TEST PAPER 2026 COMPLETE SOLUTIONS
◉ Adverse effects of MAOIs include. Answer: Serotonin syndrome
and hypertensive crisis
◉ Before starting another antidepressant MAOIs should be stopped
for at least:. 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: Answer:
hyperthermia, hypertension, tachycardia, arrhythmias, agitation
◉ Hypertensive crisis commonly occurs when people taking MAOIs
consume foods or drinks high in:. Answer: tyramine (cheese, wine,
beer, cured/smoked meats)
◉ Foods and drinks rich in tyramine:. Answer: cheese, wine, beer,
cured/smoked meats
◉ When uninhibited, these two enzymes are responsible for
breaking down tyramine:. Answer: MAO-A and MAO-B
,◉ When tyramine is not broken down, it increases the release of this
neurotransmitter, which causes hypertensive crisis:. Answer:
Norepinephrine
◉ Due to its action as an adrenergic antagonist this drug is the
treatment of hypertensive crisis:. Answer: Phentolamine
◉ TCAs are subdivided into these two groups:. Answer: Tertiary
TCAs and Secondary TCAs
◉ Three Tertiary TCAs:. Answer: amitriptyline, imipramine,
clomipramine
◉ Two Secondary TCAs:. Answer: desipramine, nortriptyline
◉ Tertiary TCAs are non-selective and act on:. Answer: Serotonin
and Norephinephrine transporters (increase 5HT and NE)
◉ Secondary TCAs are selective and act only on:. Answer:
Norepinephrine transporters (increase NE)
◉ Therapeutic benefits from TCAs typically take approximately:.
Answer: 2-4 weeks
, ◉ In addition to treatment of depression, other indications for TCAs
include:. Answer: Phobic disorders, chronic neuropathic pain,
migraine prophylaxis
◉ Medication specific indication for clomipramine:. Answer: OCD
◉ Medication specific indication for imipramine:. Answer: Nocturnal
enuresis
◉ In addition to SERTs and NETs, TCAs block (causes side effects):.
Answer: Histamine (H1) receptors, Muscarinic receptors, and Alpha
1 receptors
◉ TCAs inhibitory effects on Histamine (H1) receptors results in this
side effect:. Answer: sedation
◉ TCAs inhibitory effects on Muscarinic receptors results in this side
effect profile:. Answer: anticholinergic side effects
◉ These TCAs more commonly cause anticholinergic side effects:.
Answer: amitriptyline, imipramine, clomipramine (Tertiary TCAs)
◉ These are five main anticholinergic side effects:. Answer: dry
mouth, tachycardia, urinary retention, confusion, hallucinations