CMN 548 MODULE 5 PSYCHOPHARMACOLOGY
QUESTIONS AND ANSWERS WITH SOLUTIONS 2026-
2027
What are the two basic mechanisms for studying receptors? - correctvanswer--
Measurevthe binding of a ligand (radioactively traced)
- Measure the physiologic consequences of agonist binding (and effects of the antagonist)
How do didactic depictions of neurotransmitter signaling differvfrom real life? - correct answer--
There are hundreds to thousands of axonsvconnecting to one dendrite
- A single transmitter can evoke multiple pathways
Pharmacokinetic drug interactions are... - correct answer-
the effects of drugs on the PLASMA concentrations of each other
Pharmacokinetic concepts describe andvpredict... - correct answer--
the time course of drug concentration in different parts of the body
- onset, duration, absorption, distribution, metabolism, excretion
Remission - correct answer-- Preferred outcomevof treatment
- Absolute score of 7 or less on thevHAMD (Hamilton depression) scale
- <10 on the MADRS (Montgomery-AsbergvDepressionvRating Scale)
Responders are patients who... - correct answer-improve but do not experience full resolution of symptoms
- 50% of greater decrease from baseline onvHAMD and MADRS depression ratings
What is the probability of remissionvfrom OCD with SSRI treatment over 3 years of treatment? -
correct answer-- 38% full remission
- 65% partial remission
Withdrawal symptoms are worse with drugs that have this pharmacokinetic property. - correct answer-
Short elimination half life
,Whichvmedications are most often associated with mentally and physically distressing discontinuation reac
tions? - correct answer-- Sedative hypnotics andvopiates
- Barbiturate (part of the sedative hypnotic class) withdrawal can bevfatal
Whichvbenzodiazepine produces more intense withdrawal symptoms that it's counterparts? -
correct answer-Alprazolam (Xanax)
WhichvSSRI produces morevintense withdrawal symptoms that it's counterparts? - correct answer-
Paroxetine (Paxil)
Medications with this pharmacokinetic property have delayed discontinuation symptoms. - correct answer-
Long elimination half life
- Fluoxetine (Prozac, SSRI)vhas a long elimination half life of its active metabolite
What is autoinhibition? - correct answer-Dose dependent inhibition of a medication's own metabolism
- Paroxetine (Paxil, SSRI) inhibits P450 CYP 2D6 which isvwhat metabolizes the medication
Bupropion (Wellbutrin, atypical antidepressant) inhibits this enzyme system and paroxetine (Paxil, SSRI) i
s metabolized by it. - correct answer-CYP 2D6
-
Discontinuing bupropion would result in a rapid increase in metabolism of Paroxetine and drop in plasma
concentrations
- Paroxetine would need to bevincreased
What effect have sustained release alprazolam, paroxetine, and venlafaxine hadvon withdrawal reactions? -
correct answer-None.
-
They do notvreduce severity of withdrawal becausevthe long half life is due to delayed absorption not prolo
nged elimination
- Only benefit is the in reduced dosingvfrequency
Withdrawal symptoms present after hours or days of dose reduction or discontinuation and resolve within..
. - correct answer-A few weeks
- Persistent symptoms would indicate somethingvbesides withdrawal
, -
Psychotic and moodvsymptoms DOvNOT usually reappear abruptly after discontinuing long term treatmen
t
Signal detection is more challenging for compounds developed for psychiatric disorders because.... -
correct answer-Theveffect sizes arevnot large
What is expectation bias? - correct answer-
A situation where either the staff conducting the trial or subjects invthe trial or both groups expect that the t
est drug will confer a benefit or that it is unlikely to do so.
What effect does expectation bias play onvdrug trials? - correct answer-
Staff may have an unconscious bias toward rating more beneficial effects than are actually present.
- A larger trial may subsequently provevthatvthere is no difference from the placebo.
Explain the regression to mean phenomenon in drugvtrials. - correct answer-
As many trials enroll patients during an exacerbation of their illness, the phenomenon would tend to mean
that future measurements would be less extreme even if the subject is on a placebo.
CYP 450vtesting to predictvdrug dosing andvresponsiveness is one example of.... - correct answer-
Personalized Medicine
-
Measuring patient 2D6 metabolism can also help determine dosing of fluoxetine (Prozac, SSRI), av2D6 in
hibitorvwhen combined with medications metabolized by the same pathway
What is the ethical argument again whole genomevsequencing? - correct answer-
Findingvvariants that indicate only susceptibility and not definite disease canvaltervthe way a person lives th
eir life (eg. schizophrenia)
What does phase 1 of a nonclinical study entail and what is the goal? - correct answer-
Initial introduction of the new drug to humans, usually in healthy volunteers.
-
Goal of obtaining pharmacokinetic and pharmacologic effects of the drug in order to design a valid phase
2 study.
QUESTIONS AND ANSWERS WITH SOLUTIONS 2026-
2027
What are the two basic mechanisms for studying receptors? - correctvanswer--
Measurevthe binding of a ligand (radioactively traced)
- Measure the physiologic consequences of agonist binding (and effects of the antagonist)
How do didactic depictions of neurotransmitter signaling differvfrom real life? - correct answer--
There are hundreds to thousands of axonsvconnecting to one dendrite
- A single transmitter can evoke multiple pathways
Pharmacokinetic drug interactions are... - correct answer-
the effects of drugs on the PLASMA concentrations of each other
Pharmacokinetic concepts describe andvpredict... - correct answer--
the time course of drug concentration in different parts of the body
- onset, duration, absorption, distribution, metabolism, excretion
Remission - correct answer-- Preferred outcomevof treatment
- Absolute score of 7 or less on thevHAMD (Hamilton depression) scale
- <10 on the MADRS (Montgomery-AsbergvDepressionvRating Scale)
Responders are patients who... - correct answer-improve but do not experience full resolution of symptoms
- 50% of greater decrease from baseline onvHAMD and MADRS depression ratings
What is the probability of remissionvfrom OCD with SSRI treatment over 3 years of treatment? -
correct answer-- 38% full remission
- 65% partial remission
Withdrawal symptoms are worse with drugs that have this pharmacokinetic property. - correct answer-
Short elimination half life
,Whichvmedications are most often associated with mentally and physically distressing discontinuation reac
tions? - correct answer-- Sedative hypnotics andvopiates
- Barbiturate (part of the sedative hypnotic class) withdrawal can bevfatal
Whichvbenzodiazepine produces more intense withdrawal symptoms that it's counterparts? -
correct answer-Alprazolam (Xanax)
WhichvSSRI produces morevintense withdrawal symptoms that it's counterparts? - correct answer-
Paroxetine (Paxil)
Medications with this pharmacokinetic property have delayed discontinuation symptoms. - correct answer-
Long elimination half life
- Fluoxetine (Prozac, SSRI)vhas a long elimination half life of its active metabolite
What is autoinhibition? - correct answer-Dose dependent inhibition of a medication's own metabolism
- Paroxetine (Paxil, SSRI) inhibits P450 CYP 2D6 which isvwhat metabolizes the medication
Bupropion (Wellbutrin, atypical antidepressant) inhibits this enzyme system and paroxetine (Paxil, SSRI) i
s metabolized by it. - correct answer-CYP 2D6
-
Discontinuing bupropion would result in a rapid increase in metabolism of Paroxetine and drop in plasma
concentrations
- Paroxetine would need to bevincreased
What effect have sustained release alprazolam, paroxetine, and venlafaxine hadvon withdrawal reactions? -
correct answer-None.
-
They do notvreduce severity of withdrawal becausevthe long half life is due to delayed absorption not prolo
nged elimination
- Only benefit is the in reduced dosingvfrequency
Withdrawal symptoms present after hours or days of dose reduction or discontinuation and resolve within..
. - correct answer-A few weeks
- Persistent symptoms would indicate somethingvbesides withdrawal
, -
Psychotic and moodvsymptoms DOvNOT usually reappear abruptly after discontinuing long term treatmen
t
Signal detection is more challenging for compounds developed for psychiatric disorders because.... -
correct answer-Theveffect sizes arevnot large
What is expectation bias? - correct answer-
A situation where either the staff conducting the trial or subjects invthe trial or both groups expect that the t
est drug will confer a benefit or that it is unlikely to do so.
What effect does expectation bias play onvdrug trials? - correct answer-
Staff may have an unconscious bias toward rating more beneficial effects than are actually present.
- A larger trial may subsequently provevthatvthere is no difference from the placebo.
Explain the regression to mean phenomenon in drugvtrials. - correct answer-
As many trials enroll patients during an exacerbation of their illness, the phenomenon would tend to mean
that future measurements would be less extreme even if the subject is on a placebo.
CYP 450vtesting to predictvdrug dosing andvresponsiveness is one example of.... - correct answer-
Personalized Medicine
-
Measuring patient 2D6 metabolism can also help determine dosing of fluoxetine (Prozac, SSRI), av2D6 in
hibitorvwhen combined with medications metabolized by the same pathway
What is the ethical argument again whole genomevsequencing? - correct answer-
Findingvvariants that indicate only susceptibility and not definite disease canvaltervthe way a person lives th
eir life (eg. schizophrenia)
What does phase 1 of a nonclinical study entail and what is the goal? - correct answer-
Initial introduction of the new drug to humans, usually in healthy volunteers.
-
Goal of obtaining pharmacokinetic and pharmacologic effects of the drug in order to design a valid phase
2 study.
