Psych/Nuero Final: Flaherty Cumulative All Exam Qs

6/7

Recognize a benzodiazepine by looking for __/___ fused ring structure

3, tricyclic

Recognize a TCA by looking for___ carbon linker and ___ system

directly

The amine is _____ attached to the cyclopropyl group in trancypromine (MAOI), which differentiates it from levomilnacipran (SNRI)

t-butyl

Bupropion (Wellbutrin)

-mostly inhibits DA, but also NE and 5HT to a lesser extent

-metabolized to corresponding alcohols and hydroxylation of __-__ group

partial agonist, metabolites

Buspirone (Buspar)

-5HT1A ___ ___

-has NO active ___

blind

Tasimelteon

-for non-24 hour sleep-wake disorders (in totally __ people)

5'-pyrimidinone

Zaleplon Metabolism

-Aldehyde Oxidase/Xanthine Oxidase converts the pyrimidine to the _-___

drug-drug, cheese

2 reasons that MAO-I are not used commonly

Caution 1: Many ___-___ interactions

Caution 2: ____ effect

tyramine

The cheese effect refers to high ____ levels in cheese, pickled fish, cured meat, sauerkraut, tofu, and vegamite

MAO-A

Tyramine gets degraded by ____-__

blood pressure, hypertensive crisis

Blocking tyramine with an MAO-I will cause tyramine levels to increase, causing release of NE to increase, causing elevated ___ ___ and potentially ___ ___ (dangerous)

post-partum

Brexanolone (Zulresso)

-used for __-___ depression

GABAa

Brexanolone (Zulresso)

-a positive ___ allosteric modulator

dilution

Brexanolone (Zulresso)

-IV; requires ___ prior to use

REMS

Brexanolone (Zulresso)

-used only in ___ program

hypoxia

Brexanolone (Zulresso)

-BOX WARNING: ___ with oximetry/alarm

partial agonist

Vilazodone

-___ ___ of 5HT1A receptors

S

Escitalopram

-sold as single (___) enantiomer of citalopram

cleared

Escitalopram

-the S enantiomer is __ more rapidly resulting in cleaner PK properties

methyl hydroxylation, S-oxidation

Vortioxetine Metabolism

-Metabolism = 4' + ___ __ (CYP2D6), ___-___ (CYP3A4)

SERT

Vortioxetine

-inhibits __ binding

focus, memory

Vortioxetine

-may assist in __ and ___

NE

Mirtazapine

-increases __ release via blocking α2 receptors in the pre-frontal cortex

N-dealkylation, 3-hydroxylation

Diazepam Metabolism

-__-___ and __-___

venlafaxine

Desvenlafaxine

-metabolite of ___ (without methyl)

onset, patterns

Melatonin 2 Types of Receptors

-MT1 (related to length of sleep ___)

-MT2 (related to shift in sleep ___)

own

Carbamazepine

-induces its __ metabolism

increase

Carbamazepine

-levels of the enzyme (CYP450) ___ with chronic use

SJS, Aplastic Anemia

Carbamazepine

-BOX WARNING: ___, ___ ___

N-dealkylation

Loxapine

-undergoes __-___ to the antidepressant amoxapine

-undergoes 7-hydroxylation to an antipsychotic

partial agonist

Cariprazine (Vraylar)

-__ ___ at D2 and 5HT1A receptors

-antagonist at 5HT2a

dementia-related psychosis

Cariprazine (Vraylar)

-BOX WARNING: counter-indicated in ___-__ ___

amine

Aripiprazole (med chem properties)

-contains a basic tertiary ___, and at physiologic pH (~7.4) it will be partially protonated

partial agonist, antagonist, SERT

Lumateperone (med chem SAR)

-___ ___ at pre-synaptic D2 receptors

-___ at post-synaptic D2 receptors

-___ blocker

agranulocytosis, positive, negative

Clozapine (SAR)

-BOX WARNING: ___

-can treat both ___ and ___ symptoms with little EPS

paliperidone

Risperidone (SAR and metabolism)

-has a 9-hydroxy metabolite: ___

strong

Haloperidol (Haldol) SAR

-___ antagonist of D2

decanoate ester

Fluphenazine SAR

-fluphenazine has a ___ ___ which allows it to be formulated for depot injection

hepatotoxicity, teratogenicity, pancreatitis

Valproic Acid

-BOX WARNING: ___, ___, ___

Na+, Ca2+, GABA

Valproic Acid

-___ channel blocker (VGSC)

-T-type ___ channel blocker

-Increases ___ levels by inhibiting GABA-Transaminase

SJS

Lamotrigine

-BOX WARNING: ___

potent

Brivaracetam is about 30x more __ than levetiracetam