Pharm - Neuroleptics (Antipsychotic Drugs)
Antipsychotics are a group of drugs that are used to treat serious mental health conditions such as psychosis as well as other emotional and mental conditions. These medicines have some serious side effect when not taken according to the prescription and should be carefully administered. Take this quiz on Neuroleptics and test how good you are at prescriptions.
- 1.Directions: questions 1-3 Match each neuroleptic drug with the appropriate description (each lettered option can be selected once, more than once, or not at all): This drug has a high affinity for D4 receptors
- A.
Aripiprazole
- B.
Chlorpromazine
- C.
Clozapine
- D.
Fluphenazine
- E.
Haloperidol
- F.
Olanzapine
- G.
Qietapine
- H.
Risperidone
- I.
Thioridazine
- J.
Thiotixene
- 2.Directions: questions 1-3 Match each neuroleptic drug with the appropriate description (each lettered option can be selected once, more than once, or not at all): This drug is a phenothiazine with high risk of extrapyramidal adverse effects
- A.
Aripiprazole
- B.
Chlorpromazine
- C.
Clozapine
- D.
Fluphenazine
- E.
Haloperidol
- F.
Olanzapine
- G.
Qietapine
- H.
Risperidone
- I.
Thioridazine
- J.
Thiotixene
- 3.Directions: questions 1-3 Match each neuroleptic drug with the appropriate description (each lettered option can be selected once, more than once, or not at all): This drug can cause sialorrhea in up to 70% of patients
- A.
Aripiprazole
- B.
Chlorpromazine
- C.
Clozapine
- D.
Fluphenazine
- E.
Haloperidol
- F.
Olanzapine
- G.
Qietapine
- H.
Risperidone
- I.
Thioridazine
- J.
Thiotixene
- 4.A 44-year-old woman was admitted to the psychiatric hospital for the sixth time since the age of 32. She was confuse and threatening, saying “the voices are back”. The woman had received an antipsychotic therapy for several years but she stopped her medications one month prior to this admission. Physical examination showed involuntary, abnormal movements manifested by tongue protrusion, frequent blinking and continuous writhing of harms and legs. This syndrome was most likely due to a drug-induced primary dysfunction in which of the following brain regions?
- A.
Frontal cortex
- B.
Vestibular nuclei
- C.
Mesolimbic pathway
- D.
Striatum
- E.
Tuberoinfundibular pathway
- F.
Cerebellum
- 5.A 28-year-old man recently diagnosed with paranoid schizophrenia, started a treatment with aripiprazole, one tablet daily. The therapeutic effect of this drug was most likely mediated by blockade of dopaminergic transmission in which of the following brain structures?
- A.
Tuberoinfundibular system
- B.
Locus ceruleus
- C.
Mesolimbic mesocortical systems
- D.
Corticostriatal system
- E.
Nucleus basalis of Meynert
- 6.A 65-year-old woman was admitted to the psychiatric hospital because of the appearance of involuntary movements including tongue protrusion, frequent blinking, facial grimacing and writhing movements of her legs. The woman was diagnosed with chronic paranoid schizophrenia 10 years previously and had taken several antipsychotic drugs since then. Present medication included fluphenazine, two tablet daily. Which of the following molecular actions most likely mediated the adverse effect of the drug in the patient’s disease?
- A.
Up-regulation of D2 receptors in the tuberoinfundibular system
- B.
Down-regulation of D2 receptors in the mesolimbic pathways
- C.
Up-regulation of GABAergic receptors in basal ganglia
- D.
Down-regulation of cholinergic receptors in the neocortex
- E.
Up-regulation of D2 receptors in caudate-putamen
- 7.A 82-year-old man, resident in a nursing facility, presented with a complete urinary retention. The man had a long history of hypertension and prostatic hyperplasia and was presently treated with hydrochlorothiazide, captopril, and prazosin. Two days ago he became agitated and hostile, refused to cooperate and tried to assault other residents. He received 50 mg of chlorpromazine IM and a second injection eight hours later. Which of the following would be the most likely explanation of his urinary retention?
- A.
Decreased diuresis due to chlorpromazine
- B.
Chlorpromazine-induced relaxation of the detrusor muscle
- C.
Decreased diuresis due to captopril
- D.
Prazosin-induced relaxation of the bladder’s sphincter
- E.
Prazosin-induced relaxation the prostate capsule
- 8.A 37-year-old man complained of dry mouth, constipation and blurred vison while reading the newspaper. The man, recently diagnosed with a schizoid disorder, started a treatment with clozapine two weeks ago. The blockade of which of the following receptors most likely mediated the adverse effects the patient was suffering from?
- A.
5-HT 2
- B.
Alpha-1
- C.
H1
- D.
Nm
- E.
M3
- 9.A 60-year-old man complained to his physician of obstinate constipation. The man recently diagnosed with a schizoaffective disorder, started a treatment with olanzapine, two tablet daily. The blockade of which of the following pairs of receptors most likely mediated the adverse effect of the drug?
- A.
Nicotinic and dopaminergic
- B.
GABAergic and muscarinic
- C.
Nicotinic and alpha-1
- D.
Dopaminergic and alpha-1
- E.
Muscarinic and 5-HT2
- 10.A 24-year-old woman complained to her physician of amenorrhea of two months duration and of a white discharge from her breast during the past week. The woman had been on haloperidol and paroxetine for three months to treat a schizoaffective disorder. She was medication compliant and her illness was well controlled. Which of the following mechanisms was most likely responsible for the patient’s symptoms?
- A.
Blockade of nicotinic receptors in the tuberoinfundibular pathway
- B.
Blockade of serotonin reuptake in the median raphe
- C.
Activation of cholinergic pathways in the striatum
- D.
Blockade of dopamine receptors in the pituitary
- E.
Activation of adrenergic receptors in the locus ceruleus
- 11.A new potential neuroleptic drug was given IV to a healthy volunteer during a phase I clinical trial. It was known that the drug had significant blocking activity on D2, H1 And 5-HT2A receptors. The subject was asked about the subjective symptoms he felt during the experiment. Which of the following pairs of mental effects were most likely reported by the subject?
- A.
Euphoria, increased self confidence
- B.
Increased alertness, rapid flow of thought
- C.
Dysphoria, sleepiness
- D.
Irritability, restlessness
- E.
Delusions, perseveration
- 12.A 17-year-old boy complained of a stiff neck and a protruding tongue on day two of the admission to the psychiatric emergency room. The patient was brought to the emergency room because of assaultive behavior toward his mother. He struck her after an heavy drinking because he saw that she was about to kill him with a knife. A drug treatment was started to control his assaultive behavior and he received 3 IM injections over 24 hours. Which of the following drugs most likely caused the patient’s symptoms?
- A.
Haloperidol
- B.
Lorazepam
- C.
Chlorpromazine
- D.
The large dose of ethanol
- E.
Thioridazine
- F.
Clozapine
- 13.A 30-year-old man, recently diagnosed with paranoid schizophrenia, became increasingly restless, was unable to sit or lie down for more than few minutes, and referred that he wanted “to jump out of my skin”. Two week ago the patient had started a therapy with fluphenazine, one tablet daily. Which of the following disorders was the patient most likely suffering from?
- A.
Acute dystonia
- B.
Complex partial seizure
- C.
Parkinsonism
- D.
Akathisia
- E.
Catalonia
- F.
Tardive dyskinesia
- 14.A 27-year-old man complained of feeling “ real slow”and of a bilateral hand tremor that improved when he picked up his coffee cup. The man suffering from paranoid schizophrenia was currently treated in an outpatient program. Physical examination showed cogwheel rigidity in both harms, a stooped posture and a shuffling gait. Which of the following drugs most likely caused the adverse effects the patient was suffering from?
- A.
Clozapine
- B.
Haloperidol
- C.
Chlorpromazine
- D.
Olanzapine
- E.
Thioridazine
- 15.A 42-year-old woman was brought to the emergency room with increased agitation and confusion. Physical examination revealed temperature of 104° F, pulse of 125 bpm, labile blood pressure, profuse diaphoresis, sialorrhea and muscle rigidity. The woman, recently diagnosed from a schizoaffective disorder, had started a therapy few days previously. Which of the following drugs most likely caused the patient’s syndrome?
- A.
Imipramine
- B.
Temazepam
- C.
Haloperidol
- D.
Fluoxetine
- E.
Lithium
- 16.A-46-year-old woman complained to her physician that recently her arms began to writhe continuously, her mouth to pucker involuntarily and her eyes to blink frequently. The woman had been suffering from a psychiatric disorder for three years and had been under high dose psychotropic treatment for two years. Which of the following drugs most likely caused the patient’s symptoms?
- A.
Clozapine
- B.
Lithium
- C.
Olanzapine
- D.
Amitriptyline
- E.
Fluoxetine
- F.
Haloperidol
- 17.A 35-year-old woman, found unconscious in a park in a hot summer, was brought to the hospital. The woman, who had been a resident in a psychiatric unit for the past two years due to a chronic mental disorder, had recently shown improvement in her target symptoms and enjoyed outside privileges. She had left the ward for jogging two hour before being found in the park. Her rectal temperature was 106 °F and a diagnosis of heat stroke was made. Which of the following drugs most likely contributed to the appearance of the patient’s stroke?
- A.
Amitriptyline
- B.
Clozapine
- C.
Buspirone
- D.
Diazepam
- E.
Lithium
- F.
Fluoxetine
- 18.A 62-year-old schizophrenic woman was hospitalized because of palpitation and light-headedness of 2 hours duration. Physical examination showed a patient in moderate distress with the following vital signs: blood pressure 110/85 mm Hg, hear rate 158 bpm, respiration 20 breaths/min. An ECG disclosed polymorphic ventricular tachycardia. Upon questioning the patient admitted she had recently increased the dosage of her prescribed psychotropic drug because of her augmenting agitation. Which of the following drugs most likely caused the patient’s symptoms and signs?
- A.
Trazodone
- B.
Thioridazine
- C.
Amitriptyline
- D.
Paroxetine
- E.
Lithium
- F.
Lorazepam
- 19.A 51-year-old woman, resident in a psychiatric unit, complained about feeling dizzy to the point of fainting upon standing up rapidly. The patient was hospitalized because in the last three months she became increasingly agitated and afraid. She was convinced that people near her house were devils, plotting about stealing her money and cutting her throat. The patient started a psychotropic medication two week previously. Which of the following drugs most likely caused the patient’s symptoms?
- A.
Haloperidol
- B.
Risperidone
- C.
Amitriptyline
- D.
Buspirone
- E.
Lithium
- F.
Trazodone
- 20.A 34-year-old woman complained to his physician that during intercourse erection was difficult to achieve and ejaculation was delayed. The man, recently diagnosed with paranoid schizophrenia, was treated initially with haloperidol but he was switched to another drug because of the appearance of symptoms of pseudoparkinsonism. Which of the following drugs most likely caused the patient’s symptoms?
- A.
Fluphenazine
- B.
Amitriptyline
- C.
Paroxetine
- D.
Thioridazine
- E.
Fluoxetine
- F.
Trazodone
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