Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

iPTX II > Antidepressants and Anxiolytics Med Chem > Flashcards

Antidepressants and Anxiolytics Med Chem Flashcards

1
Q

What is the most common mood disorder in adults?

A

Major depressive disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Criteria required for diagnosis of major depressive disorder

A

One or more depressive episodes without a history of manic, mixed or hypomanic episodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Monoamine hypothesis

A

Deficiency or imbalances in the monoamine neurotransmitters (serotonin, norepinephrine, dopamine) causes depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Based on the monoamine hypothesis, increasing which two neurotransmitters could alleviate depression?

A

Serotonin and norepinephrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Drugs that selectively increase which neurotransmitter decrease depression?

A

Serotonin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Hypercholinergic hypothesis of depression

A

Hyperactivity of cholinergic system and excessive nicotinic receptor activity can lead to depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Examples of antidepressants with nicotinic acetylcholine receptor inhibitory activity

A

Bupropion
Nicotinic transdermal patch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which amino acid is a precursor for serotonin?

A

Tryptophan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which enzyme is responsible for serotonin synthesis?

A

Tryptophan hydroxylase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which amino acid is a precursor for norepinephrine?

A

Tyrosine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which enzyme is responsible for norepinephrine synthesis?

A

Tyrosine hydroxylase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

True or false: For all monoamines, the first synthetic step is rate limiting

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Serotonin is transported into the vesicles via what?

A

Vesicular monoamine transporter (VMAT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Reserpine binds irreversibly to what to inhibit packaging of DA, NE, EPI, and 5-HT into vesicles?

A

VMAT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What two compounds degrade serotonin?

A

Monoamine oxidase (MAO) and catechol-O-methyl-transferase (COMT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

MAO inhibitor MOA

A

Increase serotonin and norepinephrine available in the cytoplasm by blocking the deamination of monoamines via MAO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

MAOi contrindications

A

Concomitant use of: sympathomimetic drugs, other MAOIs, L-DOPA, L-tryptophan, phenylalanine, bupropion, excessive coffee, chocolate intake, high tyramine containing foods, heart failure, general anesthesia, local anesthesia with vasoconstrictors, liver disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the result of MAOi use with high levels of tyramine?

A

Hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Between tertiary and secondary amines, which exhibit more selectivity?

A

Secondary amines selectively inhibit norepinephrine reuptake (still have some serotonin reuptake activity)

20
Q

Examples of tertiary amine TCAs

A

Clomipramine
Imipramine
Doxepin
Amitriptyline

21
Q

Fluoxetine 20mg target plasma level

A

200 ng/mL

22
Q

SSRI contraindication

A

Concomitant use of MAOi

23
Q

Concomitant use of SSRIs and MAOis can lead to what?

A

Serotonin syndrome

24
Q

SSRI monotherapy in bipolar patients can lead to what?

A

Mania

25
Q

SSRI examples

A

Fluoxetine
Paroxetine
Sertraline
Fluvoxamine
Citalopram
Escitalopram

26
Q

SNRI contraindication

A

Concomitant use of MAOi

27
Q

SNRI examples

A

Venlafaxine
Desvenlafaxine
Duloxetine
Milnacipran
Levomilnacipran

28
Q

Bupropion (NDRI) contraindications

A

Concomitant use of MAOi
Seizure disorders
Eating disorders
Patients undergoing abrupt discontinuation of alcohol or sedatives

29
Q

Common adverse effects of agents with mixed serotonergic effects

A

Nausea, vomiting, diarrhea, constipation, dizziness

30
Q

Examples of mood stabilizers

A

Carbamazepine
Valproic acid
Lithium carbonate

31
Q

Lithium MOA

A

Therapeutic plasma levels of lithium deplete inositol pool available for resynthesis, reducing neuronal activity in the brain

32
Q

The R-enantiomer of ketamine has a (higher/lower) affinity for NMDA receptors than the S-enantiomer

A

Lower

33
Q

Esketamine contraindications

A

Ketamine hypersensitivity, aneurysmal vascular disease, intracerebral hemorrhage

34
Q

Ketamine MOA

A

NMDA receptor antagonist; increases synaptic glutamate activity

35
Q

Generalized anxiety disorder

A

Persistent and excessive anxiety and worry

36
Q

Panic disorder

A

Recurrent unexpected panic attacks and is persistently concerned or worried about having more panic attacks or changes their behavior in maladaptive ways because of panic attacks

37
Q

Social anxiety disorder

A

Fearful or anxious about or avoidant of social interactions and situations

38
Q

Substance/medication-induced anxiety disorder

A

Substance intoxication or withdrawal or to a medication treatment

39
Q

(Ionotropic/Metabotropic) GABA receptors bind GABA and open intrinsic Cl- channels

A

Ionotropic (GABAa)

40
Q

Which drug class is most effective and most commonly prescribed drugs for rapid relief of anxiety symptoms?

A

Benzodiazepines

41
Q

Benzodiazepine MOA

A

Positive allosteric modulators that enhance GABAa receptor channels in the presence of GABA

42
Q

Benzodiazepine antagonist

A

Flumazenil (Romazicon)

43
Q

What pharmacokinetic property of benzodiazepines explains their rapid and complete absorption?

A

Highly lipophilic

44
Q

Classify and explain reaction between benzodiazepines and alcohol

A

Pharmacodynamic. Additive CNS depressive effects

45
Q

Classify and explain reaction between benzodiazepines and CYP450 inhibitors (ketoconazole, ritonavir, etc.)

A

Pharmacokinetic. Increase concentration of benzodiazepines

46
Q

Which class of agents are considered first line in managing generalized anxiety disorder?

A

Antidepressants

47
Q

What is the place of therapy of buspirone in managing generalized anxiety disorder?

A

Second line agent

iPTX II (41 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions