Dopamine and Serotonin

Question 1

Sumatriptan target and function

Answer 1

5‐HT1D receptor Agonist - treats migraines

Inhibition of inflammatory mediator release Cerebrovasconstriction

Question 2

Sumatriptan indication

Answer 2

Migraines

Question 3

Sumatriptan toxicity

Answer 3

Coronary vasoconstriction

Question 4

Sumatriptan contraindication

Answer 4

Coronary artery disease

Question 5

How is the 5-HT1D family of receptors is manipulated to treat migraine?

Answer 5

5-HT1D agonists like sumatriptan inhibits inflammatory mediator release with cerebral vasoconstriction

Question 6

How are 5-HT1A receptors manipulated pharmacologically for treatment of anxiety and depression?

Answer 6

5-HT1A agonists like buspirone lead to the activation of post‐synaptic receptors in cortical regions

Question 7

How are 5-HT3 receptors manipulated pharmacologically for the treatment of chemotherapy-induced nausea and emesis?

Answer 7

There are 5-HT3 antagonists like ondansetron that reduce cancer treatment related emesis

Question 8

How is the 5-HT4 receptor manipulated for treatment of GI disorders?

Answer 8

5-HT4 agonists like mosapride will stimulate ACh release in the myenteric plexus which treats things like gastroparesis

Question 9

Buspirone target and function

Answer 9

5-HT1A partial agonist

Activation of post‐synaptic receptors in cortical regions

Question 10

Buspirone indication

Answer 10

Anxiety

Depression

Question 11

Buspirone toxicity

Answer 11

Early increase in anxiety

Question 12

5-HTP function

Answer 12

5-HT precursor

Question 13

5-HTP indication

Answer 13

Depression

Question 14

Risperidone target and function

Answer 14

5-HT2A/2C antagonist and D2/3 antagonist
Suppresses DA release in mesolimbic pathway, but
increases DA release in mesocortical pathway.

Increased activity in mesolimbic causes hallucinations
Decreased activity in mesocortical causes poor emotional affect

Question 15

Risperidone indication

Answer 15

Schizophrenia with psychosis

Question 16

Risperidone toxicity

Answer 16

Weight gain

Akithisia - restlessness

Question 17

Ondasetron target and function

Answer 17

5-HT3 antagonist

Reduces emesis

Question 18

Ondasetron indication

Answer 18

Chemotherapy induced emesis

Question 19

Ondasetron toxicity

Answer 19

None. Well tolerated in patients.

Question 20

Fluoxetine/Sertraline target and function

Answer 20

SSRI

Increases 5-HT (serotonin) post-synaptic receptor activation

Question 21

Fluoxetine/Sertraline indication

Answer 21

Depression
OCD
Anxiety
Panic disorder
PTSD
Social phobia

Question 22

Fluoxetine/Sertraline toxicity

Answer 22

Sexual dysfunction

Insomnia

Question 23

Fluoxetine/Sertraline contraindications

Answer 23

MAO inhibitors as it can cause “serotonin syndrome”

Question 24

L-DOPA effect

Answer 24

DOPA precursor

Question 25

L-DOPA indication

Answer 25

Parkinson's Disease

Question 26

L-DOPA toxicity

Answer 26

Arrhythmia | Dyskinesia

Question 27

Carbidopa effect

Answer 27

Inhibits AADC in peripheral tissue but cannot cross BBB. Used with L-DOPA to minimize peripheral DOPA

Question 28

Carbidopa indication

Answer 28

Concurrent rx with L‐DOPA to reduce peripheral DA production to protect the CV system

Question 29

Carbidopa toxicity

Answer 29

Augments SE of L‐DOPA in CNS

Question 30

Selegiline target and effect

Answer 30

MAO-B inhibitor to increase DOPA

Question 31

Selegiline indication

Answer 31

Low dose: Parkinson's Disease | High dose: Depression

Question 32

Selegiline toxicity

Answer 32

Potential for hypertensive crisis

Question 33

Bromocriptine target and effect

Answer 33

D2 agonist Post synaptic activation in basal ganglia, may also be neuroprotective so best used early in disease. Leads to increased DOPA

Question 34

Bromocriptine indication

Answer 34

Parkinson's Disease

Question 35

Bromocriptine toxicity

Answer 35

Arrhythmia | Dyskinesia

Question 36

Tolcapone target and effect

Answer 36

Inhibits COMT breakdown of DOPA

Question 37

Tolcapone indication

Answer 37

Parkinson's Disease

Question 38

Tolcapone toxicity

Answer 38

Prolongs and increases effect of L‐DOPA, reduces “off” time, can reduce required L‐DOPA dose

Question 39

Tolcapone contraindication

Answer 39

Liver failure

Question 40

Haloperidol target and effect

Answer 40

D2 antagonist

Question 41

Haloperidol indication

Answer 41

Psychosis

Question 42

Haloperidol toxicity

Answer 42

Extra- pyramidal motor disturbances

Question 43

Methylphenidate target and effect

Answer 43

Increased DA release in frontal cortex

Question 44

Methylphenidate indication

Answer 44

ADHD

Question 45

Methylphenidate toxicity

Answer 45

Tachycardia

Question 46

Methylphenidate contraindication

Answer 46

Tricyclic antidepressants

Question 47

Metaclopramide target and effect

Answer 47

D2 antagonist

Question 48

Metaclopramide indication

Answer 48

Chemotherapy‐induced‐ and post‐op nausea and vomiting

Question 49

Metaclopramide toxicity

Answer 49

Akathisia

Question 50

Metaclopramide contraindication

Answer 50

Long term prescription

Question 51

Trazadone target and effect

Answer 51

5‐HT2A/2C antagonist + SSRI

Question 52

Trazadone indication

Answer 52

Anxiety | Depression

Question 53

Trazadone toxicity/contraindication

Answer 53

Warning of suicidality in young adults at initiation of treatment Contraindication: MAO inhibitors

Question 54

Mosapride/Cisapride target and effect

Answer 54

5‐HT4 receptor agonist | Promotes GI motility

Question 55

Mosapride/Cisapride indication

Answer 55

Gastroparesis

Question 56

Mosapride/Cisapride toxicity

Answer 56

Prolonged QT syndrom