Test Bank for Julien’s Primer of Drug Action Thirteenth Edition

Test Bank for Julien’s Primer of Drug Action

Thirteenth Edition

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Name: __________________________ Date: _____________

1. The most widely used psychoactive drug is:

A) caffeine.
B) nicotine.
C) alcohol.
D) cocaine.

2. 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.

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

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

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

5. The majority of metabolism of caffeine occurs in:

A) plasma.
B) kidney.
C) liver.
D) bladder.

6. Certain antidepressants such as fluvoxamine _______ the metabolism of caffeine and

______ caffeine tolerance.
A) accelerate; increase
B) accelerate; decrease
C) inhibit ; increase
D) inhibit; decrease

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 7. Diego recently started taking an antidepressant. He also enjoys about 5–6 cups of
coffee in the morning. However, he has noticed that he now 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 ______ by the antidepressant.
A) inhibition of CYP-2A1
B) inhibition of CYP-1A2
C) stimulation of CYP-2A1
D) stimulation of CYP1A2

8. 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.

9. Caffeine _____ coronary arteries and _____ cerebral blood vessels.

A) dilates; constricts
B) constricts; dilates
C) dilates; dilates
D) constricts; constricts

10. 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.

11. 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.

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12. Granulocyte colony stimulating factor (GCSF) is _______ in patients with Alzheimer's
disease; increasing GCSF via caffeine intake has been shown to ______ performance on
memory tasks in laboratory animals.
A) lower; degrade
B) lower; improve
C) higher; degrade
D) higher; improve

13. 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.

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

15. 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.

16. 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.

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

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

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

19. 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.

20. 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

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

22. 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.

23. Adenosine levels ______ during the day promoting _____.

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

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

25. Combustible tobacco use in the United States has ______ and loose tobacco use has
_______ in the past 10 years.
A) decreased; decreased
B) snorting
C) hookah
D) gum

26. Which of the following statement is TRUE?

A) Nicotine accounts for the acute pharmacological effects of smoking.
B) Nicotine is only one of 2,000 substances in tobacco.
C) Nicotine is secondary active ingredient in tobacco.
D) Nicotine makes cigarettes burn slower.

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

28. 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.

29. The majority of nicotine is metabolized in the:

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

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30. The first morning cigarette in nicotine-dependent smokers is best described as:
A) positively reinforcing.
B) punishing.
C) negatively reinforcing.
D) secondarily reinforcing.

31. Nicotine is primarily metabolized by the ______ enzyme.

A) CYP-1A1
B) CYP-2D6
C) CYP-2A6
D) CYP-2E1

32. The rewarding effects of nicotine involve:

A) serotonin.
B) acetylcholine.
C) norepinephrine.
D) dopamine.

33. The rewarding effects of nicotine involve:

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

34. 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.

35. The direct mechanism of action of nicotine on arousal levels is:

A) stimulation of dopamine receptors.
B) blockade of dopamine receptors.
C) stimulation of acetylcholine receptors.
D) blockade of acetylcholine receptors.

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36. Nicotine-induced release of acetylcholine may:
A) improve cognitive performance and arousal.
B) cause adult ADHD.
C) stimulate depression.
D) enhance sensory perception.

37. 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.

38. In the heart, nicotine:

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

39. 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.

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

41. The main effect of carbon monoxide on the heart is:

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

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42. The carcinogen in cigarettes is the primary cause of ______ cancer.
A) bladder
B) pancreatic
C) lung
D) lip

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

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

45. Caffeine, like theophylline and theobromine, belongs to a family of substances called
xanthines.
A) True
B) False

46. Some antidepressants can inhibit the metabolism of caffeine.

A) True
B) False

47. Malakai is a moderate coffee drinker. Research suggests that this level of consumption
may provide protection against heart failure.
A) True
B) False

48. Generally speaking, people that regularly ingest coffee and tea may experience less
cognitive deterioration as they grow older.
A) True
B) False

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49. Nicotine is one of 4,000 compounds released by burning cigarette tobacco.
A) True
B) False

50. There are no barriers in the body to the distribution of nicotine.

A) True
B) False

51. Nicotine is the primary addictive substance in cigarettes.

A) True
B) False

52. Cigarette smoking is associated with a rewarding effect.

A) True
B) False

53. Nicotine decreases dopamine levels in reward areas of the brain.

A) True
B) False

54. Nicotine can improve performance on a variety of cognitive tasks due to acetylcholine.
A) True
B) False

55. Nicotine impairs cognitive functions such as working memory in nonsmokers.

A) True
B) False

56. Nicotine may exert all of its cognitive effects by activating specific receptors for
acetylcholine.
A) True
B) False

57. Nicotine stimulates the vomiting center in the brain.

A) True
B) False

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58. The addictive potential of nicotine is comparable to other illicit drugs such as heroin and
cocaine.
A) True
B) False

59. The tar in tobacco is responsible for many of the psychoactive effects of cigarettes.
A) True
B) False

60. Smoking two packs of cigarettes per day for 20 years has been estimated to reduce life
expectancy by 14 years.
A) True
B) False

61. The majority of the toxic effects of cigarettes are due to nicotine.
A) True
B) False

62. Nicotine is carcinogenic.

A) True
B) False

63. Vaccine therapy for nicotine dependence appears to be clinically effective in essentially
all subjects.
A) True
B) False

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

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65. 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

66. Research suggests that daily coffee/caffeine use may provide a protective effect against
______.
A) Bipolar disorder
B) Type 1 diabetes
C) Huntington's disease
D) Parkinson's disease

67. The lethal dose of caffeine is on the order of _____ grams.

A) 1.5
B) 5
C) 7
D) 10

68. 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.

69. 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.

70. Pregnant women:

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

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71. Chronic caffeine use, even 100 milligrams per day, is associated with:
A) tolerance.
B) withdrawal.
C) intoxication.
D) impaired motor function.

72. The DSM-5 has proposed ______ Caffeine-Related Disorders.

A) 2
B) 3
C) 4
D) 5

73. Tobacco use in the United States:

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

74. A 2012 report from the Surgeon General suggests that _____ use is higher among
young adults and that use typically involves _____.
A) cigar; smoking via hookah
B) cigar; multiple forms of tobacco
C) chewing tobacco; smoking via hookah
D) chewing tobacco; multiple forms of tobacco

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

76. Nicotine is secondarily metabolized by the ______ enzyme.

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

Page 12
77. Nicotine is thought to _____ nicotinic receptors on _____ neurons.
A) sensitize; glutamate
B) desensitize; GABA
C) sensitize; serotonin
D) desensitize; acetylcholine

78. 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

79. When people start smoking, nicotine induces:

A) feelings of pleasure.
B) a decrease in blood pressure.
C) nausea.
D) altered heart rate.

80. Nicotine withdrawal symptoms occur within about:

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

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

82. 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.

Page 13
83. 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

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

Page 15
Test Bank for Julien’s Primer of Drug Action Thirteenth Edition

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

Page 16

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