CH-15 Neurologic Drugs – Understanding Pharmacology for Health Professionals : Exam Guide

Chapter 15: Neurologic Drugs Multiple Choice Questions 1. Hydantoin drugs for epilepsy prevent the neurons from sending out impulses too rapidly or repeatedly by _______. a. acting on different types of receptors throughout the body b. affecting the flow of sodium in and out of the cell c. depressing the motor cortex of the brain and raising the seizure threshold d. inhibiting the conduction of nerve impulses in the cerebral cortex and motor areas of the brain Answer: b. affecting the flow of sodium in and out of the cell Correct Feedback: Hydantoin drugs for epilepsy affect the flow of sodium in and out of the cell, thereby preventing the neuron from depolarizing and repolarizing too rapidly or repeatedly. a. acting on different types of receptors throughout the body Incorrect Feedback: Hydantoin drugs do not work on different types of receptors throughout the body. c. depressing the motor cortex of the brain and raising the seizure threshold Incorrect Feedback: Hydantoin drugs do not depress the motor cortex of the brain and raise the seizure threshold. d. inhibiting the conduction of nerve impulses in the cerebral cortex and motor areas of the brain Incorrect Feedback: Hydantoin drugs do not inhibit the conduction of nerve impulses in the cerebral cortex and motor areas of the brain. 2. Because of how they work in the body, _____ drugs are useful in treating epilepsy and also a variety of psychiatric and muscular disorders. a. barbiturate drugs b. benzodiazepine drugs c. GABA drugs d. succinimide drugs Answer: b. benzodiazepine drugs Correct Feedback: Benzodiazepine drugs act on several different types of receptors throughout the body to affect memory, emotion, and muscles. This makes them useful drugs in treating a variety of psychiatric and muscular disorders. In addition, they exert an anticonvulsant effect on receptors in the brainstem. a. barbiturate drugs Incorrect Feedback: Barbiturate drugs are not used to treat any muscular disorders. c. GABA drugs Incorrect Feedback: Gamma-aminobutyric acid (GABA) drugs are not used to treat any muscular disorders. d. succinimide drugs Incorrect Feedback: Succinimide drugs are not used to treat any psychiatric disorders. 3. Catechol-O-methyltransferase (COMT) is the main enzyme that metabolizes the drug _____ in the blood. a. acetylcholine b. dopamine c. GABA d. levodopa Answer: d. levodopa Correct Feedback: Catechol-O-methyltransferase (COMT) is the main enzyme that metabolizes the drug levodopa in the blood. a. acetylcholine Incorrect Feedback: Acetylcholine is metabolized by acetylcholinesterase, and it is a neurotransmitter, not a drug. b. dopamine Incorrect Feedback: Dopamine is a neurotransmitter, not a drug. c. GABA Incorrect Feedback: GABA is metabolized by the enzyme GABA transaminase, and it is not a drug. 4. Drugs used to treat myasthenia gravis _____. a. block acetylcholine so that cholinesterase is not broken down b. block cholinesterase so that acetylcholine is not broken down c. keep acetylcholine from being produced d. keep cholinesterase from being produced Answer: b. block cholinesterase so that acetylcholine is not broken down Correct Feedback: Drugs used to treat myasthenia gravis block cholinesterase so that acetylcholine is not broken down and can activate the remaining receptors. a. block acetylcholine so that cholinesterase is not broken down Incorrect Feedback: Myasthenia drugs do not block acetylcholine. c. keep acetylcholine from being produced Incorrect Feedback: Myasthenia gravis drugs do not keep acetylcholine from being produced d. keep cholinesterase from being produced Incorrect Feedback: Myasthenia gravis drugs do not keep cholinesterase from being produced. 5. Drug therapy for Parkinson’s disease is divided into two different approaches that correct an imbalance in what two neurotransmitters in the brain? a. acetylcholine and cholinesterase b. acetylcholine and dopamine c. dopamine and epinephrine d. epinephrine and acetylcholine Answer: b. acetylcholine and dopamine Correct Feedback: The symptoms of Parkinson’s disease are caused by an imbalance between dopamine and acetylcholine. Drug therapy for Parkinson’s disease is divided into two main categories: drugs that increase or enhance the action of dopamine in the brain and drugs that inhibit the action of acetylcholine. a. acetylcholine and cholinesterase Incorrect Feedback: Parkinson’s disease is not caused by an imbalance between acetylcholine and cholinesterase. c. dopamine and epinephrine Incorrect Feedback: Parkinson’s disease is not caused by an imbalance between dopamine and epinephrine. d. epinephrine and acetylcholine Incorrect Feedback: Parkinson’s disease is not caused by an imbalance between epinephrine and acetylcholine. 6. The antianxiety drug clonazepam (Klonopin) is used to treat anxiety and is also used to treat _____. a. Alzheimer’s disease b. migraine headaches c. neuralgia and neuropathy d. Parkinson’s disease Answer: c. neuralgia and neuropathy Correct Feedback: Clonazepam, an antianxiety drug, is used to treat neuralgia and neuropathy. a. Alzheimer’s disease Incorrect Feedback: Clonazepam (Klonopin) is not used to treat Alzheimer’s disease. b. migraine headaches Incorrect Feedback: Clonazepam (Klonopin) is not used to treat migraine headaches. d. Parkinson’s disease Incorrect Feedback: Clonazepam (Klonopin) is not used to treat Parkinson’s disease. 7. Combination sleep aid drugs contain an analgesic drug (acetaminophen, ibuprofen) to treat pain that causes insomnia and diphenhydramine, which is a/an _____ drug. a. analgesic b. antihistamine c. antidepressant d. barbiturate Answer: b. antihistamine Correct Feedback: Combination sleep aid drugs contain an antihistamine drug (diphenhydramine) and an analgesic drug (acetaminophen, ibuprofen) to treat pain that causes insomnia. a. analgesic Incorrect Feedback: Diphenhydramine is not an analgesic drug. c. antidepressant Incorrect Feedback: Diphenhydramine is not an antidepressant drug. d. barbiturate Incorrect Feedback: Diphenhydramine is not a barbiturate drug. 8. Benzodiazepine drugs are used to treat anxiety but also have a sedative effect to treat insomnia because they enhance the action of the neurotransmitter _____. a. dopamine b. acetylcholine c. epinephrine d. GABA Answer: d. GABA Correct Feedback: Benzodiazepine drugs are commonly used to treat anxiety and also have a sedative effect because they enhance the action of gammaaminobutyric acid (GABA), a neurotransmitter in the brain that inhibits nerve impulses. a. dopamine Incorrect Feedback: Benzodiazepine drugs for insomnia do not enhance the action of the neurotransmitter dopamine. b. acetylcholine Incorrect Feedback: Benzodiazepine drugs for insomnia do not enhance the action of acetylcholine. c. epinephrine Incorrect Feedback: Benzodiazepine drugs for insomnia do not enhance the action of epinephrine. 9. COMT inhibitor drugs used for Parkinson’s disease inhibit the enzyme COMT that normally _____. a. metabolizes the drug levodopa in the blood b. decreases the tremors and rigidity of Parkinson’s disease c. increases the level of levodopa in the blood d. prevents levodopa from crossing the blood-brain barrier Answer: a. metabolizes the drug levodopa in the blood Correct Feedback: Catechol-O-methyltransferase (COMT) is the main enzyme that metabolizes the drug levodopa in the blood. b. decreases the tremors and rigidity of Parkinson’s disease Incorrect Feedback: The enzyme COMT does not decrease the tremors and rigidity of Parkinson’s disease c. increases the level of levodopa in the blood Incorrect Feedback: The enzyme COMT does not increase the level of levodopa in the blood. d. prevents levodopa from crossing the blood-brain barrier Incorrect Feedback: The enzyme COMT does not prevent levodopa from crossing the blood-brain barrier. 10. Which types of drugs elevate the mood and have an antihistamine effect that relieves skin sensations from neuropathy? a. ACE inhibitor drugs b. COMT inhibitor drugs c. anticonvulsant drugs d. antidepressant drugs Answer: d. antidepressant drugs Correct Feedback: Antidepressant drugs are used to treat neuralgia and neuropathy. They elevate the mood and are useful in treating chronic pain conditions. They also have an antihistamine effect that relieves skin sensations and produces mild sedation. a. ACE inhibitor drugs Incorrect Feedback: ACE inhibitor drugs do not elevate the mood. b. COMT inhibitor drugs Incorrect Feedback: COMT inhibitor drugs do not elevate the mood. c. anticonvulsant drugs Incorrect Feedback: Anticonvulsant drugs do not elevate the mood. 11. Which of the following is NOT one of the three categories of hypnotic drugs used to treat insomnia? a. barbiturate drugs b. benzodiazepine drugs c. nonbarbiturate drugs d. succinimide drugs Answer: d. succinimide drugs Correct Feedback: Succinimide drugs depress the motor cortex of the brain and raise the seizure threshold and are used to treat epilepsy, not insomnia. Hypnotic drugs are used on a short-term basis to treat insomnia, and they include nonbarbiturate drugs, benzodiazepine drugs, and barbiturate drugs. a. barbiturate drugs Incorrect Feedback: Barbiturate drugs are hypnotic drugs used to treat insomnia. b. benzodiazepine drugs Incorrect Feedback: Benzodiazepine drugs are hypnotic drugs used to treat insomnia. c. nonbarbiturate drugs Incorrect Feedback: Nonbarbiturate drugs are hypnotic drugs used to treat insomnia. 12. Also used to treat bipolar disorder, which drug can be used to treat all four common types of seizures (tonic-clonic seizures, absence seizures, complex partial seizures, and simple partial seizures)? a. carbamazepine (Tegretol) b. clonazepam (Klonopin) c. topiramate (Topamax) d. valproic acid (Depakene, Depakote) Answer: d. valproic acid (Depakene, Depakote) Correct Feedback: Valproic acid (Depakene, Depakote) is used to treat all four types of seizures. a. carbamazepine (Tegretol) Incorrect Feedback: Carbamazepine is only used to treat tonic-clonic seizures and complex partial seizures. b. clonazepam (Klonopin) Incorrect Feedback: Clonazepam is only used to treat absence seizures. c. topiramate (Topamax) Incorrect Feedback: Topiramate is only used to treat simple partial seizures, complex partial seizures, and tonic-clonic seizures 13. The drug memantine (Namenda) _____ to treat Alzheimer’s disease. a. blocks NMDA receptors which are overstimulated b. increases blood flow to improve cognitive skills and mental capacity c. inhibits the MAO enzyme that destroys dopamine d. inhibits the enzyme cholinesterase Answer: a. blocks NMDA receptors which are overstimulated Correct Feedback: Memantine (Namenda) blocks N-methyl D-aspartate (NMDA) receptors, which are overstimulated in Alzheimer’s disease. b. increases blood flow to improve cognitive skills and mental capacity Incorrect Feedback: Memantine (Namenda) does not increase blood flow. c. inhibits the MAO enzyme that destroys dopamine Incorrect Feedback: Memantine (Namenda) does not inhibit monoamine oxidase (MAO). d. inhibits the enzyme cholinesterase Incorrect Feedback: Memantine (Namenda) does not inhibit the enzyme cholinesterase. 14. Which of the following anticholinesterase drugs treats myasthenia gravis by blocking the enzyme cholinesterase so that it does not break down acetylcholine? a. benztropine (Cognetin) b. carbamazepine (Tegretol) c. ambenonium (Mytelase) d. tacrine (Cognex) Answer: c. ambenonium (Mytelase) Correct Feedback: Drugs used to treat myasthenia gravis block cholinesterase so that the acetylcholine is not broken down and can activate the remaining receptors for a longer period of time. These anticholinesterase drugs are used to treat myasthenia gravis: ambenonium (Mytelase). a. benztropine (Cognetin) Incorrect Feedback: Benztropine is used to treat Parkinson’s disease, not myasthenia gravis. b. carbamazepine (Tegretol) Incorrect Feedback: Carbamazepine is an anticonvulsant drug used to treat seizures, not myasthenia gravis. d. tacrine (Cognex) Incorrect Feedback: Tacrine is a cholinesterase inhibitor but it is used to treat Alzheimer’s disease, not myasthenia gravis. 15. Honoria Williams has epilepsy characterized by grand mal seizures. Which of the following drugs would be prescribed for her? a. phenytoin (Dilantin) b. tacrine (Cognex) c. flurazepam (Dalmane) d. Duodopa Answer: a. phenytoin (Dilantin) Correct Feedback: Phenytoin (Dalmane) is a hydantoin drug used to treat grand mal seizures. b. tacrine (Cognex) Incorrect Feedback: Tacrine (Cognex) is not used to treat epilepsy. c. flurazepam (Dalmane) Incorrect Feedback: Flurazepam (Dalmane) is not used to treat epilepsy. d. Duodopa Incorrect Feedback: Duodopa is not used to treat epilepsy. 16. Temazepam (Restoril) and triazolam (Halcion) are benzodiazepine drugs that are used to treat _____. a. Parkinson’s disease b. Alzheimer’s disease c. absence seizures d. insomnia Answer: d. insomnia Correct Feedback: Benzodiazepine drugs for insomnia include temazepam (Restoril) and triazolam (Halcion). The suffixes –azepam and –olam are common to generic benzodiazepine drugs. a. Parkinson’s disease Incorrect Feedback: These drugs are not used to treat Parkinson’s disease. b. Alzheimer’s disease Incorrect Feedback: These drugs are not used to treat Alzheimer’s disease. c. absence seizures Incorrect Feedback: These drugs are not used to treat absence seizures. 17. Insomnia can best be managed by which of the following categories of drugs? a. barbiturate sedative/hypnotic drugs b. nonbarbiturate sedative/hypnotic drugs c. succinimide drugs d. antidepressant drugs Answer: b. nonbarbiturate sedative/hypnotic drugs Correct Feedback: Nonbarbiturate drugs are commonly used to treat insomnia and include Lunesta, Rozerem, Sonata, and Ambien. a. barbiturate sedative/hypnotic drugs Incorrect Feedback: Barbiturate drugs were used in the past to treat insomnia but are now used infrequently. c. succinimide drugs Incorrect Feedback: Succinimide drugs are not used to treat insomnia. d. antidepressant drugs Incorrect Feedback: Antidepressant drugs are not used to treat insomnia. 18. All of the following statements about patients taking drugs for Parkinson’s disease are true EXCEPT: a. The drugs often cause side effects. b. Patients must sometimes take a drug holiday. c. Drugs containing only levodopa are broken down in the blood before they can reach the brain to act. d. All of these statements are true. Answer: d. All of these statements are true. Correct Feedback: The drawbacks of levodopa include: 1. a very large oral dose of levodopa had to be given because 99 percent of the levodopa in the blood was converted into dopamine before it could reach the brain and 2. this extra dopamine in the blood caused side effects. When the dose of a drug for Parkinson’s disease can no longer be increased or side effects become intolerable, the physician will gradually withdraw the drug, placing the patient on a drug holiday for a few days. a. The drugs often cause side effects. Incorrect Feedback: This is a true statement. b. Patients must sometimes take a drug holiday. Incorrect Feedback: This is a true statement. c. Drugs containing only levodopa are broken down in the blood before they can reach the brain to act. Incorrect Feedback: This is a true statement. 19. The symptoms of Parkinson’s disease are due to ___________ in the brain. a. a decreased level of epinephrine and an increased level of norepinephrine b. a decreased level of dopamine and a decreased level of acetylcholine c. increased flow of sodium into the brain cell d. an increased level of acetylcholine and a decreased level of dopamine Answer: d. an increased level of acetylcholine and a decreased level of dopamine Correct Feedback: The symptoms of Parkinson’s disease are caused by an imbalance between dopamine and acetylcholine, two neurotransmitters in the brain. It is a lack of dopamine in the brain and a relative increase in acetylcholine that leads to the symptoms of Parkinson’s disease. a. a decreased level of epinephrine and an increased level of norepinephrine Incorrect Feedback: This is not the cause of Parkinson’s disease symptoms. b. a decreased level of dopamine and a decreased level of acetylcholine Incorrect Feedback: This is not the cause of Parkinson’s disease symptoms. c. increased flow of sodium into the brain cell Incorrect Feedback: This is not the cause of Parkinson’s disease symptoms. 20. All of the following combination drugs containing carbidopa and levodopa are used to treat Parkinson’s disease EXCEPT _____. a. ProSom b. Duodopa c. Parcopa d. Sinemet Answer: a. ProSom Correct Feedback: Estazolam (ProSom) is a benzodiazepine drug used to treat insomnia. b. Duodopa Incorrect Feedback: Duodopa is a combination drug used to treat Parkinson’s disease. c. Parcopa Incorrect Feedback: Parcopa is a combination drug used to treat Parkinson’s disease. d. Sinemet Incorrect Feedback: Sinemet is a combination drug used to treat Parkinson’s disease. 21. The trade name for the generic drug phenytoin that is used to treat seizures is _____. a. Provigil b. Symmetrel c. Dalmane d. Dilantin Answer: d. Dilantin Correct Feedback: Phenytoin (Dilantin) is in the category of hydantoin drugs used to treat epilepsy. a. Provigil Incorrect Feedback: Provigil is not used to treat seizures. b. Symmetrel Incorrect Feedback: Symmetrel is not used to treat seizures. c. Dalmane Incorrect Feedback: Dalmane is not used to treat seizures. 22. All of the following are nonbarbiturate drugs used to treat insomnia EXCEPT _____. a. Lunesta b. Rozerem c. Keppra d. Ambien Answer: c. Keppra Correct Feedback: Levetiracetam (Keppra) is an anticonvulsant drug that is unrelated to any other anticonvulsant drugs. a. Lunesta Incorrect Feedback: Lunesta is a nonbarbiturate drug used to treat insomnia. b. Rozerem Incorrect Feedback: Rozerem is a nonbarbiturate drug used to treat insomnia. d. Ambien Incorrect Feedback: Ambien is a nonbarbiturate drug used to treat insomnia. 23. Joey Childress, age eight, has absence seizures (petit mal) and is being treated with an antiseizure drug. He most likely is taking _____. a. diazepam (Valium) b. ethosuximide (Zarontin) c. estazolam (ProSom) d. Sinemet Answer: b. ethosuximide (Zarontin) Correct Feedback: Ethosuximide (Zarontin) is a succinimide drug that is used to treat absence seizures. a. diazepam (Valium) Incorrect Feedback: Diazepam (Valium) is not use to treat absence seizures. c. estazolam (ProSom) Incorrect Feedback: Estazolam (ProSom) is not used to treat seizures. d. Sinemet Incorrect Feedback: Sinemet is not used to treat seizures. 24. When a drug prescribed for Parkinson’s disease fails to control symptoms, and the side effects become too great, the physician _____. a. knows the patient is addicted b. increases the dose of drug c. prescribes an antidote d. initiates a drug holiday Answer: d. initiates a drug holiday Correct Feedback: When the dose of a drug for Parkinson’s disease can no longer be increased or side effects become intolerable, the physician will gradually withdraw the drug, placing the patient on a drug holiday for a few days. a. knows the patient is addicted Incorrect Feedback: Drugs used to treat Parkinson’s disease are not addictive. b. increases the dose of drug Incorrect Feedback: If the side effects become too great, the physician does not increase the dose of the drug. c. prescribes an antidote Incorrect Feedback: There is no antidote for drugs used to treat Parkinson’s disease. 25. All of these drugs are used to treat narcolepsy EXCEPT _____. a. tacrine (Cognex) b. modafinil (Provigil) c. dextroamphetamine (Dexedrine) d. methylphenidate (Ritalin) Answer: a. tacrine (Cognex) Correct Feedback: Tacrine (Cognex) is a cholinesterase inhibitor drug used to treat Alzheimer’s disease. b. modafinil (Provigil) Incorrect Feedback: This drug is used to treat narcolepsy. c. dextroamphetamine (Dexedrine) Incorrect Feedback: This drug is used to treat narcolepsy. d. methylphenidate (Ritalin) Incorrect Feedback: This drug is used to treat narcolepsy. 26. All of these drugs are used to treat epilepsy EXCEPT _____. a. topiramate (Topamax) b. valproic acid (Depakene, Depakote) c. fosphenytoin (Cerebyx) d. donepezil (Aricept) Answer: d. donepezil (Aricept) Correct Feedback: Donepezil (Aricept) is a cholinesterase inhibitor drug used to treat Alzheimer’s disease. a. topiramate (Topamax) Incorrect Feedback: Topiramate (Topamax) is used to treat epilepsy. b. valproic acid (Depakene, Depakote) Incorrect Feedback: Valproic acid (Depakene, Depakote) is used to treat epilepsy. c. fosphenytoin (Cerebyx) Incorrect Feedback: Fosphenytoin (Cerebyx) is used to treat epilepsy. 27. Which of the following is not categorized as a neuralgia or neuropathy? a. multiple sclerosis b. restless legs syndrome c. postherpetic neuralgia from shingles d. phantom limb pain Answer: a. multiple sclerosis Correct Feedback: Multiple sclerosis is an autoimmune disease in which the body makes antibodies against the myelin covering around certain nerves. Neuropathy is a disease of the nerves that often results in neuralgia or nerve pain. b. restless legs syndrome Incorrect Feedback: Restless legs syndrome is a type of neuralgia or neuropathy. c. postherpetic neuralgia from shingles Incorrect Feedback: Postherpetic neuralgia from shingles is a type of neuralgia or neuropathy. d. phantom limb pain Incorrect Feedback: Phantom limb pain is a type of neuralgia or neuropathy. 28. Which of the following statements is TRUE about levodopa? a. It can be given in very small oral doses to be effective. b. It is converted to serotonin in the blood. c. It cannot cross the blood-brain barrier. d. It is in the combination drugs Duodopa and Sinemet. Answer: d. It is in the combination drugs Duodopa and Sinemet. Correct Feedback: Duodopa and Sinemet are combination drugs for Parkinson’s disease that contain carbidopa and levodopa. a. It can be given in very small oral doses to be effective. Incorrect Feedback: Levodopa must be given in large doses to be effective. b. It is converted to serotonin in the blood. Incorrect Feedback: Levodopa is converted to dopamine in the blood. c. It cannot cross the blood-brain barrier. Incorrect Feedback: Levodopa can cross the blood-brain barrier. 29. Which of the following statements about donepezil (Aricept) is FALSE? a. It is the most prescribed drug for Alzheimer’s disease. b. It was originally derived from an unusual strain of daffodil bulbs. c. It is the first FDA-approved drug for treating all stages of Alzheimer’s disease. d. It belongs to the category of cholinesterase inhibitor drugs. Answer: b. It was originally derived from an unusual strain of daffodil bulbs. Correct Feedback: Galantamine (Razadyne) was originally derived from an unusual strain of daffodil bulbs, but extracting it proved to be too expensive, and so now it is now produced synthetically. a. It is the most prescribed drug for Alzheimer’s disease. Incorrect Feedback: This is a true statement. c. It is the first FDA-approved drug for treating all stages of Alzheimer’s disease. Incorrect Feedback: This is a true statement. d. It belongs to the category of cholinesterase inhibitor drugs. Incorrect Feedback: This is a true statement. 30. Which of the following is NOT a symptom of some type of an epileptic seizure? a. unconsciousness b. staring and a lack of attention c. difficulties with memory, judgment, and reasoning d. seizures that are associated with preeclampsia/eclampsia during pregnancy Answer: c. difficulties with memory, judgment, and reasoning Correct Feedback: As Alzheimer’s disease progresses, the loss of neurons causes difficulties with memory, judgment, and reasoning, that eventually progress to dementia. Symptoms of epilepsy range from barely noticeable staring or a lack of attention to a full tonic-clonic seizure with unconsciousness, muscle jerking, tongue biting, and incontinence. a. unconsciousness Incorrect Feedback: Unconsciousness is a symptom of one type of epileptic seizure. b. staring and a lack of attention Incorrect Feedback: Staring and a lack of attention is a symptom of one type of epileptic seizure. d. seizures that are associated with preeclampsia/eclampsia during pregnancy Incorrect Feedback: Seizures associated with preeclampsia/eclampsia during pregnancy are one type of epileptic seizure. 31. Which of the following statements is FALSE? a. Dilantin, which is used to treat epilepsy, is one of the oldest drugs on the market. b. Levodopa and carbidopa are available as individual drugs to treat Parkinson’s disease, as well as in all combination drugs to treat Parkinson’s disease. c. Narcolepsy is characterized by brief, involuntary episodes of falling asleep and extreme daytime sleepiness. d. Ambien is the most popular drug for insomnia. Answer: b. Levodopa and carbidopa are available as individual drugs to treat Parkinson’s disease, as well as in all combination drugs to treat Parkinson’s disease. Correct Feedback: Levodopa and carbidopa are no longer available as individual drugs, but are available in combination drugs. a. Dilantin, which is used to treat epilepsy, is one of the oldest drugs on the market. Incorrect Feedback: This is a true statement. c. Narcolepsy is characterized by brief, involuntary episodes of falling asleep and extreme daytime sleepiness. Incorrect Feedback: This is a true statement. d. Ambien is the most popular drug for insomnia. Incorrect Feedback: This is a true statement. 32. If a patient taking zolpidem (Ambien) experiences working, eating, or driving without being aware or remembering it, it is usually because _____. a. the patient did not get a full eight hours of sleep before becoming active b. the drug is strongly addictive and is causing side effects c. the patient is having an absence seizure d. the patient has developed narcolepsy from taking Ambien Answer: a. the patient did not get a full eight hours of sleep before becoming active Correct Feedback: Some patients taking zolpidem (Ambien) have reported unusual adverse effects of amnesia (not being aware or remembering) while working, eating, and even while driving. This usually occurs when a patient takes Ambien but continues to stay awake or takes Ambien but does not get a full eight hours of sleep before becoming active. b. the drug is strongly addictive and is causing side effects Incorrect Feedback: Ambien is a Schedule IV drug with a low potential for addiction. c. the patient is having an absence seizure Incorrect Feedback: These symptoms from Ambien are not related to having an epileptic seizure. d. the patient has developed narcolepsy from taking Ambien Incorrect Feedback: Ambien does not cause narcolepsy; narcolepsy is a hereditary disease. 33. Which of the following anticonvulsant drugs is NOT structurally related to GABA, a substance in the brain that inhibits nerve impulses? a. valproic acid (Depakene, Depakote) b. topiramate (Topamax) c. ropinirole (Requip) d. gabapentin (Neurontin) Answer: c. ropinirole (Requip) Correct Feedback: Ropinirole (Requip) is a dopamine agonist drug used to treat Parkinson’s disease. a. valproic acid (Depakene, Depakote) Incorrect Feedback: Valproic acid (Depakene, Depakote) is structurally related to GABA. b. topiramate (Topamax) Incorrect Feedback: Topiramate (Topamax) is structurally related to GABA. d. gabapentin (Neurontin) Incorrect Feedback: Gabapentin (Neurontin) is structurally related to GABA. 34. Topiramate (Topamax) is used to treat which of the following conditions? a. seizures and migraine headaches b. bipolar disorder and bulimia c. alcohol and cocaine dependence and as an aid to stop smoking d. all of the above Answer: d. all of the above Correct Feedback: Topiramate (Topamax) has many different uses. As an anticonvulsant drug, it is used to treat tonic-clonic seizures and simple partial and complex partial seizures. It is also one of the most commonly prescribed drugs to treat migraine headaches. It is also used to treat bipolar disorder, alcohol and cocaine dependence, and bulimia, and is used as an aid to lose weight and stop smoking. a. seizures and migraine headaches Incorrect Feedback: This is true, but it is not the only use. b. bipolar disorder and bulimia Incorrect Feedback: This is true, but it is not the only use. c. alcohol and cocaine dependence and as an aid to stop smoking Incorrect Feedback: This is true, but it is not the only use. 35. The choice of drug therapy to treat epilepsy depends on _____. a. the proper classification of the type of seizure b. the patient’s clinical symptoms c. the patient’s EEG pattern d. all of the above Answer: d. all of the above Correct Feedback: The choice of drug therapy for epilepsy depends on the proper classification of the type of seizure, and this is based on the patient’s clinical symptoms and EEG pattern. Each type of epilepsy displays a specific EEG pattern during a seizure. a. the proper classification of the type of seizure Incorrect Feedback: This is true, but it is not the only correct statement. b. the patient’s clinical symptoms Incorrect Feedback: This is true, but it is not the only correct statement. c. the patient’s EEG pattern Incorrect statement: This is true, but it is not the only correct statement. 36. Which of the following statements about multiple sclerosis is FALSE? a. It is caused by a herpes virus infection that reappears in the elderly or at times of stress. b. It is an autoimmune disease with antibodies against the myelin covering of certain nerves. c. There is interruption of the nerve conduction between the brain and spinal cord. d. Symptoms include double vision, muscle weakness and tremors, and neuralgia. Answer: a. It is caused by a herpes virus infection that reappears in the elderly or at times of stress. Correct Feedback: Postherpetic neuralgia, not multiple sclerosis, is caused by shingles, a herpes virus infection originally from chicken pox that reappears in the elderly or at times of stress or illness. Multiple sclerosis is an autoimmune disease in which the body makes antibodies against the myelin covering around certain nerves. There is acute inflammation with chronic, progressive interruption of nerve conduction between the brain and the spinal cord. Symptoms include double vision, large muscle weakness, uncoordinated gait, muscle spasticity, tremors, and neuralgias. b. It is an autoimmune disease with antibodies against the myelin covering of certain nerves. Incorrect Feedback: This is a true statement. c. There is interruption of the nerve conduction between the brain and spinal cord. Incorrect Feedback: This is a true statement. d. Symptoms include double vision, muscle weakness and tremors, and neuralgia. Incorrect Feedback: This is a true statement. 37. Which of the following is NOT a common type of epileptic seizure? a. narcolepsy b. grand mal c. psychomotor d. simple partial Answer: a. narcolepsy Correct Feedback: Narcolepsy is not a type of epilepsy. There are four common types of seizures: 1. tonic-clonic (also known as grand mal), 2. absence (also known as petit mal), 3. complex partial (also known as psychomotor), and 4. simple partial (also known as focal motor). b. grand mal Incorrect Feedback: Grand mal (or tonic-clonic) is a common type of epileptic seizure. c. psychomotor Incorrect Feedback: Psychomotor (complex partial) is a common type of epileptic seizure. d. simple partial Incorrect Feedback: Simple partial (focal motor) is a common type of epileptic seizure. 38. Which statement about status epilepticus is FALSE? a. It is a state of prolonged, continuous seizure activity. b. It consists of frequently repeated seizures without the patient regaining consciousness. c. It is an irreversible, progressive disease that leads to dementia. d. It is a medical emergency because it can cause brain damage. Answer: c. It is an irreversible, progressive disease that leads to dementia. Correct Feedback: Alzheimer’s disease is an irreversible, progressive disease that leads to dementia. Status epilepticus is a state of prolonged, continuous seizure activity or frequently repeated individual seizures that occur without the patient regaining consciousness. Seizures lasting over 30 seconds can cause brain damage. Therefore, status epilepticus is a medical emergency. a. It is a state of prolonged, continuous seizure activity. Incorrect Feedback: This is a true statement. b. It consists of frequently repeated seizures without the patient regaining consciousness. Incorrect Feedback: This is a true statement. d. It is a medical emergency because it can cause brain damage. Incorrect Feedback: This is a true statement. 39. Which of the following diseases is characterized by beta-amyloid protein plaques and neurofibrillary tangles? a. grand mal seizures b. narcolepsy c. Parkinson’s disease d. Alzheimer’s disease Answer: d. Alzheimer’s disease Correct Feedback: Alzheimer’s disease is the most common form of dementia. Beta-amyloid protein plaques accumulate between the neurons, while neurofibrillary tangles occur within the neurons. a. grand mal seizures Incorrect Feedback: Grand mal seizures are not characterized by beta-amyloid plaques and neurofibrillary tangles. b. narcolepsy Incorrect Feedback: Narcolepsy is not characterized by beta-amyloid plaques and neurofibrillary tangles. c. Parkinson’s disease Incorrect Feedback: Parkinson’s disease is not characterized by beta-amyloid plaques and neurofibrillary tangles. 40. _____ is the only drug for Alzheimer’s disease that comes in the form of a transdermal patch. a. Memantine (Namenda) b. Galantamine (Razadyne) c. Rivastigmine (Exelon) d. Donepezil (Aricept) Answer: c. Rivastigmine (Exelon) Correct Feedback: Rivastigmine (Exelon) is the only drug for Alzheimer’s disease that comes in the form of a transdermal patch. a. Memantine (Namenda) Incorrect Feedback: This drug is used to treat Alzheimer’s disease, but it is not a transdermal patch. b. Galantamine (Razadyne) Incorrect Feedback: This drug is used to treat Alzheimer’s disease, but it is not a transdermal patch. d. Donepezil (Aricept) Incorrect Feedback: This drug is used to treat Alzheimer’s disease, but it is not a transdermal patch. 41. All of the following statements about Parkinson’s disease are true EXCEPT: a. It first appears usually in late middle age. b. It is characterized by excessive fatigue of the voluntary muscles. c. Early symptoms include muscle rigidity, tremors, and a slowing of voluntary movements. d. Late symptoms include mask-like facial expression and loss of ability to ambulate. Answer: b. It is characterized by excessive fatigue of the voluntary muscles. Correct Feedback: Myasthenia gravis is characterized by excessive fatigue of the voluntary muscles. Parkinson’s disease is a chronic, degenerative condition affecting the brain. Its early symptoms, first appearing usually in late middle age, include muscle rigidity, tremors, and a slowing of voluntary movements. Parkinson’s disease follows a progressively downhill clinical course. Later symptoms include a mask-like facial expression, drooling from rigidity of the facial muscles, resting tremor, and loss of the ability to ambulate. a. It first appears usually in late middle age. Incorrect Feedback: This is a true statement. c. Early symptoms include muscle rigidity, tremors, and a slowing of voluntary movements. Incorrect Feedback: This is a true statement. d. Late symptoms include mask-like facial expression and loss of ability to ambulate. Incorrect Feedback: This is a true statement. 42. Barbiturate drugs are commonly prescribed as sleeping pills to treat insomnia. Answer: False Feedback: Barbiturate drugs were once popular drugs for insomnia, but because they are Schedule II, III, and IV drugs and because of their higher potential to cause addiction, are used infrequently for treating insomnia. 43. Hydantoin drugs act on the cell membrane of neurons in the motor cortex of the brain. Answer: True Feedback: Hydantoin drugs act on the cell membrane of neurons in the motor cortex of the brain. 44. Sulfonamide drugs are used to treat bacterial infections, although the sulfonamide drug Zonegran is only used to treat epilepsy. Answer: True Feedback: Sulfonamide drugs are usually used to treat bacterial infections. The sulfonamide drug zonisamide (Zonegran), however, only acts as an anticonvulsant drug, although its mechanism of action is not understood. 45. Dopamine agonist drugs directly stimulate dopamine receptors to produce an effect that is similar to that of dopamine. Answer: True Feedback: Dopamine agonist drugs directly stimulate dopamine receptors to produce an effect that is similar to that of dopamine. 46. Patients with myasthenia gravis produce antibodies against their own acetylcholine receptors on voluntary muscles cells. Answer: True Feedback: On a cellular level, patients with myasthenia gravis produce antibodies against their own acetylcholine receptors that are on the cell membranes of voluntary muscle cells. 47. When MAO inhibitor drugs for Parkinson’s disease inhibit the enzyme MAO, this results in a decreased amount of dopamine. Answer: False Feedback: MAO inhibitor drugs inhibit MAO, an enzyme in the brain that destroys dopamine. When MAO is inhibited, this results in increased levels of dopamine. 48. Over-the-counter sleep aids contain an antihistamine drug that uses the drug’s side effect of drowsiness as the therapeutic effect to induce sleep. Answer: True Feedback: Over-the-counter (OTC) sleep aids contain an antihistamine drug. These drugs use the antihistamine's side effect of drowsiness as the therapeutic effect to induce sleep. 49. The anticonvulsant drug felbamate (Felbatol) is only used if other anticonvulsant drugs have failed to control seizures. Answer: True Feedback: Felbamate (Felbatol) is an anticonvulsant drug only used if other anticonvulsant drugs have failed to control seizures. 50. The Parkinson’s disease drugs NeuroCell-PD and Spheramine are actually composed of millions of cells that, when implanted in the brain, produce levodopa or dopamine. Answer: True Feedback: These drugs are actually composed of millions of cells that, when implanted in the brain, produce levodopa or dopamine. They are currently approved by the FDA as orphan drugs. NeuroCell-PD contains nerve cells from fetal pigs (the PD stands for Parkinson’s disease), while Spheramine contains pigment cells from human retinas. 51. When a barbiturate drug is used to treat epilepsy, it is said to have an antihistamine effect. Answer: False Feedback: Barbiturate drugs for epilepsy have a sedative and anticonvulsant effect. 52. Tonic-clonic seizures resistant to other drugs are treated with the orphan drug antiepilepsirine. Answer: True Feedback: Tonic-clonic seizures resistant to other drugs are treated with the orphan drug antiepilepsirine. 53. The drugs diazepam (Diastat) and phenytoin (Dilantin) are used to treat seizures associated with preeclampsia/eclampsia during pregnancy. Answer: False Feedback: Magnesium sulfate and phenytoin (Dilantin) are used to treat seizures associated with preeclampsia/eclampsia during pregnancy. 54. Melatonin, a hormone that regulates the wake-sleep cycle, is available as a prescription drug. Answer: True Feedback: Melatonin maintains the body’s internal clock, the 24-hour wake-sleep cycle (the circadian rhythm), and regulates the onset and duration of sleep. Melatonin is available as an over-the-counter drug that has the same actions. 55. Nadolol and propranolol are beta-blocker drugs that are most commonly used to treat hypertension and angina, but are also used to treat the tremors and rigidity of Parkinson’s disease. Answer: True Feedback: These drugs are specifically used to treat the tremors and rigidity of Parkinson’s disease, but Nadolol and propranolol are beta-blocker drugs most commonly used to treat hypertension and angina. 56. Tonic-clonic seizures are also known as grand mal seizures. Answer: True Feedback: Tonic-clonic seizures are also known as grand mal seizures. 57. No drug currently on the market is able to reverse the symptoms of or cure Alzheimer’s disease. Answer: True Feedback: No drug currently on the market is able to reverse the symptoms of or cure Alzheimer’s disease. 58. __________ drugs for epilepsy depress the motor cortex of the brain and raise the seizure threshold. Answer: Succinimide Feedback: Succinimide drugs depress the motor cortex of the brain and raise the seizure threshold. 59. The advertisement for the trade name drug _______ shows a moth that only comes out at night flying into a bedroom window and putting a person to sleep. Answer: Lunesta Feedback: The trade name Lunesta is a reference to the luna moth that only comes out at night. The moth’s name is derived from a Latin word that refers to the moon. In drug advertisements for Lunesta, this large, pale moth is seen flying in a bedroom window and putting a person to sleep as it comes near. 60. The medical word ______ means nerve pain. Answer: neuralgia Feedback: Neuropathy is a disease of the nerves that often results in neuralgia or nerve pain. 61. Drugs that inhibit the enzyme __________ (which breaks down acetylcholine) effectively raise the acetylcholine level in the brain. Answer: cholinesterase Feedback: Drugs that inhibit the enzyme cholinesterase (which breaks down acetylcholine) effectively raise the acetylcholine level in the brain and help available acetylcholine to continue to function without being broken down. 62. __________ drugs that are used to induce sleep and treat insomnia get their name from the Greek word for sleep. Answer: Hypnotic Feedback: Hypnotic drugs are used to induce sleep. The word hypnotic is from the Greek word hypnos for sleep. 63. The suffix __________ is common to generic benzodiazepine drugs. Answer: –azepam Feedback: The suffix –azepam is common to generic benzodiazepine drugs. 64. The drug advertisement for the trade name drug ______ shows feet being pricked by a cactus or ants crawling on the feet. Answer: Lyrica Feedback: The drug advertisement for pregabalin (Lyrica) graphically shows the sensation that some patients suffering from neuralgia have: a stabbing pain or shooting sensation in the feet. Other symptoms include burning pain, tingling, or numbness. Other Lyrica advertisements show ants crawling on the feet or thumbtacks pricking the feet. 65. The suffix __________ is common to many generic barbiturate drugs. Answer: –barbital Feedback: The suffix –barbital is common to many generic barbiturate drugs. 66. Drugs used to treat epilepsy are known as __________ drugs because epilepsy is characterized by seizures or convulsions. Answer: anticonvulsant Feedback: Drugs used to treat epilepsy are known as anticonvulsant drugs because epilepsy is characterized by seizures or convulsions. 67. __________ disease is the most common form of dementia. The drugs used to treat it cannot reverse the underlying destruction of neurons. Answer: Alzheimer’s Feedback: Alzheimer’s disease is the most common form of dementia. The drugs used to treat it cannot reverse the underlying destruction of neurons. 68. The drugs clonazepam (Klonopin) and levetiracetam (Keppra) are used to treat __________ seizures, which occur in the morning and during times of stress in children and adolescents. Answer: myoclonic Feedback: The drugs clonazepam (Klonopin) and levetiracetam (Keppra) are used to treat myoclonic seizures, which occur in the morning and during times of stress in children and adolescents. Matching Questions 69. 1. clonazepam (Klonopin) A. drug for seizures and neuralgia (tingling, burning) 2. gamma hydroxybutyrate (GHB) B. barbiturate drug for epilepsy and insomnia 3. pentobarbital (Nembutal) C. barbiturate drug for insomnia 4. phenobarbital (Luminal) D. benzodiazepine drug for epilepsy 5. phenytoin (Dilantin) E. cholinesterase inhibitor drug for Alzheimer’s disease 6. pramipexole (Mirapex) F. dopamine agonist drug for Parkinson’s disease 7. pregabalin (Lyrica) G. hydantoin drug for epilepsy 8. rasagiline (Azilect) disease H. MAO inhibitor drug for Parkinson’s 9. rivastigmine (Exelon) I. nonbarbiturate drug for insomnia 10. zolpidem (Ambien) J. Schedule I drug for narcolepsy Answer: D Answer: J Answer: C Answer: B Answer: G Answer: F Answer: A Answer: H Answer: E Answer: I Feedback: These drugs are found throughout the chapter. 70. Briefly explain how anticholinergic drugs for Parkinson’s disease work and what their effect is on dopamine. Answer: Anticholinergic drugs inhibit the action of acetylcholine at cholinergic receptors in the brain to balance the relative abundance of acetylcholine compared to the scarcity of dopamine. They also help to prolong the action of any dopamine that is present. 71. Describe how a physician makes a diagnosis of epilepsy. Answer: The choice of drug therapy for epilepsy depends on the proper classification of the type of seizure, and this is based on the patient’s clinical symptoms and EEG pattern. Each type of epilepsy displays a specific EEG pattern during a seizure. 72. Briefly explain what a drug holiday is related to the treatment of Parkinson’s disease, why it is used, and what its effects are. Answer: No drug can cure Parkinson’s disease. In fact, over time, tolerance to a drug’s therapeutic effect can develop. A larger dose is then required to maintain control of parkinsonian symptoms; however, this larger dose also produces more side effects. When the dose can no longer be increased or side effects become intolerable, the physician will gradually withdraw the drug, placing the patient on a drug holiday for a few days. When drug therapy is again initiated, the patient will respond to lower doses of antiparkinsonian drugs. 73. If Parkinson’s disease is caused by a lack of dopamine in the brain, why can’t dopamine as a drug be given to treat the symptoms of Parkinson’s disease? Answer: Early attempts to increase the diminished supply of dopamine in the brain were unsuccessful because dopamine as a drug in the blood cannot cross the blood-brain barrier and enter the brain. Test Bank for Understanding Pharmacology for Health Professionals Susan M. Turley 9780135145708, 9780133911268