NAME. Choose the most appropriate answer. Each multiple choice question is worth 2 points.

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NAME DAPH 721 - Pharmacology - Exam A

Dr. Gail Galasko November 8, 2000. PART I

Choose the most appropriate answer. Each multiple choice question is worth 2 points.

1. Benzodiazepines

a. potentiate the effects of GABA on chloride conductance. b. can enhance chloride conductance in the absence of GABA. c. markedly inhibit respiration at sedative doses.

d. are excreted in urine mainly as unchanged drug. e. markedly induce hepatic microsomal enzymes.

2. Which of the following drugs are most likely to cause extrapyramidal effects?

a. antibiotics

b. salicylates

c. barbiturates

d. phenothiazines

e. benzodiazepines

3. Use of diphenhydramine (Benadryl®) in controlling the symptoms of parkinsonism is based upon which of the following effects?

a. anticholinergic b. local anesthetic c. adrenergic-blocking

d. CNS depressant on the midbrain

e. stimulant to dopaminergic nerves in the basal ganglia

4. Administration of which of the following drugs leads to stimulation of CNS dopaminergic receptors? a. amantadine b. L-dopa c. methyldopa d. bromocriptine e. a, b and d

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5. Both trihexyphenidyl and bromocriptine a. produce emesis.

b. stimulate dopaminergic receptors.

c. are useful in the treatment of Parkinson's disease. d. are useful in the treatment of tardive dyskinesia. e. produce urinary retention.

6. The reason for giving carbidopa with L-dopa in the treatment of Parkinson's includes

a. decreasing incidence of cardiac tachyarrhythmias. b. decreasing frequency of nausea/vomiting.

c. decreasing peripheral decarboxylation of L-dopa. d. (b) and (c)

e. (a), (b) and (c)

7. L-dopa is used in the treatment of Parkinson's disease because a. L-dopa is lacking in Parkinsonism.

b. L-dopa is not biotransformed in the periphery.

c. L-dopa crosses the blood brain barrier because it is lipid soluble. d. L-dopa enters the CNS via an active transport mechanism. e. all of the above

8. Adverse effects of benzodiazepine therapy include a. increased reaction time.

b. motor incoordination. c. bitter taste.

d. all of the above e. (a) and (b)

9. Therapeutic uses of the benzodiazepines include a. treatment of insomnia.

b. treatment of seizures.

c. production of retrograde (anterograde) amnesia. d. induction of enzymes.

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10. The barbiturates

a. can induce hepatic enzymes. b. can precipitate porphyria attacks. c. are CNS depressants.

d. all of the above e. (a) and (c)

11. The addition of carbidopa to L-dopa in the treatment of Parkinson's disease causes a DECREASE in all the following EXCEPT

a. incidence of cardiac tachyarrhythmias. b. frequency of emesis.

c. biotransformation of L-dopa to dopamine in peripheral tissues. d. clearance of L-dopa.

e. decarboxylation of L-dopa in the CNS. 12. Adverse effects of L-dopa include

a. nausea.

b. cardiac arrhythmias. c. psychiatric disturbances.

d. all of the above e. (a) and (b)

13. The following statements regarding the benzodiazepines are true EXCEPT a. they are safer than the barbiturates because they are less efficacious as

non-specific CNS depressants.

b. they have less effect on liver enzyme induction than the barbiturates. c. they suppress new memory formation.

d. they potentiate the effects of GABA on chloride conductance. e. All of the above are true.

14. Benzodiazepines

a. act as agonists at GABA receptors. b. act as competition antagonists to GABA.

c. increase the frequency of GABA induced openings of chloride channels. d. decrease the frequency of GABA induced openings of chloride channels. e. all of the above

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15. A patient undergoing cancer chemotherapy is vomiting frequently. A drug that might help in this situation is

a. bromocryptine.

b. cimetidine.

c. ondasentron.

d. terfenadine.

e. none of the above

16. Parkinsonism produced as a consequence of "major tranquillizer" administration is best treated by giving

a. carbidopa or benserazide.

b. dopamine.

c. an anticholinergic such as benztropine. d. Any of the above may be used.

e. (a) and (c) 17. Baclofen

a. is a derivative of GABA.

b. acts as an agonist at GABAβ receptors.

c. causes less sedation than diazepam when used as a muscle relaxant. d. may cause increased seizure activity in epileptics.

e. All of the above are true. 18. H1-antihistamines may be used a. as sedatives.

b. for their anticholinergic effect to prevent motion sickness. c. to inhibit chemically induced vomiting (CTZ).

d. (a) and (b) e. (a), (b) and (c) 19. Phenobarbital

a. produces anticonculsant effects without causing sedation b. produces analgesia at hypnotic doses

c. decreaes (inhibits) hepatic microsomal biotransformation d. increases hepatic biotransformation

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20. Which of the following drugs, when administered intravenously, is LEAST likely to produce respiratory depression?

a. Fentanyl

b. Diazepam

c. Thiopental

d. Meperidine

e. Pentobarbital

21. Tardive dyskinesia is a neurological side-effect of which of the following classes of drugs?

a. Alcohols

b. Tricyclic antidepressants c. Barbiturate antiepileptics

d. Phenothiazine antipsychotics e. Monoamine oxidase inhibitors

22. The most important therapeutic measure to be taken in a case of barbiturate poisoning is to

a. alkalinize the urine.

b. aspirate stomach contents. c. administer a CNS stimulant. d. assure adequate respiration. e. administer osmotic diuretics.

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PART II ON NEXT PAGE

PART II

Discuss the use of metoclopramide as an anti-emetic under the following headings. 1. Where and at which receptors does metoclopramide act? [1]

2. List 2 effects of metoclopramide other than its effect as an antiemetic. [2]

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