Pharmacology of the Cardiovascular and Central Nervous Systems

121.    Major tranquilizers:

a.     are used as hypnotics.

b.     are drugs such as barbiturates and benzodiazepines.

c.     include the phenothiazines and butyrophenones. 

d.     are used in the treatment of psychotic disorders.

e.     frequently have dopamine-receptor blocking properties.

122.    5-HT:

a.     storage is disrupted by reserpine.

b.     concentration in nerves is increased by MAO inhibitors.

c.     can cause increased gastrointestinal motility.

d.     stored in enterochromaffin cells has a neurotransmitter role.

e.     re-uptake into neurons is unaffected by clomipramine.

123.    The following drugs affect 5-HT mechanisms in the ways indicated:

a.     L-tryptophan blocks the synthesis of 5-HT.

b.     methysergide is a 5-HT receptor agonist.

c.     lysergic acid diethylamide (LSD) is a 5-HT receptor blocker.

d.     fenfluramine can release 5-HT.

e.     cyproheptadine can block 5-HT receptors.

124.   The following are amino-acid neurotransmitters which decrease neural activity.

a.      glycine.

b.      glutamic acid.

c.      gamma-amino butyric acid (GABA).

d.      leucine enkephalin.

e.      tyrosine.

125.    Gamma-amino butyric acid (GABA):

a.      is found in high concentrations in the basal ganglia.

b.      concentration in the basal ganglia are abnormally low in Huntingon's chorea.

c.      receptors are sensitive to the activity of benzodiazepines.

d.      metabolism is inhibited by sodium valproate.

e.      receptor blockers have anticonvulsant activity. 

126.    Lithium:

a.      is used as an anxiolytic.

b.      has a large therapeutic / toxic ratio.

c.      is best given at 4 hourly intervals.

d.      is more toxic in Na depleted patients.

e.      toxicity can be reversed by a thiazide diuretic.

127.    The following statements about benzodiazepines are true:

a.      they lack anxiolytic activity.

b.      they are used as hypnotics.

c.      they have anticonvulsant actions.

d.      they are effective antidepressants.

e.      they are free of the risk of dependence.

128.    Temazepam:

a.      produces inactive metabolites.

b.      increases rapid eye movement (REM sleep).

c.      is a potent enzyme inducer.

d.      causes less hangover than nitrazepam.

e.      causes rebound insomnia.

129.    The following can occur with prolonged use of barbiturates:

a.      tolerance to the actions of other hypnotics.

b.      bleeding by displacing warfarin from plasma protein-binding sites.

c.      abnormally rapid metabolism of estrogens.

d.      status epilepticus on withdrawal of barbiturate.

e.      tolerance to a similar degree to both the hypnotic and respiratory depressant actions.

130.    The following barbiturates are commonly used for the purposes indicated:

a.      thiopentone: as an anxiolytic.

b.      methonexitone: for the relief of pain.

c.      phenobarbitone: in status epilepticus.

d.      phenobarbitone: in long-term therapy of epilepsy.

e.      pentobarbitone: to induce general anaesthesia.

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