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A 52---year---old woman who has had low back pain for several years is admitted to the hospital because the pain has suddenly worsened. Her current medications include oxycodone, amitriptyline, perphenazine, fluoxetine and trazodone. On physical examination, the patient is 10% below her ideal body weight, pupils are constricted and skin turgor is poor. She seems sluggish and her speech is slow. Results of neurologic examination and x---ray films of the lumbosacral spine are normal. If a medication is responsible for her mental condition, the medication is most likely to be which of the following?
Amitriptyline
Fluoxetine
Oxycodone
Perphenazine
Trazodone
The following are common side effects of SSRIs, except:
Headache
Sexual dysfunction
Vomiting
Anorexia
Orthostatic hypotension
Which of the following neurological symptoms is not produced by antipsychotic drugs?
Akathisia
Shuffling gait
Oculogyric crisis
Tremor at rest
Urinary incontinence
Which one of the following is contraindicated in a patient taking an SSRI?
Phenothiazines
Electroconvulsive therapy
Alpha---Receptor blocking agents
Monoamine oxidase inhibitors
Benzodiazepines
An 82---year---old male resident of a nursing home has developed symptoms of depression including withdrawal and sadness. The staff also reports that he doesn’t want to leave his room, and often expresses a desire to stay in bed all day. After performing an appropriate evaluation and recommending nonpharmacologic interventions, you also decide that pharmacologic treatment is indicated. Which on of the following would be the most appropriate antidepressant for this patient?
Amitriptyline (Elavil)
Doxepin (Sinequan)
Trazodone (Desyrel)
Sertraline (Zoloft)
Olanzapine (Zyprexa)
Which one of the following benzodiazepines has the shortest half---life?
Nitrazepam
Alprazolam (Xanax)
Clorazepate (Tranxene)
Diazepam (Valium)
Clonazepam (Klonopin)
Which one of the following medications is the most likely cause of the hyperglycemia?
Alprazolam
Haloperidol
Chlorpromazine
Olanzapine
Thiothixene
Which of the following cancer is caused by vinyl chloride the most?
Lung cancer
Esophagus cancer
Pharyngeal cancer
Liver cancer
Bladder cancer
A 25-year-old comatose female presents to the ED with pinpoint pupils and respiratory depression. Question 1 Which o the following is the most likely cause of coma?
Blood alcohol level of 200 mg/dL.
Cocaine overdose.
Methadone overdose.
Benzodiazepine withdrawal.
Phencyclidine (PCP) intoxication.
treat her with naloxone and she wakes up (spitting mad, agitated, and in withdrawal). Question 2 What is the minimum amount of time that you should observe a patient who has overdosed on methadone?
1 hours.
4 hours.
12 hours.
36 hours.
72 hours.
You discover that the patient has been on a methadone maintenance program, but then she relapsed and overdosed on a combination of methadone and heroin. Her urine drug screen returns positive or opioids. Question 3 What would be the next most appropriate course of action?
Detoxify the patient off methadone as an outpatient.
Contact the authorities to have the patient arrested.
Contact the patient’s methadone maintenance clinic for dose increase.
Notify the patient of her positive urine drug screen and let her know you are not surprised by the result, as methadone is metabolized to morphine.
Have the patient committed to a substance abuse treatment facility.
Methadone is typically prescribed or opioid maintenance therapy:
Once daily.
Twice daily.
Three times daily.
Three times weekly.
Once monthly.
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