Psychopharmacology Medications Warning Signs
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Questions and Answers

What is the primary mechanism of action for nonselective norepinephrine-serotonin reuptake inhibitors (NNSRIs)?

  • They inhibit the reuptake of norepinephrine and serotonin in presynaptic nerve terminals. (correct)
  • They inhibit the breakdown of monoamine neurotransmitters by monoamine oxidase.
  • They increase the production of norepinephrine and serotonin in the brain.
  • They selectively block serotonin receptors in the brain.

    • Which of the following is NOT a characteristic of NNSRIs?

  • They block α-adrenergic receptors.
  • They block serotonergic receptors.
  • They are considered first-line treatment for depression. (correct)
  • They block histaminic receptors.

    • Which of the following is an example of an NNSRI?

  • Venlafaxine
  • Fluoxetine
  • Amitriptyline (correct)
  • Bupropion

    • What is a potential benefit of NNSRIs compared to other classes of antidepressants?

    <p>They are less expensive.</p> Signup and view all the answers

    Which of the following receptors are NOT blocked by NNSRIs?

    <p>Dopaminergic receptors</p> Signup and view all the answers

    What is a potential side effect of NNSRIs?

    <p>Weight gain</p> Signup and view all the answers

    What is the maximum recommended dose of citalopram for patients older than 60 years of age?

    <p>20 mg per day</p> Signup and view all the answers

    Which symptom is NOT associated with discontinuation syndrome of SSRIs and NNSRIs?

    <p>Hypertension</p> Signup and view all the answers

    Which SSRI has the lowest risk of causing discontinuation symptoms?

    <p>Fluoxetine</p> Signup and view all the answers

    Which enzyme is responsible for metabolizing citalopram according to the text?

    <p>3A4</p> Signup and view all the answers

    Which SNRI is specifically indicated for diabetic neuropathy according to the text?

    <p>Duloxetine</p> Signup and view all the answers

    What is the recommended action if a patient experiences discontinuation syndrome symptoms?

    <p>Gradual tapering of the medication</p> Signup and view all the answers

    Which neurotransmitters do SNRIs affect by blocking reuptake mechanisms?

    <p>Serotonin and norepinephrine</p> Signup and view all the answers

    What is a potential adverse effect of taking SSRIs according to the text?

    <p>Diarrhea</p> Signup and view all the answers

    What is one reason SSRIs are not well tolerated by older adults?

    <p>Anticholinergic side effects</p> Signup and view all the answers

    Why is it recommended to take SSRIs at bedtime?

    <p>To avoid sedation</p> Signup and view all the answers

    Which class of drugs includes Paxil, Prozac, Zoloft, and Celexa?

    <p>SSRIs</p> Signup and view all the answers

    What is one severe condition that can result from excess serotonin activity?

    <p>Serotonin syndrome</p> Signup and view all the answers

    Which system do SSRIs inhibit, potentially causing various drug interactions?

    <p><em>CYP450 isoenzyme system</em></p> Signup and view all the answers

    Which class of medications includes venlafaxine and desvenlafaxine?

    <p>Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)</p> Signup and view all the answers

    What is a common side effect associated with SNRIs?

    <p>Insomnia</p> Signup and view all the answers

    Which antidepressant is indicated for treatment of major depressive disorder, including seasonal affective disorder, and for smoking cessation?

    <p>Bupropion</p> Signup and view all the answers

    What is a potential risk associated with bupropion in patients with eating disorders?

    <p>Increased risk of seizures</p> Signup and view all the answers

    Which medication is used for fibromyalgia treatment but lacks FDA indication for depression?

    <p>Milnacipran</p> Signup and view all the answers

    Why is it advised to start low with an SNRI dosing?

    <p>To prevent exacerbation of anxiety symptoms</p> Signup and view all the answers

    Which of the following is a distinguishing factor between bupropion SR and XL formulations?

    <p>Half-life</p> Signup and view all the answers

    Which adverse drug reaction is minimal with buspirone compared to SSRIs?

    <p>Sexual dysfunction effects</p> Signup and view all the answers

    What is the first-line treatment recommended by the American Psychiatric Association guidelines for depression and anxiety?

    <p>A combination of medication and psychotherapy</p> Signup and view all the answers

    Which antidepressant is FDA approved to treat MDD, OCD, panic disorder, GAD, and PTSD?

    <p>Paroxetine</p> Signup and view all the answers

    What is a significant risk associated with the use of Benzodiazepines (BZDs) when paired with alcohol?

    <p>Intense sedative effect</p> Signup and view all the answers

    What is a common side effect of long-term BZD use that may require hospitalization?

    <p>Seizures</p> Signup and view all the answers

    According to research, what is one of the most important considerations when selecting an antidepressant?

    <p>Cost</p> Signup and view all the answers

    Which medication is a nonbenzodiazepine GABA agonist approved to treat anxiety disorders?

    <p>Buspirone</p> Signup and view all the answers

    Which antidepressant is indicated for the treatment of MDD and GAD in adults and for MDD in adolescents aged 12 and older?

    <p>Escitalopram</p> Signup and view all the answers

    What can increase patient adherence to prescribed medication according to the text?

    <p>Educating patients about potential side effects</p> Signup and view all the answers

    Which SSRI is NOT approved for the treatment of major depressive disorder (MDD)?

    <p>Fluvoxamine</p> Signup and view all the answers

    In which group of patients should precaution be taken when prescribing BZDs?

    <p>Older adults and those with liver disease</p> Signup and view all the answers

    When should an antidepressant typically start showing its effects?

    <p>$3-4$ weeks</p> Signup and view all the answers

    Which medication does not directly act on the GABA receptor but is a partial agonist to the 5-HT1A receptor?

    <p>Buspirone</p> Signup and view all the answers

    What is the primary indication for venlafaxine XR among the following?

    <p><em>GAD, MDD, and panic disorder</em></p> Signup and view all the answers

    What is a significant risk associated with abrupt discontinuation of long-term BZD use?

    <p>Seizures</p> Signup and view all the answers

    What is a common side effect seen with SSRIs?

    <p>Restlessness</p> Signup and view all the answers

    What effect do SSRIs have on histamine receptors?

    <p>No effect on histamine receptors</p> Signup and view all the answers

    What is the primary mechanism of action for trazodone that contributes to its sedating effect?

    <p>Blocking histamine receptors</p> Signup and view all the answers

    Which of the following is a rare but serious side effect associated with trazodone?

    <p>Priapism</p> Signup and view all the answers

    What is the unique mechanism of action of mirtazapine that contributes to its favorable side effect profile?

    <p>It blocks the reuptake of norepinephrine and serotonin, and blocks 5-HT2 and 5-HT3 receptors</p> Signup and view all the answers

    Which of the following is a common side effect of mirtazapine that may be beneficial for some patients?

    <p>Increased appetite</p> Signup and view all the answers

    What is the primary mechanism of action of monoamine oxidase inhibitors (MAOIs)?

    <p>They block the enzyme monoamine oxidase, preventing the breakdown of monoamines</p> Signup and view all the answers

    Why is a tyramine-free diet required for patients taking MAOIs?

    <p>To prevent hypertensive crisis</p> Signup and view all the answers

    Which of the following is a potential symptom of a hypertensive crisis caused by the interaction between MAOIs and tyramine?

    <p>All of the above</p> Signup and view all the answers

    What is the advantage of the transdermal form of the MAOI selegiline (Emsam)?

    <p>It avoids first-pass metabolism, producing less inhibition of liver and gut MAO</p> Signup and view all the answers

    Why are MAOIs used less often than other antidepressants?

    <p>They have potentially lethal side effects and dangerous interactions</p> Signup and view all the answers

    What is the recommended "washout period" before starting a MAOI after discontinuing an SSRI or other serotonergic medication?

    <p>2 to 5 weeks</p> Signup and view all the answers

    What is the primary mechanism of action for benzodiazepines?

    <p>Agonism at GABA receptors</p> Signup and view all the answers

    Which of the following is an advantage of short-acting benzodiazepines?

    <p>Less drug accumulation</p> Signup and view all the answers

    What is the primary mechanism of action for vilazodone (Viibryd)?

    <p>Serotonin partial agonist reuptake inhibition</p> Signup and view all the answers

    Which of the following statements about vortioxetine (Trintellix) is true?

    <p>It increases the release of multiple neurotransmitters</p> Signup and view all the answers

    Which of the following is a long-acting benzodiazepine?

    <p>Diazepam (Valium)</p> Signup and view all the answers

    What is a potential advantage of long-acting benzodiazepines compared to short-acting ones?

    <p>Less severe withdrawal symptoms</p> Signup and view all the answers

    Which of the following statements about vilazodone (Viibryd) is false?

    <p>It has been proven to cause fewer sexual side effects than SSRIs</p> Signup and view all the answers

    Which of the following is an advantage of benzodiazepines for treating anxiety disorders?

    <p>Minimal effect on the cardiovascular system</p> Signup and view all the answers

    What is the age range for which the MAOI mentioned in the text is approved?

    <p>12 years and older</p> Signup and view all the answers

    Which of the following statements about vortioxetine (Trintellix) is true?

    <p>It has been shown to improve cognitive function in depressed patients</p> Signup and view all the answers

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