Psychopharmacology Ethical Considerations Quiz

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Questions and Answers

What is the primary function of the serotonin transporter?

To facilitate the release of serotonin into the synaptic cleft.
To increase the transcription rates of the SLC6A4 gene.
To reuptake serotonin into the presynaptic neuron. (correct)
To inhibit the reuptake of serotonin into the presynaptic neuron.

Which genetic variant of the SLC6A4 promoter results in lower transcription rates?

The L allele.
The 44 base pair insertion.
Both the S and L alleles.
The S allele. (correct)

What is the impact of the S allele on the effectiveness of SSRI treatment?

It increases the response rate, resulting in more effective SSRI treatment.
It decreases the response rate, resulting in lower rates of remission. (correct)
It has no impact on patient response to SSRI treatment.
It leads to more active sites for SSRIs, enhancing their efficacy.

How does the CYP2D6 enzyme affect the metabolism of atomoxetine?

Ultra-rapid metabolizers (UMs) are likely to experience reduced efficacy, while poor metabolizers (PMs) have higher rates of adverse events. (C) Signup and view all the answers

What is the significance of the FDA labeling information regarding atomoxetine and CYP2D6 poor metabolizers?

It highlights the risk of increased rates of adverse events in CYP2D6 poor metabolizers and recommends dosing adjustment. (D) Signup and view all the answers

What is considered an ethical imperative for practitioners in any practice?

Being sensitive to diversity and demonstrating multicultural competence. (A) Signup and view all the answers

When a discrepancy arises between a practitioner's style and a patient's assumptions, what should be considered?

It could be based on cultural background differences. (B) Signup and view all the answers

What is a primary consideration for practitioners regarding the power they hold as prescribers?

The potential for misuse through an authoritarian approach. (B) Signup and view all the answers

Why should self-disclosure by the practitioner be approached carefully within certain cultural groups?

It may not be acceptable or may create discomfort. (B) Signup and view all the answers

How should informed consent be regarded in the context of psychopharmacology?

An ongoing process, not a one-time event. (B) Signup and view all the answers

What is one of the questions that arises in the ethical use of psychopharmacology?

Is there a risk of harm when not addressing pharmacological issues? (C) Signup and view all the answers

Why is it crucial to stay informed about the effects of somatic therapies?

To stay current with evidence based medicine. (A) Signup and view all the answers

When should psychotropic medications be considered for use?

When clearly indicated with a strong evidence base. (C) Signup and view all the answers

What is the term for the existence of two or more distinct forms of a trait arising from a single gene?

Polymorphism (C) Signup and view all the answers

Which of the following is a primary function of the CYP450 enzyme system?

Drug metabolism (B) Signup and view all the answers

Genetic polymorphisms in CYP450 enzymes primarily explain variability in which of the following?

Drug-metabolizing enzyme activities (C) Signup and view all the answers

How can variations in drug-metabolizing enzyme activities impact a patient's response to a drug?

By modifying drug clearance rates and therapeutic effects (A) Signup and view all the answers

What is a potential clinical consequence of an individual possessing an unusual gene variant for drug-metabolizing enzymes?

Diminished efficacy or increased toxicity to certain drugs (D) Signup and view all the answers

The study of "how much drug is in the system" is best described as which of the following?

Pharmacokinetics (C) Signup and view all the answers

Using different delivery mechanisms (e.g., IM, transdermal) primarily avoids which process?

First-pass metabolism (A) Signup and view all the answers

What impact do variations in pharmacokinetic systems have on drug response, specifically relating to routes of administration?

Route of administration does not compensate for variations in pharmacokinetic systems. (A) Signup and view all the answers

Which of the following medications is known to be a substrate of both CYP2D6 and CYP2C9?

Phenytoin (C) Signup and view all the answers

Which of the following medications is NOT a known inducer of CYP2C9?

Cimetidine (A) Signup and view all the answers

Which of the following medications is known to be a substrate of CYP1A2?

Clozapine (B) Signup and view all the answers

Which of the following substances is NOT a known inhibitor of CYP1A2?

Carbamazepine (C) Signup and view all the answers

Which of the following substances is NOT a known inducer of CYP1A2?

Cimetidine (D) Signup and view all the answers

Which of the following medications is primarily metabolized by CYP2C9?

Warfarin (D) Signup and view all the answers

Compared to extensive metabolizers (EMs), what is the approximate increase in peak concentration of atomoxetine observed in poor metabolizers (PMs) of CYP2D6?

5-fold (C) Signup and view all the answers

According to the provided information, how should the initial dose of atomoxetine be adjusted for a CYP2D6 poor metabolizer?

Initiate at 0.5 mg/kg/day (D) Signup and view all the answers

What is the primary function of catechol-O-methyltransferase (COMT) in the synaptic cleft?

Degrades catecholamines (A) Signup and view all the answers

The Val158Met polymorphism in the COMT gene involves a change in which amino acid?

Valine to methionine (B) Signup and view all the answers

Compared with other genotypes, what is the activity level of COMT in Met/Met homozygotes?

4-5 times lower (A) Signup and view all the answers

How does the Met/Met genotype affect response to stimulant medications?

Reduced rate of response (B) Signup and view all the answers

Which of the following is NOT directly metabolized by COMT?

Serotonin (C) Signup and view all the answers

If a patient is identified as a CYP2D6 poor metabolizer, and is started on atomoxetine at 0.5 mg/kg/day but does not respond, what is the soonest the dose can be increased?

After 4 weeks (C) Signup and view all the answers

What is the process called when the activity of a metabolizing enzyme is increased?

Enzyme induction (B) Signup and view all the answers

What effect does enzyme inhibition have on drug metabolism?

It increases systemic exposure of a substrate drug. (C) Signup and view all the answers

Which of the following is a potential consequence of enzyme induction?

Increased dosage requirements for certain drugs. (D) Signup and view all the answers

How can drug interactions related to CYP isozymes affect a patient's treatment?

They may require dosage adjustments or alternative drugs. (A) Signup and view all the answers

What might occur if one drug inhibits CYP-mediated metabolism of another drug?

The second drug may accumulate to toxic levels. (B) Signup and view all the answers

Flashcards

Multicultural competence

Understanding diverse social, cultural, spiritual, and sexual backgrounds of patients.

Personal biases

Preconceived notions that affect decision-making in patient care.