LPCC Pharmacology Fundamentals 3 — Questions and Answers
Question 1: Which of the following atypical antipsychotics carries the highest risk of metabolic syndrome, including significant weight gain and diabetes?
- Aripiprazole
- Ziprasidone
- Clozapine (Correct answer)
- Lurasidone
Correct answer: Clozapine
Clozapine is associated with the greatest risk of metabolic syndrome among second-generation antipsychotics, requiring regular monitoring of weight, glucose, and lipids.
Question 2: A client on valproate reports stomach upset and hair loss. What micronutrient supplementation is often recommended to mitigate the hair loss side effect?
- Iron
- Zinc (Correct answer)
- Magnesium
- Selenium
Correct answer: Zinc
Valproate can deplete zinc levels, and zinc supplementation is commonly recommended to address valproate-associated alopecia.
Question 3: When counseling a client about bupropion, which psychiatric condition represents an absolute contraindication?
- Generalized anxiety disorder
- Current or history of seizure disorder or bulimia (Correct answer)
- Major depressive disorder with psychotic features
- Post-traumatic stress disorder
Correct answer: Current or history of seizure disorder or bulimia
Bupropion lowers the seizure threshold significantly, making seizure disorder and bulimia (due to electrolyte imbalances) absolute contraindications.
Question 4: Which term describes the phenomenon where a drug's effectiveness diminishes over time at the same dose, requiring higher doses to achieve the same effect?
- Sensitization
- Tolerance (Correct answer)
- Potentiation
- Synergism
Correct answer: Tolerance
Tolerance is the pharmacodynamic adaptation where the body responds less strongly to a drug over time, necessitating dose escalation for the same effect.
Question 5: A client taking carbamazepine for bipolar disorder starts a new oral contraceptive. What pharmacokinetic interaction is most important to address?
- Carbamazepine increases OCP absorption
- Carbamazepine induces CYP450 enzymes, reducing OCP effectiveness (Correct answer)
- Carbamazepine inhibits OCP metabolism, increasing hormone levels
- No clinically significant interaction exists
Correct answer: Carbamazepine induces CYP450 enzymes, reducing OCP effectiveness
Carbamazepine is a potent CYP450 inducer that accelerates the metabolism of oral contraceptives, significantly reducing their contraceptive effectiveness.
Question 6: Which receptor mechanism distinguishes buspirone from benzodiazepines in treating anxiety?
- Buspirone acts as a GABA-A agonist like benzodiazepines
- Buspirone is a partial agonist at 5-HT1A receptors with no GABA activity (Correct answer)
- Buspirone blocks dopamine D4 receptors exclusively
- Buspirone inhibits norepinephrine reuptake
Correct answer: Buspirone is a partial agonist at 5-HT1A receptors with no GABA activity
Buspirone exerts its anxiolytic effect as a partial agonist at serotonin 5-HT1A receptors and does not interact with GABA receptors, unlike benzodiazepines.
Question 7: An LPCC notices a client on an antipsychotic has developed muscle rigidity, high fever, altered consciousness, and autonomic instability. What medical emergency should be suspected?
- Serotonin syndrome
- Neuroleptic malignant syndrome (Correct answer)
- Tardive dyskinesia
- Acute dystonic reaction
Correct answer: Neuroleptic malignant syndrome
Neuroleptic malignant syndrome (NMS) is a life-threatening reaction to antipsychotics characterized by hyperthermia, rigidity, altered mental status, and autonomic dysfunction.
LPCC Pharmacology Fundamentals 3
Which of the following atypical antipsychotics carries the highest risk of metabolic syndrome, including significant weight gain and diabetes?