Pharmacology Central Nervous System Agents Questions and Answers

Question 1

A patient stabilized on sertraline for major depressive disorder is prescribed sumatriptan for acute migraine headaches.
Shortly after taking both medications, the patient presents to the emergency department with agitation, hyperreflexia, diaphoresis, and a temperature of 39°C.
This clinical presentation is most consistent with which adverse drug reaction?

Accepted Answer

Serotonin Syndrome

Answer

Neuroleptic Malignant Syndrome

Answer

Anticholinergic Toxicity

Answer

Hypertensive Crisis

Question 2

A patient undergoing surgery with sevoflurane and succinylcholine develops sudden tachycardia, muscle rigidity, and a rapid increase in body temperature. Which of the following intravenous agents is the definitive treatment for this life-threatening condition?

Accepted Answer

Dantrolene

Answer

Lorazepam

Answer

Labetalol

Answer

Sodium Bicarbonate

Question 3

A patient with Parkinson's disease who is managed with levodopa/carbidopa reports that the medication's effects are not lasting until the next scheduled dose, a phenomenon known as 'wearing-off'. To prolong the action of levodopa, a physician adds entacapone to the regimen. What is the mechanism of action of entacapone?

Accepted Answer

It inhibits catechol-O-methyltransferase (COMT), reducing peripheral metabolism of levodopa.

Answer

It directly stimulates dopamine D2 receptors in the striatum.

Answer

It inhibits monoamine oxidase B (MAO-B), preventing central dopamine breakdown.

Answer

It is a potent anticholinergic agent that rebalances acetylcholine and dopamine.

Question 4

Which of the following statements best describes the primary mechanism of action for the anticonvulsant drug phenytoin?

Accepted Answer

Blockade of voltage-gated sodium channels

Answer

Enhancement of GABA-mediated chloride influx

Answer

Blockade of T-type calcium channels in the thalamus

Answer

Antagonism of NMDA glutamate receptors

Question 5

A patient brought to the emergency department after a suspected overdose is unconscious with significant respiratory depression. An empty bottle of lorazepam is found at the scene. Which of the following medications should be administered to reverse the effects of the benzodiazepine?

Accepted Answer

Flumazenil

Answer

Naloxone

Answer

N-acetylcysteine

Answer

Protamine sulfate

Question 6

Second-generation (atypical) antipsychotics, such as olanzapine and clozapine, generally have a lower risk of causing extrapyramidal symptoms (EPS) compared to first-generation (typical) agents. However, they are more frequently associated with which of the following adverse effects?

Accepted Answer

Metabolic syndrome

Answer

Agranulocytosis

Answer

Tardive dyskinesia

Answer

Neuroleptic malignant syndrome