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Questions and Answers
Which of the following adverse effects is associated with increased serotonin (5-HT) levels in the gut, as seen with SSRI use?
Which of the following adverse effects is associated with increased serotonin (5-HT) levels in the gut, as seen with SSRI use?
- Nausea and GI Upset (correct)
- Hypersomnia
- Sexual dysfunction
- Headaches
Orthostatic hypotension is a common side effect associated with which class of antidepressants?
Orthostatic hypotension is a common side effect associated with which class of antidepressants?
- 5-HT2 Antagonists
- SSRIs
- Monoamine Oxidase Inhibitors (MAOIs) (correct)
- Tricyclic Antidepressants (TCAs) (correct)
What is the primary mechanism by which TCAs can lead to cardiac toxicity in overdose situations?
What is the primary mechanism by which TCAs can lead to cardiac toxicity in overdose situations?
- Blockade of norepinephrine reuptake
- Inhibition of monoamine oxidase
- Direct blockade of cardiac sodium channels (correct)
- Excessive increase in serotonin levels
Which CYP enzyme is potently inhibited by paroxetine and fluoxetine, leading to increased levels of TCAs when used concomitantly?
Which CYP enzyme is potently inhibited by paroxetine and fluoxetine, leading to increased levels of TCAs when used concomitantly?
What potentially fatal syndrome can occur when MAOIs are combined with SSRIs, SNRIs, or most TCAs?
What potentially fatal syndrome can occur when MAOIs are combined with SSRIs, SNRIs, or most TCAs?
Which of the following drugs primarily blocks the re-uptake of serotonin (5-HT) with minimal effect on norepinephrine (NE)?
Which of the following drugs primarily blocks the re-uptake of serotonin (5-HT) with minimal effect on norepinephrine (NE)?
Which of the following medications, once widely used for diabetic peripheral neuropathy, has largely been replaced by other treatments?
Which of the following medications, once widely used for diabetic peripheral neuropathy, has largely been replaced by other treatments?
Which of the following is a common anticholinergic side effect associated with tricyclic antidepressants (TCAs)?
Which of the following is a common anticholinergic side effect associated with tricyclic antidepressants (TCAs)?
Which tetracyclic antidepressant is associated with Parkinsonism due to its D2 receptor-blocking activity?
Which tetracyclic antidepressant is associated with Parkinsonism due to its D2 receptor-blocking activity?
Which mechanism of action is characteristic of second-generation antipsychotics?
Which mechanism of action is characteristic of second-generation antipsychotics?
Which dietary component should be avoided by patients taking MAOIs to prevent malignant hypertension?
Which dietary component should be avoided by patients taking MAOIs to prevent malignant hypertension?
Which drug has variable actions at dopamine (DA), norepinephrine (NE), and serotonin (5-HT) receptors?
Which drug has variable actions at dopamine (DA), norepinephrine (NE), and serotonin (5-HT) receptors?
Why might bupropion be avoided in patients who are currently being treated with MAOIs?
Why might bupropion be avoided in patients who are currently being treated with MAOIs?
A patient with schizophrenia is prescribed an antipsychotic medication. If the goal is to primarily target dopamine (D2) receptors over serotonin (5-HT) receptors, which of the following medications would be most appropriate?
A patient with schizophrenia is prescribed an antipsychotic medication. If the goal is to primarily target dopamine (D2) receptors over serotonin (5-HT) receptors, which of the following medications would be most appropriate?
A patient taking fluvoxamine concurrently begins experiencing bradycardia and significant hypotension. Which medication, when combined with fluvoxamine, is most likely the cause?
A patient taking fluvoxamine concurrently begins experiencing bradycardia and significant hypotension. Which medication, when combined with fluvoxamine, is most likely the cause?
Which medication's primary mechanism involves blocking 5HT2A receptors?
Which medication's primary mechanism involves blocking 5HT2A receptors?
A researcher is investigating the effects of various antidepressants on neurotransmitter re-uptake. They discover a novel compound that inhibits both serotonin and norepinephrine transporters with equal potency. Based on this information, which existing class of antidepressants does this new compound most closely resemble?
A researcher is investigating the effects of various antidepressants on neurotransmitter re-uptake. They discover a novel compound that inhibits both serotonin and norepinephrine transporters with equal potency. Based on this information, which existing class of antidepressants does this new compound most closely resemble?
A patient presents with symptoms of psychosis and is being considered for antipsychotic treatment. Their clinical history reveals a high risk of extrapyramidal symptoms (EPS). Which of the following antipsychotics, known for a lower risk of EPS due to its preferential 5-HT2A receptor antagonism over D2 receptor antagonism, might be the MOST appropriate initial choice?
A patient presents with symptoms of psychosis and is being considered for antipsychotic treatment. Their clinical history reveals a high risk of extrapyramidal symptoms (EPS). Which of the following antipsychotics, known for a lower risk of EPS due to its preferential 5-HT2A receptor antagonism over D2 receptor antagonism, might be the MOST appropriate initial choice?
A patient has experienced a depressed mood and loss of interest in activities for the past three weeks, accompanied by changes in sleep and appetite. According to the criteria outlined, which condition is MOST likely?
A patient has experienced a depressed mood and loss of interest in activities for the past three weeks, accompanied by changes in sleep and appetite. According to the criteria outlined, which condition is MOST likely?
Which of the following best describes the neuropathic hypothesis of major depressive disorder (MDD)?
Which of the following best describes the neuropathic hypothesis of major depressive disorder (MDD)?
Reserpine, a drug known to deplete monoamines, has which effect?
Reserpine, a drug known to deplete monoamines, has which effect?
Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, often observed in individuals with major depressive disorder (MDD), typically results in:
Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, often observed in individuals with major depressive disorder (MDD), typically results in:
Which of the following mechanisms of action is NOT typically associated with antidepressant drugs?
Which of the following mechanisms of action is NOT typically associated with antidepressant drugs?
Which of the following statements accurately describes a key difference between selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs)?
Which of the following statements accurately describes a key difference between selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs)?
Which of the following is a potential consequence of combining a selective serotonin reuptake inhibitor (SSRI) with a monoamine oxidase inhibitor (MAOI)?
Which of the following is a potential consequence of combining a selective serotonin reuptake inhibitor (SSRI) with a monoamine oxidase inhibitor (MAOI)?
Why are tricyclic antidepressants (TCAs) typically administered at night?
Why are tricyclic antidepressants (TCAs) typically administered at night?
Which receptor is antagonized by both nefazodone and trazodone?
Which receptor is antagonized by both nefazodone and trazodone?
Bupropion's antidepressant effects are believed to be primarily mediated through which mechanism?
Bupropion's antidepressant effects are believed to be primarily mediated through which mechanism?
What is a primary reason MAOIs are seldom used?
What is a primary reason MAOIs are seldom used?
Which statement accurately describes a key difference between selective serotonin-norepinephrine reuptake inhibitors (SNRIs) and tricyclic antidepressants (TCAs)?
Which statement accurately describes a key difference between selective serotonin-norepinephrine reuptake inhibitors (SNRIs) and tricyclic antidepressants (TCAs)?
Amoxapine, a tetracyclic antidepressant, possesses a unique property compared to other antidepressants due to its active metabolite. What is this unique property?
Amoxapine, a tetracyclic antidepressant, possesses a unique property compared to other antidepressants due to its active metabolite. What is this unique property?
A patient taking phenelzine needs to be counselled, what food should they avoid?
A patient taking phenelzine needs to be counselled, what food should they avoid?
${5HT_{2A}}$ receptor activation has which effect when bound by LSD?
${5HT_{2A}}$ receptor activation has which effect when bound by LSD?
Which of the following best describes the primary mechanism of action of fluoxetine?
Which of the following best describes the primary mechanism of action of fluoxetine?
What is a significant pharmacokinetic property of fluoxetine that distinguishes it from other SSRIs?
What is a significant pharmacokinetic property of fluoxetine that distinguishes it from other SSRIs?
What is a crucial consideration when switching a patient from fluoxetine to another antidepressant that also raises serotonin levels?
What is a crucial consideration when switching a patient from fluoxetine to another antidepressant that also raises serotonin levels?
How does increased serotonin in the peripheral nervous system (PNS), due to fluoxetine, typically manifest?
How does increased serotonin in the peripheral nervous system (PNS), due to fluoxetine, typically manifest?
Why is combining fluoxetine with a Monoamine Oxidase Inhibitor (MAOI) considered dangerous?
Why is combining fluoxetine with a Monoamine Oxidase Inhibitor (MAOI) considered dangerous?
A patient taking fluoxetine reports a decreased interest in sexual activity. Which of the following is the most likely reason for this side effect?
A patient taking fluoxetine reports a decreased interest in sexual activity. Which of the following is the most likely reason for this side effect?
Fluoxetine inhibits the CYP2D6 enzyme. Which of the following is a potential consequence of this inhibition?
Fluoxetine inhibits the CYP2D6 enzyme. Which of the following is a potential consequence of this inhibition?
Given its wide therapeutic index, what implications does this have on the safety profile of Fluoxetine?
Given its wide therapeutic index, what implications does this have on the safety profile of Fluoxetine?
What are some of the common side effects (ADRs) of fluoxetine?
What are some of the common side effects (ADRs) of fluoxetine?
What is Serotonin Syndrome?
What is Serotonin Syndrome?
What is the primary difference between Reactive Depression and Endogenous Depression?
What is the primary difference between Reactive Depression and Endogenous Depression?
Which of the following hypotheses of depression is described: Loss of 5-HT and/or DA leads to MDD. Reserpine, which depletes monoamines, leads to depression?
Which of the following hypotheses of depression is described: Loss of 5-HT and/or DA leads to MDD. Reserpine, which depletes monoamines, leads to depression?
All available antidepressant drugs affect the:
All available antidepressant drugs affect the:
Which of the following drugs inhibit the serotonin transporter (SERT)?
Which of the following drugs inhibit the serotonin transporter (SERT)?
Which of the following are Selective Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)?
Which of the following are Selective Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)?
Which of the following are 5-HT2 Antagonists? (Select all that apply)
Which of the following are 5-HT2 Antagonists? (Select all that apply)
Which of the following is described: 1) differs from other SSRIs, 2) metabolized to the active metabolite, norfluoxetine, 3) an SSRI combined with an MAO inhibitor can cause serotonin syndrome?
Which of the following is described: 1) differs from other SSRIs, 2) metabolized to the active metabolite, norfluoxetine, 3) an SSRI combined with an MAO inhibitor can cause serotonin syndrome?
Which of the following Serotonin Norepinephrine Reuptake Inhibitors is described as extensively metabolized in the liver and most tightly bound to protein (albumin)?
Which of the following Serotonin Norepinephrine Reuptake Inhibitors is described as extensively metabolized in the liver and most tightly bound to protein (albumin)?
Which of the following antidepressants is described as dosed once per day, given at night due to sedative effects, and has serum levels useful for predicting toxicity and efficacy?
Which of the following antidepressants is described as dosed once per day, given at night due to sedative effects, and has serum levels useful for predicting toxicity and efficacy?
What are bupropion, mirtazapine, amoxapine, and maprotiline?
What are bupropion, mirtazapine, amoxapine, and maprotiline?
Which of the following, at lower doses, is used as a hypnotic for Major Depressive Disorder (MDD)?
Which of the following, at lower doses, is used as a hypnotic for Major Depressive Disorder (MDD)?
Which of the following is described by: (a) binding presynaptic autoreceptors and (b) binding specific postsynaptic receptors like 5HT2 antagonists?
Which of the following is described by: (a) binding presynaptic autoreceptors and (b) binding specific postsynaptic receptors like 5HT2 antagonists?
Which of the following is a 5HT2A agonist?
Which of the following is a 5HT2A agonist?
Which of the following are non-selective MAO inhibitors? (Select all that apply)
Which of the following are non-selective MAO inhibitors? (Select all that apply)
Which of the following is described as an irreversible MAO B inhibitor that becomes nonselective at higher doses, and is used in Parkinsonism?
Which of the following is described as an irreversible MAO B inhibitor that becomes nonselective at higher doses, and is used in Parkinsonism?
Which of the following is used to treat insomnia?
Which of the following is used to treat insomnia?
A seven day supply of which of the following can be lethal?
A seven day supply of which of the following can be lethal?
Levels of which of the following increase when nefazodone inhibits CYP 3A4?
Levels of which of the following increase when nefazodone inhibits CYP 3A4?
Which of the following was the most widely used drug in podiatric medicine to treat diabetic peripheral neuropathy?
Which of the following was the most widely used drug in podiatric medicine to treat diabetic peripheral neuropathy?
Most SSRIs are FDA Pregnancy category C.
Most SSRIs are FDA Pregnancy category C.
Flashcards
SSRIs
SSRIs
Block re-uptake of serotonin (5HT), with little effect on norepinephrine (NE).
SNRIs
SNRIs
Block re-uptake of both serotonin (5HT) and norepinephrine (NE).
TCAs
TCAs
Variably block re-uptake of 5HT and/or NE; older class of antidepressants.
5-HT Antagonists
5-HT Antagonists
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Tetracyclics and Unicyclics
Tetracyclics and Unicyclics
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Psychosis Cause Theory
Psychosis Cause Theory
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First Generation Antipsychotics
First Generation Antipsychotics
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Second Generation Antipsychotics
Second Generation Antipsychotics
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SSRI ADR: GI Effects
SSRI ADR: GI Effects
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SSRI ADR: Sexual Dysfunction
SSRI ADR: Sexual Dysfunction
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TCA ADR: Anticholinergic Effects
TCA ADR: Anticholinergic Effects
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TCA ADR: Orthostatic Hypotension
TCA ADR: Orthostatic Hypotension
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TCA ADR: Weight Gain & Sedation
TCA ADR: Weight Gain & Sedation
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5-HT2 Antagonist ADRs
5-HT2 Antagonist ADRs
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MAOI ADRs
MAOI ADRs
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TCA Overdose Risk
TCA Overdose Risk
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SSRIs as CYP 2D6 Inhibitors
SSRIs as CYP 2D6 Inhibitors
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Serotonin Syndrome
Serotonin Syndrome
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Major Depressive Disorder (MDD)
Major Depressive Disorder (MDD)
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Brain-Derived Neurotrophic Factor (BDNF)
Brain-Derived Neurotrophic Factor (BDNF)
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Monoamine Hypothesis of MDD
Monoamine Hypothesis of MDD
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Selective Serotonin Reuptake Inhibitors (SSRIs)
Selective Serotonin Reuptake Inhibitors (SSRIs)
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Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
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Tricyclic Antidepressants (TCAs)
Tricyclic Antidepressants (TCAs)
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Monoamine Oxidase Inhibitors (MAOIs)
Monoamine Oxidase Inhibitors (MAOIs)
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Trazodone
Trazodone
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Bupropion
Bupropion
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Mirtazapine
Mirtazapine
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Amoxapine/Maprotiline
Amoxapine/Maprotiline
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Monoamine Oxidase (MAO)
Monoamine Oxidase (MAO)
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Phenelzine/Tranylcypromine
Phenelzine/Tranylcypromine
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What are SSRIs?
What are SSRIs?
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What is Fluoxetine?
What is Fluoxetine?
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How Fluoxetine Works
How Fluoxetine Works
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Fluoxetine's Mechanism
Fluoxetine's Mechanism
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SSRI GI Side Effects
SSRI GI Side Effects
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Fluoxetine as CYP2D6 Inhibitor
Fluoxetine as CYP2D6 Inhibitor
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What is Serotonin Syndrome?
What is Serotonin Syndrome?
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What is norfluoxetine?
What is norfluoxetine?
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Study Notes
Antipsychotic Drugs
- The operative theory links schizophrenia, bipolar disorder, and psychosis with elevated CNS neurotransmitters.
- Reducing the activity of these neurotransmitters is a major goal in drug therapy for these conditions.
- The neurotransmitters in excess include NE, 5HT, and DA.
- The drugs used act by attaching to and blocking a specific receptor for one or more of these neurotransmitters.
First Generation Antipsychotics
- First Generation Antipsychotics have a stronger block of dopamine receptors compared to 5HT (serotonin) receptors, D2 >>5HT.
- First Generation Antipsychotics include: chlorpromazine, thiothixene, fluphenazine, thioridazine, haloperidol.
Second Generation Antipsychotics
- Second Generation Antipsychotics exhibit a stronger block of 5HT receptors compared to dopamine receptors, 5HT > D2.
- Second Generation Antipsychotics include: aripiprazole, lurasidone, ziprasidone, brexpiprazole, olanzapine, cariprazine, quetiapine, clozapine, risperidone.
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