HSA 546 FINAL EXAM PART 1 AND PART 2
PRACTICE QUESTIONS WITH DETAILED
SOLUTIONS 2026
◉ INDICATION
-Depression
Mechanism of Action
-SARI (serotonin 2 antagonist/reuptake inhibitor). Blocks serotonin
2A receptors.
TESTS
-None for healthy individuals
Starting Dose
-150 mg/day in divided doses
Adverse Effects
-dizziness, sedation, hypotension, Nausea, vomiting, edema, blurred
vision, constipation, dry mouth, headache, incoordination, tremor,
hypotension, syncope, occasional sinus bradycardia.
-Rare: rash, priapism.. Answer: Trazodone (Desyrel)
,◉ SRI and NRI properties, but they also block α1-adrenergic,
histamine-1, and muscarinic cholinergic receptors
-not used first-line because of the high incidence of adverse effects
and the risk of potential overdose and death
• amitriptyline (Elavil)
• desipramine (Norpramin)
• doxepin (Sinequan)
• imipramine (Tofranil)
• nortriptyline (Pamelor). Answer: Tricyclic antidepressants
◉ Orthostatic hypotension. Answer: Alpha-1 adrenergic effects
◉ Dry mouth
Blurred vision
Urinary retention
Constipation. Answer: Anticholinergic effects
◉ Weight gain
Sedation. Answer: Histamine effects
,◉ first developed, LAST CHOICE medication class for depression due
to the many potential, serious side effects
-specific dietary restrictions, Foods that contain tyramine should be
avoided (Red wine, Sauerkraut, Cheese, Soy, Smoked meats)
-block enzymes responsible for the breakdown of 5-HT, NE, and DA
• two primary forms of the MAO enzyme: MAO-A and MAO-B
• both located in the brain, MAO-A also in gut
Drugs:
-phenelzine (Nardil) - duration 14 days
-selegiline (Emsam) - MAOI-B - duration 14 days
-tranylcypromine (Parnate) -duration 14-30 days
-isocarboxazid (Marplan) - duration 14 days
Side effects:
-Confusion
-Dizziness
-Insomnia
-Sedation
-Vivid dreams
Pearls:
-high risk for hypertensive crisis if tyramine is ingested
, -Do not prescribe any serotonergic agents within 2 weeks of MAOI
discontinuation due to an increased risk of serotonin syndrome
-Wait at least 5 half-lives after discontinuing a serotonergic medicati.
Answer: MAOIs
◉ breaks down 5-HT, DA, NE, and tyramine
-used to treat depression and anxiety
"A" is for antidepressant or anxiolytic. Answer: MAO-A
◉ responsible for the breakdown of dopamine, phenylethylamine,
and tyramine
-used to treat Parkinson's disease; however, high-dose selegiline
(Emsam) may be used to treat anxiety or depression. Answer: MAO-
B
◉ Tyramine is present in many aged or preserved foods including
aged cheeses, tap and nonpasteurized beers, aged or smoked meat
or fish, sauerkraut, kimchee, soy products, and tofu.. Answer: Foods
to avoid when taking MAOIs
◉ Antipsychotic medications are sometimes prescribed at low doses
as adjunctive medications for severe depression. Answer: Adjunct
treatment for depression
PRACTICE QUESTIONS WITH DETAILED
SOLUTIONS 2026
◉ INDICATION
-Depression
Mechanism of Action
-SARI (serotonin 2 antagonist/reuptake inhibitor). Blocks serotonin
2A receptors.
TESTS
-None for healthy individuals
Starting Dose
-150 mg/day in divided doses
Adverse Effects
-dizziness, sedation, hypotension, Nausea, vomiting, edema, blurred
vision, constipation, dry mouth, headache, incoordination, tremor,
hypotension, syncope, occasional sinus bradycardia.
-Rare: rash, priapism.. Answer: Trazodone (Desyrel)
,◉ SRI and NRI properties, but they also block α1-adrenergic,
histamine-1, and muscarinic cholinergic receptors
-not used first-line because of the high incidence of adverse effects
and the risk of potential overdose and death
• amitriptyline (Elavil)
• desipramine (Norpramin)
• doxepin (Sinequan)
• imipramine (Tofranil)
• nortriptyline (Pamelor). Answer: Tricyclic antidepressants
◉ Orthostatic hypotension. Answer: Alpha-1 adrenergic effects
◉ Dry mouth
Blurred vision
Urinary retention
Constipation. Answer: Anticholinergic effects
◉ Weight gain
Sedation. Answer: Histamine effects
,◉ first developed, LAST CHOICE medication class for depression due
to the many potential, serious side effects
-specific dietary restrictions, Foods that contain tyramine should be
avoided (Red wine, Sauerkraut, Cheese, Soy, Smoked meats)
-block enzymes responsible for the breakdown of 5-HT, NE, and DA
• two primary forms of the MAO enzyme: MAO-A and MAO-B
• both located in the brain, MAO-A also in gut
Drugs:
-phenelzine (Nardil) - duration 14 days
-selegiline (Emsam) - MAOI-B - duration 14 days
-tranylcypromine (Parnate) -duration 14-30 days
-isocarboxazid (Marplan) - duration 14 days
Side effects:
-Confusion
-Dizziness
-Insomnia
-Sedation
-Vivid dreams
Pearls:
-high risk for hypertensive crisis if tyramine is ingested
, -Do not prescribe any serotonergic agents within 2 weeks of MAOI
discontinuation due to an increased risk of serotonin syndrome
-Wait at least 5 half-lives after discontinuing a serotonergic medicati.
Answer: MAOIs
◉ breaks down 5-HT, DA, NE, and tyramine
-used to treat depression and anxiety
"A" is for antidepressant or anxiolytic. Answer: MAO-A
◉ responsible for the breakdown of dopamine, phenylethylamine,
and tyramine
-used to treat Parkinson's disease; however, high-dose selegiline
(Emsam) may be used to treat anxiety or depression. Answer: MAO-
B
◉ Tyramine is present in many aged or preserved foods including
aged cheeses, tap and nonpasteurized beers, aged or smoked meat
or fish, sauerkraut, kimchee, soy products, and tofu.. Answer: Foods
to avoid when taking MAOIs
◉ Antipsychotic medications are sometimes prescribed at low doses
as adjunctive medications for severe depression. Answer: Adjunct
treatment for depression
