NR546-FinalExam-Pearls WITH CORRECT
SOLUTIONS /PASS GUIDE
1. First line treatment for depression - ANSWER-SSRIs
2. Common side effect of SSRIs - ANSWER-sexual dysfunction
3. rapid cycling bipolar disorder - ANSWER-Minimum of 4 episodes a year
4. Goal of antidepressant therapy - ANSWER-complete remission of symptoms
5. Serotonin GI effects - ANSWER-Due to the fact that 90% of 5HT receptors are located
in GI tract
6. best tolerated SSRI - ANSWER-Escitalopram (Lexapro) also has fewest CYP interactions
7. Lithium levels - ANSWER-Can be increased by NSAIDS and ACE inhibitors
Can be decreased by caffeine and mania
Unaffected by amiloride, furosemide, and sulindac
8. Lithium purpose - ANSWER-Effective treatment for manic episodes, to prevent
reoccurrence and to a lower degree is effective in depressive episodes
9. Lamotrigine - ANSWER-Well tolerated except for the propensity to cause a rash
10. Monoamines - ANSWER-dopamine, norepinephrine, serotonin
,11. Lamotrigine - ANSWER-Is a mood stabilizer
12. Lithium - ANSWER-Well established to prevent suicide in clients with mood disorders
13. Lithium - ANSWER-Has a narrow therapeutic window and requires law draws
14. 1st line treatment for OCD - ANSWER-SSRIs are first line. Benzodiazepines are not!!!
15. Primary action of hallucinogenic drugs such as LSD,mescaline, psilocybin, and MDMA -
ANSWER-Agonism of 5HT2A receptors
16. Hallucinogens may have additional actions at other serotonin receptors (particularly
5HT1A and 5HT2C) and at other neurotransmitter systems, and MDMA in particular
also blocks the serotonin transporter (SERT)
17. Controls appetite - ANSWER-hypothalamus serves as the brain center that controls
appetite by utilizing a complex set of circuits and regulators. One formulation of how
the hypothalamus does this is the notion that there is a major appetite stimulating
pathway whose actions are mediated by two peptides (neuropeptide Y and agouti-
related protein)
18. Phentermine - ANSWER-Acts like amphetamine, blocking both the dopamine
transporter (DAT) and the norepinephrine transporter (NET) and, at high doses, the
vesicular monoamine transporter (VMAT)
19. Buprenorphine - ANSWER-Is also approved for <18 year olds
20. Disulfiram caution - ANSWER-Alcohol reaction may occur within two weeks of alcohol
ingestion
, 21. Methadone - ANSWER-Is a full mu-receptor agonist with a long half-life, which can
prevent withdrawal symptoms for 24 hours and provide steady control of cravings
throughout the day. In addition to its opioid receptor activity, it is also an antagonist
of the N-methyl-D-aspartate (NMDA) receptor.
22. Hallucinogenic intoxication - ANSWER-pupillary dilation, tachycardia, sweating,
palpitations, blurred vision, tremors, incoordination
23. Can be perceived as a panic attack and often called a bad trip.
24. Can experience an acute state of confusion (delirium) where the abuser is disoriented
and agitated.
25. Disulfiram - ANSWER-Irreversibly inhibits aldehyde dehydrogenase resulting in build
of toxic levels of acetaldehyde
26. Acamprosate reduces glutamate release associated with alcohol withdrawal,
naltrexone blocks the enjoyment of heavy drinking through its action on reward
circuitry.
27. sedative-hypnotics - ANSWER-Act at GABA A receptor sites in reward circuits
28. Impulsive Disorders - ANSWER-Focused on reward and associated with Mesolimbic
pathway
29. The Tuberomammillary nucleus (TMN) - ANSWER-contains the on switch where as the
off switch is located in the ventrolateral preoptic nucleus (VLPO)
30. Guanfacine - ANSWER-Is an alpha 2 agonist
31. Methylphenidate - ANSWER-Is a dopamine norepinephrine multimodal
SOLUTIONS /PASS GUIDE
1. First line treatment for depression - ANSWER-SSRIs
2. Common side effect of SSRIs - ANSWER-sexual dysfunction
3. rapid cycling bipolar disorder - ANSWER-Minimum of 4 episodes a year
4. Goal of antidepressant therapy - ANSWER-complete remission of symptoms
5. Serotonin GI effects - ANSWER-Due to the fact that 90% of 5HT receptors are located
in GI tract
6. best tolerated SSRI - ANSWER-Escitalopram (Lexapro) also has fewest CYP interactions
7. Lithium levels - ANSWER-Can be increased by NSAIDS and ACE inhibitors
Can be decreased by caffeine and mania
Unaffected by amiloride, furosemide, and sulindac
8. Lithium purpose - ANSWER-Effective treatment for manic episodes, to prevent
reoccurrence and to a lower degree is effective in depressive episodes
9. Lamotrigine - ANSWER-Well tolerated except for the propensity to cause a rash
10. Monoamines - ANSWER-dopamine, norepinephrine, serotonin
,11. Lamotrigine - ANSWER-Is a mood stabilizer
12. Lithium - ANSWER-Well established to prevent suicide in clients with mood disorders
13. Lithium - ANSWER-Has a narrow therapeutic window and requires law draws
14. 1st line treatment for OCD - ANSWER-SSRIs are first line. Benzodiazepines are not!!!
15. Primary action of hallucinogenic drugs such as LSD,mescaline, psilocybin, and MDMA -
ANSWER-Agonism of 5HT2A receptors
16. Hallucinogens may have additional actions at other serotonin receptors (particularly
5HT1A and 5HT2C) and at other neurotransmitter systems, and MDMA in particular
also blocks the serotonin transporter (SERT)
17. Controls appetite - ANSWER-hypothalamus serves as the brain center that controls
appetite by utilizing a complex set of circuits and regulators. One formulation of how
the hypothalamus does this is the notion that there is a major appetite stimulating
pathway whose actions are mediated by two peptides (neuropeptide Y and agouti-
related protein)
18. Phentermine - ANSWER-Acts like amphetamine, blocking both the dopamine
transporter (DAT) and the norepinephrine transporter (NET) and, at high doses, the
vesicular monoamine transporter (VMAT)
19. Buprenorphine - ANSWER-Is also approved for <18 year olds
20. Disulfiram caution - ANSWER-Alcohol reaction may occur within two weeks of alcohol
ingestion
, 21. Methadone - ANSWER-Is a full mu-receptor agonist with a long half-life, which can
prevent withdrawal symptoms for 24 hours and provide steady control of cravings
throughout the day. In addition to its opioid receptor activity, it is also an antagonist
of the N-methyl-D-aspartate (NMDA) receptor.
22. Hallucinogenic intoxication - ANSWER-pupillary dilation, tachycardia, sweating,
palpitations, blurred vision, tremors, incoordination
23. Can be perceived as a panic attack and often called a bad trip.
24. Can experience an acute state of confusion (delirium) where the abuser is disoriented
and agitated.
25. Disulfiram - ANSWER-Irreversibly inhibits aldehyde dehydrogenase resulting in build
of toxic levels of acetaldehyde
26. Acamprosate reduces glutamate release associated with alcohol withdrawal,
naltrexone blocks the enjoyment of heavy drinking through its action on reward
circuitry.
27. sedative-hypnotics - ANSWER-Act at GABA A receptor sites in reward circuits
28. Impulsive Disorders - ANSWER-Focused on reward and associated with Mesolimbic
pathway
29. The Tuberomammillary nucleus (TMN) - ANSWER-contains the on switch where as the
off switch is located in the ventrolateral preoptic nucleus (VLPO)
30. Guanfacine - ANSWER-Is an alpha 2 agonist
31. Methylphenidate - ANSWER-Is a dopamine norepinephrine multimodal
