Chapter·PharmacologyCNS drugs (antiepileptics, anesthetics)

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1

A 59-year-old female presents to the emergency department after a fall. She reports severe pain in her right hip and an inability to move her right leg. Her past medical history is notable for osteoporosis, rheumatoid arthritis, and has never undergone surgery before. The patient was adopted, and her family history is unknown. She has never smoked and drinks alcohol socially. Her temperature is 98.8°F (37.1°C), blood pressure is 150/90 mmHg, pulse is 110/min, and respirations are 22/min. Her right leg is shortened, abducted, and externally rotated. A radiograph demonstrates a displaced femoral neck fracture. She is admitted and eventually brought to the operating room to undergo right hip arthroplasty. While undergoing induction anesthesia with inhaled sevoflurane, she develops severe muscle contractions. Her temperature is 103.4°F (39.7°C). A medication with which of the following mechanisms of action is indicated in the acute management of this patient’s condition?

ARyanodine receptor antagonist

BAcetylcholine receptor agonist

CSerotonin 1B/1D agonist

DNMDA receptor antagonist

EGABA agonist

2

A 65-year-old male who is being treated for depression visits your emergency room complaining of being unable to urinate. In addition, the patient complains of tachycardia and dry mouth. He has no history of benign prostatic hyperplasia and reports of only being on one psychiatric medication. What type of psychiatric medication would cause such a side effect profile?

ATricyclic antidepressant

BSerotonin norepinephrine reuptake inhibitor

CMonoamine oxidase inhibitor

DSelective serotonin reuptake inhibitor

EAminoketone

3

A 40-year-old man presents with multiple episodes of sudden-onset severe pain in his right side of the face lasting for only a few seconds. He describes the pain as lancinating, giving the sensation of an electrical shock. He says the episodes are precipitated by chewing or touching the face. Which of the following side effects is characteristic of the drug recommended for treatment of this patient’s most likely condition?

ASyndrome of inappropriate ADH

BHirsutism

CPinpoint pupils

DGingival hyperplasia

EAlopecia

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