Post 12 psych/seizure/abuse

An herb thought to be useful in treating memory problems is:

A. Ginseng
B. St John's Wort
C. Ginkgo Biloba
D. Echinacea



A side effect common to most of the anticonvulsants is:

A. Hiccoughs
B. Sedation
C. Hypertension
D. Peripheral neuropathies (numbness and tingling in fingers and/or toes)



Fluoxetine (PROZAC) relieves depression by:

A. increasing the amount of serotonin in the synaptic cleft
B. blocking release of norepinephrine from the pre-synaptic nerve
C. increasing the metabolism of MAO (mono-amine oxidase)
D. depressing the metabolism of MAO



Carbamazepine is indicated for:

A. Bipolar disease
B. Febrile seizures in children
C. Depression
D. Partial seizures



Ethosuximide is indicated for:

A. Partial seizures
B. Tonic-clonic seizures
C. Absence seizures
D. Status epilepticus



Severe alcohol withdrawal:

A. May not be manifested until several days after alcohol ingestion has stopped.
B. Includes signs and symptoms of hallucinations, agitation, sweating, rapid heart rate.
C. Is treated aggressively with benzodiazepines or the patient could die.
D. All of the above.



Mr. H is brought to the emergency room with chest pain, a rapid pounding heart beat and very high blood pressure. Since he is only 28, in excellent physical shape and has no history of heart disease, it surprises you when his tests show he had a heart attack. Which of the following drugs of abuse most likely could have contributed to the decreased oxygen delivery to his heart?

A. Alcohol
B. Cocaine
C. A hallucinogen such as LSD
D. Heroin



A patient seeks medical attention for depression and receives a prescription for paroxetine 20 mg/day. 3 weeks later the patient states the symptoms have not improved. The best course of action is to:

A. Change to phenelzine
B. Suggest adding St. John's Wort herbal product
C. Change to amitriptyline
D. Increase the dose of paroxetine



Which of the following are/is a cholinesterase inhibitor(s), appropriate for the treatment of symptoms of Alzheimer's disease?

A. carbamazepine, ethosuximide, lamotrigine
B. physostigmine, pyridostigmine
C. memantine
D. donepezil, galatamine, rivastigimine



When evaluating care provided by hospitals, the Joint Commission may review whether chemical restraints are used appropriately, in the treatment of patients, or inappropriately, to "police" irritating behavior. Which of the following is an appropriate use of chemical restraints?

A. A patient is agitated and restless, writhing around in bed which is causing the dressings to be torn off a wound. The nurse gives a dose of midazolam.
B. The nurse administers risperidone to an elderly confused patient who tried to climb over the bedrail when the family has just agreed to leave one member at the bedside around the clock.
C. The doctor orders vicodin for a delirious patient who has pulled out 2 IV lines in the last hour.
D. A patient with a drug overdose is yelling obcenities in the emergency room and other patients are complaining. The nurse gives a dose of haloperidol.



The mechanism of action of the antiseizure drug valproic acid is most likely:

A. inhibition of acetylcholinesterase
B. stimulation of sodium channels
C. blocking serotonin reuptake
D. increase in GABA activity



Lamotrigine is indicated for:

A. Absence seizures
B. Insomnia
C. Tonic-clonic seizures
D. Status epilepticus



An alcoholic who was driving drunk is admitted to the hospital after an auto accident. Which statement is FALSE?

A. Folic acid, thiamine, and multivitamins will probably be ordered.
B. Delirium tremors (DTs) may develop and result in death if the patient is not treated with a drug such as lorazepam (ATIVAN).
C. Alcohol depletes liver fat so the patient will need a diet high in fat.
D. Prolonged night blindness from alcohol may have contributed to the accident.



A patient with a 3 week history of fatigue, sadness, irritability, boredom and difficulty paying attention in school seeks medical attention for insomnia. Sertraline 50 mg/day is furnished but 2 days later the patient states the symptoms have not improved. The best course of action is to:

A. Switch to paroxetine
B. Increase the dose of sertraline
C. Add zolpidem for the next 6 weeks
D. Explain that more time is needed to see effect



A patient receiving donepezil and memantine comes to the hospital with nausea and vomiting. You note he swallows frequently and drools clear saliva. His skin is wet with sweat. BP is low at 80/50 and heart rate is low at 50. You should treat shock and......

A. give atropine.
B. increase the donepezil dose.
C. give physostigimine.
D. discontinue the memantine.


Thanks Jose Rodriguez we really appreciate it!!!


The antipsychotic drug risperodone (RISPERDAL) works by:
A. Blocking H1 receptors in the brain
B. Antagonizing dopamine and serotonin receptors
C. Agonizing alpha-2 receptors
D. Stimulating release of gamma-aminobutyric acid (GABA) in the brain



Which of the following is an adverse effect of phenytoin (DILANTIN)?
A. addiction.
B. euphoria.
C. gum disease.
D. hair loss.



Zolpidem is indicated for:
A. Tonic-clonic seizures
B. Insomnia
C. Absence seizures
D. Bipolar disease


Thanks Lily (added 12/8)


An herb thought to be useful in treating anxiety and sleeping problems is:

A. Ginseng
B. Senna
C. Kava
D. Saw Palmetto



Which of the following should patients and/or their caregivers be told when they start taking antidepressant drugs?

A. Drugs often deplete potassium. Keep diet high in potassium rich food.
B. The drugs may stimulate sexual appetite.
C. Dry mouth should be managed with ice chips or sugarless gum.
D. It is safe to use herbal supplements such as St. John's wort to enhance the antidepressant effect of the drugs.



The mechanism of action of phenytoin (DILANTIN)is

A. reducing sodium transport.
B. calcium channel blockade.
C. beta receptor blockade.
D. GABA inhibition.



Ms. J is brought to the emergency room in a semi-comatose state. She has a low blood pressure and is breathing slowly. Her pupils are pinpoint. These signs and symptoms are most consistent with a drug overdose on which of the following?

A. Amphetamines
B. Cocaine
C. A hallucinogen such as LSD
D. An opiate such as heroin