Question 1 In regards to selective serotonin reuptake inhibitors (SSRIs) all of the following statements are true EXCEPT?
Onset of antidepressant action of SSRIs is slow (2-12 weeks)
Common side effects of SSRIs are GI disturbances & sexual dysfunction
SSRIs inhibit serotonin (5HT) and norepinephrine (NE) reuptake equally
Rapid withdrawl of SSRIs can cause flu-like fatigue, headache etc.
Anxiety is a side effect seen in the first few days of therapy with Fluoxetine (Prozac)
Question 2 Which one of the following antidepressants has an active metabolite with a half-life of 10 days?
Venlafaxine (Effexor)
Sertraline (Zoloft)
Fluoxetine (Prozac)
Imipramine (Tofranil)
Paroxetine (Paxil)
Question 3 A 40 yr old man is brought to the ER by his sister who reported that he had dropped by her apartment acting "drunk" & agitated. Further examination reveals symptoms consistent with serotonin syndrome (fever, hypertension, hyperreflexia, rigidity, and tremor). He had been diagnosed with severe depression one month ago & treated with Phenelzine initially. He was switched to fluvoxamine (Luvox) a week ago. What is the most likely cause for the hyperserotenergic state in this patient?
The dose of the SSRI was too high
The patient is hypersensitive to the SSRI
The patient consumed cheese prior to taking Luvox causing food interaction
Inhibition of monoamine oxidases continues for 2-3 weeks after phenelzine has been stopped
The patient consumed alcohol prior to taking Luvox
Question 4 Which one of the following is NOT a viable option to address sexual dysfunction caused by SSRIs?
Counsel the patient that these effects are only temporary
Add Sildenafil (Viagra) to antidepressant therapy
Reduce the dose of his current SSRI and add on an atypical antidepressant
Replace SSRI with Trazadone or nefazadone
Switching to Venlafaxine
Question 5 Which one of the following drugs is approved for treatment of nicotine addiction?
Fluoxetine (Prozac)
Paroxetine (Paxil)
Citalopram (Celexa)
Bupropion (Wellbutrin)
Fluvoxamine (Luvox)
Question 6 A 38 yr old woman is prescribed amitriptyline (Elavil) for her depression. Soon after she begins taking this medication, she reports to her physician that she is having fainting episodes. What peripheral system affected by amitriptyline is most likely responsible for the postural hypotension?
Blockade of x1 adrenergic receptors
Blockade of histamine receptors
Blockade of muscarinic receptors
Inhibition of norepinephrine reuptake
Inhibition of serotonin reuptake
Question 7 Which one of the following is a metabolite of Amitriptyline (Elavil)?
Desipramine (Norpramine)
Nortriptyline (Pamelor)
Clomipramine (Anfranil)
Trazadone (Desyrel)
Norfluoxetine
Question 8 Which one of the following side effects of tricyclic antidepressants (TCAs) is due to blockade of central histamine H1 receptors?
Dry mouth
Constipation
Sedation
Ejaculatory dysfunction
Blurred vision
Question 9 Which one of the following is the mechanism of action of Lithium in bipolar disorder?
Enhances synthesis of phosphoinositol phosphate2 (PIP2)
Activates phospholipase to resynthesize PIP2
Activates protein kinase C
Enhances formation of Diacylglycerol (DAG)
Interferes with the formation of Inositol and resynthesis of PIP2
Question 10 What is the most common early sign of acute lithium toxicity?
Cardiac arrhythmias
Diarrhea
Hallucinations
Renal shutdown
Change in personality