Test name: Pharmacology Final MCQ

This Test is worth: 108 points

Question 1 of 108

Which one of the following combinations of antiparkinsonian drugs is an appropriate

treatment plan?

A) Amantadine, carbidopa, and entacapone.

B) Ropinirole, carbidopa, and selegiline.
C) Levodopa, carbidopa and entacapone.
D) Ropinirole, selegiline, and entacapone.
E) Pramipexole, carbidopa, and entacapone.

Question 2 of 108

Peripheral adverse effects of levodopa, including nausea, hypotension, and cardiac

arrhythmias, can be diminished by including which of the following drugs in the
therapy?

A) Amantadine
B) Pramipexole
C) Carbidopa
D) Ropinirole
E) Tolcapone

Question 3 of 108

Which of the following drugs may produce hepatotoxicity, therefore is used only in
patients that do not respond to other therapies?

A) Tolcapone
B) Entacapone
C) Pramipexole
D) Bromocriptine
E) Carbidopa

Question 4 of 108

Each of the following statements about tolcapone is true EXCEPT:

 A) Both centrally and peripherally acting.
B) Has an antiparkinsonian effect by itself.
C) It has a long duration of action.
D) Patients receiving it require liver enzymes monitoring.

Question 5 of 108

Which of the following alleviates the peripheral symptoms of Levodopa?

A) Domperidone
B) Carbidopa
C) Clozapine
D) Selegiline
E) Both A and B

Question 6 of 108

Which of the following drugs is used to treat hallucinations and psychotic symptoms of
levodopa?

A) Clozapine
B) Diphenhydramine
C) Dompreidone
D) Selegiline
E) Meperidine

Question 7 of 108

The main reason for giving levodopa, the precursor of dopamine, instead of dopamine
is:

A) Dopamine does not cross the blood-brain barrier

B) Dopamine may induce acute psychotic reactions
C) Dopamine is intensively metabolized in humans
D) All of the above

Question 8 of 108

Which of the following agents is the most helpful in counteracting the behavioral
complications of levodopa?

A) Tolcapone
 B) Pergolide
C) Clozapine
D) Carbidopa

Question 9 of 108

Which of the following drugs antagonizes the effects of levodopa because it leads to
a junctional blockade of dopamine action?

A) Reserpine
B) Haloperidol
C) Chlorpromazine
D) All of the above

Question 10 of 108

Which of the following antiparkinsonism drugs is an anticholinergic agent?

A) Amantadine
B) Bromocriptine
C) Trihexyphenidyl
D) Selegiline

Question 11 of 108

Mental confusion and hallucinations, peripheral atropine-like toxicity (e.g. Cycloplegia,

tachycardia, urinary retention, and constipation) are possible adverse effects of:

A) selegiline
B) Benztropine
C) Tolcapone
D) Bromocriptine

Question 12 of 108

A 62-year-old man complained to his physician of facial grimacing, lip smacking, and
rocking of the trunk that occurred 1 to 2 hours after taking his prescribed medication.
The man, who suffered from Parkinson disease, had been receiving an antiparkinson
drug for 3 years. Which of the following drugs most likely caused the adverse effects
reported by the patient?

A) Amantadine
B) Levodopa
C) Selegiline
 D) Benztropine
E) Entacapone

Question 13 of 108

A 75-year-old diabetic man with Parkinson disease complained of worsening of his

tremor and rigidity in his arms and legs. His Parkinson disease had been responding
well to a treatment with levodopa/carbidopa and amantadine, and his diabetes had
been controlled by glyburide and metformin. Recently, metoclopramide was
prescribed to manage diabetic gastroparesis. Which of the following drugs could have
triggered the worsening of symptoms reported by the patient?

A) Metformin
B) Glyburide
C) Amantadine
D) Carbidopa
E) Metoclopramide

Question 14 of 108

A 53-year-old man complained to his physician of persistent and annoying salivation.

The man, recently diagnosed with Parkinson disease, had started treatment with
levodopa/ carbidopa that significantly improved his motor symptoms. The physician
decided to include another drug in the treatment. Which of the following drugs would
be appropriate to add to the therapy at this time?

A) Entacapone
B) Selegiline
C) Pramipexole
D) Pergolide
E) Benztropine

Question 15 of 108

A 63-year-old woman with Parkinson disease had been maintained on

levodopa/carbidopa with adjunctive use of a drug that acts by reducing central
dopamine metabolism. Which of the following drugs was most likely the adjunctive
drug?

A) Benztropine
B) Pramipexole
C) Levodopa
D) Selegiline

Question 16 of 108
A 45-year-old woman complained of blurred vision, dry mouth, palpitations, and
constipation. The patient was diagnosed with Parkinson disease 4 months earlier and
had been receiving a levodopa/carbidopa combination since then. Recently, her
neurologist added a drug to the therapeutic regimen because of an increase in the
patient’s resting tremor. Which of the following drugs most likely caused the patient’s
symptoms?

A) Benztropine
B) Amantadine
C) Carbidopa
D) Pramipexole
E) Selegiline

Question 17 of 108

A 52-year-old woman with a long history of Parkinson disease had been receiving
levodopa/carbidopa. Which of the following adverse effects of levodopa were most
likely reduced by adding carbidopa to the treatment?

A) Visual hallucinations
B) Dyskinesias
C) Cardiac arrhythmias
D) Nightmares
E) Mood changes

Question 18 of 108

A 65-year-old man complained to his physician that recently he felt increasingly

confused at times, often had vivid dreams, and sometimes saw strange objects
floating in the air. The patient, suffering from Parkinson disease, had been receiving
levodopa/carbidopa for 1 year, and his disease was well controlled. Which of the
following actions could be implemented to reduce the occurrence of the adverse
effects being experienced by the patient?

A) Add clozapine to the present regimen.

B) Add amantadine to the present regimen.
C) Substitute levodopa with selegiline.
D) Add benztropine to the present regimen.
E) Substitute levodopa with pramipexole.

Question 19 of 108

A 53-year-old woman presented to her physician complaining of a unilateral resting

tremor and slowing down of all movements. Her medical history was significant for
two schizophrenic episodes in her late 40s that were successfully treated with
haloperidol. On examination she showed cogwheel rigidity. A presumptive diagnosis
of parkinsonism was made. Which of the following drugs would be contraindicated for
this patient?

A) Entacapone
B) Benztropine
C) Amantadine
D) Pramipexole
E) Carbidopa

Question 20 of 108

A 62-year-old woman with Parkinson disease had been receiving levodopa/carbidopa

combination therapy. Coadministration of which of the following drugs would most
likely increase the availability of levodopa in the patient’s brain?

A) Bromocriptine
B) Entacapone
C) Haloperidol
D) Pramipexole
E) Benztropine

Question 21 of 108

Which of the following side effects is largely cased by new-generation antipsychotics?

A) None of the above

B) Akathesia
C) Tardive dyskinesia
D) Dystonia

Question 22 of 108

Which of the following side effects is mainly caused by old generation antipsychotics
after several years and could be irreversible?

A) Tardive dyskinesia
B) Dystonia
C) Tremor
D) Akathesia
E) None of the above

Question 23 of 108
Which of the following drugs is used for refractory schizophrenic cases and causes
excessive salivation?

A) Imipramine
B) Lithium carbonate
C) Clozapine
D) Olanzapine
E) Chlorpromazine

Question 24 of 108

Parkinsonian symptoms and tardive dyskinesia are caused by blockade dopamine in:

A) The tuberoinfundibular system

B) The nigrostriatal system
C) The chemoreceptor trigger zone of the medulla
D) The mesolimbic and mesofrontal systems

Question 25 of 108

Which of the following antipsychotic drugs has a high risk of potentially fatal
agranulocytosis and risk of seizures at high doses?

A) Haloperidol
B) Risperidone
C) Chlorpromazine
D) Clozapine

Question 26 of 108

A 72-year-old woman with Parkinson’s disease is taking a medication that increases

the release of dopamine, blockade of cholinergic receptors, and inhibiting the N-
methyl-d-aspartate receptor. This describes which of the following agents?

A) Amantadine
B) Tolcapone
C) Bromocriptine
D) Rotigotine
E) Pramipexole

Question 27 of 108

All of the following are observed in patients taking neuroleptic agents EXCEPT:
 A) constipation.
B) sexual dysfunction.
C) altered endocrine function.
D) orthostatic hypotension.
E) increased blood pressure.

Question 28 of 108

The neuroleptic drugs:

A) bind selectively to D2 receptors.

B) have antiparkinsonism effects similar to levodopa.
C) are equally effective against the positive and nega- tive symptoms of
schizophrenia.
D) can cause blurred vision, urinary retention and other signs of muscarinic
blockade.
E) have a rapid onset of antipsychotic action.

Question 29 of 108

All of the following statements about the extrapyramidal effects of neuroleptics are
correct EXCEPT

A) They can be countered to some degree by antimuscarinic drugs.

B) Neuroleptics may cause tardive dyskinesia.
C) They are less likely to be produced by clozapine than by fluphenazine.
D) Haloperidol does not cause extrapyramidal disturbances.
E) They are caused by blockade of dopamine receptors.

Question 30 of 108

All of the following antipsychotic drugs block H1 receptor EXCEPT

A) Risperidone
B) Olanzapine
C) Haloperidol
D) Clozapine
E) Chlorpromazine

Question 31 of 108

Acute dystonia can be controlled by:

 A) Benztropine
B) Trihexyphenidyl
C) Diphenhydramine
D) Biperiden
E) All of the above

Question 32 of 108

The following adverse effect of levodopa is not minimized by combining it with

carbidopa:

A) ‘On-off ’ effect
B) Cardiac arrhythmia
C) Involuntary movements
D) Nausea and vomiting

Question 33 of 108

Entacapone differs from tolcapone in the following respect/respects:

A) It is shorter acting
B) It acts only by inhibiting peripheral metabolism of levodopa
C) It is not hepatotoxic
D) All of the above are correct

Question 34 of 108

Which of the following adverse effects of neuroleptic drugs is positively correlated to

the antipsychotic potency of the different compounds:

A) Postural hypotension
B) Extrapyramidal motor disturbances
C) Lowering of seizure threshold
D) Sedation

Question 35 of 108

The following action of chlorpromazine is not based on its antidopaminergic property:

A) Antipsychotic
B) Hypotensive
C) Hyperprolactinemic
 D) Antiemetic

Question 36 of 108

The major limitation in the use of clozapine for the treatment of schizophrenia is:

A) Its inability to benefit negative symptoms of schizophrenia

B) Production of hyperprolactinemia
C) High incidence of extrapyramidal side effects
D) Its potential to cause agranulocytosis

Question 37 of 108

The following side effect of typical neuroleptics may respond to propranolol:

A) Tardive dyskinesia
B) Akathisia
C) Parkinsonism
D) Acute muscle dystonia

Question 38 of 108

The extrapyramidal adverse effect of antipsychotic drug therapy which does not
respond to central anticholinergics is:

A) Akathisia
B) Tardive dyskinesia
C) Parkinsonism
D) Acute muscle dystonia

Question 39 of 108

A 34-year-old woman recently diagnosed with undifferentiated schizophrenia started

treatment with haloperidol. Which of the patient’s presenting symptoms was most
likely best controlled after 1 week of therapy?

A) Affective flattening
B) Social withdrawal
C) Low energy
D) Lack of emotion
E) Persecutory delusions

Question 40 of 108
A 39-year-old man, a resident in a psychiatric unit because of disorganized
schizophrenia, presented with profound lack of motivation, remarkably blunted affect,
paucity of speech, and psychomotor retardation. He had been hospitalized three
times since his diagnosis, and had been treated with haloperidol, chlorpromazine, and
risperidone but had only a partial response to each medication. Which of the following
psychotropic drugs would be most appropriate to try at this stage?

A) Thioridazine
B) Lithium
C) Fluoxetine
D) Fluphenazine
E) Clozapine

Question 41 of 108

A 41-year-old man was admitted to a psychiatric hospital because of worsening of his

psychosis. The man was recently diagnosed with paranoid schizophrenia and had
been treated with risperidone and aripiprazole without success. A new treatment was
started. One week later, a blood test gave the following results:
• White blood cell count: 1200/mm3 (normal 4500−11,000/ mm3)
• Neutrophils 12% (normal 54−62%)
• Red blood cell count: 4.3 million/mm3 (normal 4.0−5.5 million/mm3)
• Platelet count: 145,000/mm3 (normal 150,000−400,000/ mm3)
• Hemoglobin (Hb): 15 g/dL (normal >12 g/dL)
Which of the following drugs did the patient most likely receive as the new treatment?

A) Chlorpromazine
B) Fluphenazine
C) Haloperidol
D) Risperidone
E) Clozapine

Question 42 of 108

A 27-year-old man complained to his physician 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 arms, stooped posture, and a shuffling
gait. Which of the following drugs most likely caused these adverse effects?

A) Clozapine
B) Aripiprazole
C) Haloperidol
D) Metoclopramide
E) Olanzapine
Question 43 of 108

Which of the following drugs improves the negative symptoms of schizophrenia?

A) Haloperidol
B) Trifluoperazine
C) Chlorpromazine
D) Risperidone

Question 44 of 108

Nausea and vomiting induced by L-dopa can be reduced by coadministration of:

A) Domperidone
B) Bromocriptine
C) Selegiline
D) Risperidone

Question 45 of 108

A young woman recently diagnosed as schizophrenic develops severe muscle

cramps with torticollis a short time after drug therapy is initiated with haloperidol. The
best course of action would be to

A) Discontinue haloperidol and observe the patient

B) Inject benztropine
C) Switch the patient to fluphenazine
D) Add risperidone to the drug regimen
E) Give oral diphenhydramine

Question 46 of 108

Which one of the following is an appropriate therapeutic use for imipramine?

A) Insomnia
B) Mania
C) Glaucoma
D) Epilepsy
E) Bed-wetting in children

Question 47 of 108
Which of the following is common to the tricyclic antidepressants and MA0 inhibitors?

A) They can produce sedation.

B) They show strong interaction with certain foods.
C) They can produce postural hypotension.
D) They decrease the availability of epinephrine and serotonin in the synaptic
cleft.
E) They produce physical dependence.

Question 48 of 108

Which of the following isn't an adverse effect of TCAs

A) Weight gain
B) Hypertension
C) Constipation
D) Dry mouth
E) Arrhythmia

Question 49 of 108

A 34-year-old male patient who was prescribed citalopram for depression has decided
he wants to stop taking this drug. When he asked, he said that it was affecting his
sexual performance. You ascertain that he is also trying to overcome his dependency
on tobacco products. If you decide to reinstitute therapy in this patient. The best
choice would be?

A) Fluoxetine
B) Paroxetine
C) Imipramine
D) Bupropion

Question 50 of 108

When treating patients with Clozapine we must monitor:

A) WBC count
B) RBC count
C) Platelets count
D) All of the above

Question 51 of 108
 An 83-year-old woman with Parkinson’s disease is currently being treated with
carbidopa/levodopa, but her Parkinson’s symptoms are worsening. She has normal
liver function and no history of liver disease. The physician adds tolcapone to her
regimen on tolcapone. How does tolcapone help in Parkinson’s disease?

A) Stimulation of norepinephrine release

B) Increased norepinephrine synthesis
C) Inhibition of MAO
D) Inhibition of COMT
E) Stimulation of acetylcholine release

Question 52 of 108

A 56-year-old man returns for a 6-month follow-up after starting sertraline for the
treatment of depression. Upon questioning, he still has not returned to the activities he
once enjoyed and is still not sleeping or eating well. The psychiatrist recommends
increasing the dose of sertraline, but the patient reluctantly admits that he has not
been taking it because he feels that it causes sexual dysfunction. Which of the
following antidepressants should the physician consider prescribing to avoid this side
effect?

A) Dulmetine
B) Bupropion
C) Citalopram
D) Imipramine
E) Venlafaxine

Question 53 of 108

Which of the following is incorrect regarding Mirtazapine?

A) Has a high likelihood to cause sexual dysfunction

B) It increases appetite and causes weight gain.
C) Lacks antimuscarinic activity
D) It has sedative effect
E) It function by blocking presynaptic alpha2 receptors

Question 54 of 108

Which of the following isn't an adverse effect of TCAs?

A) Arrhythmia
B) Constipation
C) Weight gain
 D) Dry mouth
E) Hypertension

Question 55 of 108

This agent can be used to treat obsessive-compulsive disorder (OCD)

A) Atomoxetine
B) Imipramine

C) Desipramine
D) Fluvoxamine

Question 56 of 108

Which of the following can be used to treat chronic pain?

A) Promethazine
B) Trazadone
C) Prochlorperazine
D) Venlafaxine

Question 57 of 108

Which of the following drug should be avoided in a patient taking Fluoxetine?

A) Quetiapine
B) Bupropion
C) Promethazine
D) Selegiline

Question 58 of 108

A patient suffering from Parkinson disease being treated with Levodopa. He started
suffering from involuntary muscle movements of proximal limbs. Which of the
following is true regarding these symptoms?

A) The symptoms can be reduced by increasing the dose of levodopa

B) The addition of Carbidopa can minimize these symptoms
C) The addition of another drug that activates dopamine receptor will exacerbate
dyskinesias
D) Tolerance to these symptoms will develop with continued treatment with
 levodopa

Question 59 of 108

A patient with Parkinson disease being treated with levodopa/ carbidopa. He started
suffering repeatedly from episodes of no drug effect with marked akinesia for few
hours followed by periods with improved symptoms. The best way to solve this
problem is by:

A) Addition of entacapone
B) Benztropine
C) Increase the dose of carbidopa
D) Addition of Olanzapine

Question 60 of 108

In treating a patient with Parkinson disease and also suffering from benign prostatic
hypertrophy (BPH) we should be cautious regarding the use of:

A) Levodopa/ carbidopa
B) Benztropine
C) Levodopa alone
D) Selegiline

Question 61 of 108

All of the following statements are true regarding Trihexyphenidyl, except:

A) Cause blurred vision and dry mouth

B) May cause sedation, mental confusion, mood changes
C) Can be used for the management of the EPS of anti-psychotic drugs
D) Isn't effective at all for early Parkinson disease

Question 62 of 108

Which of the following adverse effects is associated with Lithium use?

A) Fine hand tremor

B) Weight loss
C) Hyperthyroidism
D) Urinary retention

Question 63 of 108
Which of the following drugs is more appropriate for the management of hallucinations
caused by the treatment of Parkinson disease patients with Bromocriptine?

A) Fluphenazine
B) Haloperidol
C) Risperidone
D) Olanzapine

Question 64 of 108

Pramipexole is contraindicated in which of the following conditions?

A) Recent MI
B) Active peptic ulcer
C) History of psychotic illness
D) All of the above

Question 65 of 108

Chlorpromazine is member of first-generation antipsychotics class, shows all the

following pharmacological activity except

A) Anticholinergic
B) Anti-dopaminergic
C) Antiseratonergic
D) Antihistamine
E) Antiemetic

Question 66 of 108

Most common side effect associated with new generation antipsychotics include

A) Hyperglycemia
B) Weight gain
C) A+B
D) All of the above
E) Hyperlipidemia

Question 67 of 108

Indications of antidepressant do Not include:

 A) Obsessive-compulsive disorder
B) Convulsive disorders
C) Chronic neuropathic pain
D) Eating disorders

Question 68 of 108

Fluoxetine does NOT induce:

A) Serotonin syndrome when taken a day after Imipramine.

B) Marked sedation.
C) Nausea.
D) Anxiety.

Question 69 of 108

A 42·year-old man is referred to a psychiatrist after telling his family physician that he
often feels the need to drive back home to make sure the garage door is shut. Over
the past 6 months, he has started waking up 2 hours earlier to make it to work on
time. Which of the following medications may help manage the patient's symptoms?

A) Sertraline
B) Imipramine
C) Atomoxetine
D) Bupropion
E) Phenelzine

Question 70 of 108

A 56-year-old man presents to his physician with persistent back pain due to an injury
while making a delivery 3 months ago. The patient said that he often feels persistent
numbness and tingling in his back, and the pain often travels down his leg. Which of
the following medications may help manage the patient's symptoms?

A) Fluoxetine
B) Phenelzine
C) Trazodone
D) Duloxetine
E) Promethazine

Question 71 of 108

Fluoxetine has fewer adverse effects because of:

 A) Mixed norepinephrine and serotonin reuptake inhibition
B) Depleted stores of amine neurotransmitters
C) Minimal binding to cholinergic, histaminic, and alfa-adrenergic receptors
D) All of the above

Question 72 of 108

A very upset mother brings in her 10-year-old son to ask help in dealing with his bed-
wetting. Which of the following drugs might alleviate this problem?

A) Fluoxetine
B) Imipramine
C) Trazodone
D) Venlafaxine

Question 73 of 108

A 30-year-old male patient is on drug therapy for a psychiatric problem. He complains

that he feels “flat” and that he gets confused at times. He has been gaining weight
and has lost his sex drive. As he moves his hands, you notice a slight tremor. He tells
you that since he has been on medication he is always thirsty and frequently has to
urinate. The drug he is most likely to be taking is

A) Valproic acid
B) Risperidone
C) Clozapine
D) Carbamazepine
E) Lithium

Question 74 of 108

SSRIs are much less effective than tricyclic antidepressants in the management of

A) Obsessive-compulsive disorder
B) Bulimia
C) Premenstrual dysphoric disorder
D) Chronic neuropathic pain
E) Generalized anxiety disorder

Question 75 of 108

The major constraint in the long term use of benzodiazepines for treatment of
generalized anxiety disorder is:
 A) Cardiovascular depression
B) Development of tolerance to antianxiety action of the benzodiazepines
C) Possibility of drug dependence
D) Likelihood of overdose toxicity

Question 76 of 108

Which one of the following statements is CORRECT?

A) Clinical improvement of anxiety requires 2 to 4 weeks of treatment with

benzodiazepines.
B) Benzodiazepines, like other CNS depressants, readily produce general
anesthesia.
C) Benzodiazepines show analgesic actions.
D) Benzodiazepines directly open chloride channels.
E) All benzodiazepines have some sedative effects.

Question 77 of 108

Which one of the following statements is CORRECT?

A) Phenobarbital induces respiratory depression, which is enhanced by the

consumption of ethanol.
B) Phenobarbital shows analgesic properties.
C) Buspirone has actions similar to the benzodiazepines.
D) Phenobarbital is useful in the treatment of acute intermittent porphyria.
E) Diazepam and phenobarbital induce the P-450 enzyme system.

Question 78 of 108

All of the following response to treatment with benzodiazepines EXCEPT:

A) Epileptic seizures
B) Tetanus
C) Anxiety
D) Schizophrenia
E) Insomnia

Question 79 of 108

Which one of the following is a short-acting hypnotic?

A) Phenobarbital
 B) Diazepam
C) Chlordiazepoxide
D) Flurazepam
E) Thiopental

Question 80 of 108

A 45-year-old man who has been injured in a car accident is brought into the
emergency room. His blood-alcohol level on admission is 275 mg/dL. Hospital records
show a prior hospitalization for alcohol-related seizures. His wife confirms that he has
been drinking heavily for 3 weeks. What treatment should be provided to the patient if
he goes into withdrawal?

A) Buspiron
B) Midazolam
C) Lorazepam
D) Pentobarbital

Question 81 of 108

Which one of the following is a short-acting hypnotic and better for sleep induction
compared to sleep maintenance?

A) Temazepam.
B) Escitalopram.
C) Buspirone.
D) Flurazepam.
E) Zaleplon.

Question 82 of 108

Which of the following agents has a rapid anxiolytic effect and would be best for the
acute management of anxiety?

A) Escitalopram.
B) Venlafaxine.
C) Buspirone.
D) Lorazepam.
E) Duloxetine.

Question 83 of 108

Which of the following sedative-hypnotic agents utilizes melatonin receptor agonism

as the mechanism of action to induce sleep?
 A) Estazolam.
B) Ramelteon.
C) Diphenhydramine
D) Eszopiclone.
E) Zolpidem.

Question 84 of 108

All of the following agents may cause cognitive impairment, including memory
problems when used at recommended doses except:

A) Ramelteon.
B) Diphenhydramine.
C) Zolpidem.
D) Phenobarbital.
E) Alprazolam.

Question 85 of 108

Which agent is best used in the Emergency Room setting for patients who are
believed to have received too much of a benzodiazepine drug or taken an overdose of
benzodiazepines?

A) Diazepam.
B) Ramelteon.
C) Doxepin.
D) Naloxone.
E) Flumazenil.

Question 86 of 108

A 55-year-old teacher began to experience changes in mood. He was losing interest

in his work and lacked the desire to play his daily tennis match. He was preoccupied
with feelings of guilt, worthlessness, and hopelessness. In addition to the psychiatric
symptoms, the patient complained of muscle aches throughout his body. Physical and
laboratory tests were unremarkable. After 6 weeks of therapy with fluoxetine, his
symptoms resolved. However, the patient complains of sexual dysfunction. Which of
the following drugs might be useful in this patient?

A) Lithium.
B) Citalopram.
C) Mirtazapine.
D) Sertraline.
 E) Fluvoxamine.

Question 87 of 108

A 25-year-old woman has a long history of depressive symptoms accompanied by

body aches and pain secondary to a car accident 2 years earlier. Physical and
laboratory tests are unremarkable. Which of the following drugs might be useful in this
patient?

A) Phenelzine.
B) Sertraline.
C) Mirtazapine.
D) Fluoxetine.
E) Duloxetine.

Question 88 of 108

A 51-year-old woman with symptoms of major depression also has angle-closure

glaucoma. Which of the following antidepressants should be avoided in this patient?

A) Bupropion.
B) Mirtazapine.
C) Amitriptyline.
D) Fluvoxamine.
E) Sertraline.

Question 89 of 108

A 36-year-old man presents with symptoms of compulsive behavior. If anything is out

of order, he feels that “work will not be accomplished effectively or efficiently.” He
realizes that his behavior is interfering with his ability to accomplish his daily tasks but
cannot seem to stop himself. Which of the following drugs would be most helpful to
this patient?

A) Fluvoxamine.
B) Amitriptyline.
C) Tranylcypromine.
D) Lithium.
E) Imipramine.

Question 90 of 108

Which mood stabilizer is completely renally eliminated and may be beneficial for
patients with hepatic impairment?
 A) Carbamazepine.
B) Risperidone.
C) Valproic acid.
D) Aripiprazole.
E) Lithium.

Question 91 of 108

Which antidepressant has, as its two principle mechanisms of action, 5-HT2A

receptor antagonism and α2 receptor antagonism?

A) Mirtazapine.
B) Fluoxetine.
C) Selegiline.
D) Doxepin.
E) Maprotiline.

Question 92 of 108

An anxiolytic useful in patients with a history of drug dependance:

A) Alprazolam
B) Buspirone
C) Oxazepam
D) Lorazepam
E) Diazepam

Question 93 of 108

Which of the following is preferred for the treatment of anxiety with panic attacks:

A) Chlordiazepoxide
B) Alprazolam
C) Zolpidem
D) Buspirone
E) Diazepam

Question 94 of 108

The following concerning zolpidem is not true

 A) Its use is associated with less tolerance and dependence than
benzodiazepines.
B) More liable to induce rebound insomnia & disturbance in REM sleep than
benzodiazepines.

C) It acts on benzodiazepine - 1 receptor.

D) It is a short-acting hypnotic causing less hangover than benzodiazepines.

Question 95 of 108

Which of the following is FALSE regarding Buspirone?

A) Can help quitting smoking by attenuating the symptoms of withdrawal from

nicotine.
B) Effective for generalized anxiety disorder.
C) 5-HT1A receptor partial agonist.
D) Cause no addiction.

Question 96 of 108

Which of the following is FALSE regarding Benzodiazepines?

A) Overdose can be treated with Flumazenil.

B) They potentiate the effect of GABA on the GABAA receptor.
C) With long-term administration, tolerance develops to the anxiolytic, hypnotic,
and anticonvulsant activity.
D) Can be used for the short-term management of panic disorder.

Question 97 of 108

Phenobarbital treatment of:

A) Seizure disorders
B) Can be used for the Withdrawal syndrome from sedative-hypnotics
C) Congenital hyperbilirubinemia

D) All of the above

Question 98 of 108

Which of the following is true regarding Ramelteon?

A) A selective antagonist at the MTI and MT2 subtypes of melatonin receptors.

 B) Long-term use is associated with dependence and abuse
C) Can cause hyperprolactinemia
D) All of the above are true

Question 99 of 108

Which of the following statements is incorrect regarding Buspirone :

A) It works by stimulating the benzodiazepine receptors type BZI

B) Buspirone is useful for the chronic treatment of Generalized Anxiety Disorder

C) Buspirone lacks anticonvulsant and muscle - relaxant properties
D) It has a slow onset of action, hence it is not effective for short - term treatment
of acute anxiety states
E) None of the above

Question 100 of 108

The following drugs are considered for short-term treatment of anxiety except :

A) Pentobarbital
B) Diazepam
C) Lorazepam

D) Clonazepam
E) None of the above

Question 101 of 108

Which of the following barbiturates is used for rapid induction of anesthesia?

A) Phenobarbital
B) Amobarbital
C) Thiopental

D) Pentobarbital

Question 102 of 108

Which of the following hypnotic drugs has the lowest likelihood for developing
dependence?

A) Flurazepam
 B) Triazolam
C) Temazepam

D) Eszopiclone
E) None of the above

Question 103 of 108

A 48-year-old man recently diagnosed with generalized anxiety disorder started an

appropriate therapy with a drug that acts by increasing the availability of both
norepinephrine and serotonin in the synaptic cleft of central nervous system neurons.
Which of the following drugs was most likely prescribed?

A) Bupropion
B) Amitriptyline
C) Venlafaxine
D) Lorazepam
E) Citalopram

Question 104 of 108

A 41-year-old man recently diagnosed with major depressive disorder complained to

his psychiatrist that he felt drowsy for most of the day. The patient had started a
treatment with paroxetine 2 months earlier, but his depressive symptoms were
minimally improved. One week ago, his psychiatrist decided to shift to another
antidepressant and prescribed a drug that acts by increasing the availability of both
norepinephrine and serotonin in the synaptic cleft of central nervous system neurons.
Which of the following drugs was most likely prescribed?

A) Sertraline
B) Citalopram
C) Bupropion
D) Amitriptyline
E) Trazodone

Question 105 of 108

A 17-year-old girl was admitted to an eating disorder clinic with a 3-month history of
binge eating and vomiting and purging episodes occurring from twice per week to four
times a day. After physical examination and lab tests, psychotherapy and a drug
treatment were prescribed. Which of the following drugs would be appropriate for this
patient?

A) Phenobarbital
B) Haloperidol
C) Fluoxetine
 D) Diazepam
E) Clozapine

Question 106 of 108

A 36-year-old man was referred to a psychiatrist because of irritability, worrying

thoughts, palpitations, dry mouth, and insomnia of 1-month duration. The man had a
past history of alcohol abuse, but he was able to quit 1 year ago after psychological
counseling and drug therapy. Recently, he suffered from erectile dysfunction, treated
with sildenafil. A provisional diagnosis of generalized anxiety disorder was made, and
cognitive behavioral therapy with a drug treatment was prescribed. Which of the
following drugs would be most appropriate for this patient?

A) Haloperidol
B) Lorazepam
C) Buspirone
D) Diazepam
E) Fluoxetine

Question 107 of 108

A 43-year-old man suffering from rectal bleeding was admitted to the hospital for a
colonoscopy. An intravenous injection of diazepam was given before the procedure to
induce a conscious sedation. Which of the following symptoms did the patient most
likely experience upon recovery from sedation?

A) Anterograde amnesia
B) Delusional thoughts
C) Nausea and vomiting
D) Increased respiratory rate

Question 108 of 108

A 26-year-old woman, suffering from cerebral palsy and seizures secondary to head
injury, was seen in a clinic for a scheduled visit. She was spastic and unable to walk.
Medical history indicated that for the month prior to the visit, her seizures had not
been well controlled. Which of the following drugs would be appropriate to improve
her seizure control and muscle spasms?

A) Haloperidol
B) Diazepam
C) Buspirone
D) Lithium
E) Fluoxetine
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