Drugs

Question 1

What class: phenelzine?

Answer 1

MAOI

Question 2

What class: Isocarboxazid?

Answer 2

MAOI

Question 3

What class: Tranylcypromine?

Answer 3

MAOI

Question 4

What class: Moclobemide

Answer 4

RIMA

Question 5

What class: Amitryptiline

Answer 5

TCA (non-selective)

Question 6

What class: Clomipramine

Answer 6

TCA

Question 7

What class: Imipramine

Answer 7

TCA (non-selective)

Question 8

What class: Noritryptiline

Answer 8

TCA (NA selective)

Question 9

What class: Dosulepin

Answer 9

TCA

Question 10

What class: Fluoxetine

Answer 10

SSRI

Question 11

What class: (Es)citalopram

Answer 11

SSRI

Question 12

What class: Sertraline

Answer 12

SSRI

Question 13

What class: Fluvoxamine

Answer 13

SSRI

Question 14

What class: venlaxafine

Answer 14

SNRI

Question 15

What class: duloxetine

Answer 15

SNRI

Question 16

What class: Reboxetine

Answer 16

NARI

Question 17

What class: Mirtazapine

Answer 17

NaSSA

Question 18

Anterior cingulate

Answer 18

Attention/conflict/response selection

Question 19

Orbitofrontal cortex

Answer 19

Relative reward preference/rule learning

Question 20

Class of drug which could be used to treat premature ejaculation

Answer 20

SSRI

Question 21

Which SSRI’s inhibit CYP450?

Answer 21

Fluoxetine, paroxetine

Question 22

Most common adverse effects of SSRIs

Answer 22

• sexual dysfunction
• GI (nausea, dyspepsia, constipation, diarrhoea)
• short term anxiety is fairly common
• in young people, there is probably an increased risk of self-harm (&suicide) in the first few weeks

Question 23

TCA adverse effects

Answer 23

–  Constipation
– Dry mouth
– Blurred vision
– Effects on cardiac function
– Postural hypotension (cholinergic and adrenergic blockade causing failure of peripheral orthostatic reflexes)

Question 24

What does MAO A metabolise?

Answer 24

NA, 5-HT and tyramine

Question 25

What does MAO B metabolise?

Answer 25

DA, tryamine and phenylethylamine

Question 26

Name 3 irreversible MAOIs

Answer 26

Phenelzine Isocarboxazid Tranylcypromine

Question 27

This type of drug is really good for atypical depression

Answer 27

MAOI

Question 28

This type of drug results in increased NA and 5-HT storage and availability for release

Answer 28

MAOIS

Question 29

Which foods could cause a tyramine crisis if you are on MAOIs?

Answer 29

Cheese, yoghurt, yeast extracts, meat, alcohol, broad beans, pickled herring

Question 30

Symptoms of MAOI hypertensive crisis

Answer 30

Flushing headache, increased BP | -Rarely CVA

Question 31

Treatment for MAOI hypertensive crisie

Answer 31

Alpha blockade --> PHENTOLAMINE / CHLORPROMAZINE !!! Learn !!!

Question 32

Antipsychotic which may be antidepressant at low dose

Answer 32

Flupentixol

Question 33

Types of mood stabiliser

Answer 33

Anti-convulsant drugs "Atypical" antipsychotics Others (lithium carbonate, NIMODOPINE) -most mood stabilisers are anti-epileptic drugs (anti-convulsants)

Question 34

How does lamotrigine work?

Answer 34

Blocks Na+ channels, although it doesn't work directly via GABA, the overall effect is to reduce excitability and cell firing (potentially useful if you have over-excitable neurones) -Lamotrigine may also inhibit 5-HT (plus NA and DA uptake as well)

Question 35

One of the oldest mood stabilisers | -method of action unkown

Answer 35

Lithium - method of action unknown - but probably to do with inhibition of glycogen synthase kinase 3 (GSK-3)

Question 36

True anti-psychotic activity is related to their affinity for which receptor?

Answer 36

The D2 receptor | -desired effect is DA blockade in the mesolimbic systems

Question 37

Why can you get adverse effects such as movement disorders and hyperprlactinaemia with anti-psychotics?

Answer 37

Due to the DA blockade in the nigrostriatal and tubero-infundibular pathways)

Question 38

If you block the nigrostriatal pathways what happens?

Answer 38

Movement disorders

Question 39

If you block the tubero-infundibular pathways, what happens?

Answer 39

Hyperprolactinemia

Question 40

Which 5-HT receptors increase anti-psychotic affinity

Answer 40

5-HT2c and 5-HT2a

Question 41

Which 5-HT receptors decrease anti-psychotic efficiency

Answer 41

5-HT1a