Deck 11: Drug Treatment of Cognitive Dysfunction

Question 1

Most of the evidence accumulated to date points to which of the following as the primary cause of most cases of attention deficit disorder?

A)excessive sugar intake
B)hypersensitivity to food additives
C)hyperthyroidism
D)unknown mechanisms

Answer 1

D

Question 2

Empirical evidence indicates that the behavioral effects of amphetamine are

A)opposite in children and adults
B)qualitatively similar in normal children and children diagnosed with attention deficit hyperactivity disorder
C)identical in children and adults
D)opposite in normal children and those with attention deficit hyperactivity disorder

Answer 2

B

Question 3

Most of the recent research indicates that children diagnosed with attention deficit hyperactivity disorder who are treated with psychostimulants are at ______________________ risk for developing substance abuse disorders, compared with children with ADHD who are not treated with psychostimulants.

A)a much lower
B)the same level of
C)much higher

Answer 3

A

Question 4

Because of its low affinity for the NMDA receptor, this drug may only have an effect when the glutamate system is hyperactive and potentially neurotoxic.

A)galantamine
B)rivastigmine
C)donepezil
D)memantine

Question 5

Compare the relative efficacy of methylphenidate (Ritalin), dietary restrictions (e.g., sugar, food additives), and barbiturates in the treatment of the primary symptoms of attention deficit disorders in children.

Question 6

The conclusion from research with adults who, as children, were treated with psychostimulants for ADHD is that these individuals are likely to

A)show no significant behavioral differences when compared with adults who were not diagnosed as ADHD during childhood
B)display more social skills and self-esteem than adults who were diagnosed with ADHD as children but did not receive psychostimulant treatment
C)exhibit greater risk for abusing psychostimulants than adults who were diagnosed with ADHD as children but did not receive psychostimulant treatment
D)all of the above

Question 7

Primarily because of their low toxicity and absence of anticholinergic side-effects, ______________ are presently the recommended class of drugs for the treatment of depression in the elderly.

A)tricyclic antidepressants
B)monoamine oxidase inhibitors
C)selective serotonin reuptake inhibitors
D)psychostimulants

Question 8

This alpha-adrenergic receptor has been shown in several studies to be effective in reducing ADHD symptoms.

A)Antabuse
B)Clonidine
C)Focalin
D)lithium

Question 9

What are the major side effects of anticholinesterase inhibitors?

Question 10

Which of the following is NOT a problem associated with the treatment of depression in the elderly?

A)antidepressant drugs losing their efficacy
B)difficulty of diagnosis
C)compound drug use
D)decreased rate of drug metabolism and excretion

Question 11

ADHD may be evidenced in upwards of _________ percent of the school-age population.

A)10
B)12
C)15
D)18

Question 12

What are the benefits of the cholinesterase inhibitors in reducing the symptoms of Alzheimer's disease? Provide data to support your answer.

Question 13

Cognitive deficits in Alzheimer's disease patients

A)in most cases can be traced to one or two specific abnormalities in the brain
B)have in most cases been successfully treated by a variety of drugs
C)have in some cases been traced to a degeneration in cholinergic neurons in the brain
D)all of the above

Question 14

Are there potential problems if a child diagnosed with Attention deficit hyperactivity disorder who also exhibits motor tics is treated with a psychostimulant like methylphenidate (Ritalin)?

Question 15

Longtime speculations that there is insufficient catecholamine activity in the brains of individuals with ADHD have been supported with the observation that adults diagnosed with ADHD have a higher density of _____________ transporters.

A)serotonin
B)GABA
C)dopamine
D)acetylcholine

Question 16

What are some of the problems associated with the treatment of mental and emotional disturbances in the elderly?
e.g., decreased rate of drug metabolism and excretion, decreased drug binding to plasma proteins, the elderly are more susceptible to drug toxicity.This requires that dosages of psychotropic drugs in the elderly be reduced to one-third to one-half of dosages appropriate for young adults and requires dosages to be increased only very gradually.
e.g., the symptoms of depression may be confused with those of dementia (or vice versa), or may be the result of other medications taken for other health problems.Because of multiple health problems that require different medications, the elderly may be at risk for exhibiting complex and harmful drug interactions.Due to changes in pharmacokinetics as a result of aging,

Question 17

Research on the treatment of the attention deficit hyperactivity disorder (ADHD) with psychostimulants suggests that

A)the beneficial effects of psychostimulants cease completely at puberty
B)ADHD children exhibit decreased motor activity in response to psychostimulants, whereas normal children exhibit hyperactivity in response to psychostimulants
C)both a and b
D)neither a nor b

Question 18

A recent study investigating the efficacy of clonidine combined with methylphenidate (Ritalin) in the treatment of ADHD children who were comorbid for motor tics or Tourette's syndrome has indicated that

A)the combination was more effective in these children than either drug alone
B)clonidine reduced the motor tics but methylphenidate significantly increased them
C)the combination was less effective in these children than either drug alone

Question 19

What differences exist among dextroamphetamine, methylphenidate and pemoline in the treatment of ADHD?

Question 20

What are some of the special problems associated with pharmacotherapy in children?
e.g., anxiety and affective disorders, but the symptoms may be different.Second, there are few clinical trials conducted with children with the psychotropics that are used in the treatment of adults.Dosages appropriate for adults may not be appropriate for children, often because children metabolize drugs more efficiently than adults.Thirdly, information on treatment efficacy comes less from the child being treated and more from the observers of the child, who may differ on the outcome of a drug treatment.

Question 21

Which of the following categories of drugs is most commonly used in the treatment of ADHD?

A)tricyclic antidepressants
B)SSRIs
C)psychostimulants
D)MAOIs

Question 22

Approximately __________ percent of children diagnosed with attention deficit hyperactivity disorder exhibit significant clinical improvement with treatment with psychostimulants.

A)10- 20
B)30 - 40
C)50 - 60
D)60 - 80

Question 23

Atomoxetine (Strattera) has recently been approved for the treatment of ADHD.It differs from traditional psychostimulant medications in what dimension(s)?

A)it is more selective in its actions, primarily selectively inhibiting norepinephrine reuptake.
B)in contrast to psychostimulants, it has no abuse liability
C)its efficacy is greater than that shown with psychostimulants
D)only a and b above

Question 24

Which of the following is a problem when psychotropic drugs are used in the elderly?

A)reduced rate of drug metabolization
B)increased rate of drug excretion
C)lower ability for drugs to concentrate in fatty tissues
D)all of these

Question 25

In elderly patients, appropriate dosages of psychotropic drugs are generally ___________________ that of young adults.

A)one-third to one-half of
B)130-150% of
C)the same as
D)two to three times

Question 26

If improvement with psychostimulants is going to occur, it will become apparent ______________.

A)within 6 weeks.
B)within 4 weeks
C)within 3 days
D)immediately Chapter 11 Answers to multiple choice questions and

Question 27

The primary advances in methylphenidate treatment for ADHD stem from modifications in

A)the methyphenidate molecule that make it more selective in its actions
B)the formulations of methyphenidate that result in a more effective pharmacokinetic profiles
C)the dosages that are given

Question 28

Which of the following types of drugs are likely to be used as alternatives to Ritalin in the treatment of attention deficit disorders?

A)tricyclic antidepressants
B)atomoxetine (Strattera)
C)sedative-hypnotics
D)only a and b

Question 29

A "nootropic" is a drug that has the property of

A)specifically enhancing cognitive functions such as memory and learning
B)inhibiting the reuptake of serotonin
C)enhancing motor functioning
D)reducing extrapyramidal side effects of antipsychotics

Question 30

Over the past several years, most drug treatments attempting to reduce the symptoms of Alzheimer's disease have involved drugs that somehow amplify _________________ activity in the brain.

A)acetylcholine
B)noradrenaline
C)dopamine
D)serotonin

Question 31

The cholinergic enhancing drugs Cognex (tacrine) and Aricept (donepezil) have recently been approved for the treatment of

A)Parkinson's disease
B)Alzheimer's disease
C)schizophrenia
D)childhood autism

Question 32

For activities that require the most behavioral inhibition, children with attention deficit hyperactivity disorder show the optimal response to methylphenidate (Ritalin) when ________________________ are used.

A)low dosages in the clinical range
B)moderate dosages in the clinical range
C)high dosages in the clinical range
D)placebos