A. Incorrect! Seizures are not typically linked to alcohol use. B. Incorrect! Epilepsy is a seizure that is commonly associated with convulsions.

Transcription

1 Pharmacology - Problem Drill 17: Central Nervous System Depressants Question No. 1 of 10 Instructions: (1) Read the problem statement and answer choices carefully (2) Work the problems on paper as 1. occur(s) in heavy drinkers, causing dementia and peripheral neuropathies. Question #01 (A) Seizures (B) Epilepsy (C) Partial seizures (D) Cirrhosis (E) Neurological degeneration Seizures are not typically linked to alcohol use. Epilepsy is a seizure that is commonly associated with convulsions. Seizures are not typically linked to alcohol use. Cirrhosis does occur in cases of heavy drinking, but it does not cause dementia and peripheral neuropathies. E. Correct! Neurological degeneration occurs in heavy drinkers causing dementia and peripheral neuropathies. Neurological degeneration occurs in heavy drinkers causing dementia and peripheral neuropathies. The correct answer is (E).

2 Question No. 2 of 10 Instructions: (1) Read the problem and answer choices carefully (2) Work the problems on paper as needed (3) Pick the answer (4) Go back to review the core concept tutorial as needed. 2. is a condition characterized by the paralysis of the external eye muscles, ataxia and it confuses state that may progress to coma and death. Question #02 (A) Seizure (B) Wernicke-Korsakoff syndrome (C) Partial seizure (D) Cirrhosis (E) Neurological degeneration The seizure is caused by an abnormal high frequency discharge of a group of neurons, starting locally and spreading to a varying extent to affect other parts of the brain. B. Correct! Wernicke-Korsakoff syndrome is the condition characterized by the paralysis of the external eye muscles, ataxia and it confuses state that may progress to coma and death. Feedback on Each Answer Partial seizures are associated with brain damage. Cirrhosis is damage to the liver. Be more specific. Wernicke Korsakoff syndrome is the condition characterized by the paralysis of the external eye muscles, ataxia and it confuses state that may progress to coma and death. The correct answer is (B).

3 Question No. 3 of acts as a general CNS depressant, similar to volatile anesthetic agents, producing the familiar effects of acute intoxication. Question #03 (A) Buspirone (B) Ethanol (C) Clonazepam (D) Ethosuximide (E) Acamprosate Buspirone is an anxiolytic without sedative or hypnotic side effects and its anxiolytic side effects take days or weeks to develop. B. Correct! Ethanol acts as a general CNS depressant, similar to volatile anesthetic agents, producing the familiar effects of acute intoxication. Clonazepam is a benzodiazepine. Ethosuximide is the main drug used to treat absence seizures. Acamprosate is used to treat alcohol dependence. Ethanol acts as a general CNS depressant, similar to volatile anesthetic agents, producing the familiar effects of acute intoxication. Several cellular mechanisms have been proposed to explain its action including inhibition of calcium channel opening, enhancement of GABA action and inhibitory action at NMDA type glutamate receptors. The correct answer is (B).

4 Question No. 4 of is the main determining factor for the rate of central nervous system effects of anxiolytics. Question #04 (A) Protein size (B) Lipid solubility (C) Degree of ionization (D) Receptor binding (E) Transport rate Think of a factor that influences crossing the blood-brain barrier. B. Correct! Seizures are caused by an abnormal high frequency discharge of a group of neurons, starting locally and spreading to a varying extent to affect other parts of the brain. Think of a factor that influences crossing the blood-brain barrier. Think of a factor that influences crossing the blood-brain barrier. Think of a factor that influences crossing the blood-brain barrier. Lipid solubility is the main determining factor for the rate of central nervous system effects of anxiolytics, since highly lipophilic drugs can enter the central nervous system rapidly and therefore exert their effects more rapidly. The correct answer is (B).

5 Question No. 5 of Sedative-hypnotic drugs: Question #05 (A) Can cross the placental barrier. (B) May depress neonatal functions. (C) Are secreted in breast milk. (D) All of the above (E) None of the above Sedative-hypnotic drugs can cross the placental barrier, but that is not their only effect on the unborn child. Sedative-hypnotic drugs may depress neonatal functions, but that is not their only effect on the unborn child. Sedative-hypnotic are secreted in breast milk, but that is not their only effect on the unborn child. D. Correct! Sedative-hypnotic drugs can cross the placental barrier, may depress neonatal functions, and are secreted in breast milk. One of the above answers is correct. Since all sedative hypnotics can cross the placental during pregnancy, they may cause depression of neonatal functions if given before a delivery. Additionally, they are secreted in breast milk and can result in depressant effects in nursing babies. The correct answer is (D).

6 Question No. 6 of is an opioid receptor antagonist that is taken as a once daily dose of 50mg in the treatment of alcoholism. Question #06 (A) Disulfiram (B) Ethanol (C) Naltrexone (D) Acamprosate (E) Phenytoin Disulfiram is an inhibitor of aldehyde dehydrogenase. Ethanol is not an opioid receptor antagonist. C. Correct! Naltrexone is an opioid receptor antagonist that is taken as a once daily dose of 50mg in the treatment of alcoholism. Acamprosate blocks glutamatergic NMDA ceptors. Phenytoin blocks sodium channels. Naltrexone is an opioid receptor antagonist that is taken as a once daily dose of 50mg in the treatment of alcoholism, where it reduces the desire to drink alcohol. The correct answer is (C).

7 Question No. 7 of are often associated with damage to the brain. Question #07 (A) Partial seizures (B) Generalized seizures (C) Anticonvulsant drugs (D) Phenytoin (E) None of the above A. Correct! Partial seizures are often associated with damage to the brain. Generalized seizures occur without obvious cause and two common forms of generalized epilepsy are the tonic-clonic (grand mal) and the absence seizure (petite mal). Anticonvulsant drugs reduce electrical excitability of cell membranes possibly through use-dependant block of sodium channels. Phenytoin is thought to act mainly by use-dependant block of sodium channels. One of the above is correct. Partial seizures are often associated with damage to the brain, whereas generalized seizures occur without obvious cause. Two common forms of generalized epilepsy are the tonic-clonic (grand mal) and the absence seizure (petite mal). The correct answer is (A).

8 Question No. 8 of is a derivative of tricyclic antidepressants with a similar profile to that of phenytoin with fewer side effects. Question #08 (A) Carbamazepine (B) Valproate (C) Ethosuximide (D) Phenobarbitone (E) Disulfiram A. Correct! Carbamazepine is a derivative of tricyclic antidepressants with a similar profile to that of phenytoin with fewer side effects. Valproate is chemically unrelated to other anticonvulsants and its mechanism of action is not clear. Ethosuximide is the main drug used to treat absence seizures but may exacerbate the other forms of seizures. Phenobarbitone is a secondary drug used in the treatment of epilepsy. Disulfiram is an inhibitor of aldehyde dehydrogenase. Carbamazepine is a derivative of tricyclic antidepressants with a similar profile to that of phenytoin with fewer side effects. It is effective in most forms of epilepsy except absence seizures and is particularly useful in psychomotor epilepsy and trigeminal neuralgia. The correct answer is (A).

9 Question No. 9 of is used to treat status epilepticus. Question #09 (A) Disulfiram (B) Carbemazepine (C) Diazepam (D) Benzodiazepines (E) Ethanol Disulfiram is an inhibitor of aldehyde dehydrogenase. Carbemazepine is too slow acting to treat status eplilepticus. C. Correct! Diazepam is used to treat status epilepticus. Benzodiazepines are too slow acting to treat status eplilepticus. Ethanol is a general CNS depressant, and is not used to treat status eplielpticus. Status epilepticus must be treated as an emergency with intravenous or rectal diazepam. The correct answer is (C).

10 Question No. 10 of is chemically unrelated to other anticonvulsants and its mechanism of action is not clear. Question #10 (A) Phenytoin (B) Disulfiram (C) Carbamazepine (D) Acamprosate (E) Valproate Phenytoin is thought to act mainly by use-dependant block of sodium channels. Disulfiram is an inhibitor of aldehyde dehydrogenase. Carbamazepine is a derivative of tricyclic antidepressants. Acamprosate blocks glutamatergic NMDA ceptors. E. Correct! Valproate is chemically unrelated to other anticonvulsants and its mechanism of action is not clear. Valproate is chemically unrelated to other anticonvulsants and its mechanism of action is not clear. It is thought to have weak inhibitory properties on GABA transaminase and some effect on sodium channels. Valproate has relatively few side effects including baldness, teratogeniocity, and liver damage. The correct answer is (E).