Central Nervous System Pharmacology Practice Questions

CENTRAL NERVOUS SYSTEM PHARMACOLOGY SELF-ASSESSMENT
QUESTIONS
GENERAL ANAESTHETIC AGENTS

1. Describe the five main effects of general anaesthtic agents during surgery
2. Briefly describe the 4 main stages of general anaesthesia
3. What steps will you take if a patient gets into medullary depression during a major surgical
procedure?
4. List three examples of general anaesthetic agents which act by potentiating the effects of
GABA
5. Mention two examples of general anaesthetic agents which act by inhibiting NMDA
receptors
6. List two examples of the following general anaesthetic agents
(a) Group 1
(b) Group 2
(c) Group 3
7. Briefly describe what is meant by the following terms
(a) Dissociative anaesthesia
(b) Balanced anaesthesia
8. Discuss the effect of blood solubility on the rate of induction of gaseous anaesthetic agents
SEDATIVE/HYPNOTICS
1. Define the following terms
(a) Sedation
(b) Hypnosis
2. Give an example of each of the following benzodiazepines
(a) Short-acing
(b) Intermediate-acting
(c) Long-acting
3. Describe the specific effect of benzodiazepines and barbiturates on the GABA-mediated
chloride ion channel
4. Compare and contrast between benzodiazepines and Z-hypnotics (e.g. zolpidem)
5. What drug is used as antidote during overdose with benzodiazepines?
6. What are the general adverse effects of sedative/hypnotic drugs?
7. Mention three clinical indications for sedative/hypnotic drugs
8. Discuss the potential drug interactions between benzodiazepines and other drugs
9. Why are benzodiazepines preferred over barbiturates?
10. Discuss considerations for the use of benzodiazepines in elderly patients
11. Which benzodiazepines are preferred for pre-medication during surgery?
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ANTISEIZURE DRUGS
1. Briefly describe the following types of seizures
(a) Generalized tonic-clonic seizures
(b) Partial seizures
(c) Absence seizures
(d) Myoclonic seizures
2. Briefly describe the involvement of GABA, glutamate, and glycine the pathogenesis of
epilepsy
3. List three first-line drugs for the following types of seizures
(a) Partial seizures
(b) Generalized tonic-clonic seizures
(c) Absence seizures
(d) Myoclonic seizures
4. Briefly describe the mechanism of action of the following drugs
(a) Phenytoin
(b) Carbamazepine
(c) Valproic acid
(d) Lamotrigine
(e) Ethosoximide
(f) Benzodiazepines
(g) Barbiturates
5. Mention 4 common adverse effects of antiseizure drugs
6. List three adverse effects for the following drugs
(a) Carbamazepine
(b) Phenytoin
(c) Valproate
7. Discuss the potential drug interactions between antiseizure drugs and other drugs (e.g.
antibiotics, contraceptives, other CNS drugs)
8. How would you manage a patient presenting with phenytoin-induced gingival overgrowth?
9. Discuss considerations for the use of antiseizure drugs in children and pregnant women (for
Pharmacy students)
ANTIDEPRESSANTS
1. List two examples of emotional symptoms and two examples of biological symptoms of
depression
2. Briefly describe the following pathophysiologic mechanisms of depression
(a) Monoamine hypothesis
(b) Neuroendocrine hypothesis
(c) Neurotrophic hypothesis
3. Give two examples of the following antidepressant drugs
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(a) Tricyclic antidepressants (TCAs)
(b) SSRIs
(c) SNRIs
(d) Monoamine receptor antagonists
(e) Monoamine oxidase inhibitors
4. Mention two adverse effects of the following drugs
(a) TCAs
(b) SSRIs
(c) Monoamine oxidase inhibitors
5. Briefly describe the mechanism of action of monoamine receptor antagonists
6. Name one drug mainly indicated for resistant depression
7. Discuss the potential drug interactions between antidepressants and vasoconstrictors (e.g.
adrenaline, pseudoephedrine, cold meds)
ANTIPSYCHOTIC AGENTS
1. Give three examples of positive symptoms and three examples of negative symptoms of
schizophrenia
2. Briefly explain why negative symptoms of schizophrenia tend to persist longer than positive
symptoms
3. Describe the main functions of the following dopaminergic pathways in the brain
(a) Mesolimbic-mesocortical pathway
(b) Nigrostriatal pathway
(c) Tuberoinfindibular pathway
4. Describe the effect of serotonin on dopamine in the mesolimbic pathway and in the
mesocortical pathway
5. Briefly describe the pathophysiologic mechanisms involved in the positive symptoms and in
the negative symptoms of schizophrenia
6. Compare and contrast between typicals and atypicals under the following headings
(a) Mechanism of action
(b) Adverse effects
7. Classify the following drugs into either typical (first generation) or atypical (second
generation) antipsychotic agents
(a) Chlorpromazine
(b) Haloperidol
(c) Quetiapine
(d) Sulpiride
(e) Thioridazine
(f) Trifluperazine
(g) Olanzapine
(h) Fluphenazine
(i) Risperidone
(j) Clozapine
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(k) Aripiprazole
8. Describe the preferred first-line drug management of a patient with an initial diagnosis of
schizophrenia
9. Briefly describe the management of a patient a typical antipsychotic agent who experiences
the following adverse effects
(a) Akathisia
(b) Acute dystonic reactions
(c) Parkinson symptoms
(d) Tardive dyskinesia
10. List two drugs indicated for the treatment of patients with resistant schizophrenia
11. Mention the blood disorder commonly associated with clozapine
12. Discuss the potential interactions between antipsychotic agents with sedative/hypnotics,
anaesthetic agents, opioid analgesics
ANTIPARKINSON DRUGS
1. List the three main features of Parkinson’s disease
2. Discuss the pathophysiologic mechanism of Parkinson’ disease
3. Classify the following drugs used in Parkinson’s disease
(a) Levodopa
(b) Entacapone
(c) Bromocriptine
(d) Ropinirole
(e) Selegiline
(f) Pramipexole
(g) Trihexyphendyl
(h) Benztropine
4. Why is levodopa often combined with carbidopa in the management of PD?

5. Which drugs have been shown to delay the progression of Parkinson’s disease?
6. Compare and contrast the adverse effects of levodopa and dopamine receptor agonists
7. In which patients is it appropriate to delay the introduction of levodopa in the management of
PD?
8. Briefly describe the management of a patient experiencing the on-and-off symptoms during
treatment with levodopa
9. What is the appropriate initial drug therapy in a 50 year old patient with mild to moderate
Parkinson’s disease?
10. What is the role of acetylcholine in the pathogenesis of Parkinson’s disease?
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CENTRAL NERVOUS SYSTEM PHARMACOLOGY SELF-ASSESSMENT

GENERAL ANAESTHETIC AGENTS

4. Why is levodopa often combined with carbidopa in the management of PD?

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