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Antidepressant Flash Card Supplement

Deleted user 33 questions Updated 26 Mar 2017

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Questions in this quiz (33)

1Which of the following drugs are classified as SSRIs?
1. AVenlafaxine
2. BImipramine
3. CParoxetine
4. DBupropion
5. EPhenylzine
6. FFluoxetine
7. GSertraline
8. HDesvenlafaxine
9. ICitalopram
10. JEscitalopram
2Which of the following drugs are classified as SNRIs?
1. AImipramine
2. BDuloxetine
3. CMirtazapine
4. DFluoxetine
5. EVenlafaxine
6. FDesvenlafaxine
7. GSelegiline
3Which of the following drugs are classified as TCAs?
1. AImipramine
2. BTrazodone
3. CAmitriptyline
4. DClomipramine
5. EParoxetine
6. FEscitalopram
7. GDuloxetine
4Which of the following drugs are classified as MAO-Is?
1. AAmitriptyline
2. BSelegiline
3. CDuloxetine
4. DPhenylzine
5. ECitalopram
6. FBupropion
7. GTrazodone
5Which of the following drugs are classified as Atypical?
1. AMirtazapine
2. BFluoxetine
3. CAmitriptyline
4. DCitalopram
5. ETrazodone
6. FImipramine
7. GBupropion
6[blank_start]Amine[blank_end] Hypothesis
 Abnormally low levels of norepinephrine and/or [blank_start]serotonin[blank_end] underlie [blank_start]depression[blank_end]

Evidence for this hypothesis includes:
 Reserpine, an (old) antihypertensive drug depletes pre-synaptic stores of [blank_start]norepinephrine[blank_end] (NE) and is associated with depressive symptoms.
 Autopsy studies of the brains of depressed suicide victims indicate a [blank_start]low[blank_end] level of NE and/or serotonin (5-HT) metabolism in most brain regions
 Drugs found to be beneficial act to enhance NE or 5-HT levels.

A major weakness to this hypothesis is the therapeutic lag – effects of drugs on NE or 5-HT levels are observed [blank_start]immediately[blank_end] yet therapeutic benefit takes a minimum of 1 to 4 [blank_start]weeks[blank_end] to occur
1. AAmine
2. Bserotonin
3. Cdepression
4. Dnorepinephrine
5. Elow
6. Fimmediately
7. Gweeks
7[blank_start]Neuroendocrine[blank_end] Hypothesis
 Depression is associated with elevated [blank_start]cortisol[blank_end] levels
 [blank_start]HPA[blank_end] axis is dysregulated
 Abnormal (low) [blank_start]thyroid[blank_end] function is common in depression
1. ANeuroendocrine
2. Bcortisol
3. CHPA
4. Dthyroid
8[blank_start]Neurotrophin[blank_end] Hypothesis
 Laboratory research indicates that antidepressants [blank_start]increase[blank_end] BDNF production in [blank_start]hippocampus[blank_end]
 This requires [blank_start]long[blank_end] term (weeks) not [blank_start]short[blank_end] term (days) treatment
 BDNF increases neurogenesis and [blank_start]synaptic[blank_end] connectivity
 Stress, pain and depression can [blank_start]reduce[blank_end] BDNF
 Imaging studies indicate reduced hippocampal volume (size) in [blank_start]depression[blank_end]
1. Aincrease
2. Bhippocampus
3. Clong
4. Dshort
5. Esynaptic
6. Freduce
7. Gdepression
8. HNeurotrophin
9Which Serotonin Selective Reuptake Inhibitors (SSRIs) are approved for children?
1. AParoxetine
2. BCitalopram
3. CEscitalopram
4. DFluoxetine
5. ESertraline
10Which Serotonin Selective Reuptake Inhibitors (SSRIs) are approved for adolescents?
1. AFluoxetine
2. BParoxetine
3. CEscitalopram
4. DCitalopram
5. ESertraline

11Which of the following are uses for Serotonin Selective Reuptake Inhibitors (SSRIs)?
1. ADepression
2. BPTSD
3. CPremature ejaculation
4. DPMDD
5. EPanic disorder
6. FBulimia
7. GMenopausal “hot flashes”
8. HEnuresis
9. IOCD
10. JGAD
12Which of the following are true about SSRIs?
1. ARapid metabolism requires multiple doses per day
2. BRisk of serotonin syndrome if switching to MAOI
3. CAntagonist for 5-HT2A receptor
4. DMechanism of action: inhibition of serotonin transporter (SERT)
5. ESome are potent inhibitors of CYP 2D6
6. FNarrow therapeutic index
7. GHigh selectivity for SERT (serotonin transporter)
8. HSedating - taken at bedtime
9. IFirst line (with SNRIs) treatment for depression
10. JHigh therapeutic index
13Which seven of the following are the adverse effects of SSRIs?
1. AIncreased risk of bleeding by inhibiting SERT in platelets
2. BHeadaches, insomnia or hypersomnia
3. CSignificant weight gain in some patients
4. DIncreased sweating, urinary retention
5. EReduced sexual function; may improve over time on drug
6. FDiscontinuation syndrome (anxiety, irritability, confusion, crying)
7. GAnticholinergic (muscarinic): dry mouth, constipation, urinary retention, blurred vision,
  confusion
8. HNausea, GI upset, diarrhea; all improve after the first week
9. ILowers seizure threshold, problem in epilepsy, alcoholism, eating disorders
10. JParoxetine is Category D – risk of heart defects with first trimester exposure
14Which of the following are uses of Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)?
1. ANeuropathic pain
2. BVasomotor symptoms of menopause
3. CSocial anxiety
4. DPanic disorder
5. EOCD
6. FGAD
7. GDepression
8. HPTSD
9. ISedation
10. JStress urinary incontinence
15Which of the following are true about SNRIs?
1. ADominant class of antidepressants until ~ 1990s when SSRIs took over
2. BUsed for depression, neuropathic pain, GAD, stress urinary incontinence, vasomotor symptoms of menopause
3. CHighly sedating and not associated with tolerance or dependence
4. DAntagonist for 5-HT2A receptor
5. EDrugs have high selectivity for SERT and NET (norepinephrine transporter)
6. FHas CNS stimulating effects, inhibits NE and dopamine transporters; increases presynaptic release of NE and dopamine
7. GVenlafaxine is metabolized to desvenlafaxine by CYP 2D6
8. HNarrow therapeutic index and bothersome side effects explain reduced use
9. IDiscontinuation symptoms with venlafaxine and desvenlafaxine are common
10. JUsed for depression, GAD, PTSD, OCD, panic disorder, PMDD, bulimia
16Which of the following are the adverse effects of SNRIs?
1. ASignificant weight gain in some patients
2. BSedation
3. CDiscontinuation symptoms with venlafaxine and desvenlafaxine are common
4. DNausea, GI upset, diarrhea; all improve after the first week
5. EIncreased risk of bleeding by inhibiting SERT in platelets
6. FAnticholinergic (muscarinic): dry mouth, constipation, urinary retention, blurred vision, confusion
7. GIncreased sweating, urinary retention
8. HReduced sexual function; may improve over time on drug
9. IHeadaches, insomnia or hypersomnia
10. JIncreased blood pressure and heart rate; not a problem in most patients
17Which of the following are the uses for Tricyclic antidepressants (TCAs)?
1. AGAD
2. BEnuresis
3. CCardiac conduction delays; arrhythmogenic: Potentially lethal in overdose
4. DVasomotor symptoms of menopause
5. EHeadaches, insomnia or hypersomnia
6. FNeuropathic pain
7. GDepression
8. HAnticholinergic (muscarinic): dry mouth, constipation, urinary retention, blurred vision, confusion
9. IStress urinary incontinence
10. JCategory D – risk of heart defects with first trimester exposure
18Which of the following are true about TCAs?
1. AUsed in depression that is unresponsive to SSRIs and SNRIs
2. BNarrow therapeutic index and bothersome side effects explain reduced use
3. CDrug-drug interactions with CNS depressants, e.g. antihistamines, alcohol, benzodiazepines
4. DDominant class of antidepressants until ~ 1990s when SSRIs took over
5. EPotentially lethal in overdose
6. FLess selectivity than SSRIs, SNRIs
7. GAs a class, they inhibit NET and SERT but variable profiles of individual drugs
8. HSedating – taken at bedtime
9. IMetabolized by CYP 2D6, serum levels are affected by inhibitors
10. JEfficacy is similar to SSRIs, SNRIs
19Which of the following are the adverse effects of TCAs?
1. ASexual side effects
2. BHistamine H1 antagonism: weight gain, sedation
3. CCardiac conduction delays; arrhythmogenic: Potentially lethal in overdose
4. DIncreased risk of bleeding by inhibiting SERT in platelets
5. EAdrenergic α1 antagonism: orthostatic hypertension
6. FHas been associated with priapism
7. GAnticholinergic (muscarinic): dry mouth, constipation, urinary retention, blurred vision, confusion
8. HDiscontinuation syndrome (flu-like symptoms)
9. ICategory D – risk of heart defects with first trimester exposure
10. JHeadaches, insomnia or hypersomnia
20Which of the following are true about Trazodone?
1. ASeldom used as monotherapy
2. BRapid metabolism requires multiple doses per day
3. CAdjunct with SSRI for patients with insomnia
4. DHas CNS stimulating effects, inhibits NE and dopamine transporters; increases presynaptic release of NE and dopamine
5. EDrugs have high selectivity for SERT and NET (norepinephrine transporter)
6. FUsed for depression and anxiety
7. GAppetite stimulating – may be useful in depression plus anorexia
8. HNot associated with sexual side effects, bleeding or weight gain
9. IAntagonist for 5-HT2A receptor
10. JIs used as a hypnotic – highly sedating and not associated with tolerance or dependence
21Which of the following are the adverse effects of Trazodone?
1. ASedation
2. BPotentially lethal in overdose (autonomic, cardiac, seizures)
3. CHas been associated with priapism
4. DInsomnia, restlessness
5. Eα1-antagonism: orthostatic hypotension
6. FGI
7. GLowers seizure threshold, problem in epilepsy, alcoholism, eating disorders
8. HOrthostatic hypotension
9. IAnticholinergic (muscarinic): dry mouth, constipation, urinary retention, blurred vision,
  confusion
10. JAnorexia
22Which of the following are true about Bupropion?
1. AHas CNS stimulating effects, inhibits NE and dopamine transporters
2. BNot sedating
3. CIrreversible inhibition of MAO-A and MAO-B; long duration of effect
4. DAntagonist at adrenergic α2 and 5-HT2 receptor
5. EDrugs have high selectivity for SERT and NET (norepinephrine transporter)
6. FNot used for anxiety
7. GAs effective as nicotine patches for smoking cessation
8. HNot associated with sexual side effects, bleeding or weight gain
9. IIncreases presynaptic release of NE and dopamine
10. JHigh selectivity for SERT
23Which of the following are adverse effects of Bupropion?
1. ACardiac conduction delays; arrhythmogenic: Potentially lethal in overdose
2. BAnorexia
3. CInsomnia
4. DLowers seizure threshold
5. EIncreased risk of bleeding by inhibiting SERT in platelets
6. FAgitation, anxiety, headache, nausea
7. GSignificant weight gain in some patients
8. HSexual side effects
9. ISedation
10. JProblem in epilepsy, alcoholism, eating disorders
24Which of the following are true about Mirtazapine?
1. ASedating – useful for depression with insomnias
2. BAntagonist at adrenergic α2 and 5-HT2 receptor
3. CUsed for depression, neuropathic pain, GAD, stress urinary incontinence, vasomotor symptoms of menopause
4. DHigh selectivity for SERT (serotonin transporter)
5. EDrug-drug interactions with alcohol, benzodiazepines
6. FUsed in neuropathic pain, enuresis
7. GH1 antagonist
8. HMetabolized by CYP 2D6, serum levels are affected by inhibitors
9. IAppetite stimulating – may be useful in depression plus anorexia
10. JNot associated with sexual side effects
25Which of the following are adverse effects of Mirtazapine?
1. AOrthostatic hypotension
2. BHeadaches, insomnia or hypersomnia
3. CDry mouth
4. DIncreased risk of bleeding by inhibiting SERT in platelets
5. EConstipation
6. FCategory D – risk of heart defects with first trimester exposure
7. GWeight gain
8. HHas been associated with priapism
9. INausea, GI upset, diarrhea; all improve after the first week
10. JCardiac conduction delays; arrhythmogenic: Potentially lethal in overdose
26Which of the following are true about Monoamine oxidase inhibitors (MAOIs)?
1. APotential for drug/food interactions
2. BMAO-B: metabolizes dopamine
3. CAntagonist at adrenergic α2 and 5-HT2 receptor
4. DMAO-B: metabolizes NE, 5-HT and dopamine
5. EMAO-A: metabolizes NE, 5-HT and dopamine
6. FInhibits NE and dopamine transporters and increases presynaptic release of NE and dopamine
7. GIrreversible inhibition of MAO-A and MAO-B; long duration of effect
8. HMAO-A: metabolizes dopamine
9. IUsed in treatment resistant depression
10. JIs used as a hypnotic – highly sedating and not associated with tolerance or dependence
27Which of the following are adverse effects of MOAIs?
1. ADry mouth
2. BInsomnia, restlessness
3. CDiscontinuation syndrome
4. DAnorexia
5. EOrthostatic hypotension
6. FHeadaches, insomnia or hypersomnia
7. GPotentially lethal in overdose (autonomic, cardiac, seizures)
8. HWeight gain
9. IConstipation
10. JIncreased sweating, urinary retention
28[blank_start]Serotonin[blank_end] [blank_start]Syndrome[blank_end]
 [blank_start]Cognitive[blank_end] (delirium), [blank_start]autonomic[blank_end] (hypertension, tachycardia, sweating) and [blank_start]somatic[blank_end] (tremor), also [blank_start]fever[blank_end], shivering
 [blank_start]Discontinue[blank_end] serotonergic [blank_start]antidepressants[blank_end] at least [blank_start]2 weeks[blank_end] before starting MAOI; [blank_start]fluoxetine[blank_end] requires 5 weeks
 Discontinue MAOI for 2 weeks [blank_start]before[blank_end] starting a serotonergic agent
 Linezolid (antimicrobial), dextromethorphan, sumatriptan, tramadol, [blank_start]methadone[blank_end], St. John’s wart can cause serotonin syndrome in the presence of [blank_start]SSRI[blank_end] or MAOI
1. ASerotonin
2. BSyndrome
3. CCognitive
4. Dautonomic
5. Esomatic
6. Ffever
7. GDiscontinue
8. Hantidepressants
9. I2 weeks
10. J6 weeks
11. K4 weeks
12. Lbefore
13. Mafter
14. NSSRI
15. OSNRI
16. Pmethadone
17. Qfluoxetine
18. Rphenylzine
19. Samitriptyline
20. TContinue
21. Usweating
22. Vnausea
29Therapeutic use of antidepressants: [blank_start]Depression[blank_end]
Requires [blank_start]1-2 months[blank_end] for benefit
[blank_start]Trial period[blank_end] is [blank_start]4-12 weeks[blank_end], if inadequate response then switch or [blank_start]add[blank_end] another agent
~[blank_start]30%[blank_end] respond to [blank_start]initial[blank_end] agent
~[blank_start]70%[blank_end] respond if treatment is [blank_start]optimized[blank_end]
e.g. SSRI + bupropion/atypical antipsychotic
Many patients continue [blank_start]maintenance[blank_end] doses for year
1. ADepression
2. B1-2 months
3. C2-4 months
4. DTrial period
5. E4-12 weeks
6. Fadd
7. G30%
8. H70%
9. Iinitial
10. Joptimized
11. Kmaintenance
12. Lparoxetine
13. Mbupropion
14. Ntrazodone
15. O90%
16. P10%
17. Q50%
18. RAnxiety
19. SPain
30Therapeutic uses of [blank_start]antidepressants[blank_end]:
 Depression
 [blank_start]Anxiety[blank_end]
- SSRIs and SNRIs are approved for PTSD, OCD, social anxiety, GAD and panic disorder
- Slower onset of benefit than [blank_start]benzodiazepines[blank_end]
 [blank_start]Pain[blank_end]
- Effects on pain are [blank_start]independent[blank_end] of antidepressant effects
- [blank_start]TCAs[blank_end], SNRIs are more effective than others
 [blank_start]Premenstrual Dysphoric Disorder[blank_end]
- [blank_start]Fluoxetine[blank_end] and sertraline are approved therapies
 [blank_start]Smoking Cessation[blank_end]
- [blank_start]Bupropion[blank_end]
- As effective as nicotine patches
 [blank_start]Eating Disorders[blank_end]
- More success with [blank_start]bulimia[blank_end] than [blank_start]anorexia[blank_end]
- [blank_start]Mirtazapine[blank_end] stimulates appetite and used in anorexia
 [blank_start]Premature ejaculation[blank_end]
- [blank_start]SSRIs[blank_end]
- Most antidepressants (except bupropion, [blank_start]mirtazapine[blank_end]) have sexual side effects
 [blank_start]Menopausal “hot flashes”[blank_end]
- SSRIs and SNRIs show benefit
1. Aantidepressants
2. BAnxiety
3. CPain
4. DPremenstrual Dysphoric Disorder
5. ESmoking Cessation
6. FEating Disorders
7. GPremature ejaculation
8. HMenopausal “hot flashes”
9. Ibenzodiazepines
10. Jindependent
11. KTCAs
12. LFluoxetine
13. MBupropion
14. Nbulimia
15. Oanorexia
16. PMirtazapine
17. QSSRIs
18. RSNRIs
19. SMOAIs
20. Tmirtazapine
31Choosing an antidepressant
 At the population level, [blank_start]efficacy[blank_end] is [blank_start]similar[blank_end] for all drugs
 SSRIs and [blank_start]SNRIs[blank_end] are first line therapies
 choice is often based on [blank_start]adverse effects[blank_end], potential drug interactions, patient [blank_start]history[blank_end]
 [blank_start]Bupropion[blank_end]
1. Aefficacy
2. Bsimilar
3. Cdifferent
4. DSNRIs
5. ETCAs
6. FSSRIs
7. GMAOIs
8. Hadverse effects
9. Ihistory
10. JBupropion
32Antidepressants: Mechanisms of action
 [blank_start]SERT inhibition[blank_end] (SSRIs)
 NET and SERT inhibition ([blank_start]venlafaxine[blank_end], TCAs)
 5-HT2C agonist ([blank_start]trazodone[blank_end])
 α2 antagonist ([blank_start]mirtazapine[blank_end])
 [blank_start]5-HT2A, 2C, 3 antagonist[blank_end] (mirtazapine)
 MAO inhibition ([blank_start]MAOIs[blank_end])
 [blank_start]NE and DA potentiating[blank_end] ([blank_start]bupropion[blank_end])
1. Avenlafaxine
2. Btrazodone
3. Cmirtazapine
4. DSERT inhibition
5. E5-HT2A, 2C, 3 antagonist
6. FNE and DA potentiating
7. GMAOIs
8. Hbupropion
33Adverse effects
 Mirtazapine has [blank_start]high[blank_end] affinity for [blank_start]H1[blank_end]
 Antagonism of M, H1 and α1 is characteristic of [blank_start]TCAs[blank_end]
- Dry mouth, sedation, [blank_start]orthostatic hypotension[blank_end]
- Cardiotoxicity
 [blank_start]SSRIs[blank_end]
- Weight gain, sexual dysfunction, drug interactions (plasma protein binding, drug metabolism), nausea, [blank_start]insomnia[blank_end]
1. AH1
2. BM
3. Cα1
4. DTCAs
5. Eorthostatic hypotension
6. FSSRIs
7. GMOAIs
8. Hanorexia
9. Isedation
10. Jinsomnia
11. Khigh
12. Llow

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Description: User has deleted their subject information Quiz on Antidepressant Flash Card Supplement, created by Deleted user on 26/03/2017.
Author: Deleted user
Language: English
Views: 12
History: Created on 26 Mar 2017 · updated on 26 Mar 2017
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Antidepressant Flash Card Supplement

Questions in this quiz (33)

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