RP Pharmacology Fundamentals 3 — Questions and Answers
Question 1: A client taking a monoamine oxidase inhibitor (MAOI) consumes aged cheese at a dinner party and develops a severe throbbing headache and hypertension. What reaction has occurred?
- Serotonin syndrome
- Tyramine hypertensive crisis (Correct answer)
- Anticholinergic crisis
- Opioid toxicity
Correct answer: Tyramine hypertensive crisis
MAOIs block the breakdown of tyramine in the gut; ingesting tyramine-rich foods like aged cheese causes excessive norepinephrine release, leading to a dangerous hypertensive crisis.
Question 2: Which receptor mechanism best explains why benzodiazepines enhance GABA's inhibitory effect in the CNS?
- They act as GABA agonists by directly opening chloride channels
- They bind to a modulatory site on the GABA-A receptor, increasing chloride channel frequency (Correct answer)
- They block glutamate receptors to reduce excitatory neurotransmission
- They inhibit COMT, increasing synaptic GABA levels
Correct answer: They bind to a modulatory site on the GABA-A receptor, increasing chloride channel frequency
Benzodiazepines bind to an allosteric site on the GABA-A receptor and increase the frequency of chloride channel opening in response to GABA, enhancing inhibitory transmission.
Question 3: A client has been taking diazepam daily for 8 months and stops abruptly. Which withdrawal symptom is most life-threatening?
- Insomnia and irritability
- Rebound anxiety
- Seizures (Correct answer)
- Mild tremor
Correct answer: Seizures
Abrupt benzodiazepine withdrawal after prolonged use can cause seizures, which may be fatal; a supervised taper is required.
Question 4: Which second-generation antipsychotic carries the highest risk of metabolic syndrome, including weight gain, hyperglycemia, and dyslipidemia?
- Aripiprazole
- Ziprasidone
- Olanzapine (Correct answer)
- Lurasidone
Correct answer: Olanzapine
Olanzapine is associated with the highest risk of metabolic side effects among atypical antipsychotics, including significant weight gain, hyperglycemia, and elevated lipids.
Question 5: A psychotherapist is aware that a client's SSRI dose was recently doubled. The client now reports nausea and diarrhea. What is the most likely explanation?
- Serotonin syndrome
- Dose-dependent GI side effects from serotonin activity in the gut (Correct answer)
- Hepatotoxicity from the increased dose
- Anticholinergic side effects
Correct answer: Dose-dependent GI side effects from serotonin activity in the gut
SSRIs increase serotonin in the GI tract as well as the brain; nausea and diarrhea are common, dose-dependent GI side effects that often improve over time.
Question 6: Which term describes the phenomenon where a previously effective drug dose no longer produces the same therapeutic effect, requiring dose escalation?
- Sensitization
- Tolerance (Correct answer)
- Dependence
- Withdrawal
Correct answer: Tolerance
Tolerance is the pharmacological adaptation where repeated drug exposure reduces its effect, necessitating higher doses to achieve the same response.
Question 7: A client taking bupropion reports a new-onset seizure. Which pre-existing condition most significantly increased this risk?
- Hypertension
- Type 2 diabetes
- Bulimia nervosa (Correct answer)
- Hypothyroidism
Correct answer: Bulimia nervosa
Bupropion lowers seizure threshold, and this risk is substantially elevated in individuals with eating disorders such as bulimia nervosa due to electrolyte imbalances.
RP Pharmacology Fundamentals 3
A client taking a monoamine oxidase inhibitor (MAOI) consumes aged cheese at a dinner party and develops a severe throbbing headache and hypertension.
What reaction has occurred?