NURS6630 ///NURS 6630
PSYCHOPHARMACOLOGY MIDTERM
EXAM 2 VERSIONS ACTUAL MIDTERM
EXAM SUMMER QRT| MOST RECENT
WALDEN UNIVERSITY|AGRADED
LATEST VERSION2024/2025.
Serotonin regulates Mood, emotion, feeding, and reproductive behavior
This class of antidepressants binds to presynaptic SERT and inhibits them from reuptake of
serotonin to increase levels in the synaptic cleft to bind with postsysnaptic 5HT2 receptors
SSRIs
First line therapy for MDD due to milder side effect profiles SSRIs
Six Common SSRIs citalopram, escitalopram, fluoxetine, fluvoxamine, sertraline, paroxetine
Onset of therapeutic benefit from SSRIs 4-6 weeks
In addition to MDD, SSRIs also treat Chronic Anxiety, PTSD, OCD, and eating disorders
(bulimia)
Five Common side effects of SSRIs include Anxiety, insomnia, GI distress, sexual dysfunction
(ED), SIADH
Severe side effect of SSRIs in children/adolescents under age 25 years old suicidal ideation
Life threatening adverse effect of SSRIs, especially when used in combination with other
serotonergic drugs (SNRIs, TCAs, MAOIs, etc.) Serotonin Syndrome
Excess accumulation of serotonin resulting in overstimulation of the nervous system
Serotonin Syndrome
Seven symptoms of Serotonin Syndrome Flushing, hyperthermia, agitation, muscle rigidity,
seizure, coma, HYPERreflexia
The treatment for serotonin syndrome Cyproheptadine (5-HT2 receptor antagonist)
Cyproheptadine treats serotonin syndrome by blocking 5-HT2 receptors (serotonin
antagonist)
When SSRIs or SNRIs are stopped abruptly, common symptoms of withdrawal include
Irritability, headaches, and insomnia
Medicine specific side effect of citalopram Prolonged QT interval (normal=0.4.-0.44 seconds)
This SSRI is pregnancy category D due to associations with congenital heart defects
Paroxetine
All SSRIs but paroxetine (D) are pregnancy category C
Three SSRIs that are inhibitors of Cytochrome P450 enzymes fluoxetine, fluvoxamine, and
paroxetine
Five common SNRIs include 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 SNRIs
In addition to MDD SNRIs treat Anxiety and neuropathic pain (peripheral neuropathy)
Medication specific indications of duloxetine: urinary incontinence and Fibromyalgia
Medication specific indications of venlafaxine: social anxiety, panic disorders, PTSD, OCD,
postmenopausal hot flashes
Six common side effects of SNRIs include: Insomnia, nausea, sexual dysfunction, hypertension,
sweating, headaches
Severe side effect of SNRIs in children/adolescents under age 25 years old: suicidal
ideation
Life threatening adverse effect of SNRIs, especially when used in combination with other
serotonergic drugs: Serotonin Syndrome
This SNRI is an inhibitor of Cytochrome P450 enzymes: venlafaxine
This SNRI is hepatotoxic: duloxetine
MAOIs increase the levels of:Serotonin, Norepinephrine, and Dopamine
Norepinephrine regulates: alertness and focus
Dopamine regulates: cognitive function, motivation, and awakeness
In the synaptic cleft, Monoamine Oxidase A breaks down: Serotonin, Norepinephrine, and
Dopamine
In the synaptic cleft, Monoamine Oxidase B breaks down: Dopamine
MAOIs are especially effective in: Atypical depression (mood responds to positive events and
symptoms include increased appetite, weight gain, sleepiness, and fatigue)
Non-selective MAOIs inhibit enzymes: MAO-A and MAO-B
Selective MAOIs only inhibit the enzyme: MAO-B
Three non-selective MAOIs: isocarboxazid, phenelzine, tranylcypromine
Non-selective MAOIs increase the levels of these neurotransmitters: Serotonin,
Norepinephrine, Dopamine
These three non-selective MAOIs bind irreversibly to MAO enzymes to permanently block their
function: isocarboxazid, phenelzine, tranylcypromine
Two selective MAOIs: selegeline, rasagiline
Selective MAOIs increase the level of this neurotransmitter: 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): selegeline, rasagiline
Adverse effects of MAOIs include: Serotonin syndrome and hypertensive crisis
Before starting another antidepressant MAOIs should be stopped for at least: Two weeks (to
allow for the body to replace MAO enzymes so that serotonin syndrome does not occur)
Five main symptoms of hypertensive crisis: hyperthermia, hypertension, tachycardia,
arrhythmias, agitation
Hypertensive crisis commonly occurs when people taking MAOIs consume foods or drinks high
in: tyramine (cheese, wine, beer, cured/smoked meats)
Foods and drinks rich in tyramine: cheese, wine, beer, cured/smoked meats
When uninhibited, these two enzymes are responsible for breaking down tyramine: MAO-
A and MAO-B
PSYCHOPHARMACOLOGY MIDTERM
EXAM 2 VERSIONS ACTUAL MIDTERM
EXAM SUMMER QRT| MOST RECENT
WALDEN UNIVERSITY|AGRADED
LATEST VERSION2024/2025.
Serotonin regulates Mood, emotion, feeding, and reproductive behavior
This class of antidepressants binds to presynaptic SERT and inhibits them from reuptake of
serotonin to increase levels in the synaptic cleft to bind with postsysnaptic 5HT2 receptors
SSRIs
First line therapy for MDD due to milder side effect profiles SSRIs
Six Common SSRIs citalopram, escitalopram, fluoxetine, fluvoxamine, sertraline, paroxetine
Onset of therapeutic benefit from SSRIs 4-6 weeks
In addition to MDD, SSRIs also treat Chronic Anxiety, PTSD, OCD, and eating disorders
(bulimia)
Five Common side effects of SSRIs include Anxiety, insomnia, GI distress, sexual dysfunction
(ED), SIADH
Severe side effect of SSRIs in children/adolescents under age 25 years old suicidal ideation
Life threatening adverse effect of SSRIs, especially when used in combination with other
serotonergic drugs (SNRIs, TCAs, MAOIs, etc.) Serotonin Syndrome
Excess accumulation of serotonin resulting in overstimulation of the nervous system
Serotonin Syndrome
Seven symptoms of Serotonin Syndrome Flushing, hyperthermia, agitation, muscle rigidity,
seizure, coma, HYPERreflexia
The treatment for serotonin syndrome Cyproheptadine (5-HT2 receptor antagonist)
Cyproheptadine treats serotonin syndrome by blocking 5-HT2 receptors (serotonin
antagonist)
When SSRIs or SNRIs are stopped abruptly, common symptoms of withdrawal include
Irritability, headaches, and insomnia
Medicine specific side effect of citalopram Prolonged QT interval (normal=0.4.-0.44 seconds)
This SSRI is pregnancy category D due to associations with congenital heart defects
Paroxetine
All SSRIs but paroxetine (D) are pregnancy category C
Three SSRIs that are inhibitors of Cytochrome P450 enzymes fluoxetine, fluvoxamine, and
paroxetine
Five common SNRIs include 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 SNRIs
In addition to MDD SNRIs treat Anxiety and neuropathic pain (peripheral neuropathy)
Medication specific indications of duloxetine: urinary incontinence and Fibromyalgia
Medication specific indications of venlafaxine: social anxiety, panic disorders, PTSD, OCD,
postmenopausal hot flashes
Six common side effects of SNRIs include: Insomnia, nausea, sexual dysfunction, hypertension,
sweating, headaches
Severe side effect of SNRIs in children/adolescents under age 25 years old: suicidal
ideation
Life threatening adverse effect of SNRIs, especially when used in combination with other
serotonergic drugs: Serotonin Syndrome
This SNRI is an inhibitor of Cytochrome P450 enzymes: venlafaxine
This SNRI is hepatotoxic: duloxetine
MAOIs increase the levels of:Serotonin, Norepinephrine, and Dopamine
Norepinephrine regulates: alertness and focus
Dopamine regulates: cognitive function, motivation, and awakeness
In the synaptic cleft, Monoamine Oxidase A breaks down: Serotonin, Norepinephrine, and
Dopamine
In the synaptic cleft, Monoamine Oxidase B breaks down: Dopamine
MAOIs are especially effective in: Atypical depression (mood responds to positive events and
symptoms include increased appetite, weight gain, sleepiness, and fatigue)
Non-selective MAOIs inhibit enzymes: MAO-A and MAO-B
Selective MAOIs only inhibit the enzyme: MAO-B
Three non-selective MAOIs: isocarboxazid, phenelzine, tranylcypromine
Non-selective MAOIs increase the levels of these neurotransmitters: Serotonin,
Norepinephrine, Dopamine
These three non-selective MAOIs bind irreversibly to MAO enzymes to permanently block their
function: isocarboxazid, phenelzine, tranylcypromine
Two selective MAOIs: selegeline, rasagiline
Selective MAOIs increase the level of this neurotransmitter: 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): selegeline, rasagiline
Adverse effects of MAOIs include: Serotonin syndrome and hypertensive crisis
Before starting another antidepressant MAOIs should be stopped for at least: Two weeks (to
allow for the body to replace MAO enzymes so that serotonin syndrome does not occur)
Five main symptoms of hypertensive crisis: hyperthermia, hypertension, tachycardia,
arrhythmias, agitation
Hypertensive crisis commonly occurs when people taking MAOIs consume foods or drinks high
in: tyramine (cheese, wine, beer, cured/smoked meats)
Foods and drinks rich in tyramine: cheese, wine, beer, cured/smoked meats
When uninhibited, these two enzymes are responsible for breaking down tyramine: MAO-
A and MAO-B
