Drugs Used in Mood Disorders Part 2.docx

\#\#\# \*\*Slide 11: Monoamine Hypothesis\*\* 1\. \*\*The monoamine hypothesis of depression suggests that depression is related to a deficiency of which neurotransmitters?\*\* \- A. Serotonin, norepinephrine, and dopamine \- B. Glutamate, GABA, and acetylcholine \- C. Epinephrine, cortisol, and...

\#\#\# \*\*Slide 11: Monoamine Hypothesis\*\* 1\. \*\*The monoamine hypothesis of depression suggests that depression is related to a deficiency of which neurotransmitters?\*\* \- A. Serotonin, norepinephrine, and dopamine \- B. Glutamate, GABA, and acetylcholine \- C. Epinephrine, cortisol, and serotonin \- D. Dopamine, acetylcholine, and GABA \*\*Answer:\*\* A. Serotonin, norepinephrine, and dopamine 2\. \*\*What is one piece of evidence supporting the monoamine hypothesis?\*\* \- A. Depression has been linked to excessive serotonin levels in the brain \- B. Reserpine, which depletes monoamines, has been shown to cause depression in some patients \- C. Elevated dopamine levels are consistently found in patients with depression \- D. The monoamine hypothesis has been disproven by clinical trials \*\*Answer:\*\* B. Reserpine, which depletes monoamines, has been shown to cause depression in some patients 3\. \*\*According to the monoamine hypothesis, what role does glutamate play in depression?\*\* \- A. It is decreased in depressed patients \- B. It is unrelated to depression \- C. It is elevated in the cerebrospinal fluid of depressed patients \- D. It acts as a secondary messenger in serotonin production \*\*Answer:\*\* C. It is elevated in the cerebrospinal fluid of depressed patients \-\-- \#\#\# \*\*Slide 12: Neurotrophic Hypothesis\*\* 1\. \*\*According to the neurotrophic hypothesis, depression is associated with reduced levels of which growth factor?\*\* \- A. Nerve growth factor \- B. Brain-derived neurotrophic factor (BDNF) \- C. Epidermal growth factor \- D. Fibroblast growth factor \*\*Answer:\*\* B. Brain-derived neurotrophic factor (BDNF) 2\. \*\*What is one clinical effect of antidepressants related to the neurotrophic hypothesis?\*\* \- A. They decrease serotonin release \- B. They reduce the levels of BDNF in the brain \- C. They increase BDNF levels in the brain, promoting neurogenesis \- D. They decrease dopamine production in the limbic system \*\*Answer:\*\* C. They increase BDNF levels in the brain, promoting neurogenesis 3\. \*\*What hormonal dysregulation is frequently seen in patients with depression according to the neuroendocrine hypothesis?\*\* \- A. Low cortisol levels \- B. Elevated cortisol levels \- C. Increased estrogen levels \- D. Reduced thyroid hormone secretion \*\*Answer:\*\* B. Elevated cortisol levels \-\-- \#\#\# \*\*Slide 13: Antidepressant Mechanisms\*\* 1\. \*\*Most antidepressants work by increasing the concentration of which neurotransmitter(s) in the synaptic cleft?\*\* \- A. Serotonin and dopamine \- B. Serotonin and norepinephrine \- C. Dopamine and acetylcholine \- D. GABA and glutamate \*\*Answer:\*\* B. Serotonin and norepinephrine 2\. \*\*How do selective serotonin reuptake inhibitors (SSRIs) alleviate symptoms of depression?\*\* \- A. By blocking the reuptake of dopamine \- B. By inhibiting the enzyme that breaks down norepinephrine \- C. By blocking the reuptake of serotonin into the presynaptic neuron \- D. By increasing serotonin degradation \*\*Answer:\*\* C. By blocking the reuptake of serotonin into the presynaptic neuron 3\. \*\*Why do antidepressants typically take several weeks to show clinical efficacy?\*\* \- A. It takes time to increase serotonin and norepinephrine levels \- B. BDNF synthesis requires more than two weeks \- C. Patients must reach steady-state concentrations of the drug \- D. Dopamine levels take time to normalize \*\*Answer:\*\* B. BDNF synthesis requires more than two weeks \-\-- \#\#\# \*\*Slide 14: FDA Warning on Antidepressants\*\* 1\. \*\*What risk is associated with antidepressant use in patients younger than 25 according to the FDA warning?\*\* \- A. Increased risk of weight gain \- B. Increased risk of suicidality (suicidal ideation and behavior) \- C. Reduced efficacy in treating depression \- D. Risk of serotonin syndrome \*\*Answer:\*\* B. Increased risk of suicidality (suicidal ideation and behavior) 2\. \*\*For which trimester of pregnancy is there an association between antidepressant use and low birth weight and premature delivery?\*\* \- A. First trimester \- B. Second trimester \- C. Third trimester \- D. Throughout the entire pregnancy \*\*Answer:\*\* C. Third trimester 3\. \*\*In lactating mothers taking antidepressants, what is the recommended course of action?\*\* \- A. Discontinue breastfeeding \- B. Weigh the risks and benefits before continuing the medication \- C. Switch to a tricyclic antidepressant (TCA) \- D. Take antidepressants only during the second half of the day \*\*Answer:\*\* B. Weigh the risks and benefits before continuing the medication \-\-- \#\#\# \*\*Slide 15: Selective Serotonin Reuptake Inhibitors (SSRIs)\*\* 1\. \*\*Which receptor do SSRIs primarily target?\*\* \- A. Norepinephrine transporter (NET) \- B. Serotonin transporter (SERT) \- C. Dopamine transporter (DAT) \- D. GABA receptor \*\*Answer:\*\* B. Serotonin transporter (SERT) 2\. \*\*What is the primary indication for prescribing SSRIs?\*\* \- A. Major depressive disorder (MDD) \- B. Schizophrenia \- C. Bipolar disorder \- D. Parkinson\'s disease \*\*Answer:\*\* A. Major depressive disorder (MDD) 3\. \*\*Which SSRI is known for having a long half-life and the potential to be \"activating\"?\*\* \- A. Sertraline \- B. Paroxetine \- C. Fluoxetine \- D. Citalopram \*\*Answer:\*\* C. Fluoxetine \-\-- \#\#\# \*\*Slide 16: SSRI Pharmacokinetics\*\* 1\. \*\*Which of the following SSRIs has the longest half-life, allowing once-daily dosing?\*\* \- A. Fluoxetine \- B. Sertraline \- C. Paroxetine \- D. Escitalopram \*\*Answer:\*\* A. Fluoxetine 2\. \*\*SSRIs are primarily metabolized by which enzyme system?\*\* \- A. P-glycoprotein \- B. Cytochrome P450 (CYP) enzymes \- C. Aldehyde dehydrogenase \- D. Monoamine oxidase (MAO) \*\*Answer:\*\* B. Cytochrome P450 (CYP) enzymes 3\. \*\*Why are SSRIs generally dosed once daily?\*\* \- A. They have short half-lives \- B. They have long half-lives that allow for once-daily dosing \- C. They are metabolized quickly by the liver \- D. Patients prefer less frequent dosing \*\*Answer:\*\* B. They have long half-lives that allow for once-daily dosing \-\-- \#\#\# \*\*Slide 17: SSRI Side Effects\*\* 1\. \*\*What is the most common side effect of SSRIs related to increased serotonergic activity?\*\* \- A. Weight loss \- B. Sexual dysfunction \- C. Dry mouth \- D. Diarrhea \*\*Answer:\*\* B. Sexual dysfunction 2\. \*\*Which SSRI is associated with the highest risk of weight gain?\*\* \- A. Citalopram \- B. Paroxetine \- C. Sertraline \- D. Fluoxetine \*\*Answer:\*\* B. Paroxetine 3\. \*\*What is a notable side effect of abruptly discontinuing SSRIs?\*\* \- A. Serotonin syndrome \- B. Discontinuation syndrome with dizziness and paresthesias \- C. Hypoglycemia \- D. Hyperthermia \*\*Answer:\*\* B. Discontinuation syndrome with dizziness and paresthesias \-\-- \#\#\# \*\*Slide 18: Serotonin Syndrome\*\* 1\. \*\*What is a common sign of serotonin syndrome?\*\* \- A. Hypothermia \- B. Autonomic instability (hyperthermia, hypertension) \- C. Bradycardia \- D. Hypotension \*\*Answer:\*\* B. Autonomic instability (hyperthermia, hypertension) 2\. \*\*What drug is used to treat serotonin syndrome by blocking serotonin receptors?\*\* \- A. Lorazepam \- B. Cyproheptadine \- C. Diazepam \- D. Fluoxetine \*\*Answer:\*\* B. Cyproheptadine 3\. \*\*Which of the following is NOT a typical cause of serotonin syndrome?\*\* \- A. SSRIs \- B. S NRIs \- C. MAO inhibitors \- D. Anticholinergics \*\*Answer:\*\* D. Anticholinergics \-\-- \#\#\# \*\*Slide 19: SNRI Mechanism and Indications\*\* 1\. \*\*SNRIs block the reuptake of which neurotransmitters?\*\* \- A. Serotonin and dopamine \- B. Serotonin and norepinephrine \- C. Norepinephrine and dopamine \- D. GABA and serotonin \*\*Answer:\*\* B. Serotonin and norepinephrine 2\. \*\*Which condition, in addition to depression, is commonly treated with SNRIs?\*\* \- A. Obsessive-compulsive disorder (OCD) \- B. Neuropathic pain \- C. Bipolar disorder \- D. Schizophrenia \*\*Answer:\*\* B. Neuropathic pain 3\. \*\*Which SNRI is used for treating generalized anxiety disorder (GAD) and chronic pain conditions such as fibromyalgia?\*\* \- A. Venlafaxine \- B. Duloxetine \- C. Desvenlafaxine \- D. Sertraline \*\*Answer:\*\* B. Duloxetine \-\-- \#\#\# \*\*Slide 20: SNRI Side Effects\*\* 1\. \*\*Which side effect is most commonly associated with SNRIs, particularly at high doses?\*\* \- A. Bradycardia \- B. Hypertension \- C. Hypoglycemia \- D. Hyperthyroidism \*\*Answer:\*\* B. Hypertension 2\. \*\*What is a common gastrointestinal side effect of SNRIs?\*\* \- A. Diarrhea \- B. Nausea and vomiting \- C. Constipation \- D. Gastritis \*\*Answer:\*\* B. Nausea and vomiting 3\. \*\*SNRIs should not be combined with which of the following due to the risk of serotonin syndrome?\*\* \- A. Tricyclic antidepressants (TCAs) \- B. Monoamine oxidase inhibitors (MAOIs) \- C. Antipsychotics \- D. Beta-blockers \*\*Answer:\*\* B. Monoamine oxidase inhibitors (MAOIs)