetiracetam.
D. Lamotrigine.
E. Zonisamide.
D

12.4 A 25-year-old woman with myoclonic seizures is well controlled on valproate. She indicates that she is interested in becoming pregnant in the next year. With respect to her antiepilepsy medication, which of the following should be considered?
A. Leave her on her current therapy.
B. Consider switching to lamotrigine.
C. Consider adding a second antiepilepsy medication.
D. Decrease her valproate dose.
B

12.5 A woman with myoclonic seizures is well controlled with lamotrigine. She becomes pregnant and begins to have breakthrough seizures. What is most likely happening?
A. Her epilepsy is getting worse.
B. Lamotrigine concentrations are increasing.
C. Lamotrigine concentrations are decreasing.
D. Lamotrigine is no longer efficacious for this patient.
C

12.6 A 42-year-old man undergoes a neurologic evaluation because of episodes of apparent confusion. Over the past year, the man has experienced episodes during which he develops a blank look on his face and fails to respond to questions. Moreover, it appears to take several minutes before the man recovers from the episodes. Which one of the following best describes
this type of seizure?
A. Focal (simple partial).
B. Focal (complex partial).
C. Tonic-clonic.
D. Absence.
E. Myoclonic.
B

12.7 A 52-year-old man has had several focal complex partial seizures over the last year. Which one of the following therapies would be the most appropriate initial therapy for this patient?
A. Ethosuximide.
B. Levetiracetam.
C. Diazepam.
D. Carbamazepine plus primidone.
E. Watchful waiting.
B

12.8 A patient with focal complex partial seizures has been treated for 6 months with carbamazepine but, recently, has been experiencing breakthrough seizures on a more frequent basis. You are considering adding a second drug to the antiseizure regimen. Which of the following drugs is least likely to have a pharmacokinetic interaction with carbamazepine?
A. Topiramate.
B. Tiagabine.
C. Levetiracetam.
D. Lamotrigine.
E. Zonisamide.
C

12.9 Which of the following is a first-line medication for generalized tonic-clonic seizures?
A. Ethosuximide.
B. Felbamate.
C. Vigabatrin.
D. Ezogabine.
E. Topiramate.
E

12.10 A 75-year-old woman had a stroke approximately 1 month ago. She is continuing to have small focal seizures where she fails to respond appropriately while talking. Which of the following is the most appropriate treatment for this individual?
A. Phenytoin.
B. Oxcarbazepine.
C. Levetiracetam.
D. Phenobarbital.
C

Absence seizure A type of generalized seizure characterized by a sudden, momentary break in consciousness; formerly often called petit mal seizure. Anticonvulsant A drug to control seizures. WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC SPECIFICALLY FOR YOU …

The answer is C: Hyperplasia. Hyperplasia is defined as an increase in the number of cells in an organ or tissue. Like hypertrophy (choice D), it is often a response to trophic signals or increased functional demand and is commonly …

Diazepam (Valium) Mechanism of Action 1/3 Binds to the benzodiazepan receptor and enhances the effects of GABA. Diazepam (Valium) Mechanism of Action 2/3 Benzodiazepines act at the level of the Limbic, Thalamic, and Hypothalmic regions of the CNS WE WILL …

Drug Class including: Diazepam Alprazolam Lorazepam Chlordiazepoxide Clorazepate Oxazepam Clonazepam Benzodiazepine Diazepam brand name Valium WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC SPECIFICALLY FOR YOU FOR ONLY $13.90/PAGE Write my sample Aplrazolam Xanax Chlordiazepoxide Librium Clorazepate Tranxene …

Passive Diffusion High conc. -> low majority of drugs work this way does not involve carrier, is not saturable, and shows a low structural specificity Facilitated Diffusion involves carrier proteins High conc -> low no energy required, an be saturated, …

Properties of benzodiazepines Bind to gamma subunit of GABA(A) complex to increase frequecy of Cl- channel opening; no GABAmimetic activity; BZ1 mediates sedation; BZ2 mediates antianxiety and impairment of cognitive functions Benzodiazepine drugs Alprazolam, diazepam, lorazepam, midazolam, temazepam, oxazepam WE …

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