PART VII Antipsychotic agents
01. Neuroleptics are used to treat:
a) Neurosis
b) Psychosis
c) Narcolepsy
d) Parkinsonian disorders
02. Most antipsychotic drugs:
a) Strongly block postsynaptic d2receptor
b) Stimulate postsynaptic D2 receptor
c) Block NMDA receptor
d) Stimulate 5-HT2 receptor
03. Which of the following dopaminergic systems is most closely related to behavior?
a) The hypothalamic-pituitary system
b) The extrapyramidal system
c) The mesolimbic and mesofrontal systems
d) The chemoreceptor trigger zone of the medulla
04. Hyperprolactinemia is caused by blockade of dopamine in:
a) The chemoreceptor trigger zone of the medulla
b) The pituitary
c) The extrapiramidal system
d) The mesolimbic and mesofrontal systems
05. Parkinsonian symptoms and tarditive dyskinesia are caused by blockade dopamine in:
a) The nigrostriatal system
b) The mesolimbic and mesofrontal systems
c) The chemoreceptor trigger zone of the medulla
d) The tuberoinfundibular system
06. Extrapyramidal reactions can be treated by:
a) Levodopa
b) Benztropine mesylate
c) Bromocriptine
d) Dopamine
07. Which of the following statements is true?
a) D1 postsynaptic receptors are located in striatum
b) D2 pre- and postsynaptic receptors are located in striatum and limbic areas
c) D4 postsynaptic receptors are located in frontal cortex, mesolimbic system
d) All of the above
08. Which of the following antipsychotic drugs is typical?
a) Clozapine
b) Quetiapine
c) Haloperidol
d) Olanzapine
09. Indicate the atypical antipsychotic drug:
a) Haloperidol
b) Clozapine
c) Thioridazine
d) Thiothixene
10. Atypical antipsychotic agents (such as clozapine) differ from typical ones:
a) In reduced risks of extrapyramidal system dysfunction and tardive dyscinesia
b) In having low affinity for D1 and D2 dopamine receptors
c) In having high affinity for D4 dopamine receptors
d) All of the above
11. Tardive dyskinesia is the result of:
a) Degeneration of dopaminergic and cholinergic fibers
b) Hyperactive dopaminergic state in the presence of dopamine blockers
c) Degeneration of histaminergic fibers
d) Supersensitivity of cholinergic receptors in the caudate-putamen
12. Which of the following antipsychotic drugs has high affinity for D4 and 5-HT2 receptors?
a) Clozapine
b) Fluphenazine
c) Thioridazine
d) Haloperidole
13. Indicate the antipsychotic drug, which is a phenothiazine aliphatic derivative:
a) Thiothixene
b) Risperidone
c) Chlorpromazine
d) Clozapine
14. Indicate the antipsychotic drug, which is a butyrophenone derivative:
a) Droperidol
b) Thioridazine
c) Sertindole
d) Fluphenazine
15. Indicate the antipsychotic drug, which is a thioxanthene derivative:
a) Haloperidol
b) Clozapine
c) Chlorpromazine
d) Thiothixene
16. Indicate the antipsychotic agent – a dibenzodiazepine derivative:
a) Fluphenazine
b) Clozapine
c) Risperidone
d) Droperidol
17. The strong antiemetic effect of the phenothiazine derivatives is due to dopamine receptor blockade:
a) In the chemoreceptor trigger zone of the medulla
b) Of the receptors in the stomach
c) The medullar vomiting centre
d) All of the above
18. Phenothiazine derivatives are able to:
a) Alter temperature-regulating mechanisms producing hypothermia
b) Decrease levels of prolactin
c) Increase corticotrophin release and secretion of pituitary growth hormone
d) Decrease appetite and weight
19. Most phenothiazine derivatives have:
a) Antihistaminic activity
b) Anticholinergic activity
c) Antidopaminergic activity
d) All of the above
20. Indicate the antipsychotic drug having significant peripheral alpha-adrenergic blocking activity:
a) Haloperidol
b) Chlorpromazine
c) Clozapine
d) Risperidone
21. Indicate the antipsychotic drug having a muscarinic-cholinergic blocking activity:
a) Chlorpromazine
b) Clorprothixene
c) Risperidone
d) Haloperidol
22. Indicate the antipsychotic drug having H1-antihistaminic activity:
a) Clozapine
b) Chlorpromazine
c) Olanzapine
d) All of the above
23. Parkinson′s syndrome, acute dystonic reactions, tardive dyskinesia, antimuscarinic actions, orthostatic hypotension, galactorrhea are possible adverse effects of:
a) Haloperidol
b) Clozapine
c) Chlorpromazine
d) Risperidone
24. Orthostatic hypotension can occur as a result of:
a) The central action of phenothiazines
b) Inhibition of norepinephrine uptake mechanisms
c) Alpha adrenoreceptor blockade
d) All of the above
25. Adverse peripheral effects, such as loss of accommodation, dry mouth, tachycardia, urinary retention, constipation are related to:
a) Alpha adrenoreceptor blockade
b) Muscarinic cholinoreceptor blockade
c) Supersesitivity of the dopamine receptor
d) Dopamine receptor blockade
26. Which of the following phenothiazine derivatives is a potent local anesthetic?
a) Fluphenazine
b) Thioridazine
c) Chlorpromazine
d) None of the above
27. Which of the following phenothiazine derivatives may produce cardiac toxicity, including ventricular arrhythmias, cardiac conduction block, and sudden death?
a) Thioridazine
b) Chlorpromazine
c) Perphenazine
d) Fluphenazine
28. Which of the following antipsychotic agents is preferable in patients with coronary and cerebrovascular disease?
a) Chlorpromazine
b) Fluphenazine
c) Haloperidol
d) Perphenazine
29. Which of the following antipsychotic agents is used in combination with an opioid drug fentanyl in neuroleptanalgesia?
a) Haloperidol
b) Droperidol
c) Chlorpromazine
d) Clozapine
30. The mechanism of haloperidol antipsychotic action is:
a) Blocking D2 receptors
b) Central alpha-adrenergic blocking
c) Inhibition of norepinephrine uptake mechanisms
d) All of the above
31. Which of the following statements is correct for clozapine?
a) Has potent anticholinergic activity
b) Has high affinity for D1 and D2 dopamine receptors
c) Produces significant extrapyramidal toxicity
d) Is related to typical antipsychotic agents
32. Which of the following antipsychotic drugs has the high risk of potentially fatal agranulocytosis and risk of seizures at high doses?
a) Haloperidol
b) Risperidone
c) Clozapine
d) Chlorpromazine
33. Which of the following antipsychotic drugs has high affinity for D2 and 5-HT2 receptors?
a) Droperidol
b) Clozapine
c) Thiothixene
d) Risperidone
34. Lithium carbonate is useful in the treatment of:
a) Petit mal seizures
b) Bipolar disorder
c) Neurosis
d) Trigeminal neuralgia
35. The drug of choice for manic-depressive psychosis is:
a) Imipramine
b) Chlordiazepoxide
c) Isocarboxazid
d) Lithium carbonate
36. The lithium mode of action is:
a) Effect on electrolytes and ion transport
b) Effect on neurotransmitters
c) Effect on second messengers
d) All of the above
37. Which of the following statements is correct for lithium?
a) Stimulate dopamine and beta-adrenergic receptors
b) Decrease catecholamine-related activity
c) Stimulate the development of dopamine receptor supersensitivity
d) Decrease cholinergic activity
38. Which of the following adverse effects is associated with lithium treatment?
a) Cardiovascular anomalies in the newborn
b) Thyroid enlargement
c) Nephrogenic diabetes insipidus
d) All of the above
