MCQ Quiz-Marijuana and All-Arounders

MCQ Quiz: Marijuana and All-Arounders

by

From the evolving legal landscape of cannabis to the renewed clinical interest in psychedelics, pharmacists must be knowledgeable about “all-arounders”—substances that can distort perception and alter consciousness. Understanding their pharmacology, potential therapeutic uses, risks, and signs of intoxication is essential for modern practice. This quiz, designed for PharmD students, will test your knowledge on the science and clinical implications of these unique psychoactive agents.

1. The primary psychoactive component in marijuana responsible for its euphoric effects is:

  • Cannabidiol (CBD)
  • Cannabinol (CBN)
  • Delta-9-tetrahydrocannabinol (THC)
  • Cannabigerol (CBG)

Answer: Delta-9-tetrahydrocannabinol (THC)

2. THC primarily exerts its effects by acting as a partial agonist at which receptors in the brain?

  • Dopamine D2 receptors
  • Serotonin 5-HT2A receptors
  • Mu-opioid receptors
  • Cannabinoid receptors (CB1 and CB2)

Answer: Cannabinoid receptors (CB1 and CB2)

3. Which of the following is a potential therapeutic use for medical cannabis that is supported by some clinical evidence?

  • Curing bacterial infections
  • Reversing heart failure
  • Management of chemotherapy-induced nausea and vomiting (CINV) and neuropathic pain
  • Treating high cholesterol

Answer: Management of chemotherapy-induced nausea and vomiting (CINV) and neuropathic pain

4. A patient using cannabis regularly might experience which of the following side effects?

  • Decreased heart rate
  • Increased appetite
  • Improved short-term memory
  • Reduced anxiety in all users

Answer: Increased appetite

5. Under United States federal law, marijuana is currently classified into which controlled substance schedule?

  • Schedule I
  • Schedule II
  • Schedule III
  • Schedule IV

Answer: Schedule I

6. A Schedule I classification by the DEA indicates that a substance:

  • Has a high potential for abuse and no currently accepted medical use in treatment in the U.S.
  • Has a low potential for abuse.
  • Is available over-the-counter.
  • Can be prescribed with refills.

Answer: Has a high potential for abuse and no currently accepted medical use in treatment in the U.S.

7. “All-arounders” is a colloquial term for which class of substances?

  • CNS depressants
  • CNS stimulants
  • Hallucinogens or psychedelics
  • Opioids

Answer: Hallucinogens or psychedelics

8. Classic psychedelics like psilocybin, LSD, and DMT primarily exert their hallucinogenic effects by acting as agonists at which receptor?

  • Dopamine D2 receptor
  • Serotonin 5-HT2A receptor
  • GABA-A receptor
  • Cannabinoid CB1 receptor

Answer: Serotonin 5-HT2A receptor

9. A patient presents to the emergency department after taking an unknown substance. They have mydriasis (dilated pupils), tachycardia, and are experiencing intense visual hallucinations and synesthesia (e.g., “seeing sounds”). This presentation is most consistent with intoxication from:

  • An opioid
  • A benzodiazepine
  • A classic hallucinogen like LSD
  • An antihistamine

Answer: A classic hallucinogen like LSD

10. What is a primary risk associated with the use of classic hallucinogens?

  • Severe respiratory depression
  • High potential for physical dependence and withdrawal
  • Unpredictable and potentially distressing psychological effects (“bad trip”) and risky behavior while intoxicated
  • Liver failure

Answer: Unpredictable and potentially distressing psychological effects (“bad trip”) and risky behavior while intoxicated

11. The term “entheogen” is sometimes used to describe hallucinogenic substances when they are used for what purpose?

  • Recreational partying
  • Improving athletic performance
  • Spiritual or religious rituals
  • Increasing appetite

Answer: Spiritual or religious rituals

12. In a first response scenario, the immediate management of a person experiencing a “bad trip” from a psychedelic should focus on:

  • Administering an antidote to reverse the drug’s effects.
  • Placing them in a quiet, calm, and safe environment and providing reassurance.
  • Confronting their hallucinations as being not real.
  • Administering a stimulant to counteract the drug.

Answer: Placing them in a a quiet, calm, and safe environment and providing reassurance.

13. Which of the following is a dissociative anesthetic that is also used as a recreational hallucinogen?

  • Morphine
  • Cocaine
  • Ketamine
  • Diazepam

Answer: Ketamine

14. MDMA (ecstasy or “Molly”) is a unique “all-arounder” that has both stimulant and psychedelic properties. Its primary mechanism involves increasing the release of:

  • Acetylcholine
  • GABA
  • Serotonin, dopamine, and norepinephrine
  • Histamine

Answer: Serotonin, dopamine, and norepinephrine

15. A patient who used MDMA at a concert is at risk for which potentially life-threatening toxicities?

  • Bradycardia and hypothermia
  • Severe constipation
  • Hyperthermia, hyponatremia, and serotonin syndrome
  • Respiratory arrest

Answer: Hyperthermia, hyponatremia, and serotonin syndrome

16. The use of certain hallucinogens, like ketamine and psilocybin, is being investigated in clinical trials for the treatment of:

  • Hypertension
  • Diabetes
  • Treatment-resistant depression
  • High cholesterol

Answer: Treatment-resistant depression

17. Dronabinol is a prescription product containing a synthetic version of THC. It is FDA-approved for:

  • ADHD and narcolepsy
  • CINV and appetite stimulation in AIDS patients
  • Opioid use disorder
  • Alcohol withdrawal

Answer: CINV and appetite stimulation in AIDS patients

18. When a pharmacist counsels a patient on medical cannabis, it is important to screen for potential drug interactions, particularly with drugs metabolized by:

  • The kidneys exclusively.
  • CYP450 enzymes, as both THC and CBD are substrates and inhibitors.
  • The lungs.
  • The skin.

Answer: CYP450 enzymes, as both THC and CBD are substrates and inhibitors.

19. A major difference between THC and CBD is that:

  • THC is the primary non-psychoactive component of cannabis.
  • CBD is primarily responsible for the “high.”
  • CBD is not psychoactive and may have anti-inflammatory and anxiolytic effects.
  • CBD is a Schedule I substance, while THC is not.

Answer: CBD is not psychoactive and may have anti-inflammatory and anxiolytic effects.

20. A significant challenge for a pharmacist regarding medical cannabis is that:

  • It is legal at the federal level, simplifying all regulations.
  • There is a conflict between federal law (which prohibits it) and many state laws (which permit it).
  • It is universally covered by all insurance plans.
  • There are no known side effects.

Answer: There is a conflict between federal law (which prohibits it) and many state laws (which permit it).

21. “Hallucinogen Persisting Perception Disorder” (HPPD) is a rare condition where a person experiences:

  • A continuous “bad trip.”
  • A complete loss of memory.
  • Visual disturbances or “flashbacks” long after the drug has been eliminated.
  • A physical dependence on the hallucinogen.

Answer: Visual disturbances or “flashbacks” long after the drug has been eliminated.

22. Which part of the brain is densely populated with CB1 receptors, explaining the effects of marijuana on memory and cognition?

  • The brainstem
  • The cerebellum
  • The hippocampus
  • The medulla oblongata

Answer: The hippocampus

23. Chronic, heavy use of marijuana starting in adolescence is associated with a risk of:

  • Improved lung function.
  • Increased motivation.
  • Impaired neurocognitive development.
  • A lower lifetime risk of psychosis.

Answer: Impaired neurocognitive development.

24. For a patient experiencing severe agitation from a psychedelic, a pharmacist in the ER might recommend which class of medication for symptomatic control?

  • A stimulant
  • A benzodiazepine
  • An opioid
  • An NSAID

Answer: A benzodiazepine

25. The psychoactive effects of cannabis when inhaled are typically felt ________ than when ingested orally.

  • Much more slowly
  • Much more rapidly
  • At the same speed
  • Less intensely

Answer: Much more rapidly

26. The concept of “set and setting” is extremely important for the use of psychedelics. “Setting” refers to:

  • The dose of the drug taken.
  • The user’s mindset and expectations.
  • The physical and social environment where the drug is used.
  • The time of day the drug is taken.

Answer: The physical and social environment where the drug is used.

27. A key difference between classic hallucinogens (like LSD) and cannabis is that classic hallucinogens:

  • Have a much lower potential for causing true hallucinations.
  • Are not considered psychoactive.
  • Do not typically cause a strong physical dependence or withdrawal syndrome.
  • Are legal at the federal level.

Answer: Do not typically cause a strong physical dependence or withdrawal syndrome.

28. A patient is taking warfarin and starts using a high-potency CBD oil. A pharmacist should be concerned about a potential drug interaction that could:

  • Decrease the INR and increase clotting risk.
  • Increase the INR and increase bleeding risk.
  • Have no effect on the INR.
  • Inactivate the warfarin molecule.

Answer: Increase the INR and increase bleeding risk.

29. The pharmacist’s role regarding cannabis and hallucinogens involves:

  • Providing accurate, evidence-based, and non-judgmental information.
  • Recommending their use for all medical conditions.
  • Refusing to discuss these topics with patients.
  • Encouraging recreational use.

Answer: Providing accurate, evidence-based, and non-judgmental information.

30. A synthetic cannabinoid (e.g., “Spice,” “K2”) is dangerous because:

  • It is a pure, regulated form of THC.
  • It is often a full agonist at CB1 receptors, leading to more intense and unpredictable effects than THC.
  • It is legal in all 50 states.
  • It has no psychoactive effects.

Answer: It is often a full agonist at CB1 receptors, leading to more intense and unpredictable effects than THC.

31. The endocannabinoid system, which THC mimics, is involved in regulating:

  • Mood
  • Appetite
  • Pain sensation
  • All of the above

Answer: All of the above

32. The term “psychedelic” was coined from Greek words meaning:

  • “To harm the mind”
  • “To produce sleep”
  • “Mind-manifesting”
  • “To cause dependence”

Answer: “Mind-manifesting”

33. The use of a “trip sitter” is a harm reduction strategy for:

  • A person using cannabis alone.
  • A person using a potent psychedelic, where a trusted, sober individual is present for support.
  • A patient taking a prescribed opioid.
  • An individual trying to quit smoking.

Answer: A person using a potent psychedelic, where a trusted, sober individual is present for support.

34. Tolerance to the effects of classic psychedelics like LSD develops:

  • Very slowly over many months.
  • Very rapidly, often after just a few consecutive days of use.
  • Not at all.
  • Only in certain individuals.

Answer: Very rapidly, often after just a few consecutive days of use.

35. A patient with a personal or strong family history of ________ should be counseled to be extremely cautious with hallucinogen or cannabis use.

  • Hypertension
  • High cholesterol
  • A psychotic disorder like schizophrenia
  • Asthma

Answer: A psychotic disorder like schizophrenia

36. A significant challenge in researching the therapeutic potential of marijuana in the U.S. has been its:

  • Low cost and easy availability.
  • Schedule I status, which creates significant regulatory hurdles.
  • Lack of any psychoactive effects.
  • Unpopularity among researchers.

Answer: Schedule I status, which creates significant regulatory hurdles.

37. The effects of an orally ingested cannabis edible are typically:

  • Shorter in duration and less intense than inhaled cannabis.
  • Longer in duration and have a delayed onset compared to inhaled cannabis.
  • Identical in onset and duration to inhaled cannabis.
  • Devoid of any psychoactive effects.

Answer: Longer in duration and have a delayed onset compared to inhaled cannabis.

38. Which of the following is a potential acute cardiovascular effect of marijuana use?

  • Bradycardia and hypotension
  • Tachycardia and hypertension
  • No effect on the cardiovascular system
  • A regularizing of the heart rhythm

Answer: Tachycardia and hypertension

39. A pharmacist can advocate for public health regarding these substances by:

  • Promoting harm reduction strategies.
  • Educating on the risks of driving under the influence.
  • Providing accurate information to prevent accidental ingestion by children.
  • All of the above.

Answer: All of the above.

40. A patient reports using “microdosing” of psilocybin. This refers to the practice of:

  • Taking a large, hallucinogenic dose once a year.
  • Regularly taking very small, sub-hallucinogenic doses with the intent to improve mood or creativity.
  • A medically approved use of the drug.
  • Combining psilocybin with an antidepressant.

Answer: Regularly taking very small, sub-hallucinogenic doses with the intent to improve mood or creativity.

41. The legal status of psilocybin is:

  • Legal for recreational use in all states.
  • An over-the-counter supplement.
  • A Schedule I controlled substance at the federal level.
  • A Schedule IV controlled substance.

Answer: A Schedule I controlled substance at the federal level.

42. Which of the following is NOT a classic hallucinogen?

  • LSD (lysergic acid diethylamide)
  • Psilocybin (from mushrooms)
  • Mescaline (from peyote cactus)
  • Diazepam (Valium®)

Answer: Diazepam (Valium®)

43. A pharmacist’s knowledge of toxicology is important when:

  • A patient presents with an overdose of an unknown “all-arounder.”
  • Counseling a patient on the safe use of their prescribed stimulant.
  • Managing a patient’s cholesterol.
  • A patient asks for a flu shot.

Answer: A patient presents with an overdose of an unknown “all-arounder.”

44. A patient using a cannabis vaporizer is:

  • Avoiding all potential risks associated with cannabis.
  • Inhaling heated cannabis vapor instead of smoke, which may reduce exposure to combustion byproducts.
  • Consuming an edible form of the drug.
  • Using a form of topical cannabis.

Answer: Inhaling heated cannabis vapor instead of smoke, which may reduce exposure to combustion byproducts.

45. “Cannabis Use Disorder” is a diagnosable condition in the DSM-5 and is characterized by:

  • Using cannabis exactly as prescribed by a physician.
  • Continued use of cannabis despite clinically significant impairment or distress.
  • Using cannabis once in a lifetime.
  • An allergy to cannabis.

Answer: Continued use of cannabis despite clinically significant impairment or distress.

46. A major public health concern with the legalization of edible cannabis products is:

  • The difficulty in regulating dose and the risk of accidental over-ingestion, especially by children.
  • The low potency of the products.
  • The lack of flavor options.
  • The short duration of effect.

Answer: The difficulty in regulating dose and the risk of accidental over-ingestion, especially by children.

47. From a leadership perspective, a pharmacist who educates their community or local policymakers about the evolving landscape of cannabis is:

  • Acting as a public health advocate.
  • Overstepping their professional role.
  • Promoting recreational drug use.
  • Violating federal law.

Answer: Acting as a public health advocate.

48. Why is it important for a pharmacist to ask about cannabis use during a medication history?

  • To report the patient to law enforcement.
  • To identify potential drug interactions and assess for potential health effects.
  • To judge the patient’s lifestyle.
  • It is not important to ask about cannabis use.

Answer: To identify potential drug interactions and assess for potential health effects.

49. The renewed research interest in psychedelics for therapy is often focused on their potential to:

  • Act as a replacement for all current psychiatric medications.
  • Facilitate psychotherapy and produce rapid, durable antidepressant effects.
  • Be used as a daily maintenance medication.
  • Eliminate the need for therapists.

Answer: Facilitate psychotherapy and produce rapid, durable antidepressant effects.

50. The ultimate role of a pharmacist when confronted with questions about “all-arounders” is to be:

  • A source of unbiased, evidence-based information focused on safety and harm reduction.
  • A promoter of their use.
  • A judgmental authority figure.
  • Unwilling to discuss the topic.

Answer: A source of unbiased, evidence-based information focused on safety and harm reduction.

Leave a Comment