March 12 Exam - set 1

Question 1

Raloxifene (type)

Answer 1

SERM

Question 2

Calcitonin analogs (MOA)

Answer 2

decreased osteoclast activity;

blocks renal reabsorption of PO4 and Ca2+

Question 3

Cinacalet

Answer 3

Calcium receptor potentiator

Binds to Ca-sensing region of CaR to inhibit PTH release
–allosteric modulator .. in presence of Ca2+, it makes it more effective at stimulating receptor

Question 4

Vitamin D MOA

Answer 4

inc Ca2+ and PO4 abs from gut and reads from renal tubules

Question 5

Bisphosponates MOA

Answer 5

inhibit bone reabsorption

1. reduce formation and dissolution of hydroxyapatite crystals
2. inhibit farnesyl-PP synthesis of osteoclasts

Question 6

Suffix of bisphosphonates

Answer 6

-dronate

Question 7

Teriparatide

Answer 7

PTH analog (aa 1-34)

Question 8

Prolia (Denosumab)

Answer 8

Humanized monoclonal AB against RANKL .. binds RANKL to prevent activation of RANK and therefore prevent differentiation of osteoclasts

Question 9

What is difference about atypical vs typical antipsychotics?

Answer 9

1. Better affinity at D2 receptors
2. Addition of activity at 5HT2A and others
3. Better control over negative and cognitive sx (positive already controlled by typicals)
4. Fewer EPS

Question 10

Key feature of antipsychotics

Answer 10

block of D2 receptors

Question 11

Dopamine pathways

Answer 11

Mesocortical/mesolimbic
-therapeutic and cognitive activities of D2 antagonists

Nigrostriatal (basal ganglia)

• motor control
• EPS sx arise here

Question 12

First gen antipsychotics

Answer 12

Penothizaines

Haloperidol

Question 13

2nd gen antipsychotic

–whats diff about it?

Answer 13

Clozapine

–acquisition of 5HT2A pharmacology

Question 14

Aripirazole

Answer 14

D2 partial agonist

Question 15

Classic early and atypical antipsychotics

Answer 15

Chlorpromazine
Haloperidol
Thioridazine
Sulpiride

Question 16

Atypical antipsychotics

Answer 16

These have acquired 5HT pharm

Clozapine
Risperidone
Olazapine
Ziprasidone
Quetiapine
Aripiprazole

Question 17

What are the SSRIs?

Answer 17

Fluoxetine
Paroxetine
Fluvoxamine
Sertraline
Escitalopram

(note: -oxeltines inhibit P450s)

Question 18

What are the SNRIs?

Answer 18

Duloxetine
Venlafaxine
Desvenlafaxine

Question 19

Which class do TCAs fall under?

Answer 19

SNRIs

Question 20

What are the TCAs?

Answer 20

Imipramine
Amitriptyline
Nortriptyline
Clomipramine
Desipramine

Question 21

Imipramine

Answer 21

highly anticholinergic

Question 22

Amitriptyline

Answer 22

activity at many other receptors

sedating

Question 23

Nortriptyline

Answer 23

secondary amine

Question 24

desipramine

Answer 24

metabolite of imipramine

secondary amine

Question 25

Why does it matter if something is secondary vs tertiary amine WRT TCAs?

Answer 25

tertiary amines give rise to secondary metabolites, so administering a tertiary amine means you have a secondary on board as well

Question 26

Trazidone

Answer 26

5HT2 antagonist

Also 5HT1 partial agonist
weak reuptake blockade

Question 27

Bupropion (type and MOA)

Answer 27

Unicyclic

DAT, NET, nAChR block

Question 28

Mirtazapine

Answer 28

Tetracyclic

mixed block at 5HT, alpha AR, histamine, mACh, DAT, NET, SERT

Question 29

What are some MAOIs?

Answer 29

Selegiline - MAOB selective

Tranylcypromine - nonselective

Phenelzine - nonselective

All are irreversible

Question 30

What is the difference b/t MAO-A and MOA-B?

Answer 30

MAO-A: found in monoamine expressing neurons in the CNS

MAO-B: found in DA neurons and in cells that need to break down phenylethylamine

Question 31

Possible MOAs of lithium

Answer 31

Inositol depletion
–inositol may be increased during manic phases

Inhibition of GSK-3
–GSK3 is a multifxnal kinase in the brain and elsewhere