MH 701 2025 MIDTERM EXAM UPDATED QUESTION TEST BANK
WITH SOLUTIONS
Non-stimulants for ADHD
atomoxetine (Strattera)
clonidine (Catapres)
guanfacine (Tenex) Bupropiion
Atomoxetine (Strattera): MOA
Selective inhibitor of norepinephrine reuptake
Bupropion MOA:
a. NE DA reuptake inhibitor (NDRI).
What are the 2 alpha adrenergic agonists used for ADHD?
Clonidine (Catapres)
Guanfacine (Tenex)
Mechanism unknown
Which are the first line antidepressants for children?
Fluoxetine, sertraline and citalopram.
Escitalopram is over 12.
,What are the first line medications for anxiety for children?
Fluvoxamine, fluoxetine, sertraline & paroxetine.
Define postpartum blues:
a transient mood disturbance characterized by mood lability, sadness, dysphoria,
subjective confusion and tearfulness. May last several days. No treatment except
education & support.
Define postpartum depression
Onset within 12 weeks from delivery. Depressed mood, excessive anxiety, insomnia (her
lecture says change in weight, but everyone has that after a baby is born??) If signs of baby
blues above persists for more than 2 weeks, then evaluate for PP depression.
Define postpartum psychosis
Depression, delusions, thoughts of harming self or infant. Usually begins within days of
delivery (mean is 2-3 weeks). Have some of the same signs of depression, fatigue,
insomnia, restlessness, & tearfulness. Later they get suspicious, have confusion,
incoherence irrational statements, & obsessive concerns.,
Which antidepressants, mood stabilizers, or antipsychotic medications are safe in
pregnancy? (Are any safe in Pregnancy?)
Antidepressants - Sertraline is the first choice. Paroxetine is not used.
,Bipolar: Lamotrigine is used for bipolar maintenance, has protective effects against bipolar
depression and a growing reproductive safety profile
Antipsychotics - Lurasidone (Latuda) is a class B.
What education would you provide to a patient about the adverse effects for
antidepressants to a patient who is pregnant?
Risk versus benefits of any of these medications is taken into consideration.
Antidepressants are the most studied in pregnancy. Exposure to SSRI's in the third
trimester are associated with poor neonatal adaptation with sx of transient neonatal
complications. There are conflicting reports of pulmonary hypertension in newborns with
mother's taking SSRI's. Patients also need to know that the relapse of depression in
pregnancy is high.
What education would you provide to a patient about the adverse effects for mood
stabilizers to a patient who is pregnant?
Bipolar: relapse of bipolar is high during pregnancy. "The risk benefit decision-making
model direct the treatment structure of bipolar disorder during pregnancy based on the risk
of no treatment versus reproductive toxicity in 5 domains: intrauterine fetal death, physical
malformations, growth impairment, behavioral teratogenicity and neonatal toxicity."
Mood stabilizers are first line except for lithium. Valproate and carbamazepine can not be
given.
What education would you provide to a patient about the adverse effects for antipsychotics
to a patient who is pregnant?
Antipsychotics: Only animal studies have been performed and they have found evidence of
teratogenic or embryo/feto toxic effects in all of the antipsychotics.
, Chlorpromazine causes congenital malformations; haloperidol limb reduction defects;
chlorpromazine\ can cause lethargy in breastfeeding infants.
What is St. Johns Wort?
A plant with yellow flowers that has long been used for healing
Historically, St. John's wort has been used for a variety of conditions, including kidney and
lung ailments, insomnia, and depression, and to aid wound healing.
Promoted for depression, menopausal symptoms, attention-deficit hyperactivity disorder
(ADHD), somatic symptom disorder (a condition in which a person feels extreme,
exaggerated anxiety about physical symptoms), obsessive-compulsive disorder, and other
conditions. Topical use (applied to the skin) of St. John's wort is promoted for various skin
conditions, including wounds, bruises, and muscle pain.
Has been shown effective for treating mild to moderate depression, might be helpful for
menopausal symptoms, wound healing, and somatic symptom disorder, but there's not
enough evidence to know for certain.
There's not enough reliable evidence to know whether St. John's wort might be beneficial
for quitting smoking or improving memory or for many conditions, including anxiety, ADHD,
and seasonal affective disorder.
Which medications does St Johns Wort affect?
St. John's wort can weaken the effects of many medicines, including crucially important
medicines such as
Antidepressants
Birth control pills
Cyclosporine, which prevents the body from rejecting transplanted organs
Some heart medications, including digoxin and ivabradine
Some HIV drugs, including indinavir and nevirapine
WITH SOLUTIONS
Non-stimulants for ADHD
atomoxetine (Strattera)
clonidine (Catapres)
guanfacine (Tenex) Bupropiion
Atomoxetine (Strattera): MOA
Selective inhibitor of norepinephrine reuptake
Bupropion MOA:
a. NE DA reuptake inhibitor (NDRI).
What are the 2 alpha adrenergic agonists used for ADHD?
Clonidine (Catapres)
Guanfacine (Tenex)
Mechanism unknown
Which are the first line antidepressants for children?
Fluoxetine, sertraline and citalopram.
Escitalopram is over 12.
,What are the first line medications for anxiety for children?
Fluvoxamine, fluoxetine, sertraline & paroxetine.
Define postpartum blues:
a transient mood disturbance characterized by mood lability, sadness, dysphoria,
subjective confusion and tearfulness. May last several days. No treatment except
education & support.
Define postpartum depression
Onset within 12 weeks from delivery. Depressed mood, excessive anxiety, insomnia (her
lecture says change in weight, but everyone has that after a baby is born??) If signs of baby
blues above persists for more than 2 weeks, then evaluate for PP depression.
Define postpartum psychosis
Depression, delusions, thoughts of harming self or infant. Usually begins within days of
delivery (mean is 2-3 weeks). Have some of the same signs of depression, fatigue,
insomnia, restlessness, & tearfulness. Later they get suspicious, have confusion,
incoherence irrational statements, & obsessive concerns.,
Which antidepressants, mood stabilizers, or antipsychotic medications are safe in
pregnancy? (Are any safe in Pregnancy?)
Antidepressants - Sertraline is the first choice. Paroxetine is not used.
,Bipolar: Lamotrigine is used for bipolar maintenance, has protective effects against bipolar
depression and a growing reproductive safety profile
Antipsychotics - Lurasidone (Latuda) is a class B.
What education would you provide to a patient about the adverse effects for
antidepressants to a patient who is pregnant?
Risk versus benefits of any of these medications is taken into consideration.
Antidepressants are the most studied in pregnancy. Exposure to SSRI's in the third
trimester are associated with poor neonatal adaptation with sx of transient neonatal
complications. There are conflicting reports of pulmonary hypertension in newborns with
mother's taking SSRI's. Patients also need to know that the relapse of depression in
pregnancy is high.
What education would you provide to a patient about the adverse effects for mood
stabilizers to a patient who is pregnant?
Bipolar: relapse of bipolar is high during pregnancy. "The risk benefit decision-making
model direct the treatment structure of bipolar disorder during pregnancy based on the risk
of no treatment versus reproductive toxicity in 5 domains: intrauterine fetal death, physical
malformations, growth impairment, behavioral teratogenicity and neonatal toxicity."
Mood stabilizers are first line except for lithium. Valproate and carbamazepine can not be
given.
What education would you provide to a patient about the adverse effects for antipsychotics
to a patient who is pregnant?
Antipsychotics: Only animal studies have been performed and they have found evidence of
teratogenic or embryo/feto toxic effects in all of the antipsychotics.
, Chlorpromazine causes congenital malformations; haloperidol limb reduction defects;
chlorpromazine\ can cause lethargy in breastfeeding infants.
What is St. Johns Wort?
A plant with yellow flowers that has long been used for healing
Historically, St. John's wort has been used for a variety of conditions, including kidney and
lung ailments, insomnia, and depression, and to aid wound healing.
Promoted for depression, menopausal symptoms, attention-deficit hyperactivity disorder
(ADHD), somatic symptom disorder (a condition in which a person feels extreme,
exaggerated anxiety about physical symptoms), obsessive-compulsive disorder, and other
conditions. Topical use (applied to the skin) of St. John's wort is promoted for various skin
conditions, including wounds, bruises, and muscle pain.
Has been shown effective for treating mild to moderate depression, might be helpful for
menopausal symptoms, wound healing, and somatic symptom disorder, but there's not
enough evidence to know for certain.
There's not enough reliable evidence to know whether St. John's wort might be beneficial
for quitting smoking or improving memory or for many conditions, including anxiety, ADHD,
and seasonal affective disorder.
Which medications does St Johns Wort affect?
St. John's wort can weaken the effects of many medicines, including crucially important
medicines such as
Antidepressants
Birth control pills
Cyclosporine, which prevents the body from rejecting transplanted organs
Some heart medications, including digoxin and ivabradine
Some HIV drugs, including indinavir and nevirapine
