CMN 548 MODULE 5
PSYCHOPHARMACOLOGY
EXAM
What are the characteristics of withdrawal syndrome with MAOIs? -
ANSWERS-- Increased arousal
- Mood disturbance
- Psychosis
- Convulsions
24-72 hours after discontinuation
Trazodone is a potent antagonist of which receptor? - ANSWERS--
5HT2A
- peripheral alpha adrenergic receptors (cause for orthostatic
hypotension, dizziness, dry mouth, priapism)
What was the effective dosing regimen of Trazodone for treatment of
childhood disruptive behaviors in clinical study? - ANSWERS-
Thrice-daily dosing of trazodone at an average dose of about 5 mg/kg
per day for a duration of 3 to 4 weeks resulted in clinical
improvement in 65% of the children
What cardiovascular symptoms are caused by Trazodone? -
ANSWERS-- Postural hypotension
- Possible PR interval lengthening
,- Caution in pre-existing heart disease
What genitourinary symptoms are caused by Trazodone? -
ANSWERS-- Priapism
- Alpha adrenergic receptor antagonists induce priapism by inhibiting
sympathetically controlled detumescence
- Likely in first 28 days
- Urologic emergency lasting more than 1 hour
- Treatment with surgical procedure
Trazodone has what effects on labs? - ANSWERS-- Clinically
insignificant pseudoanemia
- False positive urine drug screen for amphetamines
What is Nefazodone (Serzone) mechanism of action? - ANSWERS--
5HT2A antagonism
- Inhibition of SERT
- limited affinity for alpha1 adrenergic receptor (lower incidence of
postural hypotension)
Nefazodone (Serzone) inhibits CYP3A4, which can cause an increase
in blood levels of which medications? - ANSWERS-Alprazolam
(Xanax)
Triazolam (Halcion)
, *If alprazolam is used with nefazodone, a 50% reduction in the initial
dose of alprazolam
- Recommended that nefazodone not be used in combination with an
MAOI or within 14 days of discontinuing treatment with an MAOI.
- combination of nefazodone and carbamazepine may lose
antidepressant efficacy
What are the two basic mechanisms for studying receptors? -
ANSWERS-- Measure the 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 differ from
real life? - ANSWERS-- There are hundreds to thousands of axons
connecting to one dendrite
- A single transmitter can evoke multiple pathways
Pharmacokinetic drug interactions are... - ANSWERS-the effects of
drugs on the PLASMA concentrations of each other
Pharmacokinetic concepts describe and predict... - ANSWERS-- the
time course of drug concentration in different parts of the body
- onset, duration, absorption, distribution, metabolism, excretion
Remission - ANSWERS-- Preferred outcome of treatment
PSYCHOPHARMACOLOGY
EXAM
What are the characteristics of withdrawal syndrome with MAOIs? -
ANSWERS-- Increased arousal
- Mood disturbance
- Psychosis
- Convulsions
24-72 hours after discontinuation
Trazodone is a potent antagonist of which receptor? - ANSWERS--
5HT2A
- peripheral alpha adrenergic receptors (cause for orthostatic
hypotension, dizziness, dry mouth, priapism)
What was the effective dosing regimen of Trazodone for treatment of
childhood disruptive behaviors in clinical study? - ANSWERS-
Thrice-daily dosing of trazodone at an average dose of about 5 mg/kg
per day for a duration of 3 to 4 weeks resulted in clinical
improvement in 65% of the children
What cardiovascular symptoms are caused by Trazodone? -
ANSWERS-- Postural hypotension
- Possible PR interval lengthening
,- Caution in pre-existing heart disease
What genitourinary symptoms are caused by Trazodone? -
ANSWERS-- Priapism
- Alpha adrenergic receptor antagonists induce priapism by inhibiting
sympathetically controlled detumescence
- Likely in first 28 days
- Urologic emergency lasting more than 1 hour
- Treatment with surgical procedure
Trazodone has what effects on labs? - ANSWERS-- Clinically
insignificant pseudoanemia
- False positive urine drug screen for amphetamines
What is Nefazodone (Serzone) mechanism of action? - ANSWERS--
5HT2A antagonism
- Inhibition of SERT
- limited affinity for alpha1 adrenergic receptor (lower incidence of
postural hypotension)
Nefazodone (Serzone) inhibits CYP3A4, which can cause an increase
in blood levels of which medications? - ANSWERS-Alprazolam
(Xanax)
Triazolam (Halcion)
, *If alprazolam is used with nefazodone, a 50% reduction in the initial
dose of alprazolam
- Recommended that nefazodone not be used in combination with an
MAOI or within 14 days of discontinuing treatment with an MAOI.
- combination of nefazodone and carbamazepine may lose
antidepressant efficacy
What are the two basic mechanisms for studying receptors? -
ANSWERS-- Measure the 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 differ from
real life? - ANSWERS-- There are hundreds to thousands of axons
connecting to one dendrite
- A single transmitter can evoke multiple pathways
Pharmacokinetic drug interactions are... - ANSWERS-the effects of
drugs on the PLASMA concentrations of each other
Pharmacokinetic concepts describe and predict... - ANSWERS-- the
time course of drug concentration in different parts of the body
- onset, duration, absorption, distribution, metabolism, excretion
Remission - ANSWERS-- Preferred outcome of treatment
