Test Bank for Julien’s Primer of Drug Action 14th Edition Advokat

Test Bank for Julien’s Primer of Drug Action 14th

Edition Advokat

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1. __________ is the most widely used psychoactive drug.
A) Caffeine
B) Nicotine
C) Alcohol
D) Cocaine

2. Xanthines are known for all of the following EXCEPT:

A) producing diuresis.
B) depressing the central nervous system.
C) stimulating cardiac muscle.
D) relaxing smooth muscle.

3. Caffeine is naturally found in all of the following EXCEPT:

A) tea leaves.
B) birch trees.
C) kola nuts.
D) cocoa beans.

4. The amount of caffeine found in hot chocolate is:

A) significantly less than soda.
B) significantly more than soda.
C) similar to soda.
D) similar to coffee.

5. The half-life of caffeine is:

A) less than 30 minutes.
B) 3 to 10 hours.
C) 24 to 48 hours.
D) greater than two days.

6. The half-life of caffeine may be shortened in:

A) inactive ingredients.
B) an active ingredient.
C) two active ingredients.
D) three active ingredients.

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 7. Of the major caffeine metabolites, __________ does not act in a similar way to caffeine.
A) theobromine
B) paraxanthine
C) theophylline
D) parabromine

8. When caffeine is metabolized, _____ is the greatest byproduct, followed by _____ and
_____, respectively.
A) theophylline; theobromine; paraxanthine
B) theophylline; paraxanthine; theobromine
C) paraxanthine; theobromine; theophylline
D) theobromine; paraxanthine; theophylline

9. All of the following are metabolites of caffeine EXCEPT:

A) theobromine.
B) paraxanthine.
C) theophylline.
D) parabromine.

10. Caffeine is _____ soluble.

A) water
B) lipid
C) water and lipid
D) neither water nor lipid

11. After oral ingestion of caffeine, significant blood levels of the drug are reached in as
soon as_____ minutes.
A) 15
B) 30
C) 45
D) 60

12. After oral ingestion of caffeine, 99 percent of the drug is absorbed in about _____
minutes.
A) 15
B) 30
C) 45
D) 60

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13. The majority of metabolism of caffeine occurs in the:
A) plasma.
B) kidney.
C) liver.
D) bladder.

14. Certain antidepressants such as fluvoxamine _______ the metabolism of caffeine and
______ caffeine tolerance.
A) accelerate; increase
B) accelerate; decrease
C) inhibit; increase
D) inhibit; decrease

15. Diego recently started taking an antidepressant. He also enjoys about 5 to 6 cups of
coffee in the morning. But now he feels anxious and jittery after drinking his coffee
rather than just more alert in the mornings. The effects he is noticing are most likely due
to the _________ of __________ by the antidepressant.
A) inhibition; CYP-2A1
B) inhibition; CYP-1A2
C) stimulation; CYP-2A1
D) stimulation; CYP1A2

16. Of the major caffeine metabolites, _____ acts in a dissimilar way to caffeine.
A) theobromine
B) paraxanthine
C) theophylline
D) parabromine

17. Moderate consumption of caffeine can:

A) substantially increase the risk of coronary heart disease.
B) increase inflammation.
C) increase the risk of stroke.
D) protect against heart failure.

18. Genetics can play a role in an individual's response to caffeine by altering the:
A) rate of absorption.
B) rate of metabolism.
C) neurotransmitter concentrations.
D) postsynaptic receptor sensitivity.

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19. Caffeine _____ coronary arteries and _____ cerebral blood vessels.
A) dilates; constricts
B) constricts; dilates
C) dilates; dilates
D) constricts; constricts

20. The antimigraine effect of caffeine appears to be due to:

A) increased cardiac output.
B) increased cardiac contractility.
C) dilatation of cerebral arteries.
D) decreased blood flow to the brain.

21. Other than the brain, research suggests that caffeine consumption may be beneficial for
the:
A) cardiovascular system.
B) urinary tract.
C) digestive tract.
D) immune system.

22. Research has shown that caffeine _____ the risk of cardiovascular disease and _____
the risk of diabetes.
A) decreases; decreases
B) decreases; increases
C) increases; decreases
D) increases; increases

23. Research has shown that caffeine reduces the risk of all of the following EXCEPT:
A) cancer.
B) cardiovascular disease.
C) multiple sclerosis.
D) urinary tract disease.

24. Research has shown that caffeine reduces the risk of all of the following EXCEPT:
A) Alzheimer's disease.
B) Parkinson's disease.
C) arthritis.
D) diabetes.

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25. All of the following are known to possess anti-inflammatory properties EXCEPT:
A) polyphenol.
B) caffeine.
C) theophylline.
D) theobromine.

26. Juan suffers from headaches. He takes over-the-counter medications for pain relief but
also drinks a can of Monster®. The effects of the caffeine in the energy drink cause
_____ of the cerebral blood vessels and _____ blood flow to the brain.
A) dilation; increased
B) constriction; increased
C) constriction; decreased
D) dilation; decreased

27. Research suggests that daily coffee or caffeine use may provide a protective effect
against:
A) bipolar disorder.
B) type 1 diabetes.
C) Huntington's disease.
D) Parkinson's disease.

28. Over all, evidence suggests that tea and coffee drinkers may experience:
A) increased cardiovascular issues.
B) poorer cognitive function.
C) greater cognitive decline with aging.
D) less cognitive decline with aging.

29. The lethal dose of caffeine is equivalent to approximately:

A) 10 to 20 cups.
B) 30 to 50 cups.
C) 100 cups.
D) There is no lethal dose.

30. Caffeine is known to do all of the following EXCEPT:

A) constrict bronchial smooth muscle.
B) reduce erectile dysfunction.
C) increase gastric acid secretion.
D) increase urine output.

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31. The lethal dose of caffeine is on the order of _____ grams.
A) 1.5
B) 5
C) 7
D) 10

32. Caffeinism:
A) is associated with about 2 cups of coffee.
B) may cause depression in healthy individuals.
C) induces bipolar disorder in depressed patients.
D) may produce psychosis in healthy individuals.

33. Caffeinism is:

A) the study of caffeine.
B) the description of the effects of moderate doses of caffeine.
C) the study of people hypersensitive to caffeine.
D) a syndrome produced by the overdose or overuse of caffeine.

34. Caffeine's most widely known adverse effect is on:

A) memory.
B) cardiovascular function.
C) sleep.
D) digestion.

35. Caffeine promotes wakefulness by:

A) activating adenosine receptors.
B) agonistic activity at adenosine receptors.
C) antagonistic activity at adenosine receptors.
D) inhibiting calcium release from intracellular stores.

36. Blockade of adenosine receptors _____ dopamine release by _____ GABA activity.
A) decreases; decreasing
B) decreases; increasing
C) increases; decreasing
D) increases; increasing

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37. The mechanism of action of caffeine appears to be _____ receptors.
A) stimulation of GABAA
B) blockade of GABAA
C) stimulation of adenosine
D) blockade of adenosine

38. Adenosine is a _____ the discharge rate of many central neurons.

A) depressant that increases
B) depressant that decreases
C) stimulant that increases
D) stimulant that decreases

39. The mildly positive reinforcing effect of caffeine appears to be ultimately due to effects
on the neurotransmitter:
A) acetylcholine.
B) dopamine.
C) norepinephrine.
D) GABA.

40. Caffeine is an _____ to adenosinergic pathways by _____ action.

A) agonist; enhancing neurotransmitter
B) agonist; enhancing receptor
C) antagonist; blocking neurotransmitter
D) antagonist; blocking receptor

41. Caffeine is an _____ to adenosine, and an _____ to dopamine.

A) agonist; agonist
B) agonist; antagonist
C) antagonist; agonist
D) antagonist; antagonist

42. Caffeine affects dopaminergic pathways primarily in the _____ cortex.

A) frontal
B) parietal
C) temporal
D) occipital

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43. The reinforcing effect of caffeine appears to be due to:
A) increased release of dopamine in reward and motivation areas of the brain.
B) increased release of dopamine in the prefrontal cortex.
C) decreased release of dopamine in reward and motivation areas of the brain.
D) increased release of dopamine throughout the brain.

44. Adenosine levels ______ during the day promoting _____.

A) decrease; sleep
B) decrease; wakefulness
C) increase; sleep
D) increase; wakefulness

45. In regard to caffeine use, it is recommended that pregnant women:

A) should avoid caffeine for the duration of their pregnancy.
B) may ingest amounts of decaffeinated beverages.
C) should limit their daily intake to about 1 gram per day.
D) may ingest about 200 milligrams per day.

46. __________ is associated with chronic caffeine use, which can be as low as 100
milligrams per day.
A) Tolerance
B) Withdrawal
C) Intoxication
D) Impaired motor function

47. Caffeine, nicotine, and _____ are the most widely used psychoactive drugs in our
society.
A) amphetamines
B) marijuana
C) alcohol
D) cocaine

48. _____ continues to be the leading cause of preventable death and disease in the United
States.
A) Alcoholism
B) Fetal alcohol syndrome
C) Tobacco use
D) Heroin use

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49. After 2009, smoking rates started to _____ due to _____.
A) decrease; educational efforts
B) decrease; tax increases on tobacco
C) increase; tax decreases on tobacco
D) increase; peer pressures

50. The success rate for quitting smoking is _____ percent.

A) 3
B) 6
C) 9
D) 12

51. Which of the following statement is TRUE?

A) Nicotine accounts for the acute pharmacological effects of smoking.
B) Nicotine is only one of 2000 substances in tobacco.
C) Nicotine is a secondary active ingredient in tobacco.
D) Nicotine makes cigarettes burn slower.

52. When smoking a cigarette, about _____ percent of the nicotine enters the bloodstream.
A) 80
B) 50
C) 25
D) 10

53. When a smoker lights up and begins smoking, they will, on average absorb about
______ milligrams of nicotine.
A) 10
B) 20
C) 2
D) 5

54. Nicotine is secondarily metabolized by the ______ liver enzyme.

A) CYP1A1
B) CYP2D6
C) CYP2A6
D) CYP1E1

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55. The elimination half-life of nicotine in a chronic user is about:
A) 30 minutes.
B) 2 hours.
C) 12 to 24 hours.
D) greater than 24 hours.

56. The majority of nicotine is metabolized in the:

A) plasma.
B) liver.
C) kidneys.
D) blood.

57. The first morning cigarette in is best described as “__________” for nicotine-dependent
smokers.
A) positively reinforcing
B) punishing
C) negatively reinforcing
D) secondarily reinforcing

58. __________ is the direct mechanism of action of nicotine on arousal levels.

A) Stimulation of dopamine receptors
B) Blockade of dopamine receptors
C) Stimulation of acetylcholine receptors
D) Blockade of acetylcholine receptors

59. Nicotine is an acetylcholine _____ by acting on acetylcholine _____.

A) agonist; neurotransmitter
B) agonist; receptors
C) antagonist; neurotransmitter
D) antagonist; receptors

60. Smokers of menthol cigarettes are _____ likely to quit and have _____ relapse rates
than smokers of nonmenthol cigarettes.
A) less; lower
B) less; higher
C) more; lower
D) more; higher

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61. Menthol cigarettes are known to _____ acetylcholine receptors to a _____ extent than
nonmenthol cigarettes.
A) upregulate; lesser
B) upregulate; greater
C) downregulate; lesser
D) downregulate; greater

62. Nicotine _____ acetylcholine receptors, and menthol _____ acetylcholine receptors
A) activates; activates
B) activates; deactivates
C) deactivates; deactivates
D) deactivates; activates

63. The rewarding effects of nicotine involve __________ and __________.

A) nicotinic receptors; the nucleus accumbens.
B) nicotinic receptors on dopamine neurons in the ventral tegmental area; dopamine
release onto the nucleus accumbens.
C) nicotinic receptors; glutamate release on neurons in the nucleus accumbens.
D) GABA release onto dopamine neurons in the ventral tegmental area; dopamine
release onto the nucleus accumbens.

64. The reinforcing effects of nicotine are the result of:

A) direct activation of dopamine release onto the nucleus accumbens.
B) direct blockade of dopamine release onto the ventral tegmental area.
C) indirect activation of dopamine receptors.
D) indirect blockade of dopamine receptors.

65. Nicotine is thought to be agonistic to all of the following EXCEPT:

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

66. Nicotine is thought to be _____ to glutamate and _____ to serotonin.

A) agonistic; agonistic
B) agonistic; antagonistic
C) antagonistic; agonistic
D) antagonistic; antagonistic

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67. Nicotine is thought to be beneficial to all of the following EXCEPT:
A) cognitive performance.
B) motor skills.
C) Alzheimer's disease.
D) Parkinson's disease.

68. Nicotine-induced release of acetylcholine may:

A) improve cognitive performance and arousal.
B) cause adult ADHD.
C) stimulate depression.
D) enhance sensory perception.

69. Tobacco use in the United States:

A) has increased since the 1950s.
B) remains at 50 percent.
C) is highest among those who are well educated.
D) is common in people with substance abuse and mental health issues.

70. The effect of nicotine on the cardiovascular system and hypothalamus are, respectively:
A) vasoconstriction and antidiuretic hormone release.
B) vasoconstriction and diuretic hormone release.
C) vasodilation and diuretic hormone release.
D) vasodilation and antidiuretic hormone release.

71. In the heart, nicotine:

A) constricts coronary arteries.
B) dilates coronary arteries.
C) decreases cardiac contractility.
D) dilates coronary arteries while decreasing cardiac contractility.

72. Evidence suggests that nicotine may produce a _____ effect for patients with ______
disease.
A) protective; Alzheimer's
B) protective; Parkinson's
C) toxic; Alzheimer's
D) toxic; Parkinson's

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73. When people start smoking, nicotine induces:
A) feelings of pleasure.
B) a decrease in blood pressure.
C) nausea.
D) altered heart rate.

74. Nicotine withdrawal symptoms occur within about:

A) 15 minutes.
B) 30 minutes.
C) 1 hour.
D) 2 hours.

75. The period of withdrawal from nicotine:

A) is typically less than 24 hours.
B) is typically 1 to 2 days.
C) is typically around one week in duration.
D) can persist for several weeks.

76. Nicotine clearly induces _____ dependence in a majority of smokers.

A) psychological
B) physiological
C) both psychological and physiological
D) either psychological or physiological

77. The pharmacological effects of tobacco are due to ______ and the disease states are due
to _______.
A) nicotine; nicotine
B) tar; nicotine
C) carbon monoxide; tar
D) nicotine; tar

78. __________ is the primary effect of carbon monoxide on the heart.

A) Decreased oxygen supply to the heart
B) Decreased atherosclerosis
C) Decreased clotting
D) Decreased blood pressure

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79. Cigarette smokers manifest a _____ percent increase in the progression of
atherosclerosis when compared with people who have never smoked.
A) 25
B) 50
C) 100
D) 150

80. Cigarette smokers are known to experience atherosclerosis in all of the following areas
EXCEPT the:
A) legs.
B) arms.
C) abdomen.
D) neck.

81. The carcinogen in cigarettes is the primary cause of ______ cancer.

A) bladder
B) pancreatic
C) lung
D) lip

82. Cancers associated with tobacco use are primarily due to:
A) nicotine.
B) tars in tobacco.
C) the delivery device.
D) poor filters.

83. Smoking may promote all of the following EXCEPT:

A) autoimmune disease.
B) diabetes.
C) cataracts.
D) attentional deficit disorder.

84. Smoking during pregnancy has been shown to produce consistent:

A) low birth weights.
B) neurological deficits.
C) frontal lobe deficits.
D) attentional issues as children age.

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85. Among partial nicotine receptor agonists, evidence suggests that smokers using
_______ increase their chances of quitting by two to three times in comparison to those
who try to quit with no other assistance.
A) bupropion (Wellbutrin)
B) dianicline
C) cytisine
D) varenicline (Chantix)

86. Hookah is absorbed by:

A) inhalation.
B) injection.
C) sublingual administration.
D) transdermal patch.

87. Evidence suggests that e-cigarettes may be _____ than regular cigarettes and could
reduce _____.
A) safer; quitting behavior
B) safer; craving
C) more addictive; quitting behavior
D) more addictive; craving

88. The e-cigarette is loaded with _____.

A) dry tobacco
B) wet tobacco
C) liquid nicotine
D) powdered nicotine

89. Compared to e-cigarettes, the use of vape-pens typically results in:

A) increased nicotine blood levels
B) decreased nicotine blood levels
C) decreased toxins
D) decreased carcinogens

90. Compared to e-cigarettes, the use of vape-pens typically results in _____ nicotine blood
levels and _____ carcinogens.
A) decreased; decreased
B) decreased; increased
C) increased; decreased
D) increased; increased

Page 15
91. The drug that is no longer under development to aid in smoking cessation is:
A) nicotine.
B) buproprion.
C) varenicline.
D) dianicline.

92. Partial nicotine receptor agonists are known to:

A) block access of nicotine to the receptor.
B) promote access of nicotine to the receptor.
C) promote release of dopamine.
D) block the release of glutamate.

93. Vaccine therapy for nicotine addiction involves:

A) antagonistic effects to nicotine.
B) antagonistic effects to acetylcholine receptors
C) agonistic effects to acetylcholine receptors
D) reducing withdrawal effects.

Page 16
Answer Key
1. A
2. B
3. B
4. A
5. B
6. C
7. A
8. B
9. D
10. C
11. A
12. C
13. C
14. D
15. B
16. A
17. D
18. B
19. A
20. D
21. A
22. A
23. D
24. C
25. B
26. C
27. D
28. D
29. C
30. A
31. D
32. D
33. D
34. C
35. C
36. C
37. D
38. B
39. B
40. D
41. C
42. C
43. B
44. C

Page 17
45. D
46. A
47. C
48. C
49. B
50. B
51. A
52. C
53. C
54. A
55. B
56. B
57. C
58. C
59. B
60. B
61. B
62. B
63. B
64. A
65. B
66. A
67. B
68. A
69. D
70. D
71. B
72. B
73. C
74. D
75. D
76. C
77. D
78. A
79. B
80. B
81. C
82. B
83. D
84. A
85. D
86. A
87. B
88. C
89. A
90. D

Page 18
Test Bank for Julien’s Primer of Drug Action 14th Edition Advokat

91. D
92. A
93. A

Page 19

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