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27 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Which of the follow patients could be diagnosed with depression? A patient presenting with…
a) Depressed mood, significant weight loss, recurrent thoughts of death or suicide, and hypersomnia b) Markedly diminished interest or pleasure in almost all activities, feelings of worthlessness, recurrent thoughts of death or suicide, and significant weight gain c) Depressed mood, feelings of worthlessness, impaired concentration, insomnia, and significant weight gain d) Recurrent thoughts of death or suicide, insomnia, psychomotor retardation, feelings of worthlessness, and significant weight loss |
c) Depressed mood, feelings of worthlessness, impaired concentration, insomnia, and significant weight gain
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At least 5 S/Sx must be present. Also, depressed mood &/or markedly diminished interest or pleasure in almost all activities must be present most of the day, almost daily & for at least 2 weeks.
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Which of the following is not associated with causing depression?
a. Fluoxetine b. EtOH c. Methyldopa d. Interferon |
a. Fluoxetine
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one of these agents is an SSRI
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This is the MOA for which drug class? Block MAO (enzyme) responsible for breakdown of neurotransmitters (NE, etc.)
a. TCA b. MAOI c. SSRI d. NE & 5-HT Reuptake Inhibitors e. Dopamine & NE Reuptake Inhibitors |
b. MAOI
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This is the MOA for which drug class? Inhibit reuptake of serotonin into presynaptic neuron
a. TCA b. MAOI c. SSRI d. NE & 5-HT Reuptake Inhibitors e. Dopamine & NE Reuptake Inhibitors |
c. SSRI
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This is the MOA for which drug class? Block 5-HT & norepi reuptake; Also block alpha-adrenergic receptors, antihistaminergic & anticholinergic effect.
a. TCA b. MAOI c. SSRI d. NE & 5-HT Reuptake Inhibitors e. Dopamine & NE Reuptake Inhibitors |
a. TCA
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Which of the following is not a TCA?
a. Imipramine (Tofranil) b. Amitriptyline (Elavil) c. Phenelzine (Nardil) d. Desipramine (Norpramin) |
c. Phenelzine (Nardil)
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one of these drugs is a MAOI
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This is the MOA for which drug? MOA: Inhibits serotonin activity & norepi & dopamine reuptake
a. Nefazodone (Serzone) b. Bupropion (Wellbutrin) c. Duloxetine (Cymbalta) d. Venlafaxine (Effexor) e. Mirtazapine (Remeron) f. Trazodone (Desyrel) |
d. Venlafaxine (Effexor)
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this drug is a serotonin & norepi reuptake inhibitor
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This is the MOA for which drug? MOA: Inhibits dopamine, norepi & minimal serotonin reuptake
a. Nefazodone (Serzone) b. Bupropion (Wellbutrin) c. Duloxetine (Cymbalta) d. Venlafaxine (Effexor) e. Mirtazapine (Remeron) f. Trazodone (Desyrel) |
b. Bupropion (Wellbutrin)
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this drug is a dopamine & norepi reuptake inhibitor
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This is the MOA for which drug? MOA: Selective serotonin & norepi reuptake inhibitor; No significant affinity for adrenergic, dopaminergic, cholinergic, histamingeric receptors or MAOI activity
a. Nefazodone (Serzone) b. Bupropion (Wellbutrin) c. Duloxetine (Cymbalta) d. Venlafaxine (Effexor) e. Mirtazapine (Remeron) f. Trazodone (Desyrel) |
c. Duloxetine (Cymbalta)
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This is the MOA for which drug? MOA: Inhibits serotonin & norepi reuptake; Also an antagonist of serotonin receptors; Some alpha-blocking activity
a. Nefazodone (Serzone) b. Bupropion (Wellbutrin) c. Duloxetine (Cymbalta) d. Venlafaxine (Effexor) e. Mirtazapine (Remeron) f. Trazodone (Desyrel) |
a. Nefazodone (Serzone)
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This is the MOA for which drug? MOA: Inhibits serotonin reuptake
a. Nefazodone (Serzone) b. Bupropion (Wellbutrin) c. Duloxetine (Cymbalta) d. Venlafaxine (Effexor) e. Mirtazapine (Remeron) f. Trazodone (Desyrel) |
f. Trazodone (Desyrel)
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this drug is a mixed serotonergic & alpha blocking activity
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This is the MOA for which drug? MOA: Serotonin, muscarinic & histamine-1 receptor antagonist
a. Nefazodone (Serzone) b. Bupropion (Wellbutrin) c. Duloxetine (Cymbalta) d. Venlafaxine (Effexor) e. Mirtazapine (Remeron) f. Trazodone (Desyrel) |
e. Mirtazapine (Remeron)
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NV is a 22 y/o F who presents to the clinic with c/o depressed mood, impaired concentration, feelings of worthlessness, insomnia, and weight loss. NV is a PA student and is extremely busy with school activities. She is concerned that her Sx are affecting her performance in school. She really wants to be able to focus on her school work. Which TCA would you prescribe her?
a. Imipramine b. Amitriptyline c. Desipramine d. Nortriptyline |
c. Desipramine
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which drug choice has the lowest risk for causing sedation?
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HR is a 21 y/o PA who presents to the clinic with depressed mood, markedly diminished interest or pleasure in almost all activities, psychomotor agitation, impaired concentration, and recurrent thoughts of death or suicide. Her Sx started this past May. Which of the following drugs would be best choice?
a. Duloxetine (Cymbalta) b. Bupropion (Wellbutrin) c. Venlafaxine (Effexor) d. SSRI |
a. Duloxetine (Cymbalta)
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think about black box warnings
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JT is a 31 y/o PA student who began taking Fluoxetine this past June. Two days ago, she contracted a skin infection for which she was prescribed linezolid. She presents to the ER with fever, confusion, tremor, agitation, and diarrhea.
a. Do nothing, it generally resolves spontaneously. b. Immediately Fluoxetine, and provide supportive treatment. c. Immediately d/c linezolid, and provide supportive treatment. d. Immediately d/c both drugs, and provide supportive treatment. |
c. Immediately d/c linezolid, and provide supportive treatment.
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Which is NOT true?
a) Major depressive disorder diagnosed according to DSM-IV TR guidelines b) Pharmacotherapy is often used in combination with psychotherapy c) Psychotherapy can lead to more rapid response than pharmacotherapy d) If pharmacotherapy is discontinued, there is a risk of relapse. |
c) Psychotherapy can lead to more rapid response than pharmacotherapy
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Which of the following is most likely to result in a hypertensive crisis?
a. TCA’s b. MAOI’s c. SSRI’s d. NE & 5-HT Reuptake Inhibitors e. Dopamine & NE Reuptake Inhibitors |
b. MAOI’s
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Which of the following is NOT a S/Sx of hypertensive crisis?
a. Stiff neck b. Occipital headache c. Impaired concentration d. Nausea e. Stroke |
c. Impaired concentration
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For which of the following should one use caution in prescribing a TCA?
a. elderly b. cardiac dz c. young adults d. seizures |
c. young adults
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When switching from an antidepressant drug to an MAOI, there needs to be a least a 2 wk washout pd. Which of the following drugs needs a longer washout pd?
a. Imipramine (Tofranil) b. Fluoxetine (prozac) c. Sertraline (zoloft) d. Paroxetine (paxil) |
b. Fluoxetine (prozac)
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This drug needs 5-6wks to washout because of its long half-life
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Which SSRI is the best tolerated when it comes to AE’s?
a. Fluoxetine (prozac) b. Sertraline (zoloft) c. Paroxetine (paxil) d. Fluvoxamine (luvox) e. Citalopram (celexa) |
e. Citalopram (celexa)
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Which of the follow is not true of Venlafaxine (Effexor)?
a. An AE is hypernatremia b. This drug needs to be tapered off c. BP should be monitored d. LFT’s should be monitored e. should be avoided in pt's with hepatic dysfunction |
a. An AE is hypernatremia
actually the AE is hyponatremia! |
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Which of the follow is not a way to minimize risk of seizures when prescribing Bupropion (Wellbutrin)?
a. Avoiding in pt’s w/ h/o seizures b. Avoiding in pt’s w/cardiovascular dysfunction c. Avoid doses >150mg d. Avoid total daily dose >450mg (IR) or >400mg (SR) e. Titrate dose slowly (q 3 days) |
b. Avoiding in pt’s w/cardiovascular dysfunction
should be avoiding in pt's w/ head trauma injuries |
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PH is a 29 y/o M who is in his 7th month of PA school. He comes into the clinic today b/c of his depressed mood, feelings of worthlessness, impaired concentration, insomnia, and markedly diminished interest or pleasure in almost all activities. He also admits to having some trouble ‘getting it up.’ Which antidepressant should the PA prescribe?
a. Trazodone (Desyrel) b. Bupropion (Wellbutrin) c. Duloxetine (Cymbalta) d. Venlafaxine (Effexor) |
b. Bupropion (Wellbutrin)
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Which is the only antidepressant that may improve sexual fxn?
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Which of the following antidepressants should be avoided in a patient who is taking a Statin?
a. Nefazodone (Serzone) b. Venlafaxine (Effexor) c. Duloxetine (Cymbalta) d Bupropion (Wellbutrin) e. Trazodone (Desyrel) |
a. Nefazodone (Serzone)
there is an increased risk of myopathy & rhabdomyolysis when combined |
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After initiating treatment of depression, which of the following is not true?
a. improvements in insomnia and anxiety should be seen in the 1st few wks b. increased libido can been seen in wks 2-4 c. there may be an increased risk of suicide after initiating treatment d. if no improvements are seen, do not prescribe another agent from the same class e. tx resistance should be considered when a pt has failed 2 or more agents from different classes |
d. if no improvements are seen, do not prescribe another agent from the same class
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If a pt is considered to be tx resistant, what should be the next step in treating this patient?
a. try another agent from a new class b. increase the dose of the drug the pt is on c. use combination therapy d. use augmentation therapy |
c. use combination therapy
d. use augmentation therapy Gotcha! Both are possible options! |
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