NURS 6630: Psychopharmacology and
Neurobiology
UNIT 1: NEUROBIOLOGY & NEUROTRANSMITTERS
Q1: What are the four main dopamine pathways in the brain?
A1: 1. Mesolimbic (reward, positive symptoms of psychosis)
2. Mesocortical (cognition, negative symptoms)
3. Nigrostriatal (movement, extrapyramidal symptoms)
4. Tuberoinfundibular (prolactin regulation)
Q2: What dopamine pathway is associated with reward and positive symptoms of
schizophrenia?
A2: Mesolimbic pathway.
Q3: What dopamine pathway is associated with cognition and negative symptoms of
schizophrenia?
A3: Mesocortical pathway.
Q4: What dopamine pathway is associated with movement and extrapyramidal symptoms
(EPS)?
A4: Nigrostriatal pathway.
Q5: What dopamine pathway is associated with prolactin regulation?
A5: Tuberoinfundibular pathway.
Q6: What are the three major monoamine neurotransmitters?
A6: Serotonin, Norepinephrine, Dopamine.
Q7: What is the role of serotonin (5-HT)?
A7: Regulates mood, sleep, appetite, pain perception, and GI function.
Q8: What is the role of norepinephrine?
A8: Regulates arousal, attention, focus, fight or flight response.
Q9: What is the role of dopamine?
A9: Regulates reward, motivation, pleasure, movement, cognition.
Q10: What is GABA and what does it do?
A10: Gamma-aminobutyric acid; primary inhibitory neurotransmitter; calms brain activity.
Q11: What is glutamate and what does it do?
,A11: Primary excitatory neurotransmitter; involved in learning and memory.
Q12: What is acetylcholine involved in?
A12: Memory, learning, muscle contraction; low levels linked to Alzheimer's.
Q13: What is the monoamine hypothesis of depression?
A13: Depression caused by low levels of serotonin, norepinephrine, and/or dopamine.
Q14: What is the dopamine hypothesis of schizophrenia?
A14: Positive symptoms caused by excess dopamine in mesolimbic pathway.
Q15: What is receptor downregulation?
A15: Decrease in receptor number due to high neurotransmitter levels or chronic agonist use.
Q16: What is receptor upregulation?
A16: Increase in receptor number due to low neurotransmitter levels or chronic antagonist use.
Q17: What is the therapeutic lag in antidepressants?
A17: 2-6 weeks before full therapeutic effect occurs due to receptor adaptations.
UNIT 2: ANTIDEPRESSANTS
Q18: What are the four main classes of antidepressants?
A18: 1. SSRIs (Selective Serotonin Reuptake Inhibitors)
2. SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors)
3. TCAs (Tricyclic Antidepressants)
4. MAOIs (Monoamine Oxidase Inhibitors)
Q19: List the SSRIs and their names.
A19: "Fluoxetine (Prozac), Sertraline (Zoloft), Paroxetine (Paxil), Citalopram (Celexa),
Escitalopram (Lexapro), Fluvoxamine (Luvox)."
Q20: What is the mechanism of action of SSRIs?
A20: Block serotonin reuptake pump, increasing serotonin in synapse.
Q21: What are common side effects of SSRIs?
A21: Sexual dysfunction, GI upset, insomnia, anxiety (initial), weight gain, serotonin syndrome
risk.
Q22: Which SSRI has the shortest half-life and causes worst withdrawal?
A22: Paroxetine (Paxil).
, Q23: Which SSRI has the longest half-life and safest discontinuation?
A23: Fluoxetine (Prozac).
Q24: Which SSRI is safest in pregnancy?
A24: Sertraline (Zoloft).
Q25: Which SSRI has the most drug interactions due to CYP450 inhibition?
A25: Fluoxetine (Prozac) and Paroxetine (Paxil).
Q26: Which SSRI is used for OCD?
A26: Fluvoxamine (Luvox) and high-dose Sertraline (Zoloft).
Q27: List the SNRIs and their names.
A27: Venlafaxine (Effexor), Duloxetine (Cymbalta), Desvenlafaxine (Pristiq), Levomilnacipran
(Fetzima).
Q28: What is the mechanism of action of SNRIs?
A28: Block serotonin and norepinephrine reuptake.
Q29: What side effect is unique to Venlafaxine (Effexor) at high doses?
A29: Dose-related hypertension.
Q30: Which SNRI is also used for neuropathic pain and fibromyalgia?
A30: Duloxetine (Cymbalta).
Q31: Which SNRI is also used for hot flashes?
A31: Venlafaxine (Effexor).
Q32: What are Tricyclic Antidepressants (TCAs)?
A32: Older antidepressants; block serotonin and norepinephrine reuptake; also block histamine,
acetylcholine, alpha-1 receptors.
Q33: List common TCAs.
A33: Amitriptyline (Elavil), Nortriptyline (Pamelor), Imipramine (Tofranil), Desipramine
(Norpramin), Doxepin (Sinequan).
Q34: What is the major safety concern with TCAs?
A34: Lethal in overdose; cardiac arrhythmias; narrow therapeutic index.
Q35: What are anticholinergic side effects of TCAs?
A35: Dry mouth, constipation, urinary retention, blurred vision, confusion.
Q36: Which TCA is most sedating?
A36: Amitriptyline (Elavil) and Doxepin (Sinequan).
Neurobiology
UNIT 1: NEUROBIOLOGY & NEUROTRANSMITTERS
Q1: What are the four main dopamine pathways in the brain?
A1: 1. Mesolimbic (reward, positive symptoms of psychosis)
2. Mesocortical (cognition, negative symptoms)
3. Nigrostriatal (movement, extrapyramidal symptoms)
4. Tuberoinfundibular (prolactin regulation)
Q2: What dopamine pathway is associated with reward and positive symptoms of
schizophrenia?
A2: Mesolimbic pathway.
Q3: What dopamine pathway is associated with cognition and negative symptoms of
schizophrenia?
A3: Mesocortical pathway.
Q4: What dopamine pathway is associated with movement and extrapyramidal symptoms
(EPS)?
A4: Nigrostriatal pathway.
Q5: What dopamine pathway is associated with prolactin regulation?
A5: Tuberoinfundibular pathway.
Q6: What are the three major monoamine neurotransmitters?
A6: Serotonin, Norepinephrine, Dopamine.
Q7: What is the role of serotonin (5-HT)?
A7: Regulates mood, sleep, appetite, pain perception, and GI function.
Q8: What is the role of norepinephrine?
A8: Regulates arousal, attention, focus, fight or flight response.
Q9: What is the role of dopamine?
A9: Regulates reward, motivation, pleasure, movement, cognition.
Q10: What is GABA and what does it do?
A10: Gamma-aminobutyric acid; primary inhibitory neurotransmitter; calms brain activity.
Q11: What is glutamate and what does it do?
,A11: Primary excitatory neurotransmitter; involved in learning and memory.
Q12: What is acetylcholine involved in?
A12: Memory, learning, muscle contraction; low levels linked to Alzheimer's.
Q13: What is the monoamine hypothesis of depression?
A13: Depression caused by low levels of serotonin, norepinephrine, and/or dopamine.
Q14: What is the dopamine hypothesis of schizophrenia?
A14: Positive symptoms caused by excess dopamine in mesolimbic pathway.
Q15: What is receptor downregulation?
A15: Decrease in receptor number due to high neurotransmitter levels or chronic agonist use.
Q16: What is receptor upregulation?
A16: Increase in receptor number due to low neurotransmitter levels or chronic antagonist use.
Q17: What is the therapeutic lag in antidepressants?
A17: 2-6 weeks before full therapeutic effect occurs due to receptor adaptations.
UNIT 2: ANTIDEPRESSANTS
Q18: What are the four main classes of antidepressants?
A18: 1. SSRIs (Selective Serotonin Reuptake Inhibitors)
2. SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors)
3. TCAs (Tricyclic Antidepressants)
4. MAOIs (Monoamine Oxidase Inhibitors)
Q19: List the SSRIs and their names.
A19: "Fluoxetine (Prozac), Sertraline (Zoloft), Paroxetine (Paxil), Citalopram (Celexa),
Escitalopram (Lexapro), Fluvoxamine (Luvox)."
Q20: What is the mechanism of action of SSRIs?
A20: Block serotonin reuptake pump, increasing serotonin in synapse.
Q21: What are common side effects of SSRIs?
A21: Sexual dysfunction, GI upset, insomnia, anxiety (initial), weight gain, serotonin syndrome
risk.
Q22: Which SSRI has the shortest half-life and causes worst withdrawal?
A22: Paroxetine (Paxil).
, Q23: Which SSRI has the longest half-life and safest discontinuation?
A23: Fluoxetine (Prozac).
Q24: Which SSRI is safest in pregnancy?
A24: Sertraline (Zoloft).
Q25: Which SSRI has the most drug interactions due to CYP450 inhibition?
A25: Fluoxetine (Prozac) and Paroxetine (Paxil).
Q26: Which SSRI is used for OCD?
A26: Fluvoxamine (Luvox) and high-dose Sertraline (Zoloft).
Q27: List the SNRIs and their names.
A27: Venlafaxine (Effexor), Duloxetine (Cymbalta), Desvenlafaxine (Pristiq), Levomilnacipran
(Fetzima).
Q28: What is the mechanism of action of SNRIs?
A28: Block serotonin and norepinephrine reuptake.
Q29: What side effect is unique to Venlafaxine (Effexor) at high doses?
A29: Dose-related hypertension.
Q30: Which SNRI is also used for neuropathic pain and fibromyalgia?
A30: Duloxetine (Cymbalta).
Q31: Which SNRI is also used for hot flashes?
A31: Venlafaxine (Effexor).
Q32: What are Tricyclic Antidepressants (TCAs)?
A32: Older antidepressants; block serotonin and norepinephrine reuptake; also block histamine,
acetylcholine, alpha-1 receptors.
Q33: List common TCAs.
A33: Amitriptyline (Elavil), Nortriptyline (Pamelor), Imipramine (Tofranil), Desipramine
(Norpramin), Doxepin (Sinequan).
Q34: What is the major safety concern with TCAs?
A34: Lethal in overdose; cardiac arrhythmias; narrow therapeutic index.
Q35: What are anticholinergic side effects of TCAs?
A35: Dry mouth, constipation, urinary retention, blurred vision, confusion.
Q36: Which TCA is most sedating?
A36: Amitriptyline (Elavil) and Doxepin (Sinequan).
