Free Analgesics and CNS Drugs MCQs with Answers

• A. Withdrawal symptoms occur when the drug is stopped suddenly
• B. The patient takes the medicine for pleasure despite no pain
• C. The patient repeatedly seeks extra doses from different clinics
• D. The patient continues the drug despite serious social harm

Explanation: Physical dependence means the body adapts to the drug and withdrawal symptoms occur after abrupt reduction or stopping.

• A. Report black, tarry stools or vomiting blood
• B. Take the medicine with alcohol to improve absorption
• C. Stop the medicine only if mild stomach upset occurs
• D. Expect increased clotting because aspirin activates platelets

Explanation: Aspirin can irritate the gastric mucosa and inhibit platelet aggregation, so gastrointestinal bleeding must be reported promptly.

• A. Perioral numbness and a metallic taste
• B. Severe ankle swelling and weight gain
• C. Yellow skin and pale stools
• D. Increased urine output and intense thirst

Explanation: Early local anaesthetic toxicity may cause circumoral numbness, metallic taste, tinnitus, dizziness, or agitation before seizures and…

• A. I may need several weeks before the full benefit appears
• B. I can use it for immediate relief during a panic attack
• C. I should stop it suddenly when my anxiety improves
• D. It produces the same rapid sedation as diazepam

Explanation: Buspirone has a delayed anxiolytic effect and is taken regularly rather than for immediate relief.

• A. Report the movements for assessment of tardive dyskinesia
• B. Reassure the patient that the movements show therapeutic response
• C. Give the next dose early to prevent worsening symptoms
• D. Encourage vigorous exercise until the movements stop

Explanation: Repetitive involuntary movements of the mouth and tongue may indicate tardive dyskinesia, which can become persistent.

• A. Rise slowly and sit at the bedside before standing
• B. Stop the antipsychotic immediately without advice
• C. Restrict all fluids to prevent further dizziness
• D. Stand quickly to train the blood vessels to respond

Explanation: Antipsychotics can cause orthostatic hypotension, so slow position changes reduce the risk of falls and fainting.

• A. Gingival overgrowth and poor oral hygiene
• B. Severe watery diarrhoea after every dose
• C. Permanent blue skin discoloration after one dose
• D. Marked hypoglycaemia immediately after meals

Explanation: Long-term phenytoin therapy may cause gingival hyperplasia, which is reduced by careful oral hygiene and regular dental care.

• A. Assist the patient to sit or lie down and check blood pressure
• B. Tell the patient to walk quickly to improve circulation
• C. Give an extra dose to prevent the symptom from returning
• D. Encourage driving so the patient can reach medical care alone

Explanation: Postural dizziness may reflect orthostatic hypotension, creating an immediate fall risk.

• A. Change positions slowly because dizziness may occur
• B. Expect the medicine to cure Parkinson disease permanently
• C. Double the next dose if one dose is missed
• D. Stop the medicine suddenly when tremor improves

Explanation: Levodopa can cause postural hypotension, so gradual position changes help prevent falls.

• A. Avoid alcohol and other sedatives unless approved
• B. Stop the drug once seizures have been absent for one week
• C. Take extra tablets whenever mild anxiety occurs
• D. Expect the drug to improve alertness during the day

Explanation: Phenobarbital causes central nervous system depression, and alcohol or other sedatives can produce dangerous excessive sedation and…

• A. Increase fluids, dietary fibre and physical activity
• B. Restrict fluids and remain in bed after meals
• C. Take an antidiarrhoeal medicine before each dose
• D. Stop morphine suddenly until bowel function returns

Explanation: Opioids commonly reduce intestinal motility, causing constipation. Fluids, fibre and mobility help prevent it, although a prescribed…

• A. It reduces pain and fever with little anti-inflammatory action
• B. It produces strong anti-inflammatory action in swollen joints
• C. It blocks all sensory nerve conduction at the injection site
• D. It causes deep sedation and loss of consciousness

Explanation: Paracetamol is mainly an analgesic and antipyretic and has limited anti-inflammatory activity at usual doses.

• A. Withhold the medicine and report possible gastrointestinal bleeding
• B. Give the next dose with milk to protect the stomach
• C. Encourage exercise because inactivity causes dark stools
• D. Reassure the patient that this is an expected effect

Explanation: Black, tarry stools may indicate upper gastrointestinal bleeding, a serious NSAID adverse effect.

• A. Take it immediately before sleep and avoid alcohol
• B. Take it early in the morning before starting work
• C. Drive if awake after taking the prescribed dose
• D. Use extra doses if sleep does not occur quickly

Explanation: Zolpidem can cause sedation, impaired coordination and next-day drowsiness, especially with alcohol or other central nervous system…

• A. Possible neutropenia requiring an urgent blood count
• B. Mild increased appetite requiring a dietary record
• C. Temporary dry mouth requiring frequent oral fluids
• D. Occasional drowsiness requiring a later bedtime

Explanation: Clozapine can cause severe neutropenia or agranulocytosis, and fever with sore throat or mouth ulcers may indicate infection.

• A. Stop further doses and arrange urgent medical assessment
• B. Apply a moisturising lotion and continue the medicine
• C. Advise sun exposure to dry the affected skin
• D. Give the next dose with food to reduce the rash

Explanation: A spreading rash with mucosal lesions may indicate Stevens-Johnson syndrome, a serious and potentially fatal reaction to lamotrigine.

• A. I should not stop the medicine suddenly without advice
• B. I should feel the full antidepressant effect after one dose
• C. I can take any herbal product without checking first
• D. I should double the next dose after missing one dose

Explanation: SSRIs usually require several weeks for their full antidepressant effect and should not be stopped abruptly without professional advice.

• A. Support the airway and breathing, then seek urgent help
• B. Offer oral fluids and reassess the patient after one hour
• C. Place the patient alone in a quiet room to promote sleep
• D. Encourage walking to reduce the sedative effect

Explanation: Shallow breathing and low oxygen saturation threaten breathing, so airway and breathing take priority over comfort or routine medication…

• A. Stop the infusion, support breathing and call for urgent help
• B. Give another dose to prevent movement during the procedure
• C. Offer food and fluids to increase alertness
• D. Place the patient in a standing position

Explanation: Marked sedation with slow respirations suggests benzodiazepine-induced respiratory depression.

• A. Avoid driving and report the episodes to the prescriber
• B. Take an extra dose before activities requiring concentration
• C. Stop all Parkinson medicines immediately
• D. Drink coffee before driving to prevent sleep episodes

Explanation: Dopamine agonists such as pramipexole can cause sudden sleep attacks, creating a serious safety risk during driving or other hazardous…