Pharma long 3 แต่ ไปอยู่ในลอง สี่ เรื่อง Antipsyco/Neuro

Antipsychotic/Neuroleptic – Dr. Soriano

1. The autonomic nervous system effects of phenothiazine derivatives include which of the following?
A. Blockade of serotonin and histamine receptor (See Antipsycotic Lecture)
B. Anti emetic effects (NMS p.60)
C. Alteration of temperature regulation (NMS p.60)
D. D. B & C only
E. All of the above

2. Which of the following agents is a piperidine antipsychotic?

A. Promazine
B. Haloperidol
C. Thiothixene
D. Molindone
E. Thioridazine

3. Which of the following neuroleptic agents causes the HIGHEST incidence of extrapyramidal reaction?
A. Thrioridazine
B. Fluphenazine
C. Mesoridazine
D. Chlorpromazine
E. Promazine

4. Which of the following antipsychotic agents would have the HIGHEST propensity to develop orthostatic hypotention?
A. Thioridazine
B. Prochlorperazine
C. Flupheriazine
D. Trifluoperazine
E. Haloperidol

5. Which of the following is the MOST potent antipsychotic?

A. Promazine
B. Thioridazine
C. Chlorpromazine
D. Haloperidol
E. Chlorprothixene

6. Which of the following is the LEAST sedation antipsychotic agent?

A. Thioridazine
B. Haloperidol
C. Chlorpromazine
D. Mesoridazine
E. Chlorprothixene

7. Which of the following is an endocrine effect of the phenothiazine derivatives?

A. False-positive HCG pregnancy test (Not found)
B. A delay in ovulation
C. increased prolactin levels and lactation
D. A & C only
E. All of the above

8. Which of the following is the MOST common pathway for microsomal biotransformation of Chlorpromazine in the liver?
A. Ring hydroxylation  Previous answer
B. Formation of sulfoxides
C. Demethylation
D. Side chain oxidation
E. Dechlorination

9. Which of the following is a preanesthetic use of the phenothiazine derivatives?

A. Reduction of anxiety and apprehension
B. Control of nausea and vomiting
C. Muscle relaxation during surgery
D. A & C only
E. All of the above

10. Which of the following is an indication for phenothiazine use?

A. Intractable cough
B. Muscle rigidity in tetanus
C. Acute Intermittent porphyra
D. A & C only
E. All of the above
 11. Which of the following phenothiazine derivatives has the GREATEST propensity is cause agranulocytosis?
A. Chlorpromazine
B. Fluphenazine
C. Haleperidol
D. Thiothizene
E. Trifluoperazine

12. Which of the following is a side effect of Haloperidol in males?

A. Testicular atrophy
B. Gynecomastia
C. Hirsutism
D. Increased libido
E. Alopecia

13. Which of the following is a characteristic of neuroleptic malignant syndrome?

A. Muscle rigidity
B. Hyperthermia
C. Altered consciousness (Not Found)
D. A & C only
E. All of the above

14. Which of the following drugs can accelerate the biotransformation of Chlopromazine by microsomal enzymes in the liver?
A. Insulin
B. Metoprolol
C. Phenobarbital
D. Digoxin
E. Warfarin

15. Which of the following statements is TRUE regarding Chlorprothixene?

A. It is a more potent antipsychotic drug than Chlorpromazine
B. It is more potent in producing sedation than Chlorpromazine
C. It is as potent as Chlorpromazine in producing orthostatic hypotension
D. A & C only
E. All of the above

16. Which of the following statements is TRUE regarding Haloperidol?

A. It is a more potent antipsychotic drug than Chlorpromazine
B. It is more potent sedative effect than Chlorpromazine
C. It has a more potent anticholinergic effect than Chlorpromazine
D. A & C only
E. All of the above

17. Which of the following antipsychotic drug is used for patients with uncontrolled Tourette’s syndrome?
A. Loxapine
B. Molindrome
C. Pimozide
D. Chlorprothixene
E. Haloperidol  also responds to Tourette’s Syndrome

18. Adverse reactions are RARELY seen when Lithium levels in the plasma are:
A. Below 2 meq/L
B. Between 2-10 meq/L
C. Between 30-300 meq/L
D. Between 300-500 meq/L
E. None of the above

19. Which of the following is an adverse effect of Lithium?

A. Tachycardia
B. Increased creatinine clearance
C. Constipation
D. Abdominal pain

AntiEpileptic Drugs/ AntiSeizure Drugs – Dr. Soriano

1. Drug of choice in the treatment of Myoclonic seizures

A. Valproic acid
B. Clonazepam
C. Both
D. neither

2. Drug used in Status Epilepticus

A. Phenytoin
B. Phenobarbital
C. Diazepam
D. All of the above
E. A & C only  previous answer
 3. Treatment of choice for Tonic clonic sezures
A. Phenytoin
B. Carbamazepines
C. both
D. neither

4. It is most commonly encountered and the most dramatic form of Epilepsy

A. Petit mal
B. Myoclonic
C. Febrile seizures
D. Grand mal
E. Simple partial

5. These seizures consist of short episodes of muscle contraction that may recur for several minutes
A. Myoclonic
B. Petit mal
C. Grand mal
D. Complex partial
E. none of the above

6. Which of the following anti-seizure drugs is most likely to elevate the plasma concentration of the drugs when
administered concomitantly
A. Carbamepine
B. Diazepam
C.
D. Phenyton
E. Valproic acid

7. Which of the following statements concerning proposed mechanism of action of Anticonvulsant is False?
A. Diazepam –facilitates GABA-mediated inhibitory action
B. Ethosuximide selectively block K ion channels in Thalamic neuron
C. Phenobarbital enchance the effects of GABA&blockade of Na ion channels
D. Phenytoin prolongs the inactivated state of Na ion channel

8. Which of the following drugs may increase plasma concentration w/ concorrect administration of
Chloramiphenicol,INH,Cimetidine & certain…?
A. Phenytoin
B. Ethosaximide
C. Phenobarbital
D. Benzodiazepam
E. none of the above

AntiEpileptic Drugs/ AntiSeizure Drugs – Dr. Soriano

1. The drug of choice for status Epilepticus in infant and children

A. Succinimides
B.
C. Barbiturates
D. Benzodiazepines
E. All of the above

2. Which of the following statements is INCORRECT concern Phenytoin

A. It is used in the treatment of grand mal epilepsy and tonic clonic disorder
B. hyperplasia is an adverse reaction
C. It is indicated in absence seizure
D. Phenytoin act by stabilizing membrane by sodium conduction ---
E. None of the above

3. The drug of first choice in the treatment of Absence seizure

A. Ethosuximide
B. Phenytoin
C. Phenobarbital
D. Diazepam
E. All of the above

4. It is drug of choice for Status Epilepticus in adult

A. Phenobarbital
B. Valpaoic acid
C. Carpamazepines
D. Diazepam
E. None of the above
 5. It is the most effective drug against Myoclonic seizure
A. Barbiturate
B. Ethosuximide
C. Benzodiazepines
D. Valproic acid
E. Any of the above

6. Which of the following drug/toxicity pairs is INCORRECT

A. Valpaoic acid : nausea and vomiting
B. Ethosuximide :hypersensitivity reaction
C. Carbamazepine:bone marrow depression
D. Primidone:hepatoxicity
E. Phenobarbital:sedation

7. All of the following drugs are useful in treating complex seizures, EXCEPT?
A. Ethosuximide
B. Phenobarbital
C. Carbamazepine
D. Phenytoin
E. Gabapentin

8. Which one of the following drugs is the therapeutic indication INCORRECT

A. Ethosuximide:absence seizure
B. Phenobarbital:febrile in children
C. Diazepam:status epilepticus in adult
D. Phenytoin :absence seizure
E. Carbamazepines:tonic-clonic seizure

9. It is used in the treatment of malignant hyperthermia

A. Clonazepam
B. Dandrolene
C. Gabapentin
D. Lamotrigone
E. None of the above

10. It is the preferred drug in partial complex seizure

A. Phenytoin
B. Carbamazepines
C. Primidone
D. A and B
E. A and C

Toxic pharmacology

Opioid – Dr. Soriano

1. The following opioids are strong agonists EXCEPT
a. Heroin
b. Fentanyl
c. codeine
d. methadone
e. meperidine

2. Mixed agonists-antagonist opioids are the following EXCEPT

a. Pentazoeine
b. Buprenorphine
c. Nalorphine
d. Naloxone
e. none of the above

3. Which of the statements about pentazocine is INCORRECT?

a. it is mixed agonist-antagonist
b. it is often combined with morphine for maximal analgesic effects
c. high doses of pentazoeine increases blood pressure
d. it can be administered orally and parenterally
e. it produces less euphoria than morphine

4. All of the following statements concerning methadone are correct EXCEPT

a. it has less potent analgesic effect than morphine
b. it has longer duration of action than morphine
c. it is effective by oral administration
d. it causes a milder withdrawal syndrome than morphine
e. it has greatest action at Mu receptor
5. Mainly agonist action of opioids at Mu receptors; EXCEPT
a. supraspinal analgesia
b. papillary dilatation
c. euphoria sedation
d. decreased GI motility
e. none of the above

6. Treatment of choice for patients addicted to heroin or other opioids

a. Methadone
b. Naltrexone
c. Meperidine
d. Palbuphane
e. naloxone

7. The following are pharmacologic effects of morphine; EXCEPT

a. cutaneous vasoconstriction
b. bronchoconstriction
c. dose-dependent analgesia
d. increased alveolar and serum carbon dioxide tension
e. none of the above

8. Adverse effects of morphine; EXCEPT

a. Constripation
b. papillary dilatation
c. bronchoconstriction
d. respiratory depression
e. none of the above

9. The following statements are true concerning codeine; EXCEPT

a. it has high oral-parenteral potency ratio
b. analgesic potency is ½ of morphine
c. 30 mg of codeine equivalent to 60 mg of aspirin
d. useful as cough suppressant
e. none of the above

10. Opioids with no gastrointestinal and antitussive action

a. Methadone
b. Codeine
c. Meperidine
d. Naloxone
e. levorphanal

11. It is used in the suppression of withdrawal symptoms due opiate addiction?

a. Nalhexone
b. Meperidine
c. Methadone
d. Naloxone
e. levorphanol

12. Its ponerpal use is to control diarrhea

a. Morphine
b. Codeine
c. Diphenoxylate
d. Methadone
e. meperidine

13. Which of the following opioids is noted to prolong labor?

a. Herom
b. Morphine
c. Codeine
d. Nabuphine
e. methadone

14. It satisfies craving for heroin without producing euphoria and somnolence
a. Propoxyphene
b. Meperidine
c. Nalbuphine
d. Methadone
e. naloxone
 15. It has no anti-inflammatory effect with pharmacologic activity similar to codeine
a. propoxyphene
b. methadone
c. oxycodone
d. meperidine
e. none of the above

End

TRUE or FALSE: Write A=TRUE; B=FALSE

B 81. Bromocriptine prevents the catabolism of dopamine in the brain. (MAO-B Inhibitor (Selegiline, Rasagiline)
B 82. Vitamin B12 reduces the beneficial effects of L-dopa . (B6-Pyridoxine reduces the beneficial effects of levodopa)
B 83. Combined therapy of carbidopa and levodopa reduces the dose of carbidopa (combined carbidopa-levodopa therapy,
and the dosage of levodopa should be reduced by 75%)
A 84. Antihistamine are less effective therapeutically but are better tolerated than anticholinergic agents in the
treatment of parkinsonian symptoms. (check NMS not found on powerpoint)
A 85. Anticholinergic agents has better activity on tremor than L-dopa (check NMS not found on powerpoint)
B 86. The example of preanesthetic medication is ketamine. (Dissociative anesthesia, such as ketamine)
A 87.Thiopental is a form of intravenous anesthetic. (Intravenous anesthetics  Barbiturates  Thiopental)
B 88. Procaine has better topical of intravenous anesthetic. (the drug lack topical activity)
B 89. Endocaine is used mainly for the anesthesia of the mucous membrane. (Lidocaine; Tetracaine; Diducaine)
B 90. 0.50% solution of bupivacaine is used for obstetric epidural anesthesia. (0.75% solution of bupivacaine used for
obstetric epidural anesthesia)
A 91. The MAC of halothane is 0.75% and is a potent anesthetic agent.
B 92. Bradycardia is pronounced following administration of enflurane. (Fentanyl and Innovar)
A 93. Cardiac output may increased with isoflurane.

B 94. Urinary urgency is adverse reaction of codeine. (Should be morphine)

A 95. Heroin has rapid onset and shorter duration of action than morphine. (Check NMS p.74)
B 96. 100 mg of meperidine is equivalent to 10 mg of morphine. (Should be 15mg of morphine NMS p.74)
B 97. Methadone has no gastrointestinal or antitussive action.
A 98. Methadone is more effective orally than morphine. (Check NMS p.75)
B 99. Fentanyl is contraindicated in Chronic cancer pain because of its potential to cause muscular rigidity.
B 100. Methadone is prepared intravenously. (both oral and IV)

Anxiolytic

1. Which of the following statements is TRUE regarding benzodiazepines?

a. The electronegative group at the C5 position is necessary for optimal anti-anxiety activity
b. Substitution at the C-7 position with a phenyl ring will increase its pharmacologic activity
c. its mechanism of action involves the potentiation of GABA activity
d. A&C only
e. All of the above

2. Which of the following is the LONGEST-acting benzodiazepines ?

a. Alprazolam
b. Halazepam
c. Lorazepam
d. Lorazepam
e. Oxazepam

3. Which of the following anxiolytic agents should be injected into the deltoid muscle where absorption is know to be
complete and predictable?
a. Diazepam
b. Alprazepam
c. Clorazepam
d. Halazepam
e. Oxazepam

4. Which of the following is the ONLY anxiolytic drug that is converted to an active product by the acid in the stomach?
a. Lorazepam
b. Chlordiazepoxide
c. Prazepam
d. Diazepam
e. Clorazepate

5. Which of the following benzodiazepines will be LEAST bound to serum albumin?

a. Diazepam
b. Alprazolam
c. Clorazepam
d. Halazepate
e. Oxazepam
6. On a weight basis,which of the following anxiolytic-agents is the MOST potent?
a. Clorazepate
b. Oxazepam
c. Chlordiazepoxide
d. Halazepam
e. Prazepam

7. Which of the following benzodiazepines is the MOST potent as a muscle relaxant?

a. Alprazolam
b. Lorazepam
c. Triazopam
d. Clorazepate
e. Diazepam

8. Which of the following benzodiazepines would have the GREATES capacity to increase the convulsive seizure threshold
level?
a. Oxazepam
b. Chlordiazepoxide
c. Diazepam
d. Clorazepate
e. Temazepam

9. Which of the following benzodiazepines possesses the LONGEST sedative action?

a. Alprazolam
b. Halazepam
c. Clorazepate
d. Lorazepam
e. Prazepam

10. Which of the following benzodiazepines will LEAST likely react with an H2-blocking agent when taken concurrently?
a. Oxazepam
b. Halazepam
c. Clorazepate
d. Diazepam
e. Temazepam

11. Which of the following benzodiazepines is MAINLY used as a hypnotic agent?

a. Halazepam
b. Temazepam
c. Alprazolam
d. Diazepam
e. Clorazepate

12. Which of the following anxiolytics may precipitate seizures in epileptic patients?
a. Hydroxazine
b. Triazolam
c. Buspirone
d. Meprobamate
e. Chlordiazenoxide

13. Which of the following statements is TRUE regarding Buspirone?

a. It is effective as an anti-anxiety agent
b. It possesses anticonvulsant activity
c. It has marked muscle relaxant effect
d. A & B only
e. All of the above

14. Which of the following is an intermediate acting barbiturate?

a. Phenobarbital
b. Mephobarbital
c. Thiopental
d. Methohexital
e. Pentobarbital

15. Which of the following sedative- hypnotic agents will have the shortest half life?
a. Amobarbital
b. Butarbital
c. Pentobarbital
d. Phenobarbital
e. Secobarbital
16. What is the correct dosage of Phenobarbital used for sedation?
a. 15-30 mg, BID-TID
b. 15-30 mg, TID-QID
c. 1-2 mg, OD-BID
d. 1-2 mg, BID-TID
e. 5-10 mg, BID-TID

17. Which of the following is MOST appropriate dosage of Chloral hydrate used for hypnosis?
a. 100-200 mg at bedtime
b. 10-30 mg at bedtime
c. 300-500 mg at bedtime
d. 20-50 mg at bedtime
e. 500-1000 mg at bedtime

18. Which of the following statements is TRUE regarding Ethchlorvynol?

a. It has the same potency as Phenobarbital as a sedative-hypnotic
b. Its action is evident in 2 hours and disappears in 24 hours
c. It is poorly absorbed from the GIT because it is localized in body fat
d. A & C only
e. All of the above

19. How much Ethchlorvynol will render physical dependence given at one time?
a. 2 mg
b. 1 mg
c. 0.5 mg
d. 500 mg
e. 200 mg

20. Toxicity from Ethinamate will MOST likely present as:

a. Hepatic failure
b. Myocardial infarction
c. Respiratory failure
d. Intracranial hemorrhage
e. renal failure

21. Which of the following statements is TRUE regarding Glutethimide?

a. It is well absorbed from the GIT and is widely distributed
b. It is biotransformed mainly in the liver
c. Its half-life is approximately 45 hours
d. A & C only
e. All of the above

22. Which of the following statements is TRUE regarding Methyprylon?

a. It is mainly as a hypnotic agent
b. Its effects are similar to those of Pentobarbital and Secobarbital
c. Toxicity may cause hypotension, respiratory depression, and coma
d. A & C only
e. All of the above

23. Which of the following statements is TRUE regarding Zolpidem?

a. It is nonbenzodiazepine that selectively binds to the benzodiazepine site on the GABA reception
b. Its actions are similar to benzodiazepines including its tolerance and dependency problems
c. It suppresses REM sleep even at lower doses
d. A & C only
e. All of the above

24. Which of the following Sedative-hypnotic is most commonly used in geriatric patients because it does not decrease
respiration as much as the other drugs in its class?
a. Paraldehyde
b. Flumazenil
c. Buspirone
d. Zolpidem
e. Chloral hydrate

25. Which of the following Sedative-hypnotic agents the MOST appropriate for agitated psychiatric patients to calm them and
help them sleep?
a. Paraldehyde
b. Chloral hydrate
c. Buspirone
d. Zolpidem
e. Flumazenil
26. Which of the following statements is TRUE regarding Buspirone?
a. It is a non-sedative drug used mainly for anxiety disorders
b. It potentiate the CNS depressive effects of Ethanol
c. It requires 3 days of administration to establish an anxiolytic effect
d. A & B only

27. Which of the following drugs is considered as a benzodiazepine antagonist?

a. Buspirone
b. Flumazenil
c. Paraldehyde
d. Chloral hydrate
e. Zolpidem

28. Which of the following is a pre-synaptic blocking agent that blocks the synthesis of serotonin?
a. Chlorophenylalanine
b. Atrychnine
c. Caffeine
d. Phenobarbital
e. Reserpine

29. Which of the following is a post-synaptic blocking drug?

a. Amobarbital
b. Amphetamine
c. Cocaine
d. Capsaicin
e. Reserpine

30. Which of the following drugs depletes the synapses of monoamines by interfering with their intracellular storage?
a. Reserpine
b. Strychnine
c. Secobarbital
d. Cocaine
e. Amphetamine

31. Which of the following drugs will MOST likely induce the release of catecholamines from adrenergic synapses?
a. Capsaicin
b. Chlorophenylalanine
c. Caffeine
d. Phenobarbital
e. Amphetamine

32. Which of the following agents can cause the release of the peptide substance P from sensory neurons?
a. Ethanol
b. Halothane
c. Caffeine
d. Capsaicin
e. Tetanus toxin

33. Which of the following agents will MOST likely block the receptor for the inhibitory transmitter Glycine?
a. Caffeine
b. Theobromine
c. Strychnine
d. Secobarbital

34. Which of the following agents will MOST likely block the uptake of catecholamines at the adrenergic synapses and thus
potentiating the action of these amines?
a. Capsaicin
b. Caffeine
c. Strychnine
d. Cocaine
e. Tetanus toxin

35. Which of the following drugs is an antagonist of the neurotransmitter serotonin?

a. Atenolol
b. Ketanserine
c. Picrotoxin
d. Atropine
e. Pirenzipine

36. Which of the following CNS drugs is a respiratory stimulant?

a. Pentylenetetrazol
b. Nikithamide
c. Methylphenidate
 d. Picrotoxin
e. Strychnine

37. This piperidine derivative is structurally related to Amphetamines and is a mild CNS stimulant with more prominent
effects on mental than on motor activities:
a. Picrotoxin
b. Strychnine
c. Nikithamide
d. Doxapram
e. Methylphenidate

38. This CNS stimulant does NOT block either pre-synaptic or post-synaptic inhibition but instead will increase the
excitability of the neuronal membranes:
a. Picrotoxin
b. Doxapram
c. Nikithamide
d. Pentylenetetrazol
e. Methylphenidate

Drug abuse
1. The following are effects of Marijuana Except
A. Uncontrollable
B. Vasodilation
C. Change in perception
D. Achievement of dream-like state
E. none of the above

2. Which of the following stament about stimulants is False

A. ”Herbak ecstasy” causes Amphetamine-like effects
B. Withdrawal for caffeine may lead to severe headache
C. Ecstasy is neurotoxic to brain
D. Physiologic dependence may not occur
E. Treament of cocaine overdose may include diazepam & Propanodol

3. Which of following statements concernine Hallucinogen is accurate

A. Messaline and related hallucinogens are throught to exert their CNS actions thru dopaminergic system in the
brain
B. Ratogenic effects are known to LSD
C. Dilated pupils, tachycardia, tremor and increased alertness are effects of Psilaybin
D. D.PCP can cause dry month and urinary retention
E. None of the above

4. Which one of the following symptom is likely to occur with Marijuana

A. Bradycardia
B. Conjunctival rediness
C. Hypertension
D. Increased psychomotor activity
E. None of the above

5. Effects of overdose of PCP may include the following Except

A. Nystagmus
B. marked HPN
C. seizures
D. Death
E. all of the above

6. “Increased appetite” is a Tolerance manifestation of:

A. Amphetamines
B. Cocaine
C. PCP
D. Marijuana

7. It is a power ful vasoconstrictive agent

A. Heroin
B. MorphineMeperidine
C. Cocaine
D. Pentanyl

Drug abuse

39. Which of the following statements is MOST acourate about Caffeine?

a. one cup of coffee approximately contains 85 mg caffeine
b. The half-life of caffeine plasma is 8-9 hours in children
c. It causes secretion of both HCL acid and pepsin
d. A & C only
e. All of the above