IC9

Question 1

MOA of MAOi

Answer 1

Inhibits monoamine oxidase, thereby preventing breakdown of monoamine

Question 2

Adverse effects of MAOi

Answer 2

• Postural hypotension
• Insomnia, restlessness

Question 3

MOA of TCAs

Answer 3

Inhibits serotonin / norepinephrine transporter hence allowing serotonin/ norepinephrine to stay in the synapse longer

Question 4

Major adverse effects of TCAs

Answer 4

• Sedation
• Postural hypotension
• Dry mouth, blurred vision, constipation

Question 5

Role of MAO

Answer 5

Breaks down monoamines

Question 6

Two major forms of MAO

Answer 6

MAO-A and MAO-B

Question 7

5-HT is mainly broken down by ___

Answer 7

MAO-A

Question 8

Both MAO-A and MAO-B act on _____

Answer 8

noradrenaline (NA) and dopamine

Question 9

3 Examples of monoamines

Answer 9

dopamine, noradrenaline, 5-HT

Question 10

5-HT is also known as ___

Answer 10

serotonin

Question 11

MAOi cause incr in bioavailability of ___

Answer 11

monoamines

Question 12

Sedation is mainly due to ____

Answer 12

H1 histamine receptor antagonism

Question 13

Postural hypotension is mainly due to ___

Answer 13

α-adrenoceptor sympathetic block

Question 14

Dry mouth, blurred vision, constipation may be mainly due to ___

Answer 14

muscarinic receptor antagonism

Question 15

MOA of SSRI

Answer 15

Selectively blocks reuptake of 5-HT (serotonin)

Question 16

Adverse effects of SSRI

Answer 16

• Nausea
• Insomnia
• Sexual dysfunction

Question 17

MOA of SNRI

Answer 17

Blocks reuptake of 5-HT (serotonin) and noradrenaline

Question 18

Adverse effects of SNRI

Answer 18

⚫ Nausea
⚫ Insomnia
⚫ Sexual dysfunction

Question 19

Fluoxetine (SSRI) approximately__-fold selectivity for 5-HT

Answer 19

50

Question 20

Citalopram (SSRI) approximately___-fold selectivity for 5-HT

Answer 20

1000

Question 21

Advantages of SSRI over TCA

Answer 21

• Less adverse effects
• Safer in overdose
• Possibly more compliant

Question 22

Which SSRI is more sedative compared to others?

Answer 22

Citalopram

Question 23

Examples of serotonin syndrome symptoms

Answer 23

• Tremor
• Hyperthermia (> 40degC)
• Cardiovascular collapse

Question 24

Advantages of venlafexine (SNRI)

Answer 24

⚫ Fewer adverse effects than TCAs.
⚫ Claimed to work slightly faster than other antidepressants.
⚫ Claimed to work better in treatment-resistant patients

Question 25

Withdrawal effects for _____ may be more common and stronger than for____ and TCAs

Answer 25

SNRI; SSRIs

Question 26

Five symptom domains of schizophrenia

Answer 26

- negative - positive - aggressive - cognitive - anxiety/depression

Question 27

First gen antipsychotics are ___ antipsychotics

Answer 27

Typical

Question 28

Second gen antipsychotics are ___ antipsychotics

Answer 28

atypical

Question 29

Schizophrenia is frequently associated with____

Answer 29

depression

Question 30

Aetiology of Schizophrenia

Answer 30

- Genetic - Environmental factors

Question 31

All antipsychotic drugs are _____

Answer 31

D2 antagonists

Question 32

Does D2 Receptor Antagonism Correlate with Clinical Efficacy?

Answer 32

Yes

Question 33

____increased in acute schizophrenia.

Answer 33

Dopamine

Question 34

mesocortical pathway is in charge of ___

Answer 34

cognition and attention

Question 35

mesolimbic pathway is in charge of ___

Answer 35

reward and emotion

Question 36

Pathway of interest in schizophrenia

Answer 36

Mesocortical/Mesolimbic Pathways

Question 37

What does Lysergic acid diethylamide (LSD) act as?

Answer 37

5-HT2 agonist, hence produces symptoms similar to acute schizophrenia

Question 38

Examples of 1st gen antipsych

Answer 38

Chlorpromazine, haloperidol

Question 39

Examples of 2nd gen antipsych

Answer 39

clozapine, olanzapine & risperidone

Question 40

Common MOA of antipysch

Answer 40

Blocks D2 receptor to lower dopamine level

Question 41

Theories for schizophrenia

Answer 41

⚫ Dopamine Theory ⚫ 5-HT (Serotonin) Theory ⚫ Glutamate Theory

Question 42

Typical/atypical antipsych adverse effects

Answer 42

- sedation, weight gain - dry mouth, constipation, blurred vision - postural hypotension, dizziness - EPS (more for typical)

Question 43

The extrapyramidal pathway involves the ______, including the ___ and ____

Answer 43

basal ganglia; striatum; substantia nigra

Question 44

The nigrostriatal pathway is the connection from the ___ to the_____.

Answer 44

substantia nigra; striatum

Question 45

What makes an antipsychotic atypical?

Answer 45

They produce less extrapyramidal side effects

Question 46

Most atypical antipsych have ____ antagonism

Answer 46

5HT2A & dopamine-2

Question 47

amisulpride MOA

Answer 47

selective D2 /D3 antagonist; 5-HT7 antagonism

Question 48

which pathway regulates prolactin secretion

Answer 48

tuberoinfundibular

Question 49

which drug incr prolactin release

Answer 49

amisulpride

Question 50

Atypical antipsych can cause additional side effects like

Answer 50

hyperglycemia, diabetes and weight gain