Central Nervous System Agents Flashcards

A patient withdrawing from long-term benzodiazepine use is at highest risk for which life-threatening complication?

Answer: Grand mal seizures

Abrupt benzodiazepine withdrawal can cause life-threatening tonic-clonic seizures due to GABA-A receptor downregulation and CNS hyperexcitability.

Which second-generation antipsychotic is also FDA-approved for bipolar depression and uniquely has minimal weight gain and metabolic effects?

Answer: Lurasidone

Lurasidone is approved for bipolar depression and schizophrenia, with a favorable metabolic profile showing minimal weight gain and lipid changes compared to other atypicals.

A patient with Parkinson's disease develops sudden 'sleep attacks' while driving. Which medication class is most likely responsible?

Answer: Dopamine agonists like pramipexole

Dopamine agonists (pramipexole, ropinirole) are associated with sudden-onset sleep attacks without warning, a critical safety concern for drivers and machine operators.

Which statement about buprenorphine's pharmacology makes it useful for opioid use disorder treatment?

Answer: Partial agonist activity with a ceiling effect limits respiratory depression risk

Buprenorphine is a partial mu-opioid agonist with a ceiling on respiratory depression, making it safer than full agonists while still suppressing withdrawal symptoms.

A patient is prescribed lamotrigine for bipolar disorder. What is the most important counseling point regarding a potentially life-threatening adverse effect?

Answer: Report any rash immediately as it may progress to Stevens-Johnson syndrome

Lamotrigine can cause Stevens-Johnson syndrome, a life-threatening skin condition; patients must be instructed to report any new rash immediately and seek emergency care.

Which drug used for insomnia works as a selective orexin receptor antagonist, blocking wake-promoting signals?

Answer: Suvorexant

Suvorexant blocks orexin (hypocretin) receptors OX1R and OX2R, reducing wake-promoting signals to promote natural sleep without CNS depression.

A patient with schizophrenia is switched from oral risperidone to an injectable long-acting formulation. What is the primary advantage of this formulation change?

Answer: Improved adherence by eliminating the need for daily oral dosing

Long-acting injectable antipsychotics eliminate the need for daily medication, dramatically improving adherence in patients who struggle to take oral medications consistently.