Test Bank Introduction to Clinical Pharmacology 10th Edition Visovsky

Chapter 10: Drug Therapy for Mental Health Visovsky: Introduction to Clinical Pharmacology, MULTIPLE CHOICE 1. Which drug category is useful in promoting sleep among patients with insomnia? a. Sedatives b. ACE inhibitors c. Atypical antipsychotics d. Selective serotonin reuptake inhibitors ANS: A Sedatives are drugs that have the main purpose of promoting sleep by changing signals in the central nervous system and reducing responses to stimulation. DIF: Cognitive Level: Knowing REF: p. 184 2. You are preparing to give the benzodiazepine Valium to a patient as a premedication before surgery. The patient asks you how this drug works. What is your best response? a. “This drug works by binding to receptors acting with GABA to induce sleep.” b. “This drug is acts by preventing binding to the benzodiazepine receptors.” c. “This drug acts by inhibiting GABA responses to relax muscles.” d. “This drug acts by binding to opioid receptors.” ANS: A Benzodiazepines are sedating hypnotic drugs that depress the CNS by binding to benzodiazepine (BNZ) receptors that act with gamma-aminobutyric acid (GABA) receptors to enhance GABA effects, resulting sleep and muscle relaxation. DIF: Cognitive Level: Applying REF: p. 186 3. You are caring for a patient in the clinic setting who has been taking a benzodiazepine alprazolam (Xanax) for anxiety. What potential problem should you observe this patient for? a. Seizure activity b. Addiction c. Insomnia d. Anorexia ANS: B The benzodiazepines have a higher risk for addiction and dependency than do the nonbenzodiazepines. They also carry a black box warning for central nervous system depression. Overdoses are possible and serious. DIF: Cognitive Level: Understanding REF: p. 185 4. Which drug would you anticipate will be given to a patient who experienced an overdose of a benzodiazepine? a. Rifampin b. Naloxone c. Flumazenil d. Epinepherine ANS: C The drug flumazenil (Romazicon) is a benzodiazepine receptor antagonist and is an antidote used to reverse an overdose of either a benzodiazepine sedative or a nonbenzodiazepine sedative. For adults, it is given intravenously with an initial dose of 0.2 mg. If there is no response after 45 seconds, the dose can be repeated. After that, it can be repeated every minute for a total of 4 doses. DIF: Cognitive Level: Knowing REF: p. 187 5. For which patient would benzodiazepines be contraindicated? a. A female with breast cancer. b. A woman who is 20 weeks pregnant. c. A male who has a history of smoking. d. A male who is about to undergo surgery. ANS: B Pregnancy is an absolute contraindication for the benzodiazepines because they have a high risk for causing birth defects. Although the chemical structure of the nonbenzodiazepines (benzodiazepine agonists) is different, these drugs bind to the same receptors and have similar actions. As a result, they are not recommended during pregnancy. DIF: Cognitive Level: Applying REF: p. 185 6. What specific information should be part of the teaching plan for a patient taking a nonbenzodiazepine sedative? a. These drugs can interact with many foods and beverages. b. These drugs can cause you to be physically active at night. c. These drugs must be takes for at least 6 weeks to see any effects. d. Excess caffeine intake can work to increase the effectiveness of these drugs. ANS: B When taking a nonbenzodiazepine (benzodiazepine agonist), be aware that drugs from this class can cause you to be physically active at night, even going for a drive, without your knowledge or memory of the event. It is best to have a family member or friend watch out for these effects when you first start taking the drug. DIF: Cognitive Level: Applying REF: p. 186 7. You are preparing to teach a patient with anxiety disorder about the actions of the nonbenzodiazepine drug buspirone. What would you inform the patient about how this drug works? a. “Buspirone acts by affecting the serotonin and dopamine neurotransmitters.” b. “Buspirone acts by inhibiting GABA pathways to decrease anxiety.” c. “Buspirone acts by affecting the monoamine oxidase pathway.” d. “Buspirone acts by inhibiting the action of dopamine receptors.” ANS: A