Pharmacology Central Nervous System Agents 2

Question 1

A patient taking an MAO inhibitor eats aged cheese and develops a hypertensive crisis. What interaction caused this?

Accepted Answer

Tyramine accumulation due to inhibited MAO-A breakdown

Answer

Serotonin syndrome from tyramine metabolism

Answer

Direct cheese-drug binding causing vasoconstriction

Answer

Increased dopamine reuptake from tyramine

Question 2

Which benzodiazepine is preferred for treating acute alcohol withdrawal seizures due to its long half-life and self-tapering effect?

Accepted Answer

Diazepam

Answer

Lorazepam

Answer

Midazolam

Answer

Alprazolam

Question 3

A patient on lithium presents with coarse tremor, confusion, and ataxia. Serum lithium is 2.8 mEq/L. What is the priority intervention?

Accepted Answer

Discontinue lithium and initiate hemodialysis

Answer

Add propranolol for tremor control

Answer

Reduce lithium dose by half

Answer

Switch to valproate immediately

Question 4

Which mechanism best explains how levodopa reduces Parkinson's symptoms?

Accepted Answer

Crosses the blood-brain barrier and is converted to dopamine

Answer

Directly activates dopamine D2 receptors in the striatum

Answer

Inhibits acetylcholinesterase to restore dopamine-ACh balance

Answer

Blocks COMT enzymes peripherally to increase CNS dopamine

Question 5

A nurse administers flumazenil to reverse benzodiazepine sedation. What critical risk must be monitored for?

Accepted Answer

Resedation as flumazenil wears off before the benzodiazepine

Answer

Prolonged hypnosis from flumazenil accumulation

Answer

Acute respiratory alkalosis from rapid arousal

Answer

Hypertensive urgency from sympathetic rebound

Question 6

Which antiepileptic drug acts primarily by blocking voltage-gated sodium channels to stabilize neuronal membranes?

Accepted Answer

Phenytoin

Answer

Gabapentin

Answer

Ethosuximide

Answer

Valproic acid

Question 7

A patient with bipolar disorder is started on valproate. Which baseline lab is most critical before initiating therapy?

Accepted Answer

Liver function tests

Answer

Serum creatinine and BUN

Answer

Thyroid function tests

Answer

Complete blood count with differential