Case 6 DRUGS

Question 1

Reserpine

Answer 1

Irreversible VMAT blocker.
Causes any excess cytoplasmic monoamines in the presynaptic terminal to be broken down by MAO and CMT, and stops exocytosis of monoamines.
RESULT = LONG LASTING DEPRESSION

Question 2

Iproniazid

Answer 2

Irreversible MAO inhibitor.

Prevents breakdown of monoamine NT’s and so increasing their availability.

Question 3

Phenelzine/ Tranylcypromine

Answer 3

Irreversible MAO inhibitor.

Prevents breakdown of monoamine NT’s and so increasing their availability.

Question 4

Moclobomide

Answer 4

Reversible MAO inhibitor.

Prevents breakdown of monoamine NT’s and so increasing their availability.

Question 5

Amitriptyline

Answer 5

Tricyclic Antidepressant (TCA)
Blocks re-uptake of 5-HT, NA, Dopamine.

Question 6

Clomipramine

Answer 6

Tricyclic Antidepressant (TCA)
Blocks re-uptake of 5-HT, NA, Dopamine.

Question 7

Venlafaxine

Answer 7

Seretonin and Noradrenaline Re-uptake Inhibitors (SNRI’s).

Thus increasing their concentration in the synaptic cleft.

Question 8

Sertraline

Answer 8

Selective Seretonin Re-uptake Inhibitor.

Increases the concentration of serotonin in the synaptic cleft.

Question 9

Fluoxetine

Answer 9

Selective Seretonin Re-uptake Inhibitor.

Increases the concentration of serotonin in the synaptic cleft.

Question 10

Paroxetine

Answer 10

Selective Seretonin Re-uptake Inhibitor.

Increases the concentration of serotonin in the synaptic cleft.

Question 11

Citalopram

Answer 11

Selective Seretonin Re-uptake Inhibitor.

Increases the concentration of serotonin in the synaptic cleft.

Question 12

Escitalopram

Answer 12

Selective Seretonin Re-uptake Inhibitor.

Increases the concentration of serotonin in the synaptic cleft.

Question 13

Fluvoxamine

Answer 13

Selective Seretonin Re-uptake Inhibitor.

Increases the concentration of serotonin in the synaptic cleft.

Question 14

Mertazapine

Answer 14

a2 adrenergic receptor antagonist. (a2 antagonist)
Negative feedback loop to inhibit release of noradrenaline is blocked.
Increases the release of NA and serotonin.

Question 15

Antipsychotics

Answer 15

5-HT2A blockers. Down-regulate the 5-HT2A receptors in chronic depression.

Question 16

Methylprednisolone

Answer 16

Corticosteroid. Anti-inflammatory effects.
Short course of high dose.
1mg/day for 3 days.
Avoid long term use.

Question 17

Prednisolone

Answer 17

Corticosteroid. Anti-inflamatory effects.
Short course of high dose.
500mg/day for 5 days.
Avoid long term use

Question 18

IFN-B (interferon B)

Answer 18

Prevents relapse. 
Decrease T-cell proliferation.
Decrease T-cell activation.
Decrease T-cell migration.
SC injection daily.

Question 19

Copaxane/ Glatiramer Acetate

Answer 19

Prevents relapse.
Binds to MHC-2 to prevent binding of antigens.
Competes with MBP for binding to T-cell receptor.
Inhibits activation of MBP reactive T-cells.
SC injection daily.

Question 20

Fingolimod/ Gilenya

Answer 20

Prevents relapse.
Blocks sphingosine 1-phosphate receptor-1 (S1P receptor), thus trapping lymphocytes in lymph nodes.
Tablet (0.5mg)

Question 21

Natalizumab/ Tysarbi

Answer 21

Prevents relapse.

Monoclonal antibody, prevents migration of WBC across BBB.

Question 22

Terifluromide/ Aubagio

Answer 22

Immunosuppressant

Decreases T-cell function by inhibiting mitochondrial DHODH enzyme.

Question 23

BG-12/ Dimethyl Fumarate

Answer 23

Anti-inflammatory

Activates Nrf-2 transcriptional pathway