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Chapter 37. Schizophrenia

Student Questions

The concentration of which of the following antipsychotics is most likely to increase if a cigarette smoker decides to stop smoking?

A. Clozapine

B. Haloperidol

C. Quetiapine

D. Risperidone

Answer: A

Option A: Correct. Cigarette smoking can affect drugs that are metabolized the through CYP 1A2 and decrease their concentrations.

Option B: Incorrect. Haloperidol's major metabolic pathway is CYP 2D6 and 3A4; CYP 1A2 is a minor metabolic pathway. There is no interaction with cigarette smoking.

Option C: Incorrect. Quetiapine's major metabolic pathway is CYP 3A4; CYP 2D6 is a minor metabolic pathway. There is no interaction with cigarette smoking.

Option D: Incorrect. Risperidone's major metabolic pathway is CYP 2D6; CYP 3A4 is a minor metabolic pathway. There is not interaction with cigarette smoking.

Which of the following is decreased in the prefrontal cortex in patients who have developed negative symptoms of schizophrenia?

A. Norepinephrine

B. Glutamate

C. Dopamine

D. Serotonin

Answer: C

Option A: Incorrect. Norepinephrine changes are not described in patients with negative symptoms.

Option B: Incorrect. Decreased glutamate is not described in patients with negative symptoms of schizophrenia.

Option C: Correct. Decreased levels of dopamine in the prefrontal cortex are noted in patients who develop negative symptoms of schizophrenia.

Option D: Incorrect. Decreased serotonin is not described in patients with negative symptoms of schizophrenia.

Which of the following tests is necessary to have been completed prior to the initiation of olanzapine?

A. Fasting glucose

B. Liver function tests

C. BUN and creatinine

D. Thyroid function test

Answer: A

Option A: Correct. Fasting glucose, lipids, weight, blood pressure, and waist circumference are recommended prior to initiating SGAs.

Option B: Incorrect. Liver function tests are not one of the recommended tests prior to initiating an SGA.

Option C: Incorrect. BUN and creatinine are not recommended tests prior to initiating an SGA.

Option D: Incorrect. Thyroid function tests are not one of the recommended tests prior to initiating an SGA.

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