NURS6630///NURS 6630 PSYCHOPHARMACOLOGY MIDTEARM EXAM 2 VERSIONS ACTUAL MIDTERM EXAM SUMMER /MOST RECENT WALDEN UNVERSITY AGRADED () The treatment for serotonin syndrome - correct answer-Cyproheptadine (5-HT2 receptor antagonist) Cyproheptadi

NURS6630///NURS 6630 PSYCHOPHARMACOLOGY MIDTEARM EXAM 2 VERSIONS ACTUAL MIDTERM EXAM SUMMER /MOST RECENT WALDEN UNVERSITY AGRADED (2025- 2026) The treatment for serotonin syndrome - correct answer-Cyproheptadine (5-HT2 receptor antagonist) Cyproheptadine treats serotonin syndrome by - correct answer-blocking 5-HT2 receptors (serotonin antagonist) When SSRIs or SNRIs are stopped abruptly, common symptoms of withdrawal include - correct answerIrritability, headaches, and insomnia Medicine specific side effect of citalopram - correct answer-Prolonged QT interval (normal=0.4.-0.44 seconds) This SSRI is pregnancy category D due to associations with congenital heart defects - correct answerParoxetine All SSRIs but paroxetine (D) are pregnancy category - correct answer-C Three SSRIs that are inhibitors of Cytochrome P450 enzymes - correct answer-fluoxetine, fluvoxamine, and paroxetine Five common SNRIs include - correct answer-duloxetine, venlafaxine, desvenlafaxine, milnacipran, levomilnacipran This antidepressant class of medications works by binding to presynaptic SERT and NET to inhibit them from reuptake of serotonin and norepinephrine to increase their levels in the synaptic cleft - correct answer-SNRIs In addition to MDD SNRIs treat - correct answer-Anxiety and neuropathic pain (peripheral neuropathy) Medication specific indications of duloxetine: - correct answer-urinary incontinence and Fibromyalgia Medication specific indications of venlafaxine: - correct answer-social anxiety, panic disorders, PTSD, OCD, postmenopausal hot flashes Six common side effects of SNRIs include: - correct answer-Insomnia, nausea, sexual dysfunction, hypertension, sweating, headaches Severe side effect of SNRIs in children/adolescents under age 25 years old: - correct answer-suicidal ideation Life threatening adverse effect of SNRIs, especially when used in combination with other serotonergic drugs: - correct answer-Serotonin Syndrome This SNRI is an inhibitor of Cytochrome P450 enzymes: - correct answer-venlafaxine This SNRI is hepatotoxic: - correct answer-duloxetine MAOIs increase the levels of: - correct answer-Serotonin, Norepinephrine, and Dopamine Norepinephrine regulates: - correct answer-alertness and focus Dopamine regulates: - correct answer-cognitive function, motivation, and awakeness In the synaptic cleft, Monoamine Oxidase A breaks down: - correct answer-Serotonin, Norepinephrine, and Dopamine In the synaptic cleft, Monoamine Oxidase B breaks down: - correct answer-Dopamine MAOIs are especially effective in: - correct answer-Atypical depression (mood responds to positive events and symptoms include increased appetite, weight gain, sleepiness, and fatigue) Non-selective MAOIs inhibit enzymes: - correct answer-MAO-A and MAO-B Selective MAOIs only inhibit the enzyme: - correct answer-MAO-B Three non-selective MAOIs: - correct answer-isocarboxazid, phenelzine, tranylcypromine Non-selective MAOIs increase the levels of these neurotransmitters: - correct answer-Serotonin, Norepinephrine, Dopamine These three non-selective MAOIs bind irreversibly to MAO enzymes to permanently block their function: - correct answer-isocarboxazid, phenelzine, tranylcypromine Two selective MAOIs: - correct answer-selegeline, rasagiline Selective MAOIs increase the level of this neurotransmitter: - correct answer-Dopamine These selective MAOIs are more commonly prescribed to treat Parkinson's Disease (a neurodegenerative disorder that effects the dopaminergic neurons in the substantia nigra region of the brain): - correct answer-selegeline, rasagiline Adverse effects of MAOIs include: - correct answer-Serotonin syndrome and hypertensive crisis Before starting another antidepressant MAOIs should be stopped for at least: - correct answer-Two weeks (to allow for the body to replace MAO enzymes so that serotonin syndrome does not occur) Five main symptoms of hypertensive crisis: - correct answer-hyperthermia, hypertension, tachycardia, arrhythmias, agitation Hypertensive crisis commonly occurs when people taking MAOIs consume foods or drinks high in: - correct answer-tyramine (cheese, wine, beer, cured/smoked meats) Foods and drinks rich in tyramine: - correct answer-cheese, wine, beer, cured/smoked meats When uninhibited, these two enzymes are responsible for breaking down tyramine: - correct answerMAO-A and MAO-B When tyramine is not broken down, it increases the release of this neurotransmitter, which causes hypertensive crisis: - correct answer-Norepinephrine Due to its action as an adrenergic antagonist this drug is the treatment of hypertensive crisis: - correct answer-Phentolamine TCAs are subdivided into these two groups: - correct answer-Tertiary TCAs and Secondary TCAs Three Tertiary TCAs: - correct answer-amitriptyline, imipramine, clomipramine Two Secondary TCAs: - correct answer-desipramine, nortriptyline Tertiary TCAs are non-selective and act on: - correct answer-Serotonin and Norephinephrine transporters (increase 5HT and NE) Secondary TCAs are selective and act only on: - correct answer-Norepinephrine transporters (increase NE) Therapeutic benefits from TCAs typically take approximately: - correct answer-2-4 weeks In addition to treatment of depression, other indications for TCAs include: - correct answer-Phobic disorders, chronic neuropathic pain, migraine prophylaxis Medication specific indication for clomipramine: - correct answer-OCD Medication specific indication for imipramine: - correct answer-Nocturnal enuresis In addition to SERTs and NETs, TCAs block (causes side effects): - correct answer-Histamine (H1) receptors, Muscarinic receptors, and Alpha 1 receptors TCAs inhibitory effects on Histamine (H1) receptors results in this side effect: - correct answer-sedation TCAs inhibitory effects on Muscarinic receptors results in this side effect profile: - correct answeranticholinergic side effects These TCAs more commonly cause anticholinergic side effects: - correct answer-amitriptyline, imipramine, clomipramine (Tertiary TCAs) These are five main anticholinergic side effects: - correct answer-dry mouth, tachycardia, urinary retention, confusion, hallucinations (common with Tertiary TCAs, amitriptyline, imipramine, clomipramine) TCAs inhibitory effects on Alpha 1 receptors results in this side effect: - correct answer-orthostatic hypotension This class of antidepressants is especially cardiotoxic and may cause arrhythmias and prolonged QT interval: - correct answer-TCAs Treatment of cardiotoxicity from TCAs: - correct answer-Sodium Bicarbonate The three most common causes of death from TCAs (The 3C's): - correct answer-Convulsion, Coma, and Cardiotoxicity This class of antidepressants inhibits Cytochrome P450 Enzymes: - correct answer-TCAs Combining these substances with Cytochrome P450 enzyme inhibitors can result in severe respiratory depression and death due to toxic levels: - correct answer-Ethanol and sedative hypnotics (benzos) These two neuron types have abundant Alpha 2 receptors: - correct answer-Noradrenergic and Serotonergic When stimulated Alpha 2 receptors inhibit the activity of the presynaptic neuron and decrease the release of these two neurotransmitters: - correct answer-Norepinephrine and Serotonin Six common Atypical Antidepressants used for individuals that did not respond to other antidepressants: - correct answer-mirtazapine, trazadone, nefazodone, vilazodone, vortioxetine, bupropion This antidepressant effects Alpha 2 receptors, 5-HT2A receptors, 5-HT3A receptors, and Histamine H1 receptors: - correct answer-mirtazapine The primary antidepressant action of this drug comes from inhibition of the Alpha 2 receptors, which reduces the inhibition of the synaptic neuron, and thus increases Norepinephrine and Serotonin release - correct answer-mirtazapine As a Serotonin Antagonist, this Atypical Antidepressant blocks 5-HT2A and 5-HT3A receptors to increase the amount of Serotonin available to bind to 5-HT1A receptors which are more strongly linked to depression: - correct answer-mirtazapine Mirtazapine's inhibition of 5-HT3A receptors reduces: - correct answer-nausea and vomiting Mirtazapine's inhibition of Histamine H1 receptors causes: - correct answer-sedation (could be desirable side effect for depressed individuals with insomnia) For depressed individuals with anorexia, increased appetite and weight gain, are possibly beneficial side effects of this Atypical Antidepressant: - correct answer-mirtazapine As Serotonin Antagonists, these two Atypical Antidepressants block 5-HT2A receptors so that more Serotonin is available to bind to 5-HT1A receptors which are more strongly linked to depression: - correct answer-trazodone and nefazodone In addition to inhibition of 5-HT2A receptors, these two Atypical Antidepressants increase levels of Serotonin in the synaptic cleft through weak inhibition of Serotonin reuptake transporters: - correct answer-trazodone and nefazodone These two Atypical Antidepressants are strong H1 receptor inhibitors, and therefore commonly used to treat insomnia: - correct answer-trazodone and nefazodone These two Atypical Antidepressants may cause orthostatic hypotension and priapism through Alpha-1 receptor inhibition: - correct answer-trazodone and nefazodone In rare cases, this Atypical Antidepressant is known to cause severe liver damage: - correct answernefazodone Similar to SSRIs, these two Atypical Antidepressants are strong inhibitors of Serotonin reuptake transporters on the presynaptic neuron: - correct answer-vilazodone and vortioxetine These two Atypical Antidepressants bind to and stimulate 5-HT1A receptors: - correct answer-vilazodone (partial agonist) and vortioxetine (full agonist) Vilazodone or Vortioxetine, which of these Atypical Antidepressants is a partial agonist?: - correct answer-vilazodone Vilazodone or Vortioxetine, which of these Atypical Antidepressants is a full agonist?: - correct answervortioxetine Since they enhance the effects of Serotonin through two different mechanisms, these two Atypical Antidepressants can cause serotonin syndrome: - correct answer-vilazodone and vortioxetine Six common side effects of vilazodone (primarily anticholinergic, **unique to vilazodone**): - correct answer-sedation, blurred vision, orthostatic hypotension, urinary retention, tachycardia, **weight gain** Six common side effects of vortioxetine (primarily anticholinergic, **unique to vortioxetine**): - c