Deck 15: Antipsychotic Drugs

Question 1

A schizophrenic's diminished capacity to filter out unimportant stimuli in his or her environment is referred to as ____.

A) perception-overload syndrome
C) input-filter deficiency
B) sensory-gating deficit
D) afference-regulation disorder

Answer 1

B

Question 2

The type of schizophrenia that does not appropriately fit into other categories of schizophrenia is the ____ type.

A) catatonic
C) undifferentiated
B) paranoid
D) disorganized

Answer 2

C

Question 3

The type of schizophrenia characterized by silly or immature emotional expression is the ____ type.

A) catatonic
C) undifferentiated
B) paranoid
D) disorganized

Answer 3

D

Question 4

What is the world wide prevalence of schizophrenia?

A) 0.1%
C) 5%
B) 1%
D) 10%

Question 5

When is schizophrenia typically first diagnosed?

A) early to late teens
C) late twenties to early thirties
B) late teens to early twenties
D) late thirties to early forties

Question 6

The type of schizophrenia characterized by predominantly negative symptoms is the ____ type.

A) catatonic
C) undifferentiated
B) paranoid
D) disorganized

Question 7

What fraction of individuals with schizophrenia qualify as treatment-resistant patients?

A) one-fourth
C) two-fourths
B) one-third
D) two-thirds

Question 8

The most consistent observations of schizophrenic brains suggest reduced volume in the sizes of structures in the ____.

A) right hemisphere and temporal lobe
C) right hemisphere and frontal lobe
B) left hemisphere and temporal lobe
D) left hemisphere and frontal lobe

Question 9

In addition to positive and negative symptoms associated with schizophrenia, researchers find striking and consistent ____ in schizophrenic individuals.

A) bipolar disorder
C) cognitive impairments
B) anxiety
D) mania

Question 10

Which prodromal symptom of schizophrenia is most predictive of being diagnosed with schizophrenia at a later point?

A) problems with sociability
C) attention impairments
B) poor working memory
D) sensory gating deficits

Question 11

According to the text, among the genes studied for risk of schizophrenia, most of the scientific evidence implicates the ____ gene (Hodgkinson et al., 2004; Roberts, 2007).

A) neuregulin (NRG1)
B) rac-alpha serine/threonine protein kinase-1 (AKT1)
C) d-amino acid oxidase (DAAO)
D) disrupted in schizophrenia 1 (DISC1)

Question 12

Functional imaging studies reveal abnormal levels of activity in schizophrenic patients during auditory hallucinations and memory tasks, and rest in the ____ (Heckers, 2001).

A) amygdala
C) nucleus accumbens
B) hippocampus
D) cerebellum

Question 13

Schizophrenia is a severe, life-long mental illness consisting of ____.

A) bipolar-like symptoms and poor emotional responsiveness
B) anxiety and disturbed thought processes
C) disturbed thought processes and bipolar-like symptoms
D) disturbed thought processes and poor emotional responsiveness

Question 14

During a plenary lecture on schizophrenia, Dr. Martin discusses a hypothesis for schizophrenia proposing that abnormal nervous system development leads to irregular neuronal signaling in the brain. This hypothesis is referred to as the ____ hypothesis.

A) dendritic arborization defect
C) neurodevelopment
B) genetic pruning error
D) axonal disorganization

Question 15

Which is an example of a positive symptom of schizophrenia?

A) delusions
C) reduced motivation
B) social withdrawal
D) limited emotional responsiveness

Question 16

Who has a thirteen percent chance of being diagnosed with schizophrenia?

A) Charlene, whose mother, but not father, has schizophrenia
B) Tim, whose parents both have schizophrenia
C) Lola, whose cousin has schizophrenia
D) Jack, whose uncle has schizophrenia

Question 17

Which is an example of a functional outcome for a person with schizophrenia?

A) Bethany, who is able to hold a steady job
B) Toby, who is responding well to his medication
C) Jessa, who has a genetic predisposition for schizophrenia but no symptoms
D) Seth, who was recently told that his schizophrenia diagnosis was downgraded to residual

Question 18

Which is an example of a negative symptom of schizophrenia?

A) delusions
C) hallucinations
B) social withdrawal
D) thoughts of persecution

Question 19

The type of schizophrenia characterized by prominent positive symptoms is the ____ type.

A) catatonic
C) undifferentiated
B) paranoid
D) disorganized

Question 20

In his twenties Drew exhibited many symptoms of schizophrenia. Now, in his thirties he exhibits very few of these symptoms. Drew would be categorized as having ____ type schizophrenia.

A) residual
C) hidden
B) dormant
D) relapsing

Question 21

In addition to effectively reducing the positive symptoms associated with schizophrenia, what are other characteristics of atypical antipsychotic drugs?

A) Generally ineffective for negative symptoms; unlikely to cause extrapyramidal side effects
B) Modestly effective for negative symptoms; unlikely to cause extrapyramidal side effects
C) Generally ineffective for negative symptoms; causes extrapyramidal side effects
D) Modestly effective for negative symptoms; causes extrapyramidal side effects

Question 22

Which statement best reflects the glutamate hypothesis of schizophrenia?

A) Diminished glutamate release in the cortex and increased levels in the limbic system lead to symptoms of schizophrenia.
B) Increased glutamate release in the cortex and diminished levels in the limbic system lead to symptoms of schizophrenia.
C) Diminished glutamate release in both the cortex and limbic system leads to symptoms of schizophrenia.
D) Increased glutamate release in both the cortex and limbic system leads to symptoms of schizophrenia.

Question 23

How were early lobotomies typically performed?

A) With precision, to avoid excess damage of brain tissue and hemorrhage
B) With precision, to decipher which brain regions are involved in schizophrenia
C) Without precision, which involved a risk of hemorrhage
D) Without precision, which resulted in a heightened state of awareness

Question 24

The dopamine hypothesis of schizophrenia originated from what data?

A) Antipsychotics are agonists for D₂ receptors; amphetamine causes psychotic symptoms by increasing dopamine release
B) Antipsychotics are antagonists for D₂ receptors; amphetamine causes psychotic symptoms by increasing dopamine release
C) Antipsychotics are agonists for D₂ receptors; amphetamine causes psychotic symptoms by decreasing dopamine release
D) Antipsychotics are antagonists for D₂ receptors; amphetamine causes psychotic symptoms by decreasing dopamine release

Question 25

The term, schizophrenia, coined by Dr. Eugen Bleuler means, "____."

A) split personality
C) divided cognition
B) splitting of psychic functions
D) break from reality

Question 26

Which drug is categorized as an atypical antipsychotic?

A) clozapine
C) haloperidol
B) perphenazine
D) chlorpromazine

Question 27

The pharmacological actions of typical antipsychotic drugs derive from ____.

A) agonism of both dopamine D₂ receptors and 5-HT_2A receptors
B) antagonism of both dopamine D₂ receptors and 5-HT_2A receptors
C) agonism of dopamine D₂ receptors only
D) antagonism of dopamine D₂ receptors only

Question 28

The pharmacological actions of atypical antipsychotic drugs derive from ____.

A) agonism of both dopamine D₂ receptors and 5-HT_2A receptors
B) antagonism of both dopamine D₂ receptors and 5-HT_2A receptors
C) agonism of dopamine D₂ receptors only
D) antagonism of dopamine D₂ receptors only

Question 29

Which statement best reflects a potential relationship between the dopamine and glutamate hypothesis of schizophrenia?

A) The hypotheses are mutually exclusive.
B) The hypotheses directly contrast one another.
C) Features of both hypotheses complement one another.
D) The hypotheses, in fact, describe parallel pathways.

Question 30

Which statement best reflects the dopamine hypothesis of schizophrenia?

A) Positive schizophrenic symptoms arise from an excess of dopamine.
B) Negative schizophrenic symptoms arise from an excess of dopamine.
C) Positive schizophrenic symptoms arise from a lack of dopamine.
D) Negative schizophrenic symptoms arise from a lack of dopamine.

Question 31

The drug chlorpromazine, first recognized by Dr. Henri Laborit, revolutionized the treatment of schizophrenia. How was it discovered as a potential treatment for schizophrenia?

A) It reduced anxiety in presurgical patients.
B) It produced a calming effect in manic patients.
C) It reduced generalized anxiety in depressed patients.
D) It facilitated streaming in psychotherapy.

Question 32

Which drug is categorized as a typical antipsychotic?

A) clozapine
C) olanzapine
B) aripiprazole
D) chlorpromazine

Question 33

Which term is used to describe an atypical antipsychotic drug?

A) novel antipsychotic drug
C) classical antipsychotic drug
B) first-generation antipsychotic drug
D) third-generation antipsychotic drug

Question 34

Which data supports the glutamate hypothesis of schizophrenia?

A) Cannabinoids reduce schizophrenia-like symptoms and improve cognition.
B) Cannabinoids cause schizophrenia-like symptoms and cognitive impairment.
C) Dissociative anesthetics reduce schizophrenia-like symptoms and improve cognition.
D) Dissociative anesthetics cause schizophrenia-like symptoms and cognitive impairment.

Question 35

Which is an example of an attempted treatment for schizophrenia during the early 20th century?

A) blood letting
C) exorcism
B) ice baths
D) lacerations

Question 36

How are the glutamate and dopamine hypotheses of schizophrenia interrelated?

A) Diminished glutamate may account for reduced dopamine in the prefrontal cortex and excessive dopamine in the limbic system.
B) Excessive glutamate may account for reduced dopamine in the prefrontal cortex and excessive dopamine in the limbic system.
C) Diminished glutamate may account for increased dopamine in the prefrontal cortex and diminished dopamine in the limbic system.
D) Excessive glutamate may account for increased dopamine in the prefrontal cortex and diminished dopamine in the limbic system.

Question 37

Lenny takes antipsychotic drugs to treat his schizophrenia. What extrapyramidal side effects is Lenny likely to display?

A) muscle rigidity
C) nausea
B) memory impairment
D) low blood pressure

Question 38

Which term is used to describe a typical antipsychotic drug?

A) novel antipsychotic drug
C) classical antipsychotic drug
B) second-generation antipsychotic drug
D) third-generation antipsychotic drug

Question 39

Most theories concerning the neuropathology of schizophrenia consider abnormalities in the neurotransmission of ____.

A) serotonin and glutamate
C) dopamine and glutamate
B) serotonin and GABA
D) dopamine and GABA

Question 40

In addition to effectively reducing the positive symptoms associated with schizophrenia, what are other characteristics of typical antipsychotic drugs?

A) Generally ineffective for negative symptoms; unlikely to cause extrapyramidal side effects
B) Modestly effective for negative symptoms; unlikely to cause extrapyramidal side effects
C) Generally ineffective for negative symptoms; causes extrapyramidal side effects
D) Modestly effective for negative symptoms; causes extrapyramidal side effects

Question 41

Currently, the only clinically available compound that might qualify as a third-generation antipsychotic drug is ____.

A) clozapine
C) haloperidol
B) aripiprazole
D) chlorpromazine

Question 42

Beyond differences in receptor actions between typical and atypical antipsychotic drugs, microdialysis studies reveal important differences in dopamine neurotransmission between these drug classes. Citing specific studies discussed in the text, analyze the differential effects of typical versus atypical antipsychotics on dopamine neurotransmission and associated physiological effects of the drugs.

Question 43

The following patients are taking atypical antipsychotic drugs to treat schizophrenia. Who is displaying signs of agranulocytosis?

A) Maury, who has a low white blood cell count
B) Donatella, who has an abnormal heartbeat
C) Nigel, who has prolonged flulike symptoms
D) Selena, who continuously clenches her jaw

Question 44

The following patients are taking typical antipsychotic drugs to treat schizophrenia. Who is displaying signs of neuroleptic malignant syndrome (NMS)?

A) Leonora, who is experiencing hallucinations and delusions
B) Aarav, who has facial twists and continuously smacks his lips
C) Katya, who experiences disruptions in her menstrual cycle
D) Frederick, who has flulike symptoms, including sweating and fever

Question 45

The actions of typical antipsychotic drugs on positive schizophrenic symptoms and extrapyramidal side effects (EPS) occur through which mechanisms?

A) positive symptoms: D₂ receptor antagonism in basal ganglia; EPS: D₂ receptor antagonism in nucleus accumbens
B) positive symptoms: D₂ receptor antagonism in nucleus accumbens; EPS: D₂ receptor antagonism in basal ganglia
C) positive symptoms: D₂ receptor antagonism in basal ganglia; EPS: D₂ receptor antagonism in basal ganglia
D) positive symptoms: D₂ receptor antagonism in nucleus accumbens; EPS: D₂ receptor antagonism in nucleus accumbens

Question 46

What is the main reason that the World Health Organization (WHO) recommends atypical antipsychotic drugs as a first-line treatment for schizophrenia?

A) They are highly effective in treating negative schizophrenic symptoms
B) They are highly effective in treating positive schizophrenic symptoms
C) They have a more specific mechanism of action than typical antipsychotics
D) They carry a lower risk of extrapyramidal side effects than typical antipsychotics

Question 47

The following patients are taking typical antipsychotic drugs to treat schizophrenia. Who is displaying signs of hyperprolactinemia?

A) Leonora, who is experiencing hallucinations and delusions
B) Aarav, who has facial twists and continuously smacks his lips
C) Katya, who experiences disruptions in her menstrual cycle
D) Frederick, who has flulike symptoms, including sweating and fever

Question 48

How do atypical psychotic drugs differ from typical psychotic drugs?

A) They slowly dissociate from D₂ receptors; they do not bind to 5-HT_2A receptors.
B) They slowly dissociate from D₂ receptors; they bind to 5-HT_2A receptors.
C) They quickly dissociate from D₂ receptors; they do not bind to 5-HT_2A receptors.
D) They quickly dissociate from D₂ receptors; they bind to 5-HT_2A receptors.

Question 49

The following patients are taking atypical antipsychotic drugs to treat schizophrenia. Who is displaying signs of QT interval prolongation?

A) Maury, who has a low white blood cell count
B) Donatella, who has an abnormal heartbeat
C) Nigel, who has prolonged flulike symptoms
D) Selena, who continuously clenches her jaw

Question 50

Which type of behavioral rodent model distinguishes typical from atypical antipsychotics?

A) rotarod
C) conditioned avoidance responding
B) conflict test
D) catalepsy

Question 51

Why have pharmaceutical companies developed alternative administration routes, other than oral routes, for antipsychotic drugs?

A) First pass metabolism is bypassed.
B) Antipsychotic drugs are typically poorly absorbed.
C) Patient compliance is often a problem.
D) Other routes allow for more rapid onset of drug effects.

Question 52

How do typical and atypical antipsychotics affect conditioned avoidance responding in rodents?

A) Atypical and typical antipsychotics decrease accuracy in this procedure.
B) Atypical and typical antipsychotics increase accuracy in this procedure.
C) Atypical antipsychotics decrease accuracy; typical antipsychotics increase accuracy.
D) Atypical antipsychotics increase accuracy; typical antipsychotics decrease accuracy.

Question 53

Darlene has been taking atypical antipsychotics for a number of years. Her doctor is likely to be concerned about ____.

A) excessive weight gain
C) liver toxicity
B) excessive weight loss
D) kidney toxicity

Question 54

Why was the atypical antipsychotic drug clozapine not used clinically for schizophrenia until the 1970s and 1980s?

A) The high cost of its production caused mental health organizations to favor typical antipsychotics.
B) Its effectiveness went mostly unnoticed because it treats mostly negative schizophrenic symptoms.
C) It produced excessive extrapyramidal side effects until a new derivative was synthesized.
D) It was initially disregarded because of a lack of extrapyramidal side effects in animal models.

Question 55

The following patients are taking typical antipsychotic drugs to treat schizophrenia. Who is displaying signs of tardive dyskinesia?

A) Leonora, who is experiencing hallucinations and delusions
B) Aarav, who has facial twists and continuously smacks his lips
C) Katya, who experiences disruptions in her menstrual cycle
D) Frederick, who has flulike symptoms, including sweating and fever

Question 56

Aside from dopamine and serotonin receptors, atypical antipsychotics also bind to ____ receptors.

A) GABA
C) muscarinic cholinergic
B) glutamate
D) nicotinic cholinergic

Question 57

As a consequence of taking atypical antipsychotic drugs, Siamus experiences dry eyes and dry mouth. This side effect likely occurs because of atypical antipsychotic actions at ____.

A) α₁ adrenoceptors
C) muscarinic cholinergic receptors
B) α₂ adrenoceptors
D) nicotinic cholinergic receptors

Question 58

Compare and contrast typical and atypical antipsychotic drugs, highlighting the effectiveness of treatment on major symptoms, side effects that may occur, and the mechanism of action in both classes of drugs. Which type is prescribed more frequently today and why?

Question 59

What two procedures are highly effective for screening atypical antipsychotic drugs in animal models?

A) conflict test and catalepsy
B) conflict test and rotarod
C) conditioned avoidance responding and catalepsy
D) conditioned avoidance responding and rotarod

Question 60

For certain atypical antipsychotic drugs such as clozapine, antagonism at which receptors may contribute to antipsychotic effects?

A) α₁ adrenoceptors
C) muscarinic cholinergic receptors
B) α₂ adrenoceptors
D) nicotinic cholinergic receptors