Transcript Pharmacology tutoring for antianxiety agents

Anxiolytic Tutoring
BY ALAINA DARBY

Which of the following is true of anxiety?
Pharmacological intervention is used to cure anxiety
b. Anxiety is caused by reduced sympathetic stimulation
c. Anxiety is often a protective response to certain events
d. Psychological intervention (cognative therapy) address only the
symptoms
a.

Which of the following is not a type of anxiety disorder?
OCD
b. PTSD
c. Simple phobias
d. Depression
a.

Which of the following is true of generalized anxiety?
It is a term used to describe chronic, low-grade anxiety
b. It is a term used to describe brief, dramatic symptoms of anxiety
c. It is a term used to describe recurrent panic attacks
d. It is defined as recurring panic attack followed by a month or more
of panic disorder
a.
Which of the following is a symptom of generalized anxiety disorder
that is not shared with depression?

a.
b.
c.
d.
Inability to relax and sleep
More easily startled
Fatigue
Difficulty concentrating

Which of the following is the cardinal symptom of panic disorder?
Generalized anxiety
b. Panic attacks
c. Phobias
d. Chronic discomfort
a.
Stacie is terrified of dogs. Whenever she sees one, her heart
immediately begins racing and she starts breathing faster. Recently,
she has become so scared of encountering a dog that she tends to
avoid going out. Which of the following best describes how the
entirety of her symptoms would be classified?

Panic attack
b. Generalized anxiety disorder
c. Panic disorder
d. Agoraphobia
a.
Which of the following is most likely to accompany a diagnosis of
panic disorder?

a.
b.
c.
d.
Alcohol abuse
Severe depression
OCD
Family denial and dysfunction
How does neurotransmission in anxiety disorder differ from that in
depression?

a.
b.
c.
d.
Serotonin is decreased in both conditions
Norepinephrine is increased in both conditions
Serotonin is increased in anxiety but decreased in depression
Norepinephrine is increased in anxiety but decreased in depression
Into which of the following would lutraphobia (fear of otters) be
classified?

a.
b.
c.
d.
Social phobia
Simple phobia
Agoraphobia
Complex phobia

Which of the following is not considered a simple phobia?
Fear of specific animals
b. Fear of heights
c. Fear of public speaking
d. Fear of enclosed spaces
a.

Which of the following is true of OCD?
It occurs more in males than females
b. Performing the compulsive behavior evokes anxiety
c. It usually begins in childhood
d. It occurs in 1-2% of the population
a.
Which of the following not a collateral medical risk of panic
disorder?

a.
b.
c.
d.
Hypertension
Hyperhidrosis
Heart attack
Stroke
Which of the following pathophysiological causes of anxiety can be
targeted by benzodiazepines?

a.
b.
c.
d.
Noradrenergic projection system
Serotonergic projection system
Limbic system
Paralimbic cortex
In which of the following ways is respiration associated with the
feeling anxiety?

a.
b.
c.
d.
Hypoventilation decreases carbon dioxide in the blood
Hyperventilation decreases carbon dioxide in the blood
Hypoventilation increases carbon dioxide in the blood
Hyperventilation increases carbon dioxide in the blood
Which of the following areas of the brain is the source of CNS
anxiety response?

a.
b.
c.
d.
Medial forebrain bundle
Ventral tegmental area
Locus coeruleus
Nucleus accumbens

Which of the following is not a physiological response to stress?
Increased force and rate of heart beat
b. Increased blood flow to viscera
c. Decreased gastrointestinal motility
d. Increased glycogen to glucose conversion
a.
Which of the following regulates the locus coeruleus by inhibiting
transmission?

a.
b.
c.
d.
Glutamate
Glycine
GABA
Norepinephrine
How does the GABA-A receptor produce it’s effect when GABA
binds to its receptor site?

a.
b.
c.
d.
Chloride channel opens causing hyperpolarization
Chloride channel opens causing hypopolarization
Calcium channel opens causing hyperpolarization
Calcium channel opens causing hypopolarization

Which of the following is not true of benzodiazepines?
They have a wider therapeutic index than barbiturates or ethanol
b. They produce nonspecific antianxiety effects
c. They are safe in overdose when taken alone
d. They have relatively low abuse potential
a.
Which of the following requires the lowest dose to produce
respiratory death?

a.
b.
c.
d.
Barbiturates
Benzodiazepines
Ethanol
Tricyclic antidepressants
Which of the following benzodiazepines is known as the date rape
drug and is outlawed in the US?

a.
b.
c.
d.
Diazepam
Midazolam
Oxazepam
Flunitrazepam
What is true of the difference between the benzodiazepines in
terms of half-life?

a.
b.
c.
d.
2-ketos have shorter half-lives than 3-hydroxys
3-hydroxys have half-lives of approximately 12 hours
Triazolos have half-lives of longer than 20 hours
3-hydroxys have shorter half-lives than triazolos

Which of the following is not classified as a 2-keto benzodiazepine?
Diazepam
b. Lorazepam
c. Chlordiazepoxide
d. Prazepam
a.
Which of the following benzodiazepines has the longest duration of
action?

a.
b.
c.
d.
Alprazolam
Estazolam
Midazolam
Flurazepam
Which of the following benzodiazepines does not have active
metabolization intermediates?

a.
b.
c.
d.
Diazepam
Lorazepam
Chlordiazepoxide
Nordiazepam
Which of the following does not determine CNS duration and action
for benzodiazepines?

a.
b.
c.
d.
Metabolism
Membrane solubility
Ion permeability
Accumulation of metabolites
Which of the following determinants of CNS duration and action for
benzodiazepines could produce tolerance?

a.
b.
c.
d.
Rate of ingress and egress from CNS
Half-life
Presence of active metabolites and their half-lives
Frequency and chronicity of dosing

Which of the following is not a clinical use for benzodiazepines?
Stage fright
b. Panic disorder
c. Seizures
d. Sleep disorder
a.
Which of the following is consistent between different
benzodiazepines?

a.
b.
c.
d.
The subunit on the GABA receptor to which the molecule binds
The efficacy of the benzodiazepine drug
The metabolization process for the molecule
The lipid solubility of the drug molecule
Which of the following benzodiazepines can be used to treat
restless leg syndrome?

a.
b.
c.
d.
Lorazepam
Diazepam
Clonazepam
Alprazolam
Which of the following benzodiazepines can be used for procedural
amnesia?

a.
b.
c.
d.
Lorazepam
Diazepam
Clonazepam
Alprazolam
Which of the following benzodiazepines can be used for bipolar
disorder?

a.
b.
c.
d.
Lorazepam
Diazepam
Clonazepam
Alprazolam
Which of the following is not a potential drug interaction with
benzodiazepines?

Calcium channel blockers
b. Proton pump inhibitors
c. Contraceptives
d. Aspirin
e. CNS depressants
a.
Which of the following is not a contraindication for using
benzodiazepines?

a.
b.
c.
d.
Myasthenia gravis
Narrow-angle glaucoma
Hypertension
Respiratory insufficiency

Which of the following decreases the half-lives of benzodiazepines?
Cimetidine
b. Alcohol
c. Rifampin
d. Antacids
e. Disulfiram
a.
Which of the following benzodiazepines is used often for the
antegrade amnesia that it produces?

a.
b.
c.
d.
Alprazolam
Diazepam
Midazolam
Triazolam
Sally hates speaking in front of crowds and often has anxiety attacks
when she if forced to do so. Which of the following drugs will most
likely be prescribed for her condition?

Mirdazolam
b. Alprazolam
c. Atenolol
d. Imipramine
a.
Serotonin has been implicated in all of the following behavioral
disorders except which of the following?

a.
b.
c.
d.
Suicidality
Anorexia
Seasonal affective disorder
Schizophrenia
Which of the following is thought to be a possible mechanism
through which anxiety occurs?

a.
b.
c.
d.
Sustaining dopamine release through 5-HT2 receptor stimulation
5-HT2 mediated serotonin reuptake into platelets
Reduced neurotransmission in central serotonergic pathways
Hypostimulation of 5-HT1A receptors due to decreased serotonin
levels
Which of the following medications used for various anxiety
disorders is not also used to treat depression?

a.
b.
c.
d.
Fluvoxamine
Fluoxetine
Sertraline
Paroxetine

Which of the following is not an off-label use for SSRI’s?
ADHD
b. Insomnia
c. Panic disorder
d. Seasonal affective disorder
a.

Which of the following SSRI’s has the longest half-life?
Fluvoxamine
b. Fluoxetine
c. Sertraline
d. Paroxetine
a.
Which of the following is a side effect of SSRI’s that does not tend to
resolve with time?

a.
b.
c.
d.
Anorexia
Headache and dizziness
Decreased libido
Nausea and vomiting

Which of the following SSRI’s is most likely to cause weight gain?
Fluvoxamine
b. Fluoxetine
c. Sertraline
d. Paroxetine
a.

Which of the following SSRI’s has the least drug-drug interactions?
Citalopram
b. Fluvoxamine
c. Paroxetine
d. Sertraline
a.

Which of the following SSRI’s has the most drug-drug interactions?
Citalopram
b. Fluvoxamine
c. Paroxetine
d. Sertraline
a.

What describes the drug interactions of SSRI’s?
Effects are concentration dependent
b. Effects are dose dependent
c. SSRI levels are altered by other drugs
d. Decrease levels of other drugs
a.
Which of the following would be given to a patient that cannot
tolerate benzodiazepines or SSRI’s and is a partial 5-HT1A agonist?

a.
b.
c.
d.
Mirtazapine
Amitriptyline
Buspirone
Pregabalin

Which of the following works quickly by reducing calcium flow?
Mirtazapine
b. Amitriptyline
c. Buspirone
d. Pregabalin
a.
Which of the following works by directing serotonin to 5-HT1A but
also causes increased sedation and weight gain?

a.
b.
c.
d.
Mirtazapine
Amitriptyline
Buspirone
Pregabalin
Which of the following antipsychotics can be admixed with
lorazepam in a parental dosage form for better anxiolytic effects?

a.
b.
c.
d.
Risperidone
Aripiprazole
Quentiapine
Haloperidol
Which of the following drugs is not used often for anxiety because
of its danger of fatal overdose in single-agent usage and its
contraindication in individuals with cardiac abnormalities, prostatic
hyperplasia, narrow-angle glaucoma and a variety of other conditions?

Benzodiazepines
b. Tricyclic antidepressants
c. MAOI’s
d. Barbiturates
a.
Which of the following has a similar mechanism of action to
benzodiazepines but with a decreased therapeutic index?

a.
b.
c.
d.
Tricyclic antidepressants
Barbiturates
Phenothiazines
Opioids
Amanda has frequent panic attacks and has been diagnosed with
panic disorder. She has just become pregnant, and in order to
supplement her calcium intake, she has begun eating more yogurt and
cheese. Which of the following medications would be suitable for her?

Alprazolam
b. Tranylcypromine
c. Buspirone
d. Fluoxetine
a.
Daniel has overdosed on benzodiazepines and has been given Flumazenil
(Romazicon) to reverse the sedative effects of the overdose. What is it’s
mechanism of action?

Irreversibly inhibits the benzodiazepine binding site on the GABA-A
receptor
b. Competitively inhibits the benzodiazepine binding site on the GABA-A
receptor
c. Irreversibly inhibits the benzodiazepine binding site on the GABA-B
receptor
d. Competitively inhibits the benzodiazepine binding site on the GABA-B
receptor
a.