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PSYCHOPHARMACOLOGY …
PSYCHOPHARMACOLOGY
Read each question carefully. Do not read into the question and trust your gut about the right answer. Select your answer and bold the entire answer – not just the letter. Send it back to me by reply. Take your time, but don’t perseverate over any one question.
1. There is a certain class or range of medications for which we simply do not know and of
the pharmacokinetic properties. This makes both prescribing and use of such
medications uncertain. This describes which one of the following?
A. Antipsychotics
B. Any medication used before the 1960s.
C. Over-the-counter medications
D. Alternative and/or Complementary medications
2. One medication for bipolar that is actually an anticonvulsant. It can cause a collapse of
the immune system and severe anemia. Fortunately, however, these side effects can be
avoided by which one of the following facts?
A. By the time these effects occur, the bipolar is already under control.
B. If the side effects occur, they occur within the first three months and the medication
can be stopped.
C. There are host of synaptic enzymes that also “kick in” when the blood-related
problems arise which prevents the problems from progressing.
D. If the side effects occur, the person doesn’t have bipolar. They can at least some
comfort in this fact.
3. One potentially dangerous risk in using too many meds that elevate serotonin levels is:
A. A potentially fatal reaction that starts with euphoria and ends in coma and death.
B. This can exacerbate depression and turn it into bipolar disease.
C. The patient can experience a total collapse of their immune system and become anemic
D. For older individuals this can produce liver and kidney failure.
4. We know a good deal about synaptic mechanisms, pharmacokinetics, etc., however, the
current state of pharmacotherapy could be summarized as:
A. Almost complete, at least with regard to the drugs we currently use.
B. Less certain than most people believe. Some of prescribing psychopharmaceuticals is still
very much an “art.”
C. Much more similar to the “old ways” than we believed. The “old “nerve tonics” like the
Bromides, for example, actually work.
D. Completely in the dark. Most of the assumptions we have made about drugs do not
hold up under empirical scrutiny.
5. The MAOIs are the “gold standard” of antidepressant medication. This is because they
are fast and very effective. The main problem with these medications is that:
A. They are the only true antidepressant medications.
B. They cause a large number of very troubling side effects.
C. They are extremely expensive and not covered by most health plans.
D. When taken with foods containing tyramine, they can cause potentially fatal hypertension.
6. Many clients complain of certain side effects with the SSRIs. The most problematic, it
seems, are:
A. Weight gain and sexual dysfunction.
B. Weight gain and Type II diabetes.
C. Disorientation and dizziness.
D. Anticholinergic and extrapyramidal effects.
7. A drug with an LD50 that is substantially higher than the ED50 is:
A. Probably too dangerous to use.
B. Probably safe with frequent blood monitoring.
C. Relatively free of side effects.
D. Probably fairly safe.
8. The pharmacokinetic factors of absorption, distribution, etc. can become an issue when
considering whether or not to take:
A. Any of the mood stabilizers.
B. A generic pill vs. a pharmaceutically tested pill.
C. A medication with good pharmacodynamics.
D. Medications with extrapyramidal side effects.
9. In general, how can you tell from a client’s withdrawal syndrome what kind of medication
the client was taking?
A. The withdrawal syndrome mirrors the effects of the drug; if sleepy, the client was
taking a sedative.
B. The withdrawal syndrome mimics the disease being treated. If the client shows
depression, the drug was a depressant.
C. The withdrawal syndrome is usually opposite to the effects of the drug. If the
client shows agitation, the drug was probably a sedative.
D. The withdrawal syndrome has little to do with the drug effect; it is more a placebo
(idiosyncratic) reaction to stopping the drug.
10. At which one of the following are psychopharmacological interventions primarily aimed?
A. The historical cause or conflict underlying the psychological problem.
B. The physical basis and/or vegetative signs of the problem.
C. The purely subjective complaints of the client; no verification is needed.
D. The long-term goals of treatment. In treatment, medications do most of the work.
11. Some benzodiazepines have an initial tranquilizing effect, and a second “wave” of effect
several hours later. How does this happen?
A. The meds are first bound in body fat, then released after the “first pass effect.”
B. The medications, and, later their metabolites, are both pharmacologically active.
C. The medications have an effect, and then trigger the body’s endorphins for the
“second wave effect.”
D. The first wave is the drug effect; the second wave is a placebo effect.
12. It is true that all of the tricyclics work about equally well. There are host of different
kinds from which to choose. What is the basis of choice when selecting a tricyclic?
A. Cost
B. Side effect profile and symptom presentation.
C. Previous history of effectiveness with the MAOIs
D. None, the patient and physician simply pick one that sounds good to him or her.
13. Mr. Smith, who has led a productive, uneventful life until his retirement at 65, is now
being treated for bipolar disease. His wife died a month ago and he was diagnosed with
lung cancer a week later. Since this time, he has been extremely moody, largely
depressed, and withdrawn. What’s your concern about this diagnosis?
A. It could still be bipolar, even in the absence of mania.
B. His age precludes the use of conventional mood stabilizers.
C. His age and history make the diagnosis of bipolar disease unlikely.
D. If he is still grieving, he cannot have bipolar.
14. Most of the minor tranquilizers (benzo’s), unlike the sedative hypnotics, act through
which one of the following neurotransmitter systems?
A. Acetylcholine
B. Dopamine and/or Norepinephrine
C. Serotonin
D. GABA
15. Which one of these childhood conditions could lead to adult OCD?
A. Panic attack disorder.
B. Conduct disorder.
C. Attachment disorder.
D. Tic disorder.
16. The second generation antipsychotics are quickly displacing the more traditional
antipsychotics for two main reasons. These are:
A. They are less expensive and require fewer precautions, some can even be used p.r.n.
B. They have fewer, and less severe side effects and can improve cognitive function.
C. They are also good at reducing seizures and are excellent with chronic pain.
D. People have developed tolerance to the traditional antipsychotics, and no such
tolerance is possible with the new drugs.
17. One of the following is a good idea to ensure long-term adherence to medications, but is often not considered by some to be necessary to effective pharmacotherapy. Research,
however, has shown this to be a very important factor in treatment success. This is:
A. Education and preparation.
B. The authority and prestige of the prescribing medical physician.
C. The side effect profile of the drug.
D. The cost of the drug.
18. The alcohol-barbiturate spectrum of drugs is a collection of drugs from ethyl alcohol
through the barbiturates. Why are these all lumped into the same class?
A. The meds are general central nervous system depressants that work through the
same, basic mechanism.
B. The meds were initially all produced by the same manufacturing company.
C. The meds are the oldest on record. They have all been used for the same purpose
for centuries.
D. All of the medications in this group are the most frequently used in suicide attempts.
19. An example of a drug with a very narrow therapeutic index is:
A. Lithium
B. Prozac
C. Any benzodiazepine.
D. Most sedative hypnotics.
20. One factor limiting the use of pharmaceuticals for very young children is:
A. A complete lack of pharmacokinetic information on any medication with children.
B. The therapeutic index is too narrow for most drugs.
C. We just don’t have enough empirical information about drug effects with children.
D. Children just can’t be relied upon to take the medications the way they are prescribed.
