PHARMA BIOCHEM + PROCESSES

Dopamine

What neurotransmitter primarily modulates the brain pathways responsible for psychotic disorders?

D2

What specific dopamine receptor subtype is the primary target for antipsychotic medications to reduce positive symptoms?

Serotonin

Which monoamine neurotransmitter is primarily linked to memory and sleep according to the sources?

Norepinephrine

Which neurotransmitter is associated with concentration, alertness, vigilance, and energy?

GABA

What is the principal inhibitory neurotransmitter in the brain?

Glutamate

What is the major excitatory neurotransmitter in the brain?

Chloride

What ion influx into the neuron is increased by GABAA receptor activation?

Sodium

Which ion's influx is slowed by the action of anticonvulsants on voltage-gated channels?

Calcium

What ion's release is modulated by Alpha 2 Delta ligands binding to presynaptic channels?

BDNF

What growth factor is responsible for neuroplasticity, neuronal growth, and survival in a normal brain?

Cortisol

Which hormone is released by the HPA axis to prepare the body for immediate action during stress?

CRH

What hormone is released by the hypothalamus to initiate the HPA axis response?

ACTH

What hormone is released by the pituitary gland to signal the adrenal glands during stress?

Prolactin

What hormone's release is normally inhibited by dopamine but increased by D2 receptor blockade?

SERT

What protein acts as the serotonin transporter and is the primary target for SSRIs?

NET

What transporter is inhibited by SNRIs to increase norepinephrine levels?

DAT

What transporter is weakly inhibited by Sertraline to provide an activating effect?

MAO A

Which enzyme is responsible for the breakdown of all three monoamine neurotransmitters?

MAO B

Which enzyme specifically breaks down dopamine and is a target in Parkinson's treatment?

Lithium

Which element is the classic mood stabilizer with a narrow therapeutic range of 0.8 to 1.2 mg/dL?

Tyrosine

What amino acid is the precursor for the synthesis of dopamine?

Tyramine

What chemical found in certain foods can cause a hypertensive crisis if consumed while taking MAOIs?

CYP1A2

Which specific liver enzyme is induced by nicotine and metabolizes clozapine?

CYP450

Which enzyme system in the liver is responsible for metabolizing most antipsychotic drugs?

H1

Blockade of which receptor by antipsychotics leads to sedation and weight gain?

Alpha 1

Blockade of which noradrenergic receptor can lead to orthostatic hypotension or postural drop?

Muscarinic M1 and M3

Blockade of which receptors leads to anticholinergic effects like dry mouth and blurred vision?

5HT1A

Which serotonin receptor acts as an autoreceptor to regulate firing rates?

5HT2A

Which serotonin receptor is the primary target for antagonism by second generation antipsychotics to decrease EPS?

5HT2C

Antagonism of which receptor by Fluoxetine contributes to its activating and fatigue reducing effects?

5HT3

Which receptor in the gut and brainstem is blocked by Ondansetron to produce antiemetic effects?

5HT7

Which serotonin receptor is targeted for its pro-cognitive effects in drugs like Vortioxetine?

GABAA

Which receptor complex is a pentamer with five subunits and contains a central chloride channel?

Alpha 1 subunit

Which GABAA subunit is associated with the sedative and sleep inducing effects of Z-drugs?

Alpha 2 and Alpha 3 subunits

Which GABAA subunits are primarily associated with the anxiolytic effects of benzodiazepines?

Gamma 2 subunit

Which GABAA subunit is associated with the development of physiological dependence?

Alpha 5 subunit

Which GABAA subunit is involved in learning and memory and is linked to the amnestic effects of certain drugs?

Alpha 4 and Alpha 6 subunits

Which subunits are found in benzodiazepine insensitive GABAA receptors?

D3

Which dopamine receptor has a high affinity and is the specific target for newer antipsychotics like Cariprazine?

GSK 3

Which enzyme is potentially inhibited by Lithium as part of its downstream signal transduction effect?

Inositol monophosphatase

The inhibition of which second messenger enzyme is the most believed theory for Lithium s mood stabilizing effect?

Tyrosine Kinase Receptor B or TRKB

Which receptor dimer is the binding site for BDNF and certain antidepressants?

NO synthase

Inhibition of which enzyme is a unique property of the SSRI Paroxetine?

SIGMA 1

Binding to which receptor is a key feature of the SSRI Sertraline?

Voltage Sensitive Calcium Channels or VSCCs

N and P/Q are subtypes of which channels targeted by Gabapentin and Pregabalin?

Alpha 2 Delta

Which subunit of voltage sensitive calcium channels is the specific target for ligands like Pregabalin?

cAMP

Which second messenger is part of the signaling pathway disrupted by Propranolol to prevent fear reconsolidation?

DOPA

What chemical is converted into dopamine by the enzyme DOPA decarboxylase?

VMAT2

What protein is responsible for packaging dopamine into vesicles for storage?

Tyrosine Hydroxylase

What enzyme converts tyrosine into DOPA in the production of dopamine?

Beta adrenergic receptors

Which receptors are blocked by Propranolol to manage the physical symptoms of stage fright?

Sodium channel

Blockade of which channel by Tricyclic Antidepressants contributes to their cardiotoxic risk in overdose?

D4

Which rare dopamine receptor is targeted by Clozapine in the prefrontal cortex and amygdala?

D1

Which dopamine receptor is concentrated in the frontal cortex and involved in executive function?

5HT1B and 5HT1D

Which serotonin receptor agonists are used as triptans for antimigraine effects?

5HT2B

Agonism of which serotonin receptor by drugs like Fenfluramine can cause cardiac valve fibrosis?

5HT4

Agonism of which receptor leads to increased bowel motility and secretions?

mCPP

Which chemical acts as a 5HT2C agonist and is known to be anxiogenic?

Inositol

Lithium works by depleting which chemical needed for second messenger signaling?

G proteins

Which membrane associated proteins are modulated by Lithium to stabilize neuronal signaling?

Epinephrine or Adrenaline

Which chemical is a competitive antagonist target for Propranolol in treating autonomic fear?

Dantrolene

What chemical is a skeletal muscle relaxant used as the antidote for Neuroleptic Malignant Syndrome?

Cyproheptadine

What chemical is the antidote used to treat Serotonin Syndrome?

Bromide

Which element was used in early 1900s sedative salts and could cause extreme somnolence and psychosis?

Chloral Hydrate

What chemical was developed in 1832 as the first ever sedative hypnotic medication?

Phenobarbital

What barbiturate medication is still used today as an anticonvulsant in neurocritical care?

Meprobamate

What chemical was introduced in 1950 as a less sedating alternative to barbiturates but still led to dependence?

Chlordiazepoxide

What was the first benzodiazepine discovered in 1955?

Benzene

What chemical ring structure is a defining characteristic of all benzodiazepines?

GABAC

Which GABA receptor type has an unknown function but is not the target of standard anxiolytics?

GABAB

Which GABA receptor is a G protein coupled receptor involved with pain and memory?

Limbic

In which brain system are serotonin receptors highly concentrated to regulate emotions?

Tyramine

Which amino acid derivative found in cheese and wine can cause hypertensive crisis in patients on MAOIs?

Alpha 2

Antagonism of which noradrenergic receptor by Mirtazapine contributes to its antidepressant effect?

Dopamine metabolites

What is formed when dopamine is broken down in the synaptic cleft?

Snare

Which protein structure hooks onto synaptic vesicles to trigger neurotransmitter release in VSCCs?

BDNF gene

Which specific gene is suppressed under chronic stress leading to neuronal atrophy?

Norquetiapine

What active metabolite of Quetiapine has more potent antidepressant effects than the parent drug?

Active metabolite of Fluoxetine

Which chemical has a very long half life of two weeks allowing for once weekly dosing?

Tyrosine transporter

What protein transports tyrosine from the bloodstream into the neuron?

5HT1A heteroreceptors

Which receptors in the PFC and hippocampus cause hyperpolarization to reduce worry output?

5HT2A receptors

Which receptors in the PFC regulate glutamate release and are associated with trait anxiety?

GABA interneurons

Which cells are inhibited by 5HT1A receptors to regulate downstream neurotransmitter release?

Neurosteroids

Which endogenous chemicals target benzodiazepine insensitive GABAA receptors to provide tonic inhibition?

Alcohol

Which chemical maintains tonic inhibition as long as it is present extracellularly?

Nicotine

Which chemical causes induction of the CYP1A2 enzyme and reduces Clozapine levels?

Coffee

What common beverage increases the concentration of Clozapine levels in the blood?

Agranulocytosis

What serious blood disorder is a rare side effect of Clozapine requiring regular CBC monitoring?

Stevens Johnson Syndrome

What life threatening skin reaction is a potential side effect of the mood stabilizer Lamotrigine?

Neural tube defects

What condition in a fetus is the primary reason Valproic Acid is contraindicated in the first trimester of pregnancy?

Sperm count

What male reproductive parameter can be decreased by the use of Valproic Acid?

Hyperprolactinemia

What condition is caused by D2 blockade in the tuberoinfundibular pathway leading to galactorrhea?

Extrapyramidal symptoms or EPS

What movement disorder is caused by D2 blockade in the nigrostriatal pathway?

Neuroleptic Malignant Syndrome

What potentially fatal syndrome is the most severe side effect of all antipsychotics?

Serotonin Syndrome

What triad of mental status changes autonomic dysfunction and neuromuscular excitability is a risk with MAOIs?

Diabetes insipidus

What condition can be a result of long term Lithium use being nephrotoxic?

Weight gain

What metabolic side effect is caused by H1 and M3 receptor antagonism in drugs like Olanzapine?

QT interval

Which cardiovascular parameter must be monitored because certain antipsychotics and SSRIs can cause its lengthening?

Seizure threshold

What physiological limit is lowered by antipsychotics like Clozapine making seizures more likely?

PKA and CREB

Which signaling cascade proteins are essential for saving fear memories into long term storage?