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Psychotherapeutic Medications 2011

Important Notes Across Medication Types

1. The generic name of a medication is the actual name of the medication and never changes, although the medication may be made by many different manufacturers.

A. True

B. False


Antipsychotics/Neuroleptics

2. Traditional antipsychotics include each of the following EXCEPT:

A. fluphenazine

B. loxapine

C. thioridazine

D. iloperidone


3. The FDA has recently approved low doses of risperadal and abilify to treat anxiety.

A. True

B. False


4. Each of the following is a true statement about the use of novel or atypical antipsychotics EXCEPT:

A. They are effective in treatment-resistant schizophrenia but may also be used with severe depression or other psychiatric illness.

B. They are less likely than traditional antipsychotics to produce serious side effects

C. Approximately 4 to 5 percent of people who take clozapine develop a condition in which their white blood cell count drops drastically

D. There is some evidence that use of atypical antipsychotics may lead to the development of diabetes mellitus.


Potential Side Effects

5. Tardive Dyskinesia, which is characterized by involuntary movements of the face and limbs, is most often seen in men.

A. True

B. False


Special Considerations-Pregnant Women

6. For pregnant women, tapering and discontinuation of antipsychotic medication _____________ before delivery is generally advised.

A. 3 days to 1 week

B. 10 days to 2 weeks

C. 15 days to 3 weeks

D. 20 days to 4 weeks


Antiparkinsonian Medications-Potential For Abuse Or Dependence

7. Research has found that abusers of antiparkinsonians used these medications “to get high, to increase pleasure, to decrease depression, to increase energy and to relax.”

A. True

B. False


Antimanic Medications

8. Lithium products include Eskallth, Eskallth CR, and:

A. Lithobid

B. Lamictal

C. Saphris

D. Gabitril


Purpose

9. Which of the following is NOT one of the positive treatment responses attributed to antimanic medications?

A. Decreased hyperactivity

B. Improved sleep and concentration

C. Less illogical thought

D. Fewer incidences of light-headedness and dizziness


Usual Dose, Frequency & Side Effects

10. Dosage for antimanic medications is determined by the active amount of medication found in the person's blood after taking the medication and by his or her response to the medication.

A. True

B. False


11. The most common side effects for lithium products are diarrhea, rash or skin changes, and fatigue.

A. True

B. False


12. The anticonvulsant, __________________ may cause mood changes, especially depression and anger.

A. Gabepentin

B. Topiramate

C. Levetiracetam

D. Oxcarbazepine


Potential For Abuse Or Dependence

13. Abrupt discontinuation of anticonvulsants may result in seizures, so slow tapering off periods of two to four weeks are generally recommended.

A. True

B. False


Cautions

14. Blood tests for medication levels need to be checked every 3 to 4 months.

A. True

B. False


Antidepressant Medications

15. Antidepressants are the first line medications for certain anxiety disorders such as panic disorders, social phobia, and obsessive-compulsive disorders.

A. True

B. False


16. Antidepressant medication treatment for a single episode of major depression should be continued for _______________ before discontinuing.

A. 6 months

B. 1 year

C. 18 months

D. 2 years


Type Of Antidepressants

17. Venlafaxine is an antidepressant that has more effect on norepinephrine and dopamine levels than on serotonin levels in the brain.

A. True

B. False


Potential Side Effects

18. Potential side effects for tricyclics and quatracyclics include:

A. Allergic reactions

B. Change in appetite

C. Confusion

D. Shakiness


Emergency Conditions

19. The potential for a fatal outcome from an overdose with the SSRIs is much less than with other classes of antidepressants.

A. True

B. False


Cautions

20. People taking MAO inhibitors must avoid all foods with high levels of tryptophan or tyramine as well as high levels of caffeine.

A. True

B. False


Special Consideration For Pregnant Woman

21. Using tricyclic medications is safer for the mother and fetus than using SSRIs.

A. True

B. False


Antianxiety Medications

22. Each of the following correctly describes the use of benzodiazepines EXCEPT:

A. Positive treatment response to benzodiazpines occurs rapidly, within days.

B. Tiagabine is a benzodiazepine that is occasionally prescribed for performance anxiety

C. Most physicians only use them for a short time as alcohol withdrawal medicines, or as sedatives in acute psychotic or manic episodes

D. Benzodiazepines are cross tolerant with alcohol and have a market as street drugs


23. Buspirone is an antihistamine that uses the drowsiness side effect of the antihistamine group to calm and relax.

A. True

B. False


24. Gabapentin and pregabalin have been used to treat anxiety, especially in those persons with a substance use disorder history and for whom antidepressants have been effective.

A. True

B. False


Usual Dose, Frequency & Side Effects

25. People taking benzodiazepines for longer than ___________ may develop physical tolerance to the medication.

A. 2 to 6 weeks

B. 4 to 8 weeks

C. 6 to 10 weeks

D. 8 to 12 weeks


Potential For Abuse Or Dependence

26. Between 6 and 10 percent of people in the United States take a form of antianxiety medication at least once each year.

A. True

B. False


Risk Factors Related To Developing Dependency On Antianxiety Medication

27. Risk factors related to developing dependency or anxiety medications include:

A. Approximately 4% of persons who do not have a current substance abuse problem or a history of substance will become dependent on antianxiety medications

B. Some studies indicate there is a moderately higher risk for alcohol dependent persons to become dependent on antianxiety medications

C. People with a prior history of substance abuse or dependence who are in recovery are at high risk of becoming dependent on antianxiety medications

D. None of the above


Special Considerations For Pregnant Woman

28. Current knowledge suggests that, in general, short term use of benzodiazepines does not pose as much risk of producing a deformed baby compared to anticonvulsants.

A. True

B. False


Stimulant Medications-Purpose

29. Bupropion is an FDA approved non-stimulant medication used to treat AD/HD.

A. True

B. False


Usual Dose, Frequency & Side Effects

30. The most common side effects of stimulant medications are sleeplessness, loss of appetite and:

A. Nervousness

B. Excitability

C. Irritability

D. Increased Pulse Rate


Potential For Abuse Or Dependence

31. People with AD/HD or narcolepsy rarely abuse or become dependent on stimulant medications unless they have other substances problems.

A. True

B. False


Emergency Conditions

32. Psychiatric symptoms including paranoid delu­sions, thought disorders, and hallucinations have been reported when stimulants are used for long periods or taken at high dosages.

A. True

B. False


Narcotic And Opioid Analgesics

33. Combination medications that contain an opioid or narcotic along with an opioid antagonist may be used to relieve pain but also prevent opioid abuse. 

A. True

B. False


Purpose

34. Opiates that are most frequently prescribed to manage chronic cancer pain include oxycodone, ___________ and methadone.

A. Tramadol

B. Propoxyphene

C. Percodan

D. Fentanyl


Emergency Conditions

35. Overdose of narcotic and opioid medications may increase pulse rate, and result in ____________ followed by coma or death.

A. Suppressed breathing

B. High blood pressure crisis

C. Convulsions

D. Stroke


Hypnotics (Sleep Aids)-Purpose

36. Lack of sleep is one of the greatest problems faced by those with chemical dependency and psychiatric illnesses, and it can cause the symptoms of these disorders to worsen.

A. True

B. False


37. Zalepion is is a non habit forming medication that works with melatonin pathways in the brain to induce sleep.

A. True

B. False


Potential Side Effects

38. Breathing difficulty is a potential side effect of which hypnotic?

A. Restoril

B. Seconal

C. Valium

D. Halcion


Alcohol-Purpose

39. Though usually only treated for ________, signs and symptoms of alcohol withdrawal go on for weeks or months.

A. 1 to 5 days

B. 3 to 7 days

C. 5 to 9 days

D. 7 to 11 days


Alcohol Relapse Prevention

40. Which of the following accurately describes medication use for alcohol relapse prevention?

A. The oldest medication used in alcohol relapse prevention is naltrexone

B. Topiramate blocks the breakdown of alcohol, resulting in toxic acetaldehyde 28 levels in the body

C. Outcome studies indicate that acamprosate is best at increasing complete abstinence from alcohol, or increasing the time before relapse.

D. Clinical observation of persons taking disulfiram showed that those who also used alcohol seemed to drink less and reported that alcohol use affected them less


Opioid Withdrawal

41. Mild opioid withdrawal can be accomplished with clonidine, a medication for treatment of high blood pressure.

A. True

B. False


Tobacco

42. Nortripyline is a recently FDA-approved smoking cessation medication and the first in its class that specifically targets the neurobiology of nicotine use disorder.

A. True

B. False


Marijuana

43. Some clinicians have used moderate doses of the older tricyclic antidepressants such as amitriptyline or imipramine to treat withdrawal from marijuana, as they also have anticholinergic and sedating qualities but do not cause a high.

A. True

B. False


Usual Dose and Frequency

44. Disulfiram should never be given until the person has abstained from alcohol for at least:

A. 24 hours

B. 20 hours

C. 16 hours

D. 12 hours


45. Bupropion, which may help with anxiety and depression associated with tobacco withdrawal, should be started 14-21 days before a targeted smoking cessation date.

A. True

B. False


46. Specific combinations of first line medications shown to be effective for smoking cessation include each of the following EXCEPT:

A. The nicotine patch and bupropion SR

B. Varenicline and the nicotine lozenge

C. The nicotine patch and the inhaler

D. The long-term nicotine patch and ad libitum NRT use


47. Potential side effects for bupropion include dry mouth, insomnia, and:

A. Increased risk for seizure

B. Body aches lasting 5-7 days

C. Swelling of face, ankles, or hands

D. Muscle twitching


Cautions

48. Although varenicline is well tolerated in most individuals, recent case reports describe exacerbations of existing psychiatric illness in clients who took the medication.

B. True

C. False


Special Considerations for Pregnant Women

49. According to the The American Academy of Pediatrics (AAP) Committee on Drugs, women who are on methadone maintenance should not breastfeed their infants.

A. True

B. False


Tips for Communicating with Physicians about Clients and Medications

50. When providing information to a physician about a client's medication use or abuse, it is important to avoid making recomendations and to allow the physician to draw his or her own conclusions.

A. True

B. False


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