Question 1

Bryce is taking modafinil for narcolepsy.It is particularly important to caution him .

Accepted Answer

Modafinil is a wakefulness-promoting agent that can help individuals with narcolepsy stay awake during the day. However, it is important to caution Bryce that he still needs to prioritize getting adequate restorative sleep even though he is taking modafinil. While the medication can help him stay awake during the day, it will not necessarily improve the quality of his nighttime sleep. Adequate restorative sleep is important for overall health and well-being.

Answer: B
 Modafinil is a stimulant medication that has a high potential for abuse and dependence. It is a Schedule IV controlled substance, which means that it has a lower potential for abuse than Schedule II substances like amphetamines. However, it is still important to caution Bryce about the risks of abuse and dependence associated with taking modafinil.

Answer: D
 Paradoxical weight gain is not a known side effect of modafinil. Therefore, it is not necessary to caution Bryce about this potential side effect.

Therefore, the best choice is A.

Question 2

Pauline is taking an antidepressant that is typically reserved for refractory or atypical depression or those associated with panic disorder or phobias.She is most likely taking a(n) .

Accepted Answer

MAOIs (Monoamine Oxidase Inhibitors) are typically reserved for cases of depression that do not respond to other treatments (refractory depression) or for atypical depression, as well as conditions associated with panic disorder or phobias. They are not the first line of treatment due to their potential side effects and dietary restrictions.

Question 3

Trent's new job requires shift rotation.He has just moved from the 8 A.M.to 4 P.M.shift to the 12 midnight to 8 A.M.shift.What medication might help with the transition?

Accepted Answer

Modafinil is a medication that promotes wakefulness and has been used to treat sleep disorders, such as shift work sleep disorder. It is often prescribed for people who work irregular or rotating shifts and need to stay alert during the night. Methylphenidate, atomoxetine, and lisdexamfetamine are medications used to treat attention deficit hyperactivity disorder (ADHD) and are not typically used for shift work sleep disorder.

Question 4

Spencer is taking a tricyclic antidepressant and complains of a dry mouth,drowsiness,and urinary retention.What property of tricyclics accounts for these side effects?

Accepted Answer

Tricyclic antidepressants have anticholinergic properties that can cause dry mouth, drowsiness, and urinary retention as side effects.

Question 5

Seven-year-old Grant's family and physician are considering pharmacologic treatment of his ADHD with one of the amphetamine/methylphenidate formulations.Accordingly,it is particularly important that the physician screen for personal and family history of .

Accepted Answer

It is important to screen for personal and family history of cardiovascular disease before initiating treatment with amphetamine/methylphenidate formulations as they can increase blood pressure and heart rate. Screening for other medical conditions such as hypothyroidism, diabetes, and cancer may also be important, but they are not directly linked to the use of these medications.

Question 6

Marsha is preparing a report on the health effects of alcohol use.She has covered alcohol poisoning and alcoholism.In her section on positive effects,Marsha discusses the inverse association between alcohol consumption and .

Accepted Answer

Moderate alcohol consumption has been associated with a lower risk of coronary heart disease in some studies. This is often referred to as the "French Paradox," where moderate drinkers seem to have lower rates of heart disease despite consuming diets high in saturated fats.

Question 7

Jillian is taking an antidepressant that inhibits the reuptake of both serotonin and norepinephrine.This medication is most likely to be .

Accepted Answer

The medication that inhibits the reuptake of both serotonin and norepinephrine is venlafaxine. A is a tricyclic antidepressant that primarily affects the reuptake of norepinephrine and serotonin, but could also affect other neurotransmitters in the brain. B is a monoamine oxidase inhibitor that mainly affects the breakdown of monoamine neurotransmitters, and is not commonly used as a first-line treatment due to severe side effects and interactions with other medications and diets. D is an antidepressant that selectively inhibits serotonin reuptake, but not norepinephrine.

Question 8

Morris,73 years of age,has been having severe anxiety following the death of his wife.What benzodiazepine is considered to be preferable for older adults because of its relatively short half-life and inactive metabolites?

Accepted Answer

Lorazepam is considered to be preferable for older adults because of its relatively short half-life and inactive metabolites, which means it is less likely to accumulate in the body and cause undesirable side effects or interactions with other medications. Additionally, lorazepam has been shown to be effective in treating anxiety in older adults. Midazolam and diazepam have longer half-lives and are more likely to accumulate in the body, potentially causing adverse effects. Clorazepate has active metabolites, which can also accumulate in older adults and cause side effects or drug interactions.

Question 9

Newborn Giana has sleep apnea.The medication of choice is .

Accepted Answer

Caffeine citrate is the medication of choice for treating newborn sleep apnea as it stimulates the respiratory center in the brain, resulting in increased breathing and better oxygenation. Methylphenidate, pseudoephedrine, and lisdexamfetamine are not indicated for newborn sleep apnea treatment and may have adverse effects.

Question 10

Lata is preparing a report on the abuse of ADHD medications in school settings,and is particularly interested in medications formulated in ways that reduce the risk of abuse.What prodrug should she include?

Accepted Answer

Vyvanse is a prodrug of dextroamphetamine, which means it is inactive until ingested and then metabolized in the body. This formulation reduces the risk of abuse as it cannot be crushed or snorted to achieve a quick high, unlike other ADHD medications like Adderall, which can be abused in this manner. Daytrana is a patch formulation of methylphenidate, which can still be abused by methods like licking the patch or heating it up, and Concerta is an extended-release formulation of methylphenidate that can still be abused by crushing and snorting. Therefore, Vyvanse is the best choice as it has been designed specifically to address the issue of abuse.

Question 11

Roxie is feeling exhausted by the constant demands of work,school,and her family.What is the only over-the- counter drug proven to be safe and effective in fighting fatigue?

Accepted Answer

Caffeine is the only over-the-counter drug proven to be safe and effective in fighting fatigue. Methylphenidate is a prescription drug used to treat ADHD, pseudoephedrine is a decongestant, and modafinil is a prescription drug used to treat narcolepsy and sleep disorders.

Question 12

Franklin is taking an antipsychotic that acts by blocking serotonin receptors and transiently blocking dopamine receptors.What antipsychotic might he be taking?

Accepted Answer

Clozapine is an atypical antipsychotic that acts by blocking serotonin receptors and transiently blocking dopamine receptors. Haloperidol and fluphenazine are typical antipsychotics that primarily block dopamine receptors. Thioridazine is also a typical antipsychotic, but it primarily acts by blocking serotonin receptors.

Question 13

Jaxson has generalized anxiety disorder and his anger often causes serious interpersonal problems.What anxiolytic might be helpful?

Accepted Answer

Buspirone is an anxiolytic medication that is often prescribed for generalized anxiety disorder. Unlike benzodiazepines such as midazolam and lorazepam, it is not sedating or habit-forming, and therefore may be less likely to exacerbate Jaxson's anger issues. Hydroxyzine can also be used to treat anxiety, but may cause sedation and could potentially worsen any anger-related problems.

Question 14

Jenny has severe depression characterized by extreme fatigue,lethargy,and psychomotor retardation.Which heterocyclic antidepressant would be most effective with these symptoms?

Accepted Answer

Bupropion is known for its stimulating effects, which can help alleviate symptoms of fatigue and lethargy associated with depression.

Question 15

Adrian's mother and father have personal and family histories of drug addiction.Therefore,Adrian's mother asks whether there are any nonstimulant medications that can be used to treat his ADHD.What drug might be suggested?

Accepted Answer

Atomoxetine is a nonstimulant medication used to treat ADHD. Given the family history of drug addiction, choosing a nonstimulant medication reduces the risk of potential addiction and abuse.

Question 16

Halle is taking an antipsychotic that may cause her to experience extrapyramidal side effects because it blocks dopamine receptors and unbalances cholinergic activities.What antipsychotic might she be taking?

Accepted Answer

Chlorpromazine is a typical antipsychotic known to block dopamine receptors, which can lead to extrapyramidal side effects due to the imbalance in cholinergic activity.

Question 17

The Black Box warning that must be included on all antidepressants notes the increased risk of .

Accepted Answer

The Black Box warning on all antidepressants notes the increased risk of suicidal thinking and behavior in children and adolescents.

Question 18

Andie is taking an antidepressant and has been told that there are a number of foods and herbal preparations she must avoid because of potentially dangerous side effects.What type of antidepressant is she likely to be taking?

Accepted Answer

Andie is likely taking a MAOI (Monoamine Oxidase Inhibitor). MAOIs can cause dangerous side effects when combined with certain foods and herbal preparations, such as aged cheeses, soy sauce, fermented foods, and St. John's Wort. Tricyclic antidepressants can also have some dietary restrictions, but not to the same extent as MAOIs. SNRIs and SSRIs typically do not have dietary restrictions.

Question 19

Fifteen-year-old Adan has major depressive disorder.Which antidepressant is recommended for treating major depressive disorder in adolescents?

Accepted Answer

Escitalopram is a selective serotonin reuptake inhibitor (SSRI) antidepressant that has been shown to be effective and safe in the treatment of major depressive disorder in adolescents. Amitriptyline and doxepin, which are tricyclic antidepressants, and isocarboxazid, which is a monoamine oxidase inhibitor, are not typically used as first-line treatments in adolescents due to their potential side effects and risk for drug interactions.

Question 20

Patrick,who has bipolar disorder,has a history of serious suicide attempts.What mood stabilizer is successful in reducing suicide rates in persons with bipolar disorder?

Accepted Answer

Lithium has been shown in several studies to reduce the risk of suicide in individuals with bipolar disorder, particularly in those with a history of attempted suicide. Carbamazepine and valproate may also have some anti-suicidal effects in bipolar disorder, but the evidence is less consistent. Olanzapine has not been shown to reliably reduce suicide rates in bipolar disorder.

Quiz 20: Psychotropic Medications, Alcohol, and Drug Abuse