Merged_Drugs_Used_in_Mood_Disorders_Final.docx

Drugs Used in Mood Disorders \#\#\# \*\*Slide 1: Overview of Drugs Used in Mood Disorders\*\* 1\. \*\*Which neurotransmitters are primarily involved in the pathophysiology of depression?\*\* \- A. Serotonin, norepinephrine, dopamine \- B. GABA, acetylcholine, histamine \- C. Cortisol, estrogen, dopamine \- D. Epinephrine, cortisol, serotonin \*\*Answer:\*\* A. Serotonin, norepinephrine, dopamine 2\. \*\*Which of the following drugs is indicated for bipolar disorder?\*\* \- A. Paroxetine \- B. Sertraline \- C. Lithium \- D. Fluoxetine \*\*Answer:\*\* C. Lithium 3\. \*\*How long does it typically take for antidepressants to show clinical improvement in patients?\*\* \- A. 1 week \- B. 2-4 weeks \- C. 5 days \- D. 3 months \*\*Answer:\*\* B. 2-4 weeks【33†source】 \-\-- \#\#\# \*\*Slide 2: Depression - DSM-5 Criteria\*\* 1\. \*\*According to DSM-5, how many symptoms must be present for a diagnosis of depression?\*\* \- A. At least 3 \- B. 5 or more \- C. 6-10 \- D. At least 2 \*\*Answer:\*\* B. 5 or more 2\. \*\*Which of the following is one of the two mandatory symptoms for a depression diagnosis according to DSM-5?\*\* \- A. Weight gain \- B. Insomnia \- C. Depressed mood \- D. Fatigue \*\*Answer:\*\* C. Depressed mood 3\. \*\*Which of the following symptoms should NOT be included when diagnosing depression according to DSM-5?\*\* \- A. Loss of interest \- B. Depressed mood \- C. Weight gain due to medical condition \- D. Psychomotor retardation \*\*Answer:\*\* C. Weight gain due to medical condition【33†source】 \-\-- \#\#\# \*\*Slide 3: Pathophysiology of Depression\*\* 1\. \*\*Which hypothesis suggests that depression is related to a deficiency in serotonin, norepinephrine, and dopamine?\*\* \- A. Neuroendocrine hypothesis \- B. Monoamine hypothesis \- C. Neurotrophic hypothesis \- D. Glutamate hypothesis \*\*Answer:\*\* B. Monoamine hypothesis 2\. \*\*Which factor is associated with a decrease in brain-derived neurotrophic factor (BDNF) in patients with depression?\*\* \- A. Glucocorticoid receptor binding \- B. Elevated norepinephrine levels \- C. Elevated serotonin levels \- D. Decreased cortisol levels \*\*Answer:\*\* A. Glucocorticoid receptor binding 3\. \*\*Which hormone dysregulation is often found in patients with depression, according to the neuroendocrine hypothesis?\*\* \- A. Prolactin \- B. Cortisol \- C. Insulin \- D. Testosterone \*\*Answer:\*\* B. Cortisol【33†source】 \-\-- \#\#\# \*\*Slide 4: Depression Symptom Mnemonic\*\* 1\. \*\*Which symptom is represented by the \"I\" in the mnemonic for depression symptoms?\*\* \- A. Irritability \- B. Insomnia \- C. Interest loss \- D. Impulsivity \*\*Answer:\*\* C. Interest loss 2\. \*\*What does the \"S\" in the depression mnemonic represent?\*\* \- A. Sleep disturbance \- B. Suicidal ideation \- C. Sadness \- D. Self-esteem issues \*\*Answer:\*\* A. Sleep disturbance 3\. \*\*Which symptom in the mnemonic indicates potential weight fluctuations?\*\* \- A. Sleep disturbance \- B. Psychomotor changes \- C. Appetite changes \- D. Energy loss \*\*Answer:\*\* C. Appetite changes【33†source】 \-\-- \#\#\# \*\*Slide 5: Normal Brain Physiology\*\* 1\. \*\*Which neurotransmitter is involved in regulating mood, appetite, and sleep?\*\* \- A. Dopamine \- B. Norepinephrine \- C. Serotonin \- D. GABA \*\*Answer:\*\* C. Serotonin 2\. \*\*What enzyme degrades serotonin and norepinephrine in the synaptic cleft?\*\* \- A. Monoamine oxidase (MAO) \- B. Acetylcholinesterase \- C. Glutaminase \- D. Catechol-O-methyltransferase (COMT) \*\*Answer:\*\* A. Monoamine oxidase (MAO) 3\. \*\*Which neurotransmitter is responsible for mood regulation and cognitive functions like memory and learning?\*\* \- A. GABA \- B. Serotonin \- C. Dopamine \- D. Norepinephrine \*\*Answer:\*\* D. Norepinephrine【33†source】 \-\-- \#\#\# \*\*Slide 6: Neurotrophic Hypothesis\*\* 1\. \*\*The neurotrophic hypothesis of depression focuses on which protein related to neural plasticity and resilience?\*\* \- A. Serotonin \- B. Brain-derived neurotrophic factor (BDNF) \- C. Cortisol \- D. Dopamine \*\*Answer:\*\* B. Brain-derived neurotrophic factor (BDNF) 2\. \*\*What effect do antidepressants have on brain-derived neurotrophic factor (BDNF) levels?\*\* \- A. Decrease BDNF levels \- B. Stabilize BDNF levels \- C. Increase BDNF levels \- D. No effect on BDNF levels \*\*Answer:\*\* C. Increase BDNF levels 3\. \*\*Which of the following factors is NOT typically associated with a reduction in BDNF levels in depression?\*\* \- A. Glucocorticoid receptor activation \- B. Chronic stress \- C. Increased norepinephrine \- D. Elevated cortisol levels \*\*Answer:\*\* C. Increased norepinephrine【33†source】 \-\-- \#\#\# \*\*Slide 7: Neuroendocrine Hypothesis\*\* 1\. \*\*Which hormone is commonly elevated in patients with depression according to the neuroendocrine hypothesis?\*\* \- A. Estrogen \- B. Insulin \- C. Cortisol \- D. Melatonin \*\*Answer:\*\* C. Cortisol 2\. \*\*Thyroid dysregulation is present in approximately what percentage of patients with depression?\*\* \- A. 5% \- B. 10% \- C. 25% \- D. 50% \*\*Answer:\*\* C. 25% 3\. \*\*What neuroendocrine factor may contribute to mood symptoms in postpartum depression?\*\* \- A. Low cortisol levels \- B. Estrogen deficiency \- C. Low prolactin levels \- D. Testosterone deficiency \*\*Answer:\*\* B. Estrogen deficiency【33†source】 \-\-- \#\#\# \*\*Slide 8: Monoamine Hypothesis\*\* 1\. \*\*Which class of drugs supports the monoamine hypothesis by increasing serotonin and norepinephrine levels?\*\* \- A. Antipsychotics \- B. SSRIs and SNRIs \- C. Benzodiazepines \- D. Anticonvulsants \*\*Answer:\*\* B. SSRIs and SNRIs 2\. \*\*Which neurotransmitter, according to the monoamine hypothesis, is NOT typically implicated in depression?\*\* \- A. Dopamine \- B. Serotonin \- C. Acetylcholine \- D. Norepinephrine \*\*Answer:\*\* C. Acetylcholine 3\. \*\*Which drug mentioned in the evidence for the monoamine hypothesis blocks central monoamine activity and can cause depression in some patients?\*\* \- A. Propranolol \- B. Fluoxetine \- C. Venlafaxine \- D. Lithium \*\*Answer:\*\* A. Propranolol【33†source】 \-\-- \#\#\# \*\*Slide 9: Neurotrophic Hypothesis\*\* 1\. \*\*What is a critical function of brain-derived neurotrophic factor (BDNF) in the brain?\*\* \- A. Regulating appetite \- B. Promoting neural plasticity and neurogenesis \- C. Increasing serotonin breakdown \- D. Inhibiting cortisol release \*\*Answer:\*\* B. Promoting neural plasticity and neurogenesis 2\. \*\*Which of the following supports the neurotrophic hypothesis in the treatment of depression?\*\* \- A. Increased BDNF levels with antidepressant therapy \- B. Increased cortisol levels in patients on antidepressants \- C. Lower dopamine levels in response to therapy \- D. Increased norepinephrine with treatment \*\*Answer:\*\* A. Increased BDNF levels with antidepressant therapy 3\. \*\*Which of the following is associated with a reduction in BDNF synthesis in the brain?\*\* \- A. Glucocorticoid receptor binding \- B. Elevated testosterone levels \- C. Low serotonin levels \- D. Increased norepinephrine activity \*\*Answer:\*\* A. Glucocorticoid receptor binding【33†source】 \-\-- \#\#\# \*\*Slide 10: Mechan ism of Antidepressants\*\* 1\. \*\*How do most antidepressants work to alleviate depression symptoms?\*\* \- A. By blocking serotonin and norepinephrine reuptake \- B. By blocking dopamine breakdown \- C. By stimulating cortisol release \- D. By increasing acetylcholine levels \*\*Answer:\*\* A. By blocking serotonin and norepinephrine reuptake 2\. \*\*Which neurotransmitter is most affected by selective serotonin reuptake inhibitors (SSRIs)?\*\* \- A. Norepinephrine \- B. Dopamine \- C. Serotonin \- D. GABA \*\*Answer:\*\* C. Serotonin 3\. \*\*Why do antidepressants typically take several weeks to show efficacy?\*\* \- A. They need time to decrease serotonin levels \- B. They require time to increase BDNF synthesis \- C. They work immediately but require close monitoring \- D. They must first decrease norepinephrine activity \*\*Answer:\*\* B. They require time to increase BDNF synthesis【33†source】 \#\#\# \*\*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) \#\#\# \*\*Slide 21: Bupropion (Wellbutrin)\*\* 1\. \*\*What is the primary mechanism of action of bupropion (Wellbutrin)?\*\* \- A. Selective serotonin reuptake inhibitor \- B. Norepinephrine and dopamine reuptake inhibitor \- C. Monoamine oxidase inhibitor \- D. Glutamate antagonist \*\*Answer:\*\* B. Norepinephrine and dopamine reuptake inhibitor 2\. \*\*Bupropion is contraindicated in patients with which of the following conditions?\*\* \- A. Anxiety disorders \- B. Seizure disorders \- C. Chronic kidney disease \- D. Hypertension \*\*Answer:\*\* B. Seizure disorders 3\. \*\*Which of the following is a benefit of bupropion compared to SSRIs?\*\* \- A. Lower risk of sexual side effects \- B. More sedating effect \- C. Increased serotonin reuptake \- D. Reduced risk of weight loss \*\*Answer:\*\* A. Lower risk of sexual side effects【48:6†source】 \-\-- \#\#\# \*\*Slide 22: New Medication - Dextromethorphan/Bupropion ER (Auvelity)\*\* 1\. \*\*What is the mechanism of action of dextromethorphan in Auvelity?\*\* \- A. NMDA receptor antagonist \- B. Serotonin reuptake inhibitor \- C. Dopamine receptor agonist \- D. GABA agonist \*\*Answer:\*\* A. NMDA receptor antagonist 2\. \*\*Which medication is combined with dextromethorphan in Auvelity to enhance its antidepressant effects?\*\* \- A. Sertraline \- B. Bupropion \- C. Fluoxetine \- D. Mirtazapine \*\*Answer:\*\* B. Bupropion 3\. \*\*What is a significant risk when combining dextromethorphan with serotonergic medications?\*\* \- A. Hypertensive crisis \- B. Hypoglycemia \- C. Serotonin syndrome \- D. Bradycardia \*\*Answer:\*\* C. Serotonin syndrome【48:13†source】 \-\-- \#\#\# \*\*Slide 23: Trazodone (Desyrel)\*\* 1\. \*\*What is the primary mechanism of action of trazodone at low doses?\*\* \- A. NMDA receptor antagonist \- B. Histamine receptor antagonist \- C. Alpha-1 receptor antagonist and 5-HT2A receptor antagonist \- D. Dopamine receptor agonist \*\*Answer:\*\* C. Alpha-1 receptor antagonist and 5-HT2A receptor antagonist 2\. \*\*Trazodone is commonly used at low doses to treat which of the following conditions?\*\* \- A. Anxiety disorders \- B. Hypertension \- C. Insomnia \- D. Bipolar disorder \*\*Answer:\*\* C. Insomnia 3\. \*\*What is a rare but serious side effect of trazodone that requires immediate medical attention?\*\* \- A. Priapism \- B. Serotonin syndrome \- C. Agranulocytosis \- D. Stevens-Johnson syndrome \*\*Answer:\*\* A. Priapism【48:13†source】 \-\-- \#\#\# \*\*Slide 24: Mirtazapine (Remeron)\*\* 1\. \*\*Which receptor is antagonized by mirtazapine to increase norepinephrine and serotonin levels?\*\* \- A. Alpha-2 adrenergic receptor \- B. Beta-adrenergic receptor \- C. Dopamine D2 receptor \- D. NMDA receptor \*\*Answer:\*\* A. Alpha-2 adrenergic receptor 2\. \*\*What is a common side effect of mirtazapine, especially at lower doses?\*\* \- A. Insomnia \- B. Weight gain \- C. Nausea \- D. Hypertension \*\*Answer:\*\* B. Weight gain 3\. \*\*Mirtazapine is less likely to cause which of the following side effects compared to SSRIs?\*\* \- A. Sexual dysfunction \- B. Weight gain \- C. Drowsiness \- D. Dry mouth \*\*Answer:\*\* A. Sexual dysfunction【48:1†source】 \-\-- \#\#\# \*\*Slide 25: NMDA Receptor Antagonists\*\* 1\. \*\*Which of the following NMDA receptor antagonists is approved for treatment-resistant depression?\*\* \- A. Ketamine \- B. Fluoxetine \- C. Lithium \- D. Sertraline \*\*Answer:\*\* A. Ketamine 2\. \*\*What is a common side effect of esketamine (Spravato), an NMDA receptor antagonist?\*\* \- A. Euphoria \- B. Dissociation \- C. Bradycardia \- D. Hypoglycemia \*\*Answer:\*\* B. Dissociation 3\. \*\*NMDA receptor antagonists are thought to work in depression by modulating which neurotransmitter system?\*\* \- A. Serotonin \- B. Glutamate \- C. Dopamine \- D. GABA \*\*Answer:\*\* B. Glutamate【48:13†source】 \-\-- \#\#\# \*\*Slide 26: Monoamine Oxidase Inhibitors (MAOIs)\*\* 1\. \*\*What is the primary mechanism of action of monoamine oxidase inhibitors (MAOIs)?\*\* \- A. Inhibition of serotonin reuptake \- B. Inhibition of the enzyme that breaks down norepinephrine, dopamine, and serotonin \- C. Activation of GABA receptors \- D. Antagonism of NMDA receptors \*\*Answer:\*\* B. Inhibition of the enzyme that breaks down norepinephrine, dopamine, and serotonin 2\. \*\*Which of the following foods should be avoided by patients taking MAOIs?\*\* \- A. Bananas \- B. Cheese \- C. Chicken \- D. Oranges \*\*Answer:\*\* B. Cheese 3\. \*\*Combining MAOIs with SSRIs can result in which life-threatening condition?\*\* \- A. Hypothyroidism \- B. Serotonin syndrome \- C. Renal failure \- D. Hyperkalemia \*\*Answer:\*\* B. Serotonin syndrome【48:5†source】 \-\-- \#\#\# \*\*Slide 27: MAOI Side Effects and Interactions\*\* 1\. \*\*Which of the following is a common side effect of MAOIs?\*\* \- A. Weight loss \- B. Orthostatic hypotension \- C. Hypertension \- D. Hyperglycemia \*\*Answer:\*\* B. Orthostatic hypotension 2\. \*\*MAOIs should not be combined with which of the following medications due to the risk of hypertensive crisis?\*\* \- A. Beta-blockers \- B. SSRIs \- C. Antipsychotics \- D. Antihistamines \*\*Answer:\*\* B. SSRIs 3\. \*\*Which of the following is a serious interaction that can occur when MAOIs are combined with sympathomimetics?\*\* \- A. Bradycardia \- B. Hypothermia \- C. Hypertensive crisis \- D. Hyperthermia \*\*Answer:\*\* C. Hypertensive crisis【48:6†source】 \-\-- \#\#\# \*\*Slide 28: Tricyclic Antidepressants (TCAs)\*\* 1\. \*\*Tricyclic antidepressants (TCAs) block the reuptake of which neurotransmitters?\*\* \- A. Serotonin and dopamine \- B. Serotonin and norepinephrine \- C. Norepinephrine and acetylcholine \- D. GABA and dopamine \*\*Answer:\*\* B. Serotonin and norepinephrine 2\. \*\*Which of the following is a serious side effect of TCA overdose?\*\* \- A. QT prolongation and cardiac arrhythmias \- B. Hyperglycemia \- C. Bradycardia \- D. Hyponatremia \*\*Answer:\*\* A. QT prolongation and cardiac arrhythmias 3\. \*\*Which TCA is most commonly prescribed for obsessive-compulsive disorder (OCD)?\*\* \- A. Amitriptyline \- B. Desipramine \- C. Clomipramine \- D. Imipramine \*\*Answer:\*\* C. Clomipramine【48:9†source】 \-\-- \#\#\# \*\*Slide 29: TCA Side Effects\*\* 1\. \*\*Which of the following side effects is associated with the anticholinergic properties of TCAs?\*\* \- A. Diarrhea \- B. Urinary retention \- C. Bradycardia \- D. Weight loss \*\*Answer:\*\* B. Urinary retention 2\. \*\*What is a common central nervous system (CNS) side effect of TCAs?\*\* \- A. Insomnia \- B. Sedation \- C. Anxiety \- D. Hallucinations \*\*Answer:\*\* B. Sedation 3\. \*\*Which receptor blockade contributes to the fall risk associated with TCAs? \*\* \- A. Alpha-1 adrenergic receptor blockade \- B. Beta-2 adrenergic receptor blockade \- C. NMDA receptor blockade \- D. GABA receptor blockade \*\*Answer:\*\* A. Alpha-1 adrenergic receptor blockade【48:9†source】 \-\-- \#\#\# \*\*Slide 30: TCA Overdose\*\* 1\. \*\*What is the primary cause of death in TCA overdose?\*\* \- A. Respiratory depression \- B. Cardiovascular toxicity (arrhythmias) \- C. Liver failure \- D. Seizures \*\*Answer:\*\* B. Cardiovascular toxicity (arrhythmias) 2\. \*\*Which electrolyte imbalance is commonly associated with TCA overdose?\*\* \- A. Hyperkalemia \- B. Hyponatremia \- C. Hypocalcemia \- D. Hyperphosphatemia \*\*Answer:\*\* B. Hyponatremia 3\. \*\*What treatment is contraindicated in TCA overdose due to its worsening effect on arrhythmias?\*\* \- A. Sodium bicarbonate \- B. Class I antiarrhythmics (e.g., procainamide) \- C. Activated charcoal \- D. Benzodiazepines \*\*Answer:\*\* B. Class I antiarrhythmics (e.g., procainamide)【48:9†source】 \#\#\# \*\*Slide 31: Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)\*\* 1\. \*\*What is the mechanism of action of SNRIs?\*\* \- A. Inhibition of serotonin and norepinephrine reuptake \- B. Inhibition of dopamine reuptake \- C. Inhibition of monoamine oxidase \- D. Blocking serotonin receptors \*\*Answer:\*\* A. Inhibition of serotonin and norepinephrine reuptake 2\. \*\*Which SNRI is indicated for both depression and neuropathic pain?\*\* \- A. Duloxetine (Cymbalta) \- B. Sertraline (Zoloft) \- C. Paroxetine (Paxil) \- D. Fluoxetine (Prozac) \*\*Answer:\*\* A. Duloxetine (Cymbalta) 3\. \*\*What additional condition, besides depression, is venlafaxine used to treat?\*\* \- A. Obsessive-compulsive disorder (OCD) \- B. Social anxiety disorder \- C. Bipolar disorder \- D. Schizophrenia \*\*Answer:\*\* B. Social anxiety disorder \-\-- \#\#\# \*\*Slide 32: SNRI Pharmacokinetics\*\* 1\. \*\*SNRIs are metabolized through which enzyme system?\*\* \- A. Cytochrome P450 \- B. P-glycoprotein \- C. Monoamine oxidase \- D. Acetylcholinesterase \*\*Answer:\*\* A. Cytochrome P450 2\. \*\*In patients with renal insufficiency, how should SNRI doses be adjusted?\*\* \- A. Dose should be increased \- B. No adjustment is needed \- C. Dose should be reduced \- D. SNRI should be discontinued \*\*Answer:\*\* C. Dose should be reduced 3\. \*\*Which of the following is a common side effect of SNRIs?\*\* \- A. Hypotension \- B. Hypertension \- C. Bradycardia \- D. Constipation \*\*Answer:\*\* B. Hypertension \-\-- \#\#\# \*\*Slide 33: SNRI Side Effects\*\* 1\. \*\*Which of the following is a dose-dependent side effect of SNRIs?\*\* \- A. Hypertension \- B. Hypoglycemia \- C. Sedation \- D. Hypercalcemia \*\*Answer:\*\* A. Hypertension 2\. \*\*Which side effect is commonly associated with both SSRIs and SNRIs?\*\* \- A. Increased sweating \- B. Dry mouth \- C. Tachycardia \- D. Rash \*\*Answer:\*\* A. Increased sweating 3\. \*\*Why should SNRIs not be combined with monoamine oxidase inhibitors (MAOIs)?\*\* \- A. Risk of hypertensive crisis \- B. Risk of serotonin syndrome \- C. Increased risk of arrhythmias \- D. Increased risk of liver toxicity \*\*Answer:\*\* B. Risk of serotonin syndrome \-\-- \#\#\# \*\*Slide 34: Tricyclic Antidepressants (TCAs)\*\* 1\. \*\*What is the mechanism of action of tricyclic antidepressants (TCAs)?\*\* \- A. Inhibition of serotonin and norepinephrine reuptake \- B. Inhibition of dopamine reuptake \- C. Inhibition of serotonin breakdown \- D. Blocking acetylcholine receptors \*\*Answer:\*\* A. Inhibition of serotonin and norepinephrine reuptake 2\. \*\*Which TCA is commonly used to treat obsessive-compulsive disorder (OCD)?\*\* \- A. Clomipramine \- B. Nortriptyline \- C. Desipramine \- D. Amitriptyline \*\*Answer:\*\* A. Clomipramine 3\. \*\*What is a common adverse effect associated with TCAs?\*\* \- A. QT prolongation \- B. Hypotension \- C. Hyperglycemia \- D. Anemia \*\*Answer:\*\* A. QT prolongation \-\-- \#\#\# \*\*Slide 35: TCA Pharmacokinetics\*\* 1\. \*\*Which enzyme system is responsible for the metabolism of tricyclic antidepressants (TCAs)?\*\* \- A. Cytochrome P450 \- B. Acetylcholinesterase \- C. Monoamine oxidase \- D. P-glycoprotein \*\*Answer:\*\* A. Cytochrome P450 2\. \*\*Why are TCAs generally administered at night?\*\* \- A. They have a short half-life \- B. They cause sedation \- C. They are best absorbed with food \- D. To avoid drug interactions \*\*Answer:\*\* B. They cause sedation 3\. \*\*In which population is TCA use particularly risky due to slow metabolism?\*\* \- A. Elderly \- B. Children \- C. Men \- D. Smokers \*\*Answer:\*\* A. Elderly \-\-- \#\#\# \*\*Slide 36: TCA Overdose\*\* 1\. \*\*What is the primary cause of death in TCA overdose?\*\* \- A. Respiratory depression \- B. Cardiotoxicity (arrhythmias) \- C. Seizures \- D. Hyperthermia \*\*Answer:\*\* B. Cardiotoxicity (arrhythmias) 2\. \*\*Which electrolyte abnormality is commonly seen in TCA overdose?\*\* \- A. Hyperkalemia \- B. Hyponatremia \- C. Hypercalcemia \- D. Hypomagnesemia \*\*Answer:\*\* B. Hyponatremia 3\. \*\*What is contraindicated in the treatment of TCA-induced arrhythmias?\*\* \- A. Sodium bicarbonate \- B. Class I antiarrhythmic drugs \- C. Beta-blockers \- D. Benzodiazepines \*\*Answer:\*\* B. Class I antiarrhythmic drugs \-\-- \#\#\# \*\*Slide 37: Monoamine Oxidase Inhibitors (MAOIs)\*\* 1\. \*\*What is the mechanism of action of monoamine oxidase inhibitors (MAOIs)?\*\* \- A. Inhibition of serotonin and norepinephrine reuptake \- B. Inhibition of monoamine oxidase, preventing neurotransmitter breakdown \- C. Stimulation of dopamine release \- D. Blockade of NMDA receptors \*\*Answer:\*\* B. Inhibition of monoamine oxidase, preventing neurotransmitter breakdown 2\. \*\*Which enzyme does MAO-A primarily degrade?\*\* \- A. Dopamine \- B. Acetylcholine \- C. Serotonin and norepinephrine \- D. Glutamate \*\*Answer:\*\* C. Serotonin and norepinephrine 3\. \*\*Which of the following foods should be avoided by patients taking MAOIs due to the risk of hypertensive crisis?\*\* \- A. Cheese \- B. Bananas \- C. Chicken \- D. Broccoli \*\*Answer:\*\* A. Cheese \-\-- \#\#\# \*\*Slide 38: MAOI Drug Interactions\*\* 1\. \*\*What serious condition can result from combining MAOIs with SSRIs?\*\* \- A. Hypertensive crisis \- B. Serotonin syndrome \- C. Hyperkalemia \- D. Hypoglycemia \*\*Answer:\*\* B. Serotonin syndrome 2\. \*\*Which of the following drugs should be avoided with MAOIs due to the risk of hypertensive crisis?\*\* \- A. Pseudoephedrine \- B. Metoprolol \- C. Omeprazole \- D. Lorazepam \*\*Answer:\*\* A. Pseudoephedrine 3\. \*\*MAOIs should not be combined with which type of foods?\*\* \- A. High-protein foods \- B. Tyramine-rich foods \- C. Fatty foods \- D. Carbohydrate-rich foods \*\*Answer:\*\* B. Tyramine-rich foods \-\-- \#\#\# \*\*Slide 39: MAOI Side Effects\*\* 1\. \*\*Which of the following is a common side effect of MAOIs?\*\* \- A. Weight gain \- B. Hypertension \- C. Hypoglycemia \- D. Hypercalcemia \*\*Answer:\*\* A. Weight gain 2\. \*\*What is a life-threatening complication associated with the sudden discontinuation of MAOIs?\*\* \- A. Serotonin syndrome \- B. Discontinuation syndrome with psychosis and confusion \- C. Hypertensive crisis \- D. Hyperglycemia \*\*Answer:\*\* B. Discontinuation syndrome with psychosis and confusion 3\. \*\*Why are MAOIs rarely used as first-line therapy for depression?\*\* \- A. High risk of drug and food interactions \- B. Low efficacy compared to SSRIs \- C. Increased risk of serotonin syndrome \- D. High cost \*\*Answer:\*\* A. High risk of drug and food interactions \-\-- \#\#\# \*\*Slide 40: Bupropion (Wellbutrin)\*\* 1\. \*\*Bupropion primarily inhibits the reuptake of which neurotransmitters?\*\* \- A. Serotonin and norepinephrine \- B. Norepinephrine and dopamine \- C. Dopamine and serotonin \- D. Acetylcholine and serotonin \*\*Answer:\*\* B. Norepinephrine and dopamine 2\. \*\*Bupropion is contraindicated in patients with which condition?\*\* \- A. Hypertension \- B. Seizure disorder \- C. Depression \- D. Schizophrenia \*\*Answer:\*\* B. Seizure disorder 3\. \*\*What is a common reason bupropion is chosen over SSRIs for some patients?\*\* \- A. Lower risk of sexual side effects \- B. Increased sedative effects \- C. Reduced efficacy for anxiety \- D. Increased risk of weight gain \*\*Answer:\*\* A. Lower risk of sexual side effects \#\#\# \*\*Slide 32: SNRI Pharmacokinetics\*\* 1\. \*\*Which enzyme is primarily responsible for metabolizing SNRIs like duloxetine?\*\* \- A. Cytochrome P450 1A2 and 2D6 \- B. Monoamine oxidase A \- C. Acetylcholinesterase \- D. Catechol-O-methyltransferase \*\*Answer:\*\* A. Cytochrome P450 1A2 and 2D6 2\. \*\*How should the dose of SNRIs be adjusted in patients with renal insufficiency?\*\* \- A. Increased by 50% \- B. No adjustment needed \- C. Dose should be reduced \- D. Discontinue the medication \*\*Answer:\*\* C. Dose should be reduced 3\. \*\*What is a common pharmacokinetic feature of SNRIs that may contribute to side effects like hypertension?\*\* \- A. Active metabolites increase serotonin concentration in the brain \- B. Metabolites and the parent drug are eliminated by the kidneys \- C. They are metabolized through the liver and excreted through the bile \- D. SNRIs are stored in fat and slowly released \*\*Answer:\*\* B. Metabolites and the parent drug are eliminated by the kidneys【58:0†source】【58:2†source】 \-\-- \#\#\# \*\*Slide 33: SNRI Side Effects\*\* 1\. \*\*What cardiovascular side effect is commonly associated with SNRIs, especially at high doses?\*\* \- A. Bradycardia \- B. Hypotension \- C. Hypertension \- D. Heart block \*\*Answer:\*\* C. Hypertension 2\. \*\*Which central nervous system (CNS) side effect may occur with SNRIs and is related to their dose?\*\* \- A. Sedation \- B. Anxiety and insomnia \- C. Seizures \- D. Fatigue \*\*Answer:\*\* B. Anxiety and insomnia 3\. \*\*SNRIs can cause a discontinuation syndrome similar to SSRIs. Which of the following symptoms is commonly associated with this syndrome?\*\* \- A. Hyperactivity and agitation \- B. Diarrhea and vomiting \- C. Dizziness and somnolence \- D. Hyperglycemia and increased appetite \*\*Answer:\*\* C. Dizziness and somnolence【58:2†source】【58:2†source】 \#\#\# \*\*Slide 41: Monoamine Oxidase Inhibitors (MAOIs)\*\* 1\. \*\*What is the primary mechanism of action of MAOIs in the treatment of mood disorders?\*\* \- A. Inhibition of serotonin and norepinephrine reuptake \- B. Inhibition of the enzyme monoamine oxidase, preventing the breakdown of neurotransmitters \- C. Activation of dopamine receptors \- D. Inhibition of GABA receptors \*\*Answer:\*\* B. Inhibition of the enzyme monoamine oxidase, preventing the breakdown of neurotransmitters【62:0†source】 2\. \*\*Which type of food must be avoided while taking MAOIs due to the risk of hypertensive crisis?\*\* \- A. High-protein foods \- B. Tyramine-rich foods (e.g., cheese, red wine) \- C. Fatty foods \- D. Carbohydrate-rich foods \*\*Answer:\*\* B. Tyramine-rich foods (e.g., cheese, red wine)【62:0†source】 3\. \*\*Which isoform of monoamine oxidase is responsible for degrading serotonin, norepinephrine, and dopamine?\*\* \- A. MAO-B \- B. MAO-A \- C. COMT \- D. SERT \*\*Answer:\*\* B. MAO-A【62:0†source】 \-\-- \#\#\# \*\*Slide 42: MAOI Side Effects\*\* 1\. \*\*Which side effect is most commonly associated with MAOIs?\*\* \- A. Hypertension \- B. Orthostatic hypotension \- C. Hypercalcemia \- D. Bradycardia \*\*Answer:\*\* B. Orthostatic hypotension【62:0†source】 2\. \*\*MAOIs are associated with the highest rate of which of the following side effects?\*\* \- A. Sexual dysfunction \- B. Weight loss \- C. Constipation \- D. Hepatotoxicity \*\*Answer:\*\* A. Sexual dysfunction【62:0†source】 3\. \*\*Which of the following conditions is associated with discontinuation syndrome upon sudden cessation of MAOIs?\*\* \- A. Psychosis, excitement, and confusion \- B. Seizures and coma \- C. Hyperglycemia and tremors \- D. Bradycardia and hypotension \*\*Answer:\*\* A. Psychosis, excitement, and confusion【62:0†source】 \-\-- \#\#\# \*\*Slide 43: Bupropion (Wellbutrin)\*\* 1\. \*\*What is the primary mechanism of action of bupropion (Wellbutrin)?\*\* \- A. Selective serotonin reuptake inhibitor (SSRI) \- B. Norepinephrine and dopamine reuptake inhibitor \- C. Monoamine oxidase inhibitor (MAOI) \- D. GABA agonist \*\*Answer:\*\* B. Norepinephrine and dopamine reuptake inhibitor【62:0†source】 2\. \*\*In which patient population should bupropion be avoided due to the risk of seizures?\*\* \- A. Patients with a history of hypertension \- B. Patients with a history of seizure disorder \- C. Patients with schizophrenia \- D. Patients with bipolar disorder \*\*Answer:\*\* B. Patients with a history of seizure disorder【62:0†source】 3\. \*\*Which of the following is an advantage of bupropion compared to SSRIs?\*\* \- A. Lower risk of sexual side effects \- B. Greater sedative effects \- C. Faster onset of action \- D. Increased serotonin reuptake \*\*Answer:\*\* A. Lower risk of sexual side effects【62:0†source】 \-\-- \#\#\# \*\*Slide 44: Dextromethorphan/Bupropion ER (Auvelity)\*\* 1\. \*\*Dextromethorphan in Auvelity works as an antagonist of which receptor?\*\* \- A. GABA-A receptor \- B. NMDA receptor \- C. Dopamine receptor \- D. Alpha-1 receptor \*\*Answer:\*\* B. NMDA receptor【62:0†source】 2\. \*\*Which drug is combined with dextromethorphan in Auvelity to enhance its antidepressant effects?\*\* \- A. Fluoxetine \- B. Bupropion \- C. Venlafaxine \- D. Mirtazapine \*\*Answer:\*\* B. Bupropion【62:0†source】 3\. \*\*What serious adverse reaction can occur when combining dextromethorphan with other serotonergic medications?\*\* \- A. Hypertensive crisis \- B. Serotonin syndrome \- C. Hypercalcemia \- D. Bradycardia \*\*Answer:\*\* B. Serotonin syndrome【62:0†source】 \-\-- \#\#\# \*\*Slide 45: Trazodone (Desyrel)\*\* 1\. \*\*What is the primary use of trazodone at low doses (25-150 mg)?\*\* \- A. Antidepressant \- B. Insomnia treatment \- C. Antipsychotic \- D. Weight loss \*\*Answer:\*\* B. Insomnia treatment【62:0†source】 2\. \*\*Which receptor blockade is responsible for trazodone's sedative effects?\*\* \- A. NMDA receptor \- B. Histamine H1 receptor \- C. GABA receptor \- D. Dopamine D2 receptor \*\*Answer:\*\* B. Histamine H1 receptor【62:0†source】 3\. \*\*What is a rare but serious side effect of trazodone?\*\* \- A. Serotonin syndrome \- B. Priapism \- C. Agranulocytosis \- D. Hepatitis \*\*Answer:\*\* B. Priapism【62:0†source】 \-\-- \#\#\# \*\*Slide 46: Nefazodone\*\* 1\. \*\*What receptor does nefazodone block that contributes to its antidepressant effects?\*\* \- A. 5-HT2A receptor \- B. Dopamine D2 receptor \- C. NMDA receptor \- D. Beta-1 receptor \*\*Answer:\*\* A. 5-HT2A receptor【62:0†source】 2\. \*\*Nefazodone is chemically related to which of the following antidepressants?\*\* \- A. Trazodone \- B. Mirtazapine \- C. Bupropion \- D. Venlafaxine \*\*Answer:\*\* A. Trazodone【62:0†source】 3\. \*\*Why is nefazodone no longer commonly prescribed?\*\* \- A. Risk of hepatotoxicity \- B. Risk of seizures \- C. High rate of weight gain \- D. Increased risk of serotonin syndrome \*\*Answer:\*\* A. Risk of hepatotoxicity【62:0†source】 \-\-- \#\#\# \*\*Slide 47: Mirtazapine (Remeron)\*\* 1\. \*\*What is the mechanism of action of mirtazapine?\*\* \- A. Alpha-2 receptor antagonist \- B. Dopamine D2 receptor antagonist \- C. GABA receptor agonist \- D. NMDA receptor antagonist \*\*Answer:\*\* A. Alpha-2 receptor antagonist【62:0†source】 2\. \*\*Which of the following is a common side effect of mirtazapine?\*\* \- A. Weight gain \- B. Hypertension \- C. Tachycardia \- D. Nausea \*\*Answer:\*\* A. Weight gain【62:0†source】 3\. \*\*Mirtazapine is less likely to cause which of the following side effects compared to SSRIs?\*\* \- A. Sexual dysfunction \- B. Weight gain \- C. Sedation \- D. Dry mouth \*\*Answer:\*\* A. Sexual dysfunction【62:0†source】 \-\-- \#\#\# \*\*Slide 48: Vortioxetine (Trintellix)\*\* 1\. \*\*Which of the following receptors does vortioxetine partially agonize?\*\* \- A. 5-HT1A \- B. NMDA \- C. Alpha-2 adrenergic \- D. Dopamine D2 \*\*Answer:\*\* A. 5-HT1A【62:0†source】 2\. \*\*Which of the following is a common side effect of vortioxetine?\*\* \- A. Diarrhea \- B. Headache \- C. Tachycardia \- D. Weight loss \*\*Answer:\*\* B. Headache【62:0†source】 3\. \*\*Vortioxetine primarily inhibits which transporter in the treatment of depression?\*\* \- A. SERT (Serotonin transporter) \- B. DAT (Dopamine transporter) \- C. NET (Norepinephrine transporter) \- D. GAT (GABA transporter) \*\*Answer:\*\* A. SERT (Serotonin transporter)【62:0†source】 \#\#\# \*\*Slide 49: Bupropion Pharmacokinetics\*\* 1\. \*\*What is the primary enzyme responsible for the metabolism of bupropion?\*\* \- A. CYP3A4 \- B. CYP2D6 \- C. MAO-B \- D. CYP1A2 \*\*Answer:\*\* B. CYP2D6【67:0†source】 2\. \*\*Bupropion is contraindicated in patients with a history of which condition?\*\* \- A. Hypertension \- B. Anxiety \- C. Seizure disorder \- D. Obesity \*\*Answer:\*\* C. Seizure disorder【67:0†source】 3\. \*\*In addition to its use in depression, bupropion is approved for which of the following conditions?\*\* \- A. Alcohol dependence \- B. Smoking cessation \- C. Migraine prevention \- D. ADHD \*\*Answer:\*\* B. Smoking cessation【67:0†source】 \-\-- \#\#\# \*\*Slide 50: New Medication: Dextromethorphan/Bupropion ER (Auvelity)\*\* 1\. \*\*What is the mechanism of action of dextromethorphan in Auvelity?\*\* \- A. NMDA receptor antagonist \- B. Serotonin reuptake inhibitor \- C. GABA receptor agonist \- D. Alpha-2 adrenergic antagonist \*\*Answer:\*\* A. NMDA receptor antagonist【67:0†source】 2\. \*\*What is a potential adverse reaction when combining dextromethorphan with other serotonergic medications?\*\* \- A. Serotonin syndrome \- B. Hypertensive crisis \- C. Bradycardia \- D. Respiratory depression \*\*Answer:\*\* A. Serotonin syndrome【67:0†source】 3\. \*\*How soon can symptom improvement begin after starting Auvelity for depression?\*\* \- A. 2 weeks \- B. 4 weeks \- C. 1 week \- D. 6 weeks \*\*Answer:\*\* C. 1 week【67:0†source】 \-\-- \#\#\# \*\*Slide 51: Trazodone (Desyrel)\*\* 1\. \*\*What receptor does trazodone antagonize that contributes to its sedative effects?\*\* \- A. Histamine H1 receptor \- B. Alpha-2 adrenergic receptor \- C. Serotonin 5-HT2A receptor \- D. GABA-A receptor \*\*Answer:\*\* A. Histamine H1 receptor【67:0†source】 2\. \*\*At low doses, trazodone is commonly used to treat which condition?\*\* \- A. Depression \- B. Anxiety \- C. Insomnia \- D. Bipolar disorder \*\*Answer:\*\* C. Insomnia【67:0†source】 3\. \*\*What is a rare but serious side effect associated with trazodone?\*\* \- A. Serotonin syndrome \- B. Priapism \- C. Hepatotoxicity \- D. Weight gain \*\*Answer:\*\* B. Priapism【67:0†source】 \-\-- \#\#\# \*\*Slide 52: Nefazodone\*\* 1\. \*\*Nefazodone is chemically related to which other antidepressant?\*\* \- A. Mirtazapine \- B. Trazodone \- C. Bupropion \- D. Sertraline \*\*Answer:\*\* B. Trazodone【67:0†source】 2\. \*\*What is a serious risk associated with nefazodone that has limited its use?\*\* \- A. Hepatotoxicity \- B. Seizures \- C. Hypertension \- D. Sexual dysfunction \*\*Answer:\*\* A. Hepatotoxicity【67:0†source】 3\. \*\*Nefazodone inhibits which enzyme, leading to significant drug interactions?\*\* \- A. CYP2D6 \- B. CYP3A4 \- C. MAO-B \- D. CYP1A2 \*\*Answer:\*\* B. CYP3A4【67:0†source】 \-\-- \#\#\# \*\*Slide 53: Mirtazapine (Remeron)\*\* 1\. \*\*What is the mechanism of action of mirtazapine?\*\* \- A. Serotonin reuptake inhibitor \- B. Alpha-2 adrenergic receptor antagonist \- C. Dopamine reuptake inhibitor \- D. GABA receptor agonist \*\*Answer:\*\* B. Alpha-2 adrenergic receptor antagonist【67:0†source】 2\. \*\*Which of the following is a common side effect of mirtazapine?\*\* \- A. Weight loss \- B. Hypertension \- C. Weight gain \- D. Sexual dysfunction \*\*Answer:\*\* C. Weight gain【67:0†source】 3\. \*\*Mirtazapine is less likely to cause which side effect compared to SSRIs?\*\* \- A. Sedation \- B. Sexual dysfunction \- C. Weight gain \- D. Dry mouth \*\*Answer:\*\* B. Sexual dysfunction【67:0†source】 \-\-- \#\#\# \*\*Slide 54: Vortioxetine (Trintellix)\*\* 1\. \*\*What is the primary mechanism of action of vortioxetine?\*\* \- A. Dopamine reuptake inhibitor \- B. Serotonin transporter (SERT) inhibitor \- C. NMDA receptor antagonist \- D. Alpha-2 adrenergic agonist \*\*Answer:\*\* B. Serotonin transporter (SERT) inhibitor【67:0†source】 2\. \*\*Which of the following receptors does vortioxetine partially agonize?\*\* \- A. 5-HT1A \- B. NMDA \- C. GABA-A \- D. Alpha-1 adrenergic \*\*Answer:\*\* A. 5-HT1A【67:0†source】 3\. \*\*Which of the following is a common side effect of vortioxetine?\*\* \- A. Diarrhea \- B. Nausea \- C. Bradycardia \- D. Weight gain \*\*Answer:\*\* B. Nausea【67:0†source】 \-\-- \#\#\# \*\*Slide 55: Vilazodone (Viibryd)\*\* 1\. \*\*Vilazodone acts as a partial agonist at which receptor?\*\* \- A. 5-HT1A receptor \- B. NMDA receptor \- C. Alpha-2 adrenergic receptor \- D. GABA-B receptor \*\*Answer:\*\* A. 5-HT1A receptor【67:0†source】 2\. \*\*What is a significant adverse effect associated with vilazodone that requires monitoring?\*\* \- A. Long QT syndrome \- B. Hypertensive crisis \- C. Weight gain \- D. Hepatotoxicity \*\*Answer:\*\* A. Long QT syndrome【67:0†source】 3\. \*\*Vilazodone's mechanism enhances serotonergic activity by inhibiting which transporter?\*\* \- A. SERT (Serotonin transporter) \- B. DAT (Dopamine transporter) \- C. NET (Norepinephrine transporter) \- D. GAT (GABA transporter) \*\*Answer:\*\* A. SERT (Serotonin transporter)【67:0†source】 \#\#\# \*\*Slide 55: NMDA Receptor Antagonists\*\* 1\. \*\*What is the primary mechanism of action of NMDA receptor antagonists like ketamine in depression treatment?\*\* \- A. Serotonin reuptake inhibition \- B. NMDA receptor antagonism \- C. Dopamine receptor blockade \- D. GABA receptor activation \*\*Answer:\*\* B. NMDA receptor antagonism 2\. \*\*Esketamine (Spravato) is indicated for which of the following conditions?\*\* \- A. Generalized anxiety disorder \- B. Treatment-resistant depression and acute suicidal ideation \- C. Obsessive-compulsive disorder \- D. Bipolar disorder \*\*Answer:\*\* B. Treatment-resistant depression and acute suicidal ideation 3\. \*\*What is a major concern regarding the use of ketamine in depression treatment?\*\* \- A. Weight gain \- B. Risk of dissociative symptoms and abuse potential \- C. Increased risk of seizures \- D. Hyperglycemia \*\*Answer:\*\* B. Risk of dissociative symptoms and abuse potential \-\-- \#\#\# \*\*Slide 56: How to Choose an Antidepressant\*\* 1\. \*\*Which of the following antidepressants is least likely to cause sexual side effects?\*\* \- A. Bupropion \- B. Fluoxetine \- C. Paroxetine \- D. Citalopram \*\*Answer:\*\* A. Bupropion 2\. \*\*What is a key consideration when choosing an antidepressant for a patient?\*\* \- A. Only the cost of the drug \- B. Indication, cost, availability, adverse effects, drug interactions, and history of response \- C. The patient\'s weight \- D. The patient\'s age \*\*Answer:\*\* B. Indication, cost, availability, adverse effects, drug interactions, and history of response 3\. \*\*Which antidepressant class is most commonly prescribed for major depressive disorder (MDD) and anxiety disorders?\*\* \- A. Tricyclic antidepressants (TCAs) \- B. Monoamine oxidase inhibitors (MAOIs) \- C. Selective serotonin reuptake inhibitors (SSRIs) \- D. NMDA receptor antagonists \*\*Answer:\*\* C. Selective serotonin reuptake inhibitors (SSRIs) \-\-- \#\#\# \*\*Slide 57: Clinical Indications for Antidepressants\*\* 1\. \*\*What is the goal of acute treatment with antidepressants in patients with depression?\*\* \- A. Reduce the number of depressive symptoms by half \- B. Achieve full remission of depressive symptoms \- C. Manage symptoms to a tolerable level \- D. Maintain the patient on therapy for life \*\*Answer:\*\* B. Achieve full remission of depressive symptoms 2\. \*\*How long should a trial of antidepressant therapy last before determining efficacy?\*\* \- A. 1-2 weeks \- B. 8-12 weeks \- C. 6 months \- D. 4 weeks \*\*Answer:\*\* B. 8-12 weeks 3\. \*\*In patients who have experienced two or more serious episodes of major depressive disorder (MDD) in the last 5 years, what is recommended?\*\* \- A. Short-term therapy for 3 months \- B. Long-term antidepressant therapy \- C. Discontinue medication and focus on psychotherapy \- D. Use only psychotherapy \*\*Answer:\*\* B. Long-term antidepressant therapy \-\-- \#\#\# \*\*Slide 58: Antidepressant Side Effects and Discontinuation\*\* 1\. \*\*Which antidepressant class is associated with the highest risk of fatal overdose?\*\* \- A. Selective serotonin reuptake inhibitors (SSRIs) \- B. Serotonin-norepinephrine reuptake inhibitors (SNRIs) \- C. Tricyclic antidepressants (TCAs) \- D. NMDA receptor antagonists \*\*Answer:\*\* C. Tricyclic antidepressants (TCAs) 2\. \*\*What is a common symptom of antidepressant discontinuation syndrome?\*\* \- A. Euphoria \- B. Dizziness and paresthesias \- C. Seizures \- D. Constipation \*\*Answer:\*\* B. Dizziness and paresthesias 3\. \*\*Which antidepressants are most likely to cause severe withdrawal symptoms if stopped abruptly?\*\* \- A. Long half-life SSRIs (e.g., fluoxetine) \- B. Short half-life SSRIs (e.g., paroxetine, sertraline) \- C. NMDA receptor antagonists \- D. MAOIs \*\*Answer:\*\* B. Short half-life SSRIs (e.g., paroxetine, sertraline) \-\-- \#\#\# \*\*Slide 59: Antidepressant Drug Interactions\*\* 1\. \*\*What effect do paroxetine and fluoxetine have on the cytochrome P450 (CYP) enzyme system?\*\* \- A. They are potent CYP2D6 inhibitors \- B. They induce CYP2D6 activity \- C. They inhibit CYP3A4 \- D. They have no effect on the CYP enzyme system \*\*Answer:\*\* A. They are potent CYP2D6 inhibitors 2\. \*\*Which antidepressants are relatively free from significant drug interactions?\*\* \- A. Paroxetine and fluoxetine \- B. Citalopram and sertraline \- C. Venlafaxine and duloxetine \- D. Bupropion and mirtazapine \*\*Answer:\*\* B. Citalopram and sertraline 3\. \*\*Which of the following drugs is contraindicated with SSRIs due to the risk of serotonin syndrome?\*\* \- A. Beta-blockers \- B. MAOIs \- C. Antihistamines \- D. NSAIDs \*\*Answer:\*\* B. MAOIs \-\-- \#\#\# \*\*Slide 60: Serotonin Syndrome\*\* 1\. \*\*What is a key sign of serotonin syndrome?\*\* \- A. Hypotension \- B. Hyperthermia and autonomic instability \- C. Bradycardia \- D. Hypoglycemia \*\*Answer:\*\* B. Hyperthermia and autonomic instability 2\. \*\*Which of the following is commonly used to treat serotonin syndrome by blocking serotonin receptors?\*\* \- A. Cyproheptadine \- B. Diazepam \- C. Lorazepam \- D. Fluoxetine \*\*Answer:\*\* A. Cyproheptadine 3\. \*\*Which class of drugs is most commonly associated with serotonin syndrome?\*\* \- A. Antipsychotics \- B. Antidepressants (e.g., SSRIs, SNRIs) \- C. Beta-blockers \- D. Benzodiazepines \*\*Answer:\*\* B. Antidepressants (e.g., SSRIs, SNRIs) \#\#\# \*\*Slide 61: Antidepressant Selection and Considerations\*\* 1\. \*\*What is the primary consideration when selecting an antidepressant for a patient?\*\* \- A. Cost and availability only \- B. Indication, cost, availability, adverse effects, drug interactions, and history of response \- C. Weight of the patient \- D. Age of the patient \*\*Answer:\*\* B. Indication, cost, availability, adverse effects, drug interactions, and history of response【75:0†source】 2\. \*\*Which antidepressants are known to have the lowest sexual side effects?\*\* \- A. SSRIs \- B. Bupropion, mirtazapine, and nefazodone \- C. SNRIs \- D. Tricyclic antidepressants (TCAs) \*\*Answer:\*\* B. Bupropion, mirtazapine, and nefazodone【75:0†source】 3\. \*\*Which antidepressants are most commonly prescribed for major depressive disorder (MDD) and anxiety disorders?\*\* \- A. Monoamine oxidase inhibitors (MAOIs) \- B. Selective serotonin reuptake inhibitors (SSRIs) \- C. Tricyclic antidepressants (TCAs) \- D. Bupropion and nefazodone \*\*Answer:\*\* B. Selective serotonin reuptake inhibitors (SSRIs)【75:0†source】 \-\-- \#\#\# \*\*Slide 62: Clinical Indications for Antidepressants\*\* 1\. \*\*What is the goal of acute treatment with antidepressants in patients with depression?\*\* \- A. Reduce symptoms by 50% \- B. Achieve full remission of depressive symptoms \- C. Manage symptoms to a tolerable level \- D. Maintain the patient on therapy for life \*\*Answer:\*\* B. Achieve full remission of depressive symptoms【75:0†source】 2\. \*\*How long does it typically take to see maximum benefit from antidepressants?\*\* \- A. 1 week \- B. 2-3 weeks \- C. 1-2 months \- D. 4 months \*\*Answer:\*\* C. 1-2 months【75:0†source】 3\. \*\*For patients with two or more serious episodes of major depressive disorder (MDD) in the last 5 years, what is recommended?\*\* \- A. Short-term therapy for 3 months \- B. Long-term antidepressant therapy \- C. Discontinue medication after symptoms improve \- D. Use only psychotherapy \*\*Answer:\*\* B. Long-term antidepressant therapy【75:0†source】 \-\-- \#\#\# \*\*Slide 63: Antidepressant Drug Interactions\*\* 1\. \*\*Which antidepressants are potent inhibitors of CYP2D6, leading to significant drug interactions?\*\* \- A. Citalopram and sertraline \- B. Paroxetine and fluoxetine \- C. Venlafaxine and duloxetine \- D. Bupropion and mirtazapine \*\*Answer:\*\* B. Paroxetine and fluoxetine【75:0†source】 2\. \*\*Which antidepressants are relatively free from significant drug interactions?\*\* \- A. Paroxetine and fluoxetine \- B. Citalopram and sertraline \- C. Venlafaxine and duloxetine \- D. Bupropion and mirtazapine \*\*Answer:\*\* B. Citalopram and sertraline【75:0†source】 3\. \*\*What is a serious contraindication when using SSRIs due to the risk of serotonin syndrome?\*\* \- A. Use with beta-blockers \- B. Use with MAOIs \- C. Use with benzodiazepines \- D. Use with NSAIDs \*\*Answer:\*\* B. Use with MAOIs【75:0†source】 \-\-- \#\#\# \*\*Slide 64: Serotonin Syndrome\*\* 1\. \*\*What are the hallmark signs of serotonin syndrome?\*\* \- A. Hypotension and bradycardia \- B. Hyperthermia, autonomic instability, and neuromuscular abnormalities \- C. Hypoglycemia and confusion \- D. Hyperactivity and tremors \*\*Answer:\*\* B. Hyperthermia, autonomic instability, and neuromuscular abnormalities【75:0†source】 2\. \*\*Which medication is commonly used to treat serotonin syndrome by blocking serotonin receptors?\*\* \- A. Cyproheptadine \- B. Diazepam \- C. Fluoxetine \- D. Lorazepam \*\*Answer:\*\* A. Cyproheptadine【75:0†source】 3\. \*\*Which drug class is most commonly associated with causing serotonin syndrome?\*\* \- A. Antipsychotics \- B. Antidepressants (SSRIs, SNRIs) \- C. Beta-blockers \- D. Benzodiazepines \*\*Answer:\*\* B. Antidepressants (SSRIs, SNRIs)【75:0†source】

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