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Central Nervous System Agents Flashcards

7 cards from real Pharmacology practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A patient taking clozapine develops a fever, sore throat, and absolute neutrophil count of 400/mm³. What is the immediate action?

    Answer: Permanently discontinue clozapine and notify the registry

    ANC below 500/mm³ indicates severe agranulocytosis; clozapine must be permanently discontinued and the REMS registry notified immediately.

  2. Which opioid is contraindicated in patients with renal failure due to accumulation of an active neurotoxic metabolite?

    Answer: Meperidine

    Meperidine's active metabolite normeperidine accumulates in renal failure and causes CNS excitation, tremors, and seizures.

  3. A depressed patient starts an SSRI. Which adverse effect should be specifically discussed during the first 1-2 weeks of therapy?

    Answer: Increased suicidal ideation, especially in patients under 25

    The FDA black box warning for antidepressants highlights increased suicidal thinking and behavior in patients under 25, most prominent in the first few weeks.

  4. Which drug combination is most likely to cause serotonin syndrome?

    Answer: Phenelzine + meperidine

    Phenelzine (MAO inhibitor) combined with meperidine (which also inhibits serotonin reuptake) causes dangerous serotonin excess.

  5. A patient receiving haloperidol develops sustained muscle rigidity, hyperthermia of 40°C, and autonomic instability. What is the diagnosis?

    Answer: Neuroleptic malignant syndrome

    Neuroleptic malignant syndrome is characterized by the tetrad of hyperthermia, rigidity, autonomic instability, and altered consciousness from dopamine blockade.

  6. Carbidopa is combined with levodopa in Parkinson's treatment primarily to:

    Answer: Inhibit peripheral DOPA decarboxylase, reducing peripheral dopamine conversion

    Carbidopa inhibits peripheral DOPA decarboxylase, preventing levodopa conversion to dopamine outside the CNS and reducing peripheral side effects while increasing CNS availability.

  7. A patient reports taking a medication for neuropathic pain that works by binding to alpha-2-delta subunits of voltage-gated calcium channels. This drug is most likely:

    Answer: Gabapentin

    Gabapentin (and pregabalin) bind to the alpha-2-delta subunit of voltage-gated calcium channels, reducing neuronal excitability and neuropathic pain signaling.