FINAL EXAM
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,1) The half-life of lithium is about…?
A. 8 hours
B. 12 hours
C. 24 hours
D. 48 hours
Answer: C. 24 hours
Expert-Verified Explanation:
Lithium’s plasma half-life (the time it takes for the drug’s concentration to
reduce by half in the bloodstream) is typically around 24 hours in individuals
with normal renal function. This relatively medium-range half-life allows for
once- or twice-daily dosing in many cases. Adequate monitoring of serum
lithium level is crucial because slight variations in kidney function or fluid
balance can significantly affect lithium levels and risk of toxicity.
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2) Fluoxetine is the SSRI with the ______ withdrawal risk, due to its long half-
life.
A. Highest
B. Lowest
C. Moderate
D. No
Answer: B. Lowest
Expert-Verified Explanation:
Fluoxetine (Prozac) has one of the longest half-lives among SSRIs (about 2
weeks when considering its active metabolite). A longer half-life means the
medication exits the body more gradually, typically resulting in fewer and
,less severe withdrawal symptoms compared to shorter half-life
antidepressants. This makes fluoxetine a commonly used “bridge”
medication when trying to taper patients off SSRIs that have more
pronounced discontinuation syndromes.
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3) Which one of the following antipsychotics is incorrectly associated with a
long half-life?
A. Cariprazine (2–4 days; active metabolites up to 3 weeks)
B. Aripiprazole (≈3 days)
C. Risperidone (≈12–24 hours)
D. Brexipiprazole (≈4 days)
Answer: C. Risperidone (≈12–24 hours)
Expert-Verified Explanation:
Cariprazine, aripiprazole, brexipiprazole, pimozide, and pimavanserin are
known for their lengthy half-lives (ranging from about 2 days to several days,
or even weeks for active metabolites). These longer half-lives can be
advantageous for patients who occasionally miss doses because blood levels
remain more stable. Risperidone, conversely, has a shorter half-life of around
12–24 hours and can drop more quickly if doses are missed.
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4) Disulfiram’s alcohol-interaction effects can persist for up to how long after
the medication is stopped?
A. 1 day
B. 2–3 days, up to 2 weeks
C. 4 weeks
D. 12 hours
, Answer: B. 2–3 days, up to 2 weeks
Expert-Verified Explanation:
Disulfiram (Antabuse) irreversibly inhibits aldehyde dehydrogenase, causing
an unpleasant reaction when alcohol is consumed. Its effects can remain
active in the body for 1–2 weeks after stopping regular dosing because the
body must synthesize new enzyme to replace the inhibited enzyme.
Clinicians advise patients to avoid alcohol for at least 14 days after
discontinuation to prevent a severe disulfiram-alcohol reaction.
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5) Which TCA is known for having a long half-life?
A. Amitriptyline
B. Doxepin
C. Nortriptyline
D. Protriptyline (Vivactil)
Answer: D. Protriptyline (Vivactil)
Expert-Verified Explanation:
Protriptyline (Vivactil) is a lesser-prescribed tricyclic antidepressant but
stands out for its relatively long half-life among TCAs. This can influence
dosing schedules and side-effect profiles. TCAs in general must be monitored
for anticholinergic side effects, conduction abnormalities, and potential
toxicity in overdose, but a longer half-life such as protriptyline’s can also
affect how quickly (or slowly) symptoms of toxicity or withdrawal might
present.
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6) Most psychotropics (including many psychiatric medications) have a
“medium-range” half-life of approximately…?