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Test Your Antipsychotic Pharmacology Quiz Skills

Boost Understanding of Antipsychotic Drug Mechanisms

Difficulty: Moderate
Questions: 20
Learning OutcomesStudy Material
Colorful paper art representing a quiz on Antipsychotic Pharmacology.

Ready to dive into antipsychotic pharmacology? This quiz is perfect for nursing and medical students seeking to sharpen their understanding of drug mechanisms and side effects. It's part of our quizzes library and builds on foundational assessments like the Pharmacology Review Quiz and Clinical Pharmacology Knowledge Assessment . You'll get 15 challenging multiple-choice questions designed to enhance recall and clinical reasoning. And remember, you can freely modify this quiz in our editor to tailor it to your curriculum needs.

Which receptor subtype is the primary target of typical antipsychotic drugs?
D2 dopamine receptor
5-HT2A serotonin receptor
H1 histamine receptor
M1 muscarinic receptor
Typical antipsychotics exert their antipsychotic effects primarily by antagonizing D2 dopamine receptors. This blockade in the mesolimbic pathway reduces positive symptoms of schizophrenia.
Clozapine is unique among antipsychotics for its high-affinity antagonism at which receptor?
5-HT2A serotonin receptor
D4 dopamine receptor
H1 histamine receptor
α1 adrenergic receptor
Clozapine has potent antagonism at 5-HT2A receptors in addition to D4 and other receptors. The high 5-HT2A affinity contributes to its atypical profile and efficacy against negative symptoms.
Extrapyramidal symptoms are most strongly associated with which class of antipsychotics?
Typical antipsychotics
Atypical antipsychotics
Selective serotonin reuptake inhibitors
Tricyclic antidepressants
Typical antipsychotics have a high D2 receptor blockade in the nigrostriatal pathway, which leads to extrapyramidal side effects. Atypicals have lower EPS risk due to serotonin - dopamine interactions.
Which antipsychotic requires regular white blood cell monitoring due to risk of agranulocytosis?
Clozapine
Risperidone
Olanzapine
Haloperidol
Clozapine carries a significant risk of agranulocytosis and requires regular WBC and neutrophil monitoring. This risk management strategy reduces the incidence of severe neutropenia.
Which antipsychotic is most associated with QT interval prolongation?
Ziprasidone
Haloperidol
Chlorpromazine
Aripiprazole
Ziprasidone is known to prolong the QT interval more than most other antipsychotics. This effect is due to its blockade of cardiac potassium channels.
Which atypical antipsychotic acts as a partial agonist at D2 receptors?
Aripiprazole
Risperidone
Clozapine
Olanzapine
Aripiprazole is a dopamine D2 partial agonist, which modulates dopaminergic activity rather than fully blocking it. This mechanism reduces the risk of both EPS and hyperprolactinemia.
Which cytochrome P450 enzyme primarily metabolizes clozapine?
CYP1A2
CYP2D6
CYP3A4
MAO-A
Clozapine is mainly metabolized by CYP1A2. Factors such as smoking induction or fluvoxamine inhibition of CYP1A2 significantly alter clozapine levels.
A patient on haloperidol develops acute dystonia. Which agent is most appropriate for immediate treatment?
Benztropine
Propranolol
Diazepam
Lorazepam
Benztropine, an anticholinergic, is the treatment of choice for acute dystonia because it restores the cholinergic - dopaminergic balance in the basal ganglia. Benzodiazepines are less effective acutely.
Which antipsychotic is most associated with significant weight gain and metabolic syndrome?
Olanzapine
Ziprasidone
Haloperidol
Aripiprazole
Olanzapine has the highest risk for weight gain, dyslipidemia, and insulin resistance among antipsychotics. Monitoring metabolic parameters is essential when prescribing it.
If a patient quits smoking while on clozapine, what is the expected effect on clozapine plasma levels?
Plasma levels will increase
Plasma levels will decrease
No significant change
Levels become unpredictable
Smoking induces CYP1A2, increasing clozapine clearance. Upon smoking cessation, clearance decreases and plasma levels rise, necessitating dose reduction to avoid toxicity.
What is a typical initial oral dose of risperidone for schizophrenia?
1 mg twice daily
5 mg once daily
2 mg three times daily
10 mg once daily
Risperidone is often started at 1 mg twice daily and titrated up based on response and tolerability. Higher single doses increase EPS risk early on.
Antipsychotic-induced hyperprolactinemia is primarily caused by blockade of D2 receptors in which pathway?
Tuberoinfundibular pathway
Mesolimbic pathway
Nigrostriatal pathway
Mesocortical pathway
Prolactin secretion is regulated by dopamine in the tuberoinfundibular pathway. D2 receptor blockade here removes inhibition on prolactin release, leading to hyperprolactinemia.
Which antipsychotic has the lowest risk of extrapyramidal side effects?
Clozapine
Haloperidol
Fluphenazine
Risperidone
Clozapine has minimal D2 blockade in the nigrostriatal pathway compared to others and often improves EPS rather than worsening it. Its unique profile reduces motor side effects.
Which antipsychotic formulation has the longest effective half-life?
Fluphenazine decanoate injection
Olanzapine oral
Aripiprazole oral
Risperidone oral
Fluphenazine decanoate is a long-acting injectable ester with a half-life of several weeks, allowing monthly dosing. Oral formulations have much shorter half-lives.
A CYP2D6 poor metabolizer will have elevated plasma levels of which antipsychotic?
Aripiprazole
Ziprasidone
Clozapine
Haloperidol
Aripiprazole is metabolized significantly by CYP2D6. Poor metabolizers have reduced clearance, leading to higher drug exposure and potential toxicity.
A patient on a high-potency antipsychotic develops Neuroleptic Malignant Syndrome. What is the first-line pharmacologic treatment?
Dantrolene
Bromocriptine
Propranolol
Benztropine
Dantrolene acts on skeletal muscle to reduce rigidity and hyperthermia and is the first-line treatment for NMS. Dopamine agonists like bromocriptine can be used adjunctively.
Smoking induces the metabolism of which antipsychotic via CYP1A2, often requiring dose adjustments?
Clozapine
Risperidone
Haloperidol
Aripiprazole
Polycyclic aromatic hydrocarbons in tobacco smoke induce CYP1A2, increasing the clearance of clozapine. Clinicians often increase clozapine dose in smokers and reduce it when smoking stops.
When converting a patient from oral haloperidol to haloperidol decanoate, the decanoate dose is approximately how many times the oral daily dose?
10 times
1.2 times
3 times
20 times
The standard conversion is to multiply the oral daily dose of haloperidol by 10 to determine the monthly decanoate dose. This accounts for the depot release and prolonged half-life.
Which antipsychotic has a higher 5-HT2A-to-D2 receptor antagonism ratio compared to haloperidol?
Risperidone
Haloperidol
Fluphenazine
Pimozide
Risperidone blocks 5-HT2A receptors more potently than D2 receptors, giving it an atypical profile. Haloperidol and other high-potency typicals have much stronger D2 than 5-HT2A blockade.
Tardive dyskinesia is believed to result from which pathophysiological mechanism?
D2 receptor supersensitivity
D1 receptor blockade
5-HT2A receptor activation
GABA receptor inhibition
Chronic D2 blockade leads to upregulation and supersensitivity of dopamine receptors in the nigrostriatal pathway, causing the involuntary movements characteristic of tardive dyskinesia.
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Learning Outcomes

  1. Identify key receptor targets of typical and atypical antipsychotics.
  2. Analyze pharmacokinetic properties of antipsychotic medications.
  3. Evaluate side effect profiles and risk management strategies.
  4. Apply knowledge of antipsychotic drug interactions clinically.
  5. Master dosing principles for optimal therapeutic outcomes.
  6. Demonstrate mechanisms of action for major antipsychotic agents.

Cheat Sheet

  1. Receptor targets - Typical antipsychotics mainly block dopamine D₂ receptors, while atypicals team up with serotonin 5-HT₂A receptors for a double-action punch. This dynamic duo helps soothe both the positive and negative symptoms of schizophrenia for a smoother ride. Antipsychotic drugs | Pharmacology Education Project
  2. Pharmacokinetics - Lipid-loving antipsychotics easily slip past the blood-brain barrier, then get happily chopped up by liver enzymes like CYP2D6 and CYP3A4 before exiting via the kidneys. Knowing this helps you predict how fast a drug kicks in or wears off - and dodge unwanted interactions! Pharmacology of Antipsychotic Drugs | Pharmacology Mentor
  3. Common side effects - Typical antipsychotics can trigger extrapyramidal symptoms (think tremors and stiffness), while atypicals are famous for metabolic mischief like weight gain and elevated blood sugar. Spotting these issues early makes you a monitoring ninja and keeps patients safe. Antipsychotic drugs | Pharmacology Education Project
  4. Drug interactions - Mixing antipsychotics with other QT-prolonging medicines can spell trouble for the heart, so check those combinations twice! A solid grasp of interactions ensures you prescribe safely and avoid nasty surprises. Antipsychotic Medications - StatPearls | NCBI Bookshelf
  5. Dosing strategies - Start low, go slow! Titrate upward from the smallest effective dose to dodge side effects without losing efficacy. Regular check-ins let you tweak the dose like a pro for the best outcome. Antipsychotic Medications - StatPearls | NCBI Bookshelf
  6. Mechanisms of action - Blocking D₂ receptors helps crush positive symptoms, while adding 5-HT₂A antagonism can lift negative symptoms out of the shadows. This balanced blockade explains why atypicals often get top marks in clinical practice. Mechanisms of Action | JEBMS
  7. Monitoring essentials - Keep tabs on movement disorders, blood sugar, lipids and overall symptom relief on a regular schedule. Routine checks are your best friend for catching issues early and celebrating treatment wins! Antipsychotic Medications - StatPearls | NCBI Bookshelf
  8. Contraindications - Watch out for severe cardiac issues or a history of neuroleptic malignant syndrome - these red flags mean certain antipsychotics are off-limits. Knowing the no-go list keeps every prescription safe and sound. Antipsychotic Medications - StatPearls | NCBI Bookshelf
  9. Drug profiles - Each antipsychotic is a unique character: clozapine fights tough cases but demands blood monitoring, while others boast lighter side-effect packages. Match the profile to the patient like a perfect puzzle piece. Antipsychotic drugs | Pharmacology Education Project
  10. Patient education - The secret weapon! Teach patients about side effects, why sticking to the plan matters, and lifestyle tweaks to boost results. When patients know the why and how, adherence soars and relapse rates plummet. Antipsychotic Medications - StatPearls | NCBI Bookshelf
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