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. (D)</p> Signup and view all the answers

Which of the following receptors are NOT blocked by NNSRIs?

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

What is a potential side effect of NNSRIs?

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

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

<p>Hypertension (C)</p> Signup and view all the answers

Which SSRI has the lowest risk of causing discontinuation symptoms?

<p>Fluoxetine (A)</p> Signup and view all the answers

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

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

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

<p>Duloxetine (D)</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 (A)</p> Signup and view all the answers

Which neurotransmitters do SNRIs affect by blocking reuptake mechanisms?

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

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

<p>Diarrhea (D)</p> Signup and view all the answers

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

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

Why is it recommended to take SSRIs at bedtime?

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

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

<p>SSRIs (D)</p> Signup and view all the answers

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

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

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

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

Which class of medications includes venlafaxine and desvenlafaxine?

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

What is a common side effect associated with SNRIs?

<p>Insomnia (C)</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 (D)</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 (B)</p> Signup and view all the answers

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

<p>Milnacipran (D)</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 (A)</p> Signup and view all the answers

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

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

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

<p>Sexual dysfunction effects (B)</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 (D)</p> Signup and view all the answers

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

<p>Paroxetine (C)</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 (C)</p> Signup and view all the answers

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

<p>Seizures (B)</p> Signup and view all the answers

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

<p>Cost (A)</p> Signup and view all the answers

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

<p>Buspirone (D)</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 (D)</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 (C)</p> Signup and view all the answers

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

<p>Fluvoxamine (D)</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 (B)</p> Signup and view all the answers

When should an antidepressant typically start showing its effects?

<p>$3-4$ weeks (C)</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 (C)</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> (B)</p> Signup and view all the answers

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

<p>Seizures (A)</p> Signup and view all the answers

What is a common side effect seen with SSRIs?

<p>Restlessness (C)</p> Signup and view all the answers

What effect do SSRIs have on histamine receptors?

<p>No effect on histamine receptors (C)</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 (B)</p> Signup and view all the answers

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

<p>Priapism (C)</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 (C)</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 (B)</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 (B)</p> Signup and view all the answers

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

<p>To prevent hypertensive crisis (C)</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 (D)</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 (A)</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 (A)</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 (A)</p> Signup and view all the answers

What is the primary mechanism of action for benzodiazepines?

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

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

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

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

<p>Serotonin partial agonist reuptake inhibition (C)</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 (B)</p> Signup and view all the answers

Which of the following is a long-acting benzodiazepine?

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

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