SNRIs Mechanism of Action Quiz

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Which statement about the mechanism of action of SNRIs is correct?

SNRIs inhibit the synthesis of both norepinephrine and serotonin in the presynaptic neuron.

SNRIs selectively block the reuptake of serotonin into the presynaptic nerve terminal.

SNRIs cause enhanced noradrenergic neurotransmission but have no effect on serotonergic neurotransmission.

SNRIs block the reuptake of both norepinephrine (NE) and serotonin (5-HT) into the presynaptic nerve terminal. (correct)

Which of the following SNRIs has high protein binding?

Venlafaxine

Desvenlafaxine

Duloxetine (correct)

Levomilnacipran

Which of the following adverse effects is commonly associated with lithium therapy?

Tardive dyskinesia

Postural hand tremor (correct)

Akathisia

Agranulocytosis

Which of the following EKG changes is associated with lithium toxicity?

Inverted T-waves and U-waves Signup and view all the answers

Which of the following statements about lithium-induced nephrogenic diabetes insipidus is correct?

It is a rare adverse effect of lithium therapy, and amiloride can be given for treatment if it develops. Signup and view all the answers

Which of the following statements about the pharmacokinetics of SNRIs is correct?

Duloxetine has low protein binding, while venlafaxine, desvenlafaxine, and levomilnacipran have high protein binding. Signup and view all the answers

Which of the following is the MOST important consideration when transitioning a patient from an SSRI to an MAOI?

Waiting at least 5 weeks after stopping fluoxetine before starting the MAOI Signup and view all the answers

Which SSRI is considered the most potent inhibitor of the CYP450 enzyme system?

Fluoxetine Signup and view all the answers

Which of the following best describes the metabolism of fluoxetine (Prozac)?

Fluoxetine has a prolonged half-life and is extensively metabolized in the liver to an active metabolite, norfluoxetine, which also has a long half-life. Signup and view all the answers

Which CYP450 enzyme is primarily involved in the metabolism of most SSRIs?

CYP 2D6 Signup and view all the answers

What is the MOST important drug interaction to consider when prescribing an SSRI concurrently with a monoamine oxidase inhibitor (MAOI)?

Increased risk of serotonin syndrome Signup and view all the answers

Which SSRI has the LOWEST risk of causing serotonin discontinuation syndrome when abruptly discontinued?

Fluoxetine Signup and view all the answers

Which of the following drugs, when combined with an SSRI, can increase the risk of serotonin syndrome?

Triptans Signup and view all the answers

Which SSRI is the LEAST likely to cause anticholinergic adverse effects like dry mouth?

Fluoxetine Signup and view all the answers

Which SNRI has a slightly higher incidence of anticholinergic side effects compared to other SNRIs?

Duloxetine Signup and view all the answers

Which of the following is the MOST important adverse effect to monitor for when a patient is taking an SSRI and an antiplatelet or anticoagulant medication concurrently?

Increased risk of bleeding Signup and view all the answers

What response should be anticipated when giving a direct-acting or indirect-acting sympathomimetic to a patient recently started on a tricyclic antidepressant (TCA)?

Exaggerated pressor response Signup and view all the answers

Why are smaller than usual doses of direct-acting sympathomimetics recommended when co-administered with TCAs?

To avoid exaggerated pressor responses Signup and view all the answers

In patients chronically treated with TCAs, why may conventional sympathomimetics be ineffective in restoring systemic blood pressure?

Catecholamine stores are depleted Signup and view all the answers

How should the initial dose of a sympathomimetic be adjusted in patients on TCA therapy for more than 6 weeks?

Decrease to 1/3rd the usual dose Signup and view all the answers

Why may patients on TCA therapy exhibit complex and unpredictable systemic blood pressure effects when administered sympathomimetics?

Desensitization/down-regulation of adrenergic receptors Signup and view all the answers

What is a potential consequence of administering a direct-acting or indirect-acting sympathomimetic to a patient recently started on a tricyclic antidepressant (TCA)?

Exaggerated pressor response Signup and view all the answers

Why are smaller than usual doses of direct-acting sympathomimetics recommended when co-administered with TCAs?

To mitigate an exaggerated pressor response Signup and view all the answers

Which enzyme is primarily involved in the metabolism of most SSRIs?

CYP2D6 Signup and view all the answers

What response should be expected when giving a conventional sympathomimetic to a patient chronically treated with TCAs?

No response due to receptor desensitization Signup and view all the answers

Which of the following is a potential consequence of administering a direct-acting or indirect-acting sympathomimetic to a patient recently started on a TCA?

Exaggerated pressor response Signup and view all the answers

Which SNRI has the highest incidence of anticholinergic side effects compared to other SNRIs?

Duloxetine (Cymbalta) Signup and view all the answers

What happens to adrenergic receptors in patients chronically treated with TCAs?

They are desensitized/down-regulated Signup and view all the answers

Which of the following is the MOST important drug interaction to consider when prescribing an SSRI concurrently with a monoamine oxidase inhibitor (MAOI)?

Increased risk of serotonin syndrome Signup and view all the answers

Which SSRI is considered the MOST potent inhibitor of the CYP450 enzyme system?

Fluoxetine (Prozac) Signup and view all the answers

Which of the following best describes the metabolism of fluoxetine (Prozac)?

Primarily metabolized by CYP2D6 Signup and view all the answers

Which of the following drugs, when combined with an SSRI, can increase the risk of serotonin syndrome?

Lithium Signup and view all the answers

Which of the following is a potential consequence of administering a direct-acting or indirect-acting sympathomimetic to a patient recently started on a tricyclic antidepressant (TCA)?

Decreased effectiveness of the sympathomimetic Signup and view all the answers

Which of the following is the LEAST likely to cause anticholinergic adverse effects like dry mouth when compared to other SSRIs?

Sertraline (Zoloft) Signup and view all the answers

Which of the following statements regarding the interaction between SSRIs and monoamine oxidase inhibitors (MAOIs) is correct?

At least 14 days must elapse after stopping an SSRI before starting an MAOI, except for fluoxetine, which requires a 5-week washout period. Signup and view all the answers

Which of the following statements regarding CYP2D6 inhibition by SSRIs is correct?

CYP2D6 inhibition by SSRIs can lead to increased plasma concentrations of other drugs metabolized by CYP2D6, potentially increasing the risk of adverse effects. Signup and view all the answers

Which of the following statements regarding the metabolism of SSRIs is correct?

CYP2D6 is involved in the metabolism of most SSRIs, but other enzymes like CYP2C9 and CYP2C19 may also play a role. Signup and view all the answers

Which of the following SSRIs is considered the most potent inhibitor of the CYP450 enzyme system?

Fluoxetine Signup and view all the answers

Which of the following drugs, when combined with an SSRI, can increase the risk of serotonin syndrome?

Linezolid Signup and view all the answers

Which of the following statements regarding the interaction between SSRIs and antiplatelet or anticoagulant agents is correct?

Patients taking SSRIs in combination with antiplatelet or anticoagulant agents should be monitored closely for an increased risk of bleeding. Signup and view all the answers

Which of the following statements regarding the metabolism of fluoxetine (Prozac) is correct?

Fluoxetine is extensively metabolized in the liver to norfluoxetine, an active metabolite with an even longer half-life than fluoxetine. Signup and view all the answers

Which of the following drugs, when combined with an SSRI, can increase the risk of serotonin syndrome?

Triptan medications Signup and view all the answers

Which of the following statements regarding the interaction between SSRIs and CYP2D6 inhibitors is correct?

Concomitant use of CYP2D6 inhibitors with SSRIs can lead to increased plasma concentrations of the SSRI, potentially increasing the risk of adverse effects. Signup and view all the answers

SNRIs Mechanism of Action Quiz

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Questions and Answers

Which statement about the mechanism of action of SNRIs is correct?

Which of the following SNRIs has high protein binding?

Which of the following adverse effects is commonly associated with lithium therapy?

Which of the following EKG changes is associated with lithium toxicity?

Which of the following statements about lithium-induced nephrogenic diabetes insipidus is correct?

Which of the following statements about the pharmacokinetics of SNRIs is correct?

Which of the following is the MOST important consideration when transitioning a patient from an SSRI to an MAOI?

Which SSRI is considered the most potent inhibitor of the CYP450 enzyme system?

Which of the following best describes the metabolism of fluoxetine (Prozac)?

Which CYP450 enzyme is primarily involved in the metabolism of most SSRIs?

What is the MOST important drug interaction to consider when prescribing an SSRI concurrently with a monoamine oxidase inhibitor (MAOI)?

Which SSRI has the LOWEST risk of causing serotonin discontinuation syndrome when abruptly discontinued?

Which of the following drugs, when combined with an SSRI, can increase the risk of serotonin syndrome?

Which SSRI is the LEAST likely to cause anticholinergic adverse effects like dry mouth?

Which SNRI has a slightly higher incidence of anticholinergic side effects compared to other SNRIs?

Which of the following is the MOST important adverse effect to monitor for when a patient is taking an SSRI and an antiplatelet or anticoagulant medication concurrently?

What response should be anticipated when giving a direct-acting or indirect-acting sympathomimetic to a patient recently started on a tricyclic antidepressant (TCA)?

Why are smaller than usual doses of direct-acting sympathomimetics recommended when co-administered with TCAs?

In patients chronically treated with TCAs, why may conventional sympathomimetics be ineffective in restoring systemic blood pressure?

How should the initial dose of a sympathomimetic be adjusted in patients on TCA therapy for more than 6 weeks?

Why may patients on TCA therapy exhibit complex and unpredictable systemic blood pressure effects when administered sympathomimetics?

What is a potential consequence of administering a direct-acting or indirect-acting sympathomimetic to a patient recently started on a tricyclic antidepressant (TCA)?

Why are smaller than usual doses of direct-acting sympathomimetics recommended when co-administered with TCAs?

Which enzyme is primarily involved in the metabolism of most SSRIs?

What response should be expected when giving a conventional sympathomimetic to a patient chronically treated with TCAs?

Which of the following is a potential consequence of administering a direct-acting or indirect-acting sympathomimetic to a patient recently started on a TCA?

Which SNRI has the highest incidence of anticholinergic side effects compared to other SNRIs?

What happens to adrenergic receptors in patients chronically treated with TCAs?

Which of the following is the MOST important drug interaction to consider when prescribing an SSRI concurrently with a monoamine oxidase inhibitor (MAOI)?

Which SSRI is considered the MOST potent inhibitor of the CYP450 enzyme system?

Which of the following best describes the metabolism of fluoxetine (Prozac)?

Which of the following drugs, when combined with an SSRI, can increase the risk of serotonin syndrome?

Which of the following is a potential consequence of administering a direct-acting or indirect-acting sympathomimetic to a patient recently started on a tricyclic antidepressant (TCA)?

Which of the following is the LEAST likely to cause anticholinergic adverse effects like dry mouth when compared to other SSRIs?

Which of the following statements regarding the interaction between SSRIs and monoamine oxidase inhibitors (MAOIs) is correct?

Which of the following statements regarding CYP2D6 inhibition by SSRIs is correct?

Which of the following statements regarding the metabolism of SSRIs is correct?

Which of the following SSRIs is considered the most potent inhibitor of the CYP450 enzyme system?

Which of the following drugs, when combined with an SSRI, can increase the risk of serotonin syndrome?

Which of the following statements regarding the interaction between SSRIs and antiplatelet or anticoagulant agents is correct?

Which of the following statements regarding the metabolism of fluoxetine (Prozac) is correct?

Which of the following drugs, when combined with an SSRI, can increase the risk of serotonin syndrome?

Which of the following statements regarding the interaction between SSRIs and CYP2D6 inhibitors is correct?

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