1. PHARMACOLOGY TUTORING FOR ANTIDEPRESSANTS By Alaina Darby

2. Stella is feeling sad, hopeless, and guilty and has persistent headaches, fatigue and insomnia. With no additional symptoms, which of the following classes of depression would this fall into? a. Reactive b. Major depressive disorder c. Bipolar disorder d. Post-partum

3. Which of the following is most responsive to antidepressant drugs and ECT? a. Reactive b. Major depressive disorder c. Bipolar disorder d. Post-partum

4. What is the biogenic amine hypothesis for depression? a. Deficit of norepinephrine and serotonin b. Deficit of dopamine and serotonin c. Excess of norepinephrine and serotonin d. Excess of dopamine and serotonin

5. Which of the following is not an adaptive change that could underlie the therapeutic lag of antidepressive treatment? a. Beta-receptors b. cAMP and serotonergic neurotransmission c. Norepinephrine receptor uncoupling d. Neurogenesis

6. Which of the following is an issue with using St. John’s Wort to treat depression? a. It is much less effective than the placebo at treating depression b. It interferes with various medications c. It is not available in the US d. It has similar efficacy to SSRI’s

7. Which of the following can cause resistance to antidepressants? a. Downregulation in norepinephrine receptors b. Downregulation in serotonin receptors c. Single nucleotide polymorphisms in MDR1 d. Single nucleotide polymorphisms in norepinephrine receptors

8. Which of the following is derived from amitriptyline through metabolism? a. Doxepin b. Nortriptyline c. Trimipramine d. Desipramine

9. Sally has just started taking an antidepressant. She is experiencing drowsiness, dysphoria, anxiety, and impaired cognition. Which of the following is she most likely taking? a. Duloxetine b. Clomipramine c. Paroxetine d. Tranylcypromine

10. Which of the following is not an adverse effect of tricyclic antidepressants? a. Hypertension b. Sedation c. Weight gain d. Sexual disturbances

11. Which of the following should not be taken with clonidine? a. Duloxetine b. Clomipramine c. Paroxetine d. Tranylcypromine

12. Which of the following is a norepinephrine transport inhibitor that can also be used as an antipsychotic? a. Trazodone b. Vilazodone c. Amoxapine d. Maprotiline

13. Which of the following is most similar to vilazodone in its mechanism of action? a. Duloxetine b. Venlafaxine c. Bupropion d. Vortioxetine

14. Molly needs to lose weight. Which of the following would be least likely to be prescribed for her depression? a. Bupropion b. Duloxetine c. Trazodone d. Mirtazapine

15. Which of the following has a main MOA that does not block neurotransmitter transporters? a. Bupropion b. Duloxetine c. Trazodone d. Mirtazapine

16. Which of the following can also be used to aid in smoking cessation? a. Bupropion b. Duloxetine c. Trazodone d. Mirtazapine

17. Which of the following might be prescribed to someone who needs to be alert in his job and has low blood pressure? a. Venlafaxine b. Duloxetine c. Mirtazepine d. Amitriptyline

18. Which of the following might be considered first line therapy in a patient with major depression? a. Amoxapine b. Trazodone c. Citalopram d. Tranylcypromine

19. Which of the following would be least likely to be considered in a patient with major depression? a. Amoxapine b. Trazodone c. Citalopram d. Tranylcypromine

20. Which of the following can be administered for weekly administration? a. Citalopram b. Fluoxetine c. Paroxetine d. Fluvoxamine

21. Katie just switched from tranylcypromine to paroxetine for her depression and has begun to exibit signs of hyperpyrexia, hyperreflexia, tremor, shivering, and seizures. What is the reason for these symptoms? a. Understimulation of 5-HT1A receptors b. Overstimulation of 5-HT1A receptors c. Downregulation of 5-HT1A receptors d. Upregulation of 5-HT1A receptors

22. What action should immediately be taken to treat Katie? a. Antiparkinson’s drug (benzamine) for her tremors b. Discontinue paroxetine c. Supportive therapy d. Anticonvulsant (phenytoin) for her seizures

23. Which of the following is not metabolized by MAO-B? a. Norepinephrine b. Serotonin c. Tyramine d. Dopamine

24. Which of the following could be taken with MAOI’s? a. Pseudoephedrine b. Dextromethorphan c. Fluoxetine d. Lithium

25. Which is not true of lithium? a. Its activity is thought to occur through inhibition of inositol phosphate signaling b. Its therapeutic window is very narrow c. It is a potent blocker of the Na/K-ATPase pump d. It is extensively metabolized

26. Which of the following would be safe to take with lithium? a. Aspirin b. Furosemide c. Carbemazepine d. Hydrochlorithiazide

27. Sandra has bipolar disorder and is taking birth control. Which of the following drugs/drug combinations would be not be suitable for her? a. Lithium b. Valproic acid c. Carbamazepine d. Antipsychotic/antidepressant combination

28. Which would not be a reason to choose valproate or carbamazepine over lithium to treat bipolar disorder? a. Ability to increase the dose faster b. Quicker response c. Risk of pregnancy d. Better therapeutic index