Test 4: Affective Disorders

Question 1

A person affected by this type of bipolar has had at least one manic episode in their life

Answer 1

bipolar I

Question 2

A person affected by this type of bipolar has moods cycling between high and low, but the “up” moods never reach full on mania

Answer 2

bipolar II

Question 3

In this type of bipolar, a person experiences 4+ episodes of mania or depression in one year

Answer 3

rapid cycling

Question 4

in this type of bipolar, a person experiences both mania and depression simultaneously or in rapid sequence

Answer 4

mixed bipolar

Question 5

this mood disorder is like bipolar, but has milder symptoms

Answer 5

cyclothymia

Question 6

Genetics contributes __% to mood disorders

Answer 6

40-50

Question 7

Genetics contributes __% to bipolar disorder

Answer 7

60-70

Question 8

Which neurotransmitters modulate the ability of hypothalamic neurons to secrete corticotropin releasing factor?

Answer 8

GABA, NE, Ach

Question 9

CRF increases the secretion of ___ from pituicytes in the anterior pituitary into the blood

Answer 9

ACTH

Question 10

ATCH acts upon the ___ glands to increase release of cortisol

Answer 10

adrenal

Question 11

cortisol normally [turns on/off] the stress response

Answer 11

off

Question 12

Depressed patients have [increased/decreased] cortisol secretion in response to [increased/decreased] ACTH release

Answer 12

increased, increased

Question 13

MAOIs and TCAs both [increase/decrease] biogenic amines

Answer 13

increase

Question 14

common way to determine 5HT function is by measuring levels of metabolite __

Answer 14

5HTIAA

Question 15

[lower/higher] amount of 5HTIAA in brain of depressed patients

Answer 15

lower

Question 16

___ levels in blood measure 5HT function

Answer 16

tryptophan

Question 17

unmedicated depression patients have an [increased/decreased] density of postsynaptic 5HT2

Answer 17

increased

Question 18

amygdala [increase/decrease] correlates with severity of depression

Answer 18

increase

Question 19

Acute ADs increase 5HT by [inhibiting/exciting] MAO

Answer 19

inhibiting

Question 20

Chronic ADs result in pharmacodynamic [up/down regulation] of 5HT autoreceptors

Answer 20

down

Question 21

T or F: polypharmacy is frequently used to increase clinical outcomes of affective disorders

Answer 21

true

Question 22

Increase in clinical outcomes occurs usually __ weeks into AD treatment

Answer 22

4-6

Question 23

MAO normally metabolizes which 3 monoamines not packaged into vesicles?

Answer 23

NE, DA, 5HT

Question 24

[Excitation/Inhibition] of MAO increases amount of monoamines available for packaging and release

Answer 24

inhibition

Question 25

In which two places does MAO mechanism of action occur?

Answer 25

synaptic terminal and cleft

Question 26

Though one dose of MAOI can increase monoamine release, clinical effects are not seen for weeks - suggests that alterations in receptor ___ and ___ or 2nd messenger signaling are responsible for clinical efficacy

Answer 26

density and activity

Question 27

4 common side effects of MAOIs

Answer 27

changes in BP, sleep, appetite, weight gain

Question 28

Dangerous MAOI side effects occur from MAO inhibition in ___

Answer 28

liver

Question 29

TCAs are closely related to what type of drugs?

Answer 29

antipsychotics

Question 30

TCAs bind to ___ to [inhibit/increase] uptake into presynaptic terminal

Answer 30

reuptake pumps, inhibit

Question 31

TCAs prolong action at ___

Answer 31

synapse

Question 32

TCAs act on __ and __

Answer 32

SERTs and NERTs

Question 33

Because of TCA affinity for Ach, 3 common side effects are

Answer 33

dry mouth, dizziness, confusion

Question 34

Because of TCA affinity for histamine receptors, a common side effect is

Answer 34

sedation/fatigue

Question 35

Dangerous TCA side effects come from affinity for ___ receptors

Answer 35

a1 NE

Question 36

SSRIs have [greater/weaker] affinity for SERT than TCA

Answer 36

greater

Question 37

T or F: SSRIs have greater affinity for NERTs than SERTs

Answer 37

false

Question 38

4 common side effects of SSRIs

Answer 38

restlessness, insomnia, nausea, sexual dysfunction

Question 39

dangerous side effect of SSRIs is called

Answer 39

serotonin syndrome

Question 40

SSRIs [do/do not] have dependence problems

Answer 40

do

Question 41

Atypical ADs either block ___, __/___, or __/___

Answer 41

NERTs, SERTs/NERTs, or NERTS/DATs

Question 42

T or F: side effects of atypical ADs are similar to SSRIs

Answer 42

true

Question 43

2 major classes of pharmacotherapies for bipolar

Answer 43

lithium and anticonvulsants

Question 44

__ weeks on lithium eliminates or reduces manic episodes

Answer 44

2

Question 45

lithium enhances ___ action

Answer 45

5HT

Question 46

lithium [increases/decreases] catecholamine action

Answer 46

decreases

Question 47

5 common side effects of lithium

Answer 47

thirst, urination, impaired concentration, fatigue, tremor

Question 48

Where in the body is lithium toxicity problematic?

Answer 48

kidneys

Question 49

first anticonvulsant approved by FDA for mania treatment

Answer 49

valproate (depakote)

Question 50

Depakote increases GABA by stimulating __ and inhibiting __

Answer 50

GAD, GABA transaminase

Question 51

dangerous side effects of depakote

Answer 51

liver toxicity and pancreatitis

Question 52

Carbamazepine (Tegretol) blocks __ channels on __ presynaptic terminals

Answer 52

NA, GLU

Question 53

Tegretol [increases/decreases] GLU release

Answer 53

decreases

Question 54

Tegretol common side effects

Answer 54

sedation, dizziness, incoordination, nausea

Question 55

Tegretol dangerous side effects

Answer 55

liver toxicity, blood diseases