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Advance Psychopharmacology

NU643 Advance Psychopharmacology

Week 3 Quiz   

Question 1Matching:

Dendrite             

Pharmacokinetics           

Excitation-secretion coupling     

 

Pharmacodynamics        

 

Axon     Ionic filter           

 

Question 2A neurotransmitter binds to a receptor, causing electrical impulses to travel the neuron’s axon; it eventually releases the neurotransmitter and repeats the process with a postsynaptic neuron. Which type of neurotransmission does this describe?

 

Select one:

 

 a.Classic synaptic neurotransmission

 

 b.Retrograde neurotransmission

 

c.Volume neurotransmission

 

 d.Signal transduction cascade

 

Question 3Carbamazepine has a half-life of approximately 12 hours. The clinical implications of this are:

 

Select one:

 

 a.carbamazepine will be 50% less effective 6 hours after taking the medication.

 

 b.carbamazepine requires once daily dosing.

 

 c.therapeutic blood monitoring of carbamazepine should not occur before 2 ½ days of starting the medication.

 

 d.one-half of the dose of carbamazepine will be excreted from the kidneys in 12 hours.

 

Question 4Elimination of a drug can be impacted by all of the following scenarios except:

 

Select one:

 

 a.a Mediterranean diet.

 

b. metabolic acidosis, in which plasma pH is lowered.

 

 c.concurrent use of loop diuretics.

 

 d.dehydration.

 

Question 5Enzyme inhibition as a target of drug therapies is:

 

Select one:

 

 a.a common mechanism of action of psychotropic medications.

 

 b.always irreversible.

 

 c.a means of preventing the degradation of neurotransmitters.

 

 d.activates voltage-sensitive calcium channels.

 

Question 6First pass effect refers to the:

 

Select one:

 

 a.portion of the drug that is absorbed prior to reaching systemic circulation.

 

 b.rate at which IV and IM medications are metabolized.

 

 c.metabolism of the drug in the liver, prior to reaching systemic circulation.

 

d.effect of glucuronic acid on a drug.

 

Question 7G-linked proteins:

 

Select one:

 

 a.are examples of third messengers.

 

 b.have a static, or unchanging, 3-dimensional shape.

 

 c.bind enzymes that synthesize second messengers.

 

 d.All of the above.

 

Question 8In ligand-gated ion channels, an:

 

Select one:

 

 a.agonist has no effect on the flow of ions in the channel.

 

 b.antagonist blocks the flow of ions in the channel.

 

 c.antagonist, in the presence of an agonist, can return a channel to resting state.

 

d.antagonist, in the presence of a partial agonist, blocks the flow of ions in the channel.

 

Question 9Pharmacokinetics involves consideration all of the following EXCEPT the:

 

Select one:

 

 a.effects of taking a medication with an antacid.

 

b.percent fat content in the body.

 

 c.receptor binding site of the drug.

 

 d.health and function of the kidneys.

 

Question 10Retrograde neurotransmission refers to:

 

Select one:

 

 a.the reuptake of neurotransmitter in the presynaptic neuron.

 

 b.the flow of neurotransmitter from presynaptic neuron to postsynaptic neuron.

 

 c.the flow of neurotransmitter from postsynaptic neuron to presynaptic neuron.

 

d.the diffusion of neurotransmitter to nearby neurons.

 

Question 11 Second messengers are:

 

Select one:

 

 a.intracellular messengers activated by extracellular messengers.

 

b.neurotransmitters that influence gene expression.

 

 c.G-protein bound.

 

 d.the final step in signal transduction cascades.

 

Question 12The direct role of transcription factors is to:

 

Select one:

 

 a.cause neurotransmitter release.

 

 b.influence gene expression.

 

c. synthesize enzymes.

 

 d.trigger signal transduction cascades.

 

Question 13The two main targets of signal transduction cascades are:

 

Select one:

 

 a.receptors and neurotransmitters.

 

b.enzymes and receptor sites.

 

 c.gene expression and phosphoproteins.

 

 d.synaptic vesicles and sodium ion channels.

 

Question 14Use the following CYP450 table to hypothesize drug interactions and their clinical significance for a patient on clozapine, an antipsychotic, who takes ibuprofen for a back ache.

 

CYP450 Table

 

CYP1A2 Substrate            CYP2D6 Substrate            CYP2C9 Substrate

 

Caffeine

 

Clozapine            Amitriptyline

 

S-metoprolol

 

Haloperidol         Ibuprofen

 

Losartan

 

CYP1A2 Inhibitor              CYP2D6 Inhibitor              CYP2C9 Inhibitor

 

Fluvoxamine      Paroxetine

 

Bupropion

 

Fluoxetine          Fluconazole

 

Sertraline

 

CYP1A2 Inducer                CYP2D6 Inducer                CYP2C9 Inducer

 

Brussel Sprouts

 

Carbamazepine                Dexamethasone              Carbamazepine

 

St. John’s Wort

 

Select one:

 

 a.Clozapine levels would decrease, placing the patient at risk for re-emergence of psychotic symptoms.

 

 b.Clozapine levels would increase, placing the patient at risk for clozapine side effects.

 

 c.Ibuprofen levels would decrease, providing inadequate pain relief.

 

 d.Ibuprofen levels would increase, placing the patient at risk for liver toxicity associated with ibuprofen overdose.

 

 e.There is no theoretical interaction between these two medications.

 

Question 15Use the following CYP450 table to hypothesize drug interactions and their clinical significance for a patient on clozapine who is prescribed carbamazepine, a mood stabilizer.

 

CYP450 Table

 

CYP1A2 Substrate            CYP2D6 Substrate            CYP2C9 Substrate

 

Caffeine

 

Clozapine            Amitriptyline

 

S-metoprolol

 

Haloperidol         Ibuprofen

 

Losartan

 

CYP1A2 Inhibitor              CYP2D6 Inhibitor              CYP2C9 Inhibitor

 

Fluvoxamine      Paroxetine

 

Bupropion

 

Fluoxetine          Fluconazole

 

Sertraline

 

CYP1A2 Inducer                CYP2D6 Inducer                CYP2C9 Inducer

 

Brussel Sprouts

 

Carbamazepine                Dexamethasone              Carbamazepine

 

St. John’s Wort

 

Select one:

 

 a.Clozapine levels would decrease, placing the patient at risk for re-emergence of psychotic symptoms.

 

 b.Clozapine levels would increase, placing the patient at risk for clozapine side effects.

 

 c.Carbamazepine levels would decrease, placing the patient at risk for recurrent mood episodes.

 

 d.Carbamazepine levels would increase, placing the patient at the risk for carbamazepine side effects.

 

 e.There is no theoretical interaction between these two medications.

 

Question 16Use the following CYP450 table to hypothesize drug interactions and their clinical significance for a patient on haloperidol, a conventional antipsychotic, who is prescribed paroxetine, an antidepressant.

 

CYP450 Table

 

CYP1A2 Substrate            CYP2D6 Substrate            CYP2C9 Substrate

 

Caffeine

 

Clozapine            Amitriptyline

 

S-metoprolol

 

Haloperidol         Ibuprofen

 

Losartan

 

CYP1A2 Inhibitor              CYP2D6 Inhibitor              CYP2C9 Inhibitor

 

Fluvoxamine      Paroxetine

 

Bupropion

 

Fluoxetine          Fluconazole

 

Sertraline

 

CYP1A2 Inducer                CYP2D6 Inducer                CYP2C9 Inducer

 

Brussel Sprouts

 

Carbamazepine                Dexamethasone              Carbamazepine

 

St. John’s Wort

 

Select one:

 

 a.Haloperidol levels would decrease, placing the patient at risk for re-emergence of psychotic symptoms.

 

b.Haloperidol levels would increase, placing the patient at risk for antipsychotic side effects.

 

 c.Paroxetine levels would decrease, placing the patient at risk for recurrent mood episodes.

 

 d.Paroxetine levels would increase, placing the patient at the risk for paroxetine side effects.

 

 e.There is no theoretical interaction between these two medications.

 

Question 17Volume neurotransmission refers to:

 

Select one:

 

 a.the reuptake of neurotransmitter in the presynaptic neuron.

 

 b.the flow of neurotransmitter from presynaptic neuron to postsynaptic neuron.

 

 c.the flow of neurotransmitter from postsynaptic neuron to presynaptic neuron.

 

 d.the diffusion of neurotransmitter to nearby neurons.

 

Question 18When a partial agonist binds to a G-protein-linked receptor, signal transduction is:

 

Select one:

 

 a.fully enhanced.

 

 b.partially enhanced.

 

c.unchanged.

 

 d.inactivated.

 

Question 19When an agonist binds to a G-protein-linked receptor, signal transduction is:

 

Select one:

 

 a.fully enhanced.

 

b.partially enhanced.

 

 c.unchanged.

 

 d.An agonist produces a change in the G-protein-linked receptor that turns on the synthesis of the second messenger to the greatest extent and this is the action of a full agonist.

 

Question 20

 

When an antagonist binds to a G-protein-linked receptor, signal transduction is:

 

Select one:

 

 a.fully enhanced.

 

 b.partially enhanced.

 

 c.unchanged.

 

 d.inactivated.

 

Question 21When an inverse agonist binds to a G-protein linked receptor, signal transduction is:

 

Select one:

 

 a.fully enhanced.

 

 b.partially enhanced.

 

 c.unchanged.

 

d.inactivated.

 

Question 22When comparing Phase I and Phase II metabolism which of the following statements is true?

 

Select one:

 

 a.Poor liver function impairs Phase I and Phase II metabolism.

 

 b.Phase I and Phase II metabolism are dependent on liver function.

 

 c.Phase I metabolism refers to CYP450 enzyme activity whereas Phase II metabolism refers to conjugation of drug.

 

d.Drugs must go through both Phase I metabolism and Phase II metabolism.

 

Question 23Which of the following methods of drug delivery is slowest to reach the bloodstream?

 

Select one:

 

 a.Sublingual formulations

 

 b.Oral pills

 

c.IM route

 

 d.IV route

 

Question 24Which of the following statements about drug absorption is true?

 

Select one:

 

 a.The large intestine absorbs IV medications.

 

 b.The presence of food impairs absorption for many psychotropic drugs.

 

 c.Most medications bypass the absorption phase of pharmacokinetics.

 

 d.Concurrent use of some medications can slow absorption.

 

Question 25Which of the following statements about pharmacokinetics is true?

 

Select one:

 

 a.The rate at which a person absorbs medication is relatively consistent across time.

 

 b.Accumulation of psychotropic drugs occurs faster in the brain than adipose tissue.

 

c.All psychotropic medications are metabolized through the liver.

 

 d.Once metabolized, psychotropic drugs become inactive.

 

Question 26Which of the following statements is true about concentration-time curve of medication absorption?

 

Select one:

 

 a.Medications take a relatively equal amount of time to reach T-max.

 

 b.C-max refers to the blood level at which a medication is therapeutic.

 

 c.Slow-release medications extenuate the concentration-time curve.

 

d.Steady-state refers to the point at which blood level fluctuations are mild and not clinically significant.

 

Question 27Which of the following statements is true about drug distribution?

 

Select one:

 

 a.Most psychotropic medications are lipophobic and water soluble.

 

 b.Psychotropic medications are most highly concentrated in plasma.

 

 c.Body composition does not impact drug distribution.

 

 d.Protein binding of psychotropic drugs can impact their availability at receptor sites.

 

Question 28Which of the following statements is true about ligand-gated ion channels?

 

Select one:

 

 a.Allosteric modulators can enhance or inhibit ion channels when in the presence of neurotransmitter.

 

b. Neurotransmitter action is the only factor in ligand-gated ion channel flow.

 

 c.Positive allosteric modulators bind to second messengers.

 

 d.Negative allosteric modulators inactivate ligand-gated ion channels.

 

Question 29Which of the following statements is true about neuronal gene expression?

 

Select one:

 

 a.Environmental factors can alter a neuron’s gene expression.

 

b.Gene expression is determined in development.

 

 c.Inactive genes remain inactive throughout a neuron’s lifetime.

 

 d.Only active genes can be targets of psychotropic medications.

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