CNS Drugs

Topics in this chapter

• CNS Drug Pharmacology
• Antiepileptic Drugs
• Antipsychotic Drugs
• Antidepressants and Serotonin
• Anxiolytics and Sedative-Hypnotics
• Mood Stabilizers and Lithium
• Parkinson Disease Drugs
• Anesthetics and Malignant Hyperthermia

Practice questions

1. Question 1Q-7FD645

   A 35-year-old male with treatment-resistant schizophrenia is started on clozapine. Which of the following life-threatening adverse effects requires mandatory weekly blood monitoring during the first 18 weeks of therapy?

   1. A.Agranulocytosis
   2. B.Torsades de pointes
   3. C.Hepatotoxicity
   4. D.Pulmonary fibrosis
   See the answer and solution
2. Question 2Q-2C4120

   A 65-year-old man with Parkinson disease is managed with levodopa/carbidopa. To reduce peripheral adverse effects such as nausea and orthostatic hypotension while preventing peripheral conversion of levodopa to dopamine, carbidopa is co-administered. Which enzyme does carbidopa specifically inhibit?

   1. A.Monoamine oxidase B
   2. B.Catechol-O-methyltransferase
   3. C.Aromatic L-amino acid decarboxylase
   4. D.Tyrosine hydroxylase
   See the answer and solution
3. Question 3Q-C81809

   A patient with generalized anxiety disorder is prescribed buspirone. Unlike benzodiazepines, buspirone lacks sedative, hypnotic, anticonvulsant, and muscle-relaxant properties. What is the primary mechanism of action of buspirone?

   1. A.Positive allosteric modulator at the GABA-A receptor
   2. B.Partial agonist at the 5-HT1A receptor
   3. C.Selective serotonin reuptake inhibitor
   4. D.Antagonist at central dopamine D2 receptors
   See the answer and solution
4. Question 4Q-742A35

   An epileptic patient maintained on phenytoin develops acute cerebellar ataxia, nystagmus, and diplopia. Serum drug level is found to be significantly elevated. Which kinetic profile best explains why a small increment in the phenytoin dose can lead to a disproportionately large, toxic increase in serum concentration?

   1. A.Zero-order elimination kinetics
   2. B.First-order elimination kinetics
   3. C.Renal tubular secretion saturation
   4. D.Rapid induction of hepatic CYP3A4
   See the answer and solution
5. Question 5Q-F5685C

   A 28-year-old woman with a history of bipolar disorder presents to the emergency department with coarse tremors, hyperreflexia, ataxia, and confusion. She recently started a new antihypertensive medication for mild blood pressure elevation. Which of the following drugs is most likely to have precipitated lithium toxicity?

   1. A.Amlodipine
   2. B.Hydrochlorothiazide
   3. C.Metoprolol
   4. D.Hydralazine
   See the answer and solution