15: Antidepressants, Antipsychotics

Question 1

Drugs with a high therapeutic index:

Slight changes in drug dosage are unlikely to produce toxicity

Slight changes in drug concentration are likely to produce toxicity

Slight changes in drug concentration are unlikely to produce toxicity

Need frequent therapeutic drug monitoring

Large changes in drug dosage are likely to produce toxicity

Answer 1

Slight changes in drug dosage are unlikely to produce toxicity

Question 2

First drug used to treat seizure:

Answer 2

Phenobarbital

Question 3

Much of this drug’s pharmacological activity is derived from its two active metabolites, PEMA and phenobarbital:

Answer 3

Primidone

Question 4

A Novel Psychoactive Substance and the metabolite of trazodone:

Answer 4

mCPP

Question 4

Major drawback of clozapine treatment:

Answer 4

Agranulocytosis

Question 5

Metabolism of SSRIs

Answer 5

Extensively metabolized to mostly inactive metabolites

Question 6

Considered to be the most toxic complication of neuroleptic use:

Answer 6

Neuroleptic Malignant Syndrome

Question 7

For the SSRIs, the major metabolite route for the production of active metabolites:

Answer 7

Demethylation

Question 8

Associated with high-potency antipsychotic medication and is dose-related:

Answer 8

Parkinsonism

Question 9

Drug-induced movement disorders:

Answer 9

Extrapyramidal Effects

Question 10

Used to treat absence seizures; not effective in the treatment of motor seizures:

Answer 10

Ethosuximide

Question 11

An abnormal, excessive firing of neurons in the gray matter of the brain:

Answer 11

Seizures

Question 12

What class of drugs is Fluoxetine?

Answer 12

SSRIs

Question 12

Prone to postmortem redistribution:

Answer 12

TCAs

Question 12

Late elution time on a 5% phenyl-methyl silicone column:

Answer 12

Trazodone

Question 12

These drugs have a three-ring structure common to all members of this group:

Answer 12

TCAs

Question 13

Serotonin Syndrome usually occurs in this time frame following taking a new drug:

Answer 13

Hours

Question 14

This is an antidepressant and tobacco-addiction medication:

Answer 14

Bupropion

Question 15

Although taking just one drug that increases serotonin levels can cause serotonin syndrome, this condition occurs most often when:

Answer 15

Medications are combined

Question 16

Fluorometry is a not a specific method for measuring some neuroleptic drugs because:

Answer 16

Interferences from metabolites

Question 17

Death following barbiturate intoxication is often due to:

Answer 17

Respiratory Failure

Question 18

True/False:
In general, plasma concentrations of neuroleptic agents do not correlate well with clinical signs and symptoms.

Answer 18

True

Question 19

Has become the drug of choice for the treatment of myoclonic seizures and generalized absence seizures:

Answer 19

Valproic Acid

Question 19

This drug was derived from clozapine:

Answer 19

Olanzapine

Question 20

Atypical antipsychotic agents reach steady-state plasma concentrations within:

Answer 20

2 - 10 days

Question 21

A weakly acidic drug is: Readily absorbed from the stomach into the blood Readily absorbed from the intestine into the blood Absorbed equally from the stomach and intestine into the blood All of the above None of the above

Answer 21

Readily absorbed from the stomach into the blood

Question 22

Dystonia, Tardive Dyskinesia and Akathisia are examples of what?

Answer 22

Extrapyramidal effects

Question 22

Number of Subtypes of Generalized Seizures

Answer 22

7

Question 22

Used as an adjunct therapy for partial seizures and used to treat neuropathic pain in adults:

Answer 22

Gabapentin

Question 23

When used to treat seizures, the therapeutic range is:

Answer 23

15-40 mcg/mL

Question 24

Type of seizures that involve both hemispheres of the brain:

Answer 24

Generalized seizures

Question 25

A naturally occurring mono-saccharide derived from D-fructose:

Answer 25

Topiramate

Question 26

The most common side effect associated with this anticonvulsant is a rash:

Answer 26

Lamotrigine

Question 27

AED has structural similarities to GABA:

Answer 27

Gabapentin

Question 28

Tue/False: There is considerable first-pass metabolism with most of the antidepressants.

Answer 28

True

Question 29

One significant toxic effect of this drug is aplastic anemia:

Answer 29

Carbamazepine

Question 30

Immunoassay and/or chromatography can assay virtually all drugs that require TDM with the exception of this one notable exception:

Answer 30

Lithium

Question 31

Used to treat generalized tonic-clonic and partial seizures:

Answer 31

Carbamazepine

Question 32

A prodrug used to treat generalized tonic-clonic and partial seizures:

Answer 32

Oxcarbazepine

Question 33

Its main metabolite is HPPH, which is inactive:

Answer 33

Phenytoin

Question 34

Inhibition of the reuptake of _____ or _____ is regarded as an important action for the antidepressant drugs.

Answer 34

5-HT or NE

Question 35

For major psychoses, daily doses may range up to 2400 mg.

Answer 35

Chlorpromazine

Question 36

Loxapine metabolite

Answer 36

Amoxapine

Question 37

Antidepressants: Organic bases with low pKa Organic bases with high pKa Organic bases with moderate pKa Acidic drugs with low pKa Acidic drugs with low pKa

Answer 37

Organic bases with moderate pKa

Question 38

Its mechanism of action is to inhibit GABA transferase:

Answer 38

Vigabatrin

Question 39

Most common type of antidepressant

Answer 39

Selective serotonin reuptake inhibitors (SSRIs) Increase serotonin in brain Sertraline, Fluoxetine, Citalopram

Question 40

Type of antidepressant that increases serotonin and norepinephrine in the brain

Answer 40

Serotonin and norepinephrine reuptake inhibitors (SNRIs) Desvenlafaxine, duloxteine, venlafaxine

Question 41

An older class of antidepressants that increase serotonin and norepinephrine levels in the brain. These are often reserved for treatment-resistant depression and anxiety.

Answer 41

TCAs Clomipramine, Protriptyline, TCA confirm drugs

Question 42

The oldest antidepressants; target the brain enzyme monoamine oxidase, which helps break down neurotransmitters such as serotonin; typically used as a last resort if other types haven't worked.

Answer 42

MAOIs Selegiline, Moclobemide, Tranylcypromine, Isocarboxazid, Phenelzine

Question 43

Atypical Antidepressants

Answer 43

Bupropion Mirtazapine Agomelatine