Exam 2

Question 1

Which of the following is the effect of GABA at the GABA-A receptor in the presence of lorazepam?

Answer 1

A

Question 2

Name (2) long acting benzodiazepines

Answer 2

Long acting:
1. Chlordiazepoxide
2. Diazepam

Question 3

Name (3) intermediate acting benzos

Answer 3

Intermediate acting:
1. Clonazepam
2. Lorazepam
3. Temazepam

Question 4

Name (4) short acting benzos

Answer 4

Short acting benzos
1. Alprazolam
2. Triazolam
3. Oxazepam
4. Midazolam

Question 5

[Drug] is an anxiolytic which acts as a partial agonist of 5HT-1A

Answer 5

Buspirone is an anxiolytic which acts as a partial agonist of 5HT-1A

Question 6

[Drug] is an anxiolytic that acts as a histamine antagonist

Answer 6

Hydroxyzine is an anxiolytic that acts as a histamine antagonist

Question 7

Benzos, Z drugs, and barbiturates are all GABAa _

Answer 7

Benzos, Z drugs, and barbiturates are all GABAa positive modulators
* They work by enhancing GABA’s ability to open the Cl- channel

Question 8

Only high dose [drugs] can directly open the GABAa receptor as agonists; usually benzos, z-drugs, and barbiturates are just positive modulators

Answer 8

Only high dose barbiturates can directly open the GABAa receptor as agonists; usually benzos, z-drugs, and barbiturates are just positive modulators

Question 9

Name some symptoms of benzo withdrawal

Answer 9

Name some symptoms of benzo withdrawal
* Anxiety
* Insomnia
* Tachycardia/HTN
* Tremors

Question 10

[Drug] competitively inhibits the binding of benzos to the GABA receptor

Answer 10

Flumazenil competitively inhibits the binding of benzos to the GABA receptor

Question 11

The reason that benzos act as anxiolytics while Z-drugs act as hypnotics is _

Answer 11

The reason that benzos act as anxiolytics while Z-drugs act as hypnotics is they target different subsets of GABAa receptors

Question 12

Benzodiazepines target _ subunits on GABAa

Answer 12

Benzodiazepines target a2/5 subunits on GABAa

Question 13

Z-drugs target _ subunits on GABAa

Answer 13

Z-drugs target a1 subunits on GABAa

Question 14

Benzos that are metabolized in the liver tend to have (long/short) acting metabolites that can cause [side effect] and [side effect]

Answer 14

Benzos that are metabolized in the liver tend to have long- acting metabolites that can cause sedation and hepatotoxicity
* Ex: chlordiazepoxide and diazepam have sedating metabolites

Question 15

Name (3) benzos that are not metabolized in the liver and are safe for patients with cirrhosis

Answer 15

1. Lorazepam
2. Oxazepam
3. Temazepam

Question 16

Neuroimaging of a depressed brain may show decreased volume of the _ and _ and increased size of the _

Answer 16

Neuroimaging of a depressed brain may show decreased volume of the frontal lobe and hippocampus and increased size of the ventricles

Question 17

Depression symptoms can be remembered by the mneumonic _

Answer 17

Depression symptoms can be remembered by the mneumonic SIG E CAPS

Question 18

Postpartum blues begin _ days after delivery and last for _ days

Answer 18

Postpartum blues begin 2-3 days after delivery and last for 2-3 days

Question 19

Postpartum blues can be correlated to decreasing levels of [hormone]

Answer 19

Postpartum blues can be correlated to decreasing levels of progesterone

Question 20

Why does it take weeks for SSRIs and SNRIs to take full effect?

Answer 20

The presynaptic inhibitory serotonin autoreceptor has to downregulate before drugs take full effect

Question 21

Desipiramine and Doxepin are [category of drugs]

Answer 21

Desipiramine and Doxepin are tricyclic antidepressants

Question 22

TCAs can have anti-histamine effects, causing _ and _

Answer 22

TCAs can have anti-histamine effects, causing sedation and confusion
* TCAs are structurally very similar to anti-histamine drugs

Question 23

TCA toxicities include effects from blocking [receptors] and [receptors]

Answer 23

TCA toxicities include effects from blocking M3 and a1

Question 24

TCAs can cause “anti-cholinergic” effects from blocking [receptors] including _

Answer 24

TCAs can cause “anti-cholinergic” effects from blocking M3 including blurred vision, dry mouth, urinary retention, constipation, tachycardia

Question 25

TCAs can cause [BP]

Answer 25

TCAs can cause **orthostatic hypotension** * *Due to blockage of a1*

Question 26

TCAs may cause [cardiac effects]

Answer 26

TCAs may cause **arrhythmias and sudden death**

Question 27

Vilazodone and Vortioxetine act via [mechanism]

Answer 27

Vilazodone and Vortioxetine act via **SERT inhibition + partial agonism of 5HT receptors**

Question 28

MAO inhibitors work via [mechanism]

Answer 28

MAO inhibitors work via **slowing the degradation of monoamine NTs**

Question 29

Hypertensive crisis can occur with MAOi use due to the inhibition of [enzyme] in the gut

Answer 29

Hypertensive crisis can occur with MAOi use due to the inhibition of **MAO-A** in the gut * *Avoid foods with tyramine*

Question 30

SSRIs, SNRIs, and MAOi drugs can all cause sexual dysfunction; the best drug for avoiding this side effect is _

Answer 30

SSRIs, SNRIs, and MAOi drugs can all cause sexual dysfunction; the best drug for avoiding this side effect is **buproprion**

Question 31

Symptoms of serotonin syndrome include:

Answer 31

Symptoms of serotonin syndrome include: * Clonus * Rhabdomyolysis * Autonomic dysfunction * AMS

Question 32

Trazodone is an antagonist of _ receptors

Answer 32

Trazodone is an antagonist of **SERT, H1, 5HT** receptors * Meaning it has anti-histamine effects (sedation) * And it reduces sert reuptake

Question 33

Mirtazapine is an a2 receptor _ meaning it increases _

Answer 33

Mirtazapine is an a2 receptor **antagonist** meaning it increases **NE, DA, SE**

Question 34

Name four mood stabilizing drugs that may be used in bipolar disorder

Answer 34

1. **Lithium** 2. **Carbamazepine** 3. **Lamotrigine** 4. **Valproic acid**

Question 35

What is the proposed mechanism of lithium?

Answer 35

Question 36

Lithium may cause [GI] side effects, [Metabolic] side effects, [Renal] side effects

Answer 36

Lithium may cause **nausea/vomiting, hypothyroidism, kidney damage**