PMHNP Psychopharmacology – Exam 2 Review – Nurse
Practitioner Program – Comprehensive Q&A Format
This document provides an in-depth review for the second exam in the PMHNP
Psychopharmacology course. It includes 113 detailed questions and answers covering
neurotransmitter systems, psychiatric pharmacology, mechanisms of drug action, side effects,
and disorders such as schizophrenia, depression, and bipolar disorder. Topics range from
catecholamines and serotonin to cannabis pharmacokinetics and hallucinogens. The content is
structured in a study-friendly format ideal for exam preparation.
1. How is the function of a particular neurotransmitter system determined?:
By the region of the brain that it innervates and the behavior of its receptor
- it has nothing to do with the transmitter molecule itself
2. Biogenic Amines: What do catecholamine systems and indoleamine
include?: Catecholamine Systems: Dopamine, Norepinephrine, epinephrine
Indoleamine: Serotonin (5HT)
all are found in PNS and CNS
3. How do you make a catecholamine in a neuron?: - phenylalanine to
tyrosine by phenylalanine hydroxylase (phenylketonuria, PKU, is an inability to
metabolize phenylalanine)
- tyroside to L-DOPA by tyrosine hydroxylase (rate limiting step because it
requires iron and anemics may become depressed due to low DA and NE
production by these neurons)
,- DOPA to dopamine by dopa decarboxylase (occurs in cytoplasm; DA
packaged into vesicles)
- Dopamine to NE by dopamine beta hydroxylase (enzyme stored in vesicles
which possess an uptake mechanism for DA; metabolizes en route from soma;
released with NE into synapse; copper containing)
4. What happens when you have a diet deficient in tyrosine-phenylalanine?:
ability to activate their dopamine reward center (uncles accumbens) is reduced
- loss of ability to be motivated to work for a reward
- most drugs of abuse lead to a general blunting of dopamine release in the
chronic phase of dependence, which contributes to poor outcome
5. Catecholamine Production: Epinephrine: - some in neurons, most in adrenal
glands
- acts as a hormone, less frequently as a neurotransmitter
6. What if the vesicles were not able to store the catecholamines?: they
would be trapped within the cytoplasm where the enzyme MAO would catabolize
them
- one drug is capable of doing this: reserpine
7. Rauvolfia or rauwolfia serpentina: - dogbane family
- small woody perennial from Indian and the East Indies
- roots of this plan yield the alkaloid reserpine, which was the first major
tranquilizer used for paranoia and schizophrenia (lowers blood pressure and
controls hypertension)
- produces drowsiness, depression, nightmares, bradycardia, nausea, nasal
congestion, diarrhea and various sexual endocrine dysfunctions (inhibition of
menses and impotence)
- explained by the depletion of transmitters from eh pre-synaptic terminal in the
brain and ANS
8. Termination Neurotransmitter Action: - principally by re-uptake
, - dilution due to diffusion from synapse
- enzymatic breakdown by deamination by MAO (monoamine oxidase); located on
outer mitochondrial membrane
9. How do neurons regulate the release of their
neurotransmitters?: - auto receptors found on presynaptic membrane
of many types of neurons
10. Dopamine: PNS: DA system in gut controls motility CNS: 3
Pathways ascending into forebrain
Nigro-striatal pathway: Sunstantia Nigra to Striatum
- inhibits cholinergic cells in caudate
- decreased DA levels resulting in Parkinson's disease (tremors, spasticity,
akinesia or difficult in starting or stopping movements)
Mesocorticolimbic Pathway: psychosis, ADHD and Addiction
- axons from neurons in the VTA project form midbrain to forebrain
- involved with euphoria and the control of mood
11. Smiling: - even expression of reward
- spontaneous (real) smile requires activity in the basal ganglia (including striatum)
driven by DA
- voluntary (fake, top) smile is derived by the motor cortex
12. Where do dopamine neurons in VTA project to?: - neucleus accumbens
(all rewarding thing activate the forebrain dopamine system into this) -
pathway is responsible for producing feelings of pleasure and euphoria
13. Top Down Control: - NAC --> drive for immediate reward, impulsivity
- top down suppression of NAC by inferior prefrontal cortex (PFC) --> long term
goals
Practitioner Program – Comprehensive Q&A Format
This document provides an in-depth review for the second exam in the PMHNP
Psychopharmacology course. It includes 113 detailed questions and answers covering
neurotransmitter systems, psychiatric pharmacology, mechanisms of drug action, side effects,
and disorders such as schizophrenia, depression, and bipolar disorder. Topics range from
catecholamines and serotonin to cannabis pharmacokinetics and hallucinogens. The content is
structured in a study-friendly format ideal for exam preparation.
1. How is the function of a particular neurotransmitter system determined?:
By the region of the brain that it innervates and the behavior of its receptor
- it has nothing to do with the transmitter molecule itself
2. Biogenic Amines: What do catecholamine systems and indoleamine
include?: Catecholamine Systems: Dopamine, Norepinephrine, epinephrine
Indoleamine: Serotonin (5HT)
all are found in PNS and CNS
3. How do you make a catecholamine in a neuron?: - phenylalanine to
tyrosine by phenylalanine hydroxylase (phenylketonuria, PKU, is an inability to
metabolize phenylalanine)
- tyroside to L-DOPA by tyrosine hydroxylase (rate limiting step because it
requires iron and anemics may become depressed due to low DA and NE
production by these neurons)
,- DOPA to dopamine by dopa decarboxylase (occurs in cytoplasm; DA
packaged into vesicles)
- Dopamine to NE by dopamine beta hydroxylase (enzyme stored in vesicles
which possess an uptake mechanism for DA; metabolizes en route from soma;
released with NE into synapse; copper containing)
4. What happens when you have a diet deficient in tyrosine-phenylalanine?:
ability to activate their dopamine reward center (uncles accumbens) is reduced
- loss of ability to be motivated to work for a reward
- most drugs of abuse lead to a general blunting of dopamine release in the
chronic phase of dependence, which contributes to poor outcome
5. Catecholamine Production: Epinephrine: - some in neurons, most in adrenal
glands
- acts as a hormone, less frequently as a neurotransmitter
6. What if the vesicles were not able to store the catecholamines?: they
would be trapped within the cytoplasm where the enzyme MAO would catabolize
them
- one drug is capable of doing this: reserpine
7. Rauvolfia or rauwolfia serpentina: - dogbane family
- small woody perennial from Indian and the East Indies
- roots of this plan yield the alkaloid reserpine, which was the first major
tranquilizer used for paranoia and schizophrenia (lowers blood pressure and
controls hypertension)
- produces drowsiness, depression, nightmares, bradycardia, nausea, nasal
congestion, diarrhea and various sexual endocrine dysfunctions (inhibition of
menses and impotence)
- explained by the depletion of transmitters from eh pre-synaptic terminal in the
brain and ANS
8. Termination Neurotransmitter Action: - principally by re-uptake
, - dilution due to diffusion from synapse
- enzymatic breakdown by deamination by MAO (monoamine oxidase); located on
outer mitochondrial membrane
9. How do neurons regulate the release of their
neurotransmitters?: - auto receptors found on presynaptic membrane
of many types of neurons
10. Dopamine: PNS: DA system in gut controls motility CNS: 3
Pathways ascending into forebrain
Nigro-striatal pathway: Sunstantia Nigra to Striatum
- inhibits cholinergic cells in caudate
- decreased DA levels resulting in Parkinson's disease (tremors, spasticity,
akinesia or difficult in starting or stopping movements)
Mesocorticolimbic Pathway: psychosis, ADHD and Addiction
- axons from neurons in the VTA project form midbrain to forebrain
- involved with euphoria and the control of mood
11. Smiling: - even expression of reward
- spontaneous (real) smile requires activity in the basal ganglia (including striatum)
driven by DA
- voluntary (fake, top) smile is derived by the motor cortex
12. Where do dopamine neurons in VTA project to?: - neucleus accumbens
(all rewarding thing activate the forebrain dopamine system into this) -
pathway is responsible for producing feelings of pleasure and euphoria
13. Top Down Control: - NAC --> drive for immediate reward, impulsivity
- top down suppression of NAC by inferior prefrontal cortex (PFC) --> long term
goals
