American Board of Psychiatry and Neurology ABPN Neuropharmacology and Psychopharmacology 2

Question 1

Which mechanism best describes how benzodiazepines produce their sedative-anxiolytic effects?

Accepted Answer

Potentiate GABA-A chloride channel opening

Answer

Benzodiazepines bind to GABA-A receptors and increase the frequency of chloride channel opening in response to GABA, enhancing inhibitory neurotransmission.

Question 2

Which antidepressant is CONTRAINDICATED in patients with a seizure disorder or eating disorders due to lowered seizure threshold?

Accepted Answer

Bupropion

Answer

Bupropion dose-dependently lowers the seizure threshold and is contraindicated in patients with seizure disorders or active eating disorders.

Question 3

A patient stabilized on olanzapine gains 25 pounds over 6 months and develops hyperglycemia. This best exemplifies which pharmacological mechanism?

Accepted Answer

H1 histamine receptor antagonism and 5-HT2C blockade

Answer

Olanzapine's metabolic side effects are primarily attributed to H1 and 5-HT2C receptor blockade, which increase appetite and impair glucose regulation.

Question 4

Which drug interaction is MOST clinically significant in a patient taking valproate who starts carbamazepine?

Accepted Answer

Carbamazepine induces CYP enzymes, decreasing valproate levels

Answer

Carbamazepine is a potent CYP3A4 inducer that significantly reduces valproate serum levels, potentially causing loss of seizure control.

Question 5

What is the mechanism by which acetylcholinesterase inhibitors improve symptoms in Alzheimer's disease?

Accepted Answer

They increase acetylcholine availability at synapses

Answer

Acetylcholinesterase inhibitors (e.g., donepezil, rivastigmine) prevent the breakdown of acetylcholine, compensating for the cholinergic deficit in Alzheimer's disease.

American Board of Psychiatry and Neurology Practice Test

American Board of Psychiatry and Neurology Practice Test

American Board of Psychiatry and Neurology ABPN Neuropharmacology and Psychopharmacology 2