Basic Pharmacology Flashcards
The new antipsychotic drug paliperidone belongs to the class of
Select one:
1. dibenzothiazepines
2. benzixosazoles
3. thienobenzodiazepine
4. dibenzodiazepines
5. benzamides
Benzixosazoles
Being a metabolite of risperidone, paliperidone belongs to the same class - benzixosazoles.
Which of the following best applies to the chemical structure of buspirone?
Select one:
1. Imidazopyridine
2. Benzisoxazole
3. Thienobenzodiazepine
4. Aminoketone
5. Azaspirone-decanedione
Azaspirone-decanedione
Buspirone, anxiolytics, is an azaspirone. Bupropion is an aminoketone.
Which one of the following names is associated with the use of valproate in mania?
Select one:
1. Delay and Deniker
2. John Cade
3. Kuhn
4. Janssen
5. Bowden
Bowden
Bowden is associated with use of valproate in Mania (1994). A controlled trial by Kane et al in 1987 showed that clozapine might be effective in schizophrenia that had been resistant to all other types of antipsychotic
therapy.
A placebo is best described as which one of the following?
Select one:
1. A preparation of active compound without a label
2. An active preparation of precursor molecules
3. A preparation with higher than average propensity to cause side effects
4. A compound that is active for an unrelated disorder
5. A dummy preparation of inactive compound
A dummy preparation of inactive compound
Medication possesses a potential for therapeutic efficacy far beyond its chemical capacity. The placebo effect is a psychobiological phenomenon that can be attributable to different mechanisms, including an expectation of clinical improvement and Pavlovian conditioning.
Zimeldine caused demyelination disorder on introduction, leading to its withdrawal. Which of the following class does it belong to?
Select one:
1. MAO inhibitors
2. Tricyclics
3. Benzodiazepines
4. Antipsychotics
5. SSRIs
SSRIs
Carlssen synthesized purpose made SSRI Zimeldine - but withdrawn due to the incidence of a hypersensitivity syndrome and demyelinating disease that followed its use.
A 45-year-old man with paranoid schizophrenia is started on a thienobenzodiazepine. Which of the
following drugs is prescribed here?
Select one:
1. Paliperidone
2. Piperazine
3. Olanzapine
4. Quetiapine
5. Clozapine
Olanzapine
Olanzapine is a thienobenzodiazepine.
Venlafaxine is best described as a
Select one:
1. SNRI (Serotonin and noradrenaline reuptake inhibitor)
2. SSRI (Selective serotonin reuptake inhibitors)
3. NARI (Nor adrenaline reuptake inhibitors)
4. Tricyclic antidepressant
5. Alpha 2 adrenoreceptor antagonist
SNRI (Serotonin and noradrenaline reuptake inhibitor)
Venlafaxine and duloxetine are drugs showing selectivity in inhibiting the reuptake of both noradrenaline and serotonin. They are best grouped as SNRIs.
Which of the following best describes lofexidine?
Select one:
1. Natural opioid
2. Alpha 1 antagonist
3. Alpha 2 agonist
4. Synthetic opioid
5. Opioid antagonist
Alpha 2 agonist
In opioid detoxification, if short duration of treatment is desirable, a2 adrenergic agonists such as lofexidine and clonidine are preferred to methadone.
Acamprosate is a
Select one:
1. Synthetic taurine analogue
2. Type of benzodiazepine
3. Long acting opioid agonist
4. Alpha-1 agonist
5. Opiod receptor antagonist
Synthetic taurine analogue
Acamprosate is a synthetic taurine analogue, which appears to act centrally on glutamate and GABA neurotransmitter systems, although the mechanism has not been fully established.
Placebo effect is NOT mediated via
Select one:
1. Nocebo response
2. Natural remission
3. Classical conditioning
4. Expectancy
5. Operant conditioning
Nocebo response
A placebo makes patients feel better for reasons unrelated to the specific healing properties of the treatment. A nocebo
makes patients feel worse (or does other harm) in the same way.
Which of the following can be called a major tranquilliser?
Select one:
1. Risperidone
2. Chlorpromazine
3. Propofol
4. Chlordiazepoxide
5. Secobarbital
Chlorpromazine
Antipsychotics came to be known as major tranquilizers while barbiturates and benzodiazepines were called minor tranquilizers. 1950-52, Presurgical antihistamine chlorpromazine was shown to have antipsychotic effects independently by Delay and Deniker’s team, and Charpentier from France.
You are giving a talk to your hospital staff about the importance of clinical trials. How would you explain the term ‘standardised difference in effectiveness’?
Select one:
1. The difference in the effect of treatment in the active treatment group compared to the placebo group after taking into account the variation in the treatment effect
2. The effect of treatment in the active treatment group
3. The difference in the effect of treatment in the active treatment group compared to the placebo group
4. The number of patients that require one treatment compared to the other in order to detect one positive response
5. The effect of treatment in the placebo group
The difference in the effect of treatment in the active treatment group compared to
the placebo group after taking into account the variation in the treatment effect
The number of patients that require one treatment compared to the other in order to detect one positive response Is the NNT (Number Needed to Treat). The standardised mean difference is also called Cohen’s d.
Which of the following has at least a preliminary evidence base for managing Treatment-Resistant Depression?
Select one:
1. Fluoxetine and clonazepam
2. Fluoxetine and mianserin
3. Citalopram and valproate
4. Venlafaxine and Mirtazapine
5. Duloxetine and fluoxetine
Venlafaxine and Mirtazapine
Venlafaxine-mirtazapine combination is called Californian rocket fuel, which is recommended by NICE in the treatments of refractory depression. It is usually well tolerated, has reasonable literature support and is becoming more widely used.
Rivastigmine is a
Select one:
1. Irreversible inhibitor of AchEs
2. NMDA receptor antagonist
3. Reversible non-competitive inhibitor of AchEs
4. Competitive inhibitor of AchEs
5. Reversible competitive inhibitor of AchEs
Reversible non-competitive inhibitor of AchEs
Rivastigmine is a reversible and non-competitive inhibitor of acetylcholinesterase. It inhibits both acetylcholinesterase and butyryl cholinesterase in CNS.
Which of the following is a true statement about the placebo effect?
Select one:
1. Placebo response is perceived to be better for tablets than capsules
2. Placebo effects do not operate on active drugs
3. Placebo response is likely if patient is of lower social class
4. Severely depressed subjects respond well to placebos than mildly depressed ones
5. Oral medications elicit a stringer placebo effect than injections
Placebo response is likely if patient is of lower social class
Placebo reactors are often less educated and belong to somewhat lower social class than non-reactors.
Which of the following hormones is most commonly used in the treatment of depression?
Select one:
1. Cortisol
2. Vasopressin
3. Prolactin
4. Thyroid hormone
5. Growth hormone
Thyroid hormone
The link between thyroid function and depression is well-studied in psycho-endocrinology. Notably, hypothyroidism can be accompanied by depression. All the hormones of the hypothalamic- pituitary-thyroid axis have been used in the treatment of depression, alone or in combination with other agents, although the most commonly used are thyroxine and levothyroxine.
Choose the correct match from the following pairs:
Select one:
1. Risperidone: dibenzoxapine
2. Droperidol: butyrophenones
3. Aripiprazole: Benzisothiazole
4. Thioridazine: diphenyl butyl piperidine
3. Flupentixol: dihydroindole
Droperidol: butyrophenones
Droperidol and haloperidol are classified as butyrophenones. The correct matching for other mentioned drugs is given below- Piperidine derivatives- Thioridazine, Thioxanthenes- Flupentixol; Benzisoxazole
derivative- Risperidone; arylpiperidylindole (quinolone)- Aripiprazole.
Which one of the following is the first antidepressant to be introduced?
Select one:
1. SNRIs
2. Tetracyclics
3. SSRIs
4. Tricyclics
5. MAO inhibitors
MAO inhibitors
Iproniazid is a monoamine oxidase inhibitor. This was the first antidepressant developed in 1952. Iproniazid was being used in treating tuberculosis discovery of mood lifting properties. But hypertensive reactions precluded large-scale use. Imipramine manufactured as chlorpromazine derivative came to market soon.
Which of the following is true about placebo response in drug trials?
Select one:
1. No placebo response is seen in personality disorders
2. A group of ‘placebo reactors’ with stereotyped personality can be identified
3. Degree of placebo response is similar irrespective of the treatment studied
4. Opioids may have a role to play in placebo response
5. Placebo response to depression is gradual but persistent
Opioids may have a role to play in placebo response
Endogenous opioids (e.g. endorphins) play a significant role in mediating placebo-induced analgesia. Dopamine reward system is being increasingly implicated in placebo effects in psychotropic. Placebo
response to depression starts abruptly, occurs early in treatment and is less likely to persist. Placebos work better for severe than mild pain, but mildly depressed patients respond well than severely depressed ones. There are no homogenous placebo reactors in the population.
Duloxetine and milnacipran are classified as
Select one:
1. Monoamine oxidase inhibitors
2. Tricyclic antidepressants
3. Selective serotonin reuptake inhibitors
4. Serotonergic and noradrenergic reuptake inhibitors
5. Adrenergic type 2 antagonists
Serotonergic and noradrenergic reuptake inhibitors
Both these drugs belong to the same class as venlafaxine.
Which of the following chemical class of drugs used as antidepressants can increase seizure risk heavily?
Select one:
1. Triazolopyridine
2. Hydrazine derivatives
3. SSRIs
4. Cyclopyrrolone
5. Aminoketone
Aminoketone
Aminoketone ( Bupropion) is contraindicated in seizure disorder.
Which of the following drugs is correctly matched with its metabolite?
Select one:
1. Naloxone - naltrexone
2. Imipramine - nomifensine
3. Citalopram - escitalopram
4. Risperidone - paliperidone
5. Fluoxetine - duloxetine
Risperidone - paliperidone
Escitalopram is not a metabolite but an enantiomer of citalopram. Paliperidone is the active phase 1 metabolic product of risperidone.
What is cyproterone acetate?
Select one:
1. Glucocorticoid analogue
2. Testosterone antagonist
3. Mineralocorticoid anatagonist
4. Progesterone antagonist
5. Testosterone partial agonist
Testosterone antagonist
Cyproterone has a structure similar to testosterone. It works by preventing testosterone from binding to the
receptors (antagonist).
Which of the following is linked with intentional nonadherence?
Select one:
1. Missed doses after long period on treatment
2. High degree of trust on the treating doctor
3. A desire for self-efficacy
4. Receipt of adequate levels of drug information
5. Higher severity of illness
A desire for self-efficacy
Patients with a high desire for self-efficacy are found to have higher degree of intentional nonadherence
Zopiclone belongs to the chemical class of
Select one:
1. Butyrophenone
2. Cyclopyrrolones
3. Imidazopyridine
4. Pyrazopyrimidine
5. Azaspirones
Cyclopyrrolones
Zopiclone- cyclopyrrolone; Zolpidem-imidazopyridine; Zaleplon-pyrazopyrimidine.
A 15-year-old boy has not been to his school for last few weeks as he has been disturbed by derogatory auditory hallucinations. He has been hearing voices in the third person for two months and is receiving messages from the television. The most likely treatment option is
Select one:
1. Parental Training
2. Family Therapy
3. Fluoxetine
4. Cognitive Behavioural Therapy for anxiety
5. Low dose risperidone
Low dose risperidone
The diagnosis is early onset schizophrenia and treatment should be one of the second-generation antipsychotics like Risperidone (low dose).
Which one of the following led a trial that proved Clozapine’s effectiveness in treating resistant schizophrenia?
Select one:
1. Kretschmer
2. Cade
3. Kraepelin
4. Kane
5. Bleurer
Kane
The most widely cited study on rebirth of clozapine was the one published in Archives of Psychiatry in 1988
by Kane and colleagues (Arch Gen Psychiatry 1988; 45:789-796). 268 patients with treatment-resistant schizophrenia (failing three different conventional neuroleptic trials, including a six-week trial of haloperidol at maximum (60mg) doses) were randomly assigned to clozapine up to 900 mg or chlorpromazine up to 1800 mg. 30% of the clozapine group responded while only 4% in the chlorpromazine group responded.
Flupenthixol belongs to the chemical class of
Select one:
1. Diphenylbutylpiperidine
2. Piperidine phenothiazine
3. Thioxanthene
4. Piperazine phenothiazine
5. Aliphatic phenothiazine
Thioxanthene
Flupenthixol and zuclopenthixol are thioxanthenes.
An 81-year-old woman with dementia presented to the hospital with chest pain. Upon admission, she becomes acutely confused and agitated. She is combative and attacks a nurse who tried to pacify her. She refuses to accept a nurse to sit beside her and observe her continuously and threatens to kick anyone who attempts this. The best option available for the medical team is
Select one:
1. Use heavy sedation to prevent physical attacks
2. Discharge her back to home
3. Use temporary physical or pharmacological restraints with regular re-evaluation of her medical status
4. Continue to try verbal de-escalation to calm her down
5. Transfer her to a psychiatric ward
Use temporary physical or pharmacological restraints with regular re-evaluation of
her medical status
Using rapid tranquillisation or physical restraints is sometimes necessary for the elderly to reduce harm to the patient and/or the health professionals. Only a minimal amount of restraint should be used, and the need for continued restraint re-evaluated frequently. Transferring to a psychiatry ward does not seem practical at this time due to the acute level of patient agitation and her behaviours, and verbal de-escalation has already failed to calm the patient. Involving a carer may help to calm the patient down, and that individual may be able to assist in making decisions for his care.
Reserpine was originally introduced as an antipsychotic. It is extracted from which of the following plants?
Select one:
1. Hypericum alkaloids
2. Solanacea Henbane
3. Rauwolfia serpentina
4. Hellebore
5. Belladonna
Rauwolfia serpentina
Rauwolfia serpentina was used in India for more than 2000 years ago for insanity. Reserpine was isolated from it in 1953 and synthesized and introduced as an antipsychotic in 1954. It provided insights into the role of dopamine, noradrenaline and serotonin in the brain and also the mechanism of antidepressant and antipsychotic drug actions.
Which of the following is an inhibitor of norepinephrine and serotonin re-uptake?
Select one:
1. Reboxetine
2. Bupropion
3. Galantamine
4. Duloxetine
5. Aripiprazole
Duloxetine
SNRIs - serotonin and noradrenaline reuptake inhibitor. This includes venlafaxine, milnacipran, duloxetine.
Reboxetine is an NARI - Noradrenaline reuptake inhibitor. NaSSA - Noradrenergic and specific serotonergic antagonist - which includes Mirtazapine and mianserin.
Which of the following ethnic differences in pharmacogenetics create natural alcohol deterrence?
Select one:
1. Low cholinesterase
2. Lack of aldehyde dehydrogenase
3. High aldehyde dehydrogenase
4. High alcohol dehydrogenase
5. High CYP 3A4
Nearly 40% Asians and around 60% South American Native Indians lack aldehyde dehydrogenase enzyme in sufficient amounts to metabolise alcohol - this serves as a natural deterrent in these communities.
Which one among the following is a butyrophenone derivative?
Select one:
1. Chlorpromazine
2. Thioridazine
3. Haloperidol
4. Flupenthixol
5. Zuclopenthixol
Haloperidol
First-generation agents are usually classified into three groups: phenothiazines (chlorpromazine,
thioridazine), butyrophenones (e.g., haloperidol), and several other minor chemicals (e.g., thiothixene, molindone, and loxapine), based on their structure.
Which of the following psychotropic agents has the same pharmacokinetic properties in Asians and White Europeans?
Select one:
1. Alprazolam
2. Haloperidol
3. Diazepam
4. Chlorpromazine
5. Lithium
Lithium
Lithium is completely excreted renally; its excretion does not differ between Asians and Europeans.
Which of the following psychotropics is well known to cause sudden death?
Select one:
1. Temazepam
2. Procyclidine
3. Zopiclone
4. Lithium
5. Thioridazine
Thioridazine
Antipsychotic related sudden death may be due to cardiac arrhythmias or even seizures, asphyxiation or malignant hyperthermia. Drugs causing QT prolongation are associated with more sudden deaths (esp. thioridazine, droperidol). Clozapine is also implicated.
Discovery of psychotropic use of lithium is associated with
Select one:
1. Sen and Ghose
2. Bleuler
3. Delay and Deniker
4. Cade
5. Kane
Cade
Believing that mania might be caused by intoxication by normal body products, Cade’s experiments led him to focus on lithium urate. He observed that guinea pigs became very lethargic on the compound, and he subsequently conducted a clinical trial of lithium with ten manic patients.
Discovery of tranquilising properties of chlorpromazine is associated with
Select one:
1. Delay and Deniker
2. Bleuler
3. Cade
4. Sen and Ghose
5. Kane
Delay and Deniker
Chlorpromazine was synthesized on December 11, 1951 by Paul Charpentier, in the laboratories of Rhone-Poulenc, a French pharmaceutical company, and released for clinical investigation in May 1952 as a possible potentiator of general anaesthesia. Clinical investigations with CPZ began at Saint-Anne’s hospital - at Pierre Deniker’s service in Jean Delay’s department in 1952.
Which of the following antidepressant is an enantiomer of another antidepressant drug?
Select one:
1. Fluoxetine
2. Paroxetine
3. Citalopram
4. Escitalopram
5. Sertraline
Escitalopram
Research evidence suggests that escitalopram may be more effective and have an earlier onset of action than citalopram. This is attributed to escitalopram’s binding to both the re-uptake site and an allosteric site causing conformational changes in the 5-HT transporter and enhancing re-uptake blockade.
A patient is diagnosed with mild cognitive impairment. Which one of the following is recommended for prevention of dementia?
Select one:
1. Arachidonic acid (unsaturated fatty acid)
2. Donepezil
3. No recommendation
4. Memantine
5. NSAIDS
No recommendation
Currently no recommended prophylactic intervention is available for preventing the conversion of MCI to dementia.
The drug alprazolam belongs to which of the following class of psychotropics?
Select one:
1. Stimulant
2. Antipsychotics
3. Anticholinesterase
4. Benzodiazepines
5. Antidepressant
Benzodiazepines
Alprazolam is a benzodiazepine that is used for panic disorder in the USA.
Which drug is useful for the treatment of OCD?
Select one:
1. Trazadone
2. Duloxetine
3. Phenelzine
4. Venlafaxine
5. Sertraline
Sertraline
SSRIs remain as the first-line treatments for OCD. Sertraline is SSRI drug, which is also useful for the treatment of OCD in children. (Refer - POTS study).
The term active placebo refers to which one of the following?
Select one:
1. None of the above
2. The placebo produces side effects
3. The placebo gains positive effect with repeated use.
4. The placebo has activity against the treated illness.
5. The placebo has some activity inherently
The placebo has some activity inherently
An ‘active placebo’ has some activity inherently, but not against the treated condition. When a drug administered as placebo produces prominent side-effects, it is known as a ‘nocebo’. Placebo sag is a term used to refer to decrease in placebo effect with repeated or chronic administration of placebo drugs.
Which one of the following drugs is not correctly paired with its proponents?
Select one:
1. Chlorpromazine-Delay and Deniker
2. Imipramine-Kuhn
3. Clozapine-Bowden
4. Lithium-John Cade
5. Haloperidol-Janssen
Clozapine-Bowden
Since the publication of the landmark study by Kane et al (1988), clozapine has been regarded as an effective treatment for people with treatment-resistant schizophrenia.
A potential advancement in the treatment of dementia is
Select one:
1. Drugs acting on dendritic receptors
2. Drugs acting on plasma enzymes
3. Drugs acting on presynaptic receptors
4. Drugs acting on intracellular mechanisms
5. Drugs acting on synaptic enzymes
Drugs acting on intracellular mechanisms
Drugs acting on ß-secretase are promising candidates to enter clinical trial for Alzheimer’s disease as of now. ß-secretase activity has a low optimum pH, and this membrane-bound enzyme is predominantly localized in acidic intracellular compartments (for example, endosomes and the trans-Golgi network).Bart De Strooper, Robert Vassar, and Todd Golde, ‘The secretases: enzymes with therapeutic potential in Alzheimer disease,’ Nat Rev Neurol 6, no. 2 (February 2010): 99-107.
Which of the following is a substituted benzamide used as an antipsychotic?
Select one:
1. Amisulpride
2. Benzhedrine
3. Paliperidone
4. Risperidone
5. Olanzapine
Amisulpride
Amisulpride is a substituted benzamide that has atypical antipsychotic activity.
Which one among the following is a benzisoxazole derivative?
Select one:
1. Amisulpride
2. Clozapine
3. Risperidone
4. Sulpiride
5. Ziprasidone
Risperidone
Risperidone is a benzisoxazole derivative while sulpride and amisulpride are
substituted benzamides. Ziprasidone, rather confusingly, is a Benzisothiazole, while clozapine is a Dibenzodiazepine.
The antidementia drug with an NMDA receptor antagonistic property is;
Select one:
1. Tacrine
2. Galantamine
3. Donepezil
4. Rivastigmine
5. Memantine
Memantine
Memantine as an NMDA receptor antagonist can prevent the pathological stimulation of NMDA receptors.
Select the reason why clozapine was initially withdrawn before Kane’s landmark trial:
Select one:
1. High costs
2. High fatality rates
3. Lack of efficacy
4. Unclear dosing schedule
5. Excessive sedation
High fatality rates
Clozapine was introduced in Europe in 1975. As a result of reports from Finland, where 16 patients out of 2260 exposed (0.7%) developed agranulocytosis and 8 (50%) of them subsequently died from secondary infections, the drug was voluntarily withdrawn from use. Following pressure from psychiatrists to reintroduce clozapine, trials in patients with treatment-resistant schizophrenia, under close haematological monitoring were devised, which showed significant improvement in 30% of patients after six months (Kane et al., 1988). Subsequent studies showed improvement in 61% of patients if treatment was continued for up to one year (Meltzer et al., 1989; Meltzer, 1992).
Which drug could be used for the treatment of mixed affective episodes of bipolar disorder?
Select one:
1. Carbamazepine
2. Gabapentin
3. Sodium Valproate
4. Lithium
5. Lamotrigine
Sodium Valproate
Mixed affective states are characterised by combinations of manic and depressive symptoms during one episode and may occur in up to 40% of bipolar patients. Mixed affective states have been insufficiently researched to arrive at definitive recommendations for treatment. Sixty six percent of these patients exhibit a
poor response to lithium (SIGN Guidelines on bipolar disorder: Guideline 82 Section 3: NICE recommends that mixed affective episodes are treated as manic episodes. Sodium valproate as a first line option for the treatment of acute manic episode and prophylaxis of bipolar affective disorder, and thus can be used as first line for mixed affective episodes as well.
Ethnic differences in psychiatric drug effects are noted in which of the following pharmacological actions?
Select one:
1. Blood levels of haloperidol
2. Hydroxylation of tricyclics
3. All of the listed
4. Prolactin response to antipsychotics
5. Alcohol metabolism
All of the listed
Maximal haloperidol concentration in plasma after rapid tranquillisation is significantly high for Asians than
Caucasians. Nearly 40% Asians and around 60% South American Native Indians lack aldehyde dehydrogenase enzyme in sufficient amounts to metabolise alcohol. Caucasians appear to have lower plasma levels of tricyclic antidepressants and attain plasma peaks later when compared with Asians (of Far Eastern ancestry as well as those from the Indian subcontinent). These differences have been attributed to a greater incidence of slow hydroxylation among Asians when compared with Caucasians. On administration of antipsychotics, Asian subjects were reported to produce greater serum prolactin levels than Caucasian subjects. (Bhugra, D., & Bhui, K. (1999). Ethnic and cultural factors in psychopharmacology. Advances in Psychiatric Treatment, 5, 89-95.)
Which drugs among the following is classified as a reversible MAOI?
Select one:
1. Isocarboxazid
2. Tranylcypromine
3. Moclobemide
4. Raclopride
5. Phenelzine
Moclobemide
Reversible MAO inhibitors include moclobemide and brofaromine. These are less likely to induce hypertensive crisis than first-generation MAOIs.
Buspirone belongs to the chemical class of
Select one:
1. Azaspirones
2. Cyclopyrrolone
3. Imidazopyridine
4. Pyrazopyrimidine
5. Butyrophenone
Azaspirones
Buspirone is believed to exert its anxiolytic effect by acting as a partial agonist at the 5-HT1A autoreceptor. It is an azaspirodecanedione anxiolytic.
Buspirone is a
Select one:
1. GABA agonist
2. 5-HT1A partial agonist
3. 5-HT1A agonist
4. 5-HT1A antagonist
5. GABA antagonist
5-HT1A partial agonist
It is a partial agonist.
Before approval of a drug molecule, mutagenicity, carcinogenicity and organ system toxicity are studied at which phase of clinical trials?
Select one:
1. Preclinical animal phase
2. Phase 1
3. Phase 3
4. Postmarketing surveillance
5. Phase 2
Preclinical animal phase
The pathway a drug must undergo before approval starts with animal studies where the molecule is demonstrated to have specific actions. These extensive preclinical animal studies must be carried out at least on two different animal species. Mutagenicity, carcinogenicity and organ system toxicity are studied at this phase
Choose a secondary amine from the below list:
Select one:
1. Clomipramine
2. Dothiepin
3. Amitriptyline
4. Amoxapine
5. Imipramine
Amoxapine
Secondary amines = desipramine, amoxapine, nortriptyline and protriptyline also duloxetine) [more potent mg to mg basis; less sedating; more noradrenergic, less antihistaminic or anticholinergic than tertiary].
Which of the following is termed as a norepinephrine and dopamine re-uptake inhibitor?
Select one:
1. Varenicline
2. Nefazadone
3. Buspirone
4. Mirtazapine
5. Bupropion
Bupropion
Buproprion is quite widely used in the USA as an antidepressant; it appears to inhibit the reuptake of both dopamine and noradrenaline and, therefore, tends to have a slightly alerting action. In many European countries, it has been introduced, at a lower than antidepressant dose, in the treatment of nicotine withdrawal in smoking cessation programmes
