P3F COMPOSITE 2 (IPT) EXAM QUESTIONS AND ANSWERS GRADED A+ 2025/2026

P3F COMPOSITE 2 (IPT) EXAM
QUESTIONS AND ANSWERS GRADED A+
2025/2026




*biogenic amines:*

- Dopamine (DA)

- Norepinephrine (NE)

- Serotonin (5-HT) - ANS What are the three main neurotransmitters that affect depression?
What do their structures look like?



- Hydrazine used to make Isoniazid to treat TB (side effect on pts mood)



- Isoniazid (not cross BBB) -> added isopropyl to increase lipophilicity -> Iproniazid



- Iproniazid amide bond cleaved by carboxylic esterases -> alkylazo and alkyl radical produced ->
hepatotoxicity - ANS How were MAOIs discovered? Why were the initial drugs not successful



- covalent modification of the cofactor (FAD) -> inactivates the enzyme responsible for breaking
down catecholamines like 5HT and NE



- *phenyl ring* (binds tightly to enzyme to lock in place)


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,- *hydrazinyl or cyclopropyl link* (form reactive intermediates - close proximity to FAD ->
covalent mod) - ANS What is the MOA of MAOIs? What is the general SAR?



- Chlorpromazine

- adding additional atom in middle ring (6 -> 7 membered) changed from 0 degree tilt to 30
degree tilt

- NET

- secondary amine - ANS What drug were SNRIs built upon? What modification was made?
What transporter are they selective for? What function group is responsible for selectivity?



- *tricylic ring system* (center = cycloheptane or bicyclooctadiene; outer rings = unsubstituted
benzene) -> interacts with Tyr and Phe

- *secondary amine* (NET selective) -> interacts with Asp and Phe

- *3 C linker* - ANS SAR of SNRIs?



- Reboxetine

- 4 (2 active SS and RR)

- SS (shown) (RR responsible for cardiac effects) - ANS Which SNRI is a biaryl-SNRI? How
many isomers? Which isomer is more potent?



Chlorimipramine + Diphenhydramine - ANS What drug were SSRIs built upon?



- A site = *amine* -> interacts w Asp and Tyr

- B site = *polar aromatic ring w halogen/e- group* (selectivity for SERT) -> interacts w Tyr, Thr,
Phen

- C site = *hydrophobic group* -> interacts w Ile, Phe - ANS SSRIs SAR?




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,- S 100x more potent than R (racemic marketed)

- SS is selective (RR is nonselective and not marketed)

- marketed as racemic -> S 2x more potent than racemic (Escitalopram)

- E is active isomer (double bond is susceptible to UV isomerization to inactive Z) -
ANS Stereochemistry of SSRIs?

- Fluoxetine

- Sertraline

- Citalopram

- Fluvoxamine



- tricyclic rely on metabolism (dealkylation) to go from SERT to NET selectivity

- bicyclic rely on stereochemistry to affect selectivity - ANS How do the tricyclic and bicyclic
analogs of NSRIs differ?



Doxepin (E = NET ; Z = SERT) - ANS Which NSRI has transporter selectivity dependent on
geometric isomers?



- R = SERT/NET ; S = SERT -> racemic marketed

- S = 10x more potent SERT than NET (S marketed) - ANS Stereochemistry of NSRIs:

- Venlafaxine

- Duloxetine



- Bupropion

- Dextromethorophan (NMDA antagonist)

- CYP 2D6 inhibitor - ANS Which drug is a DNRI? What is it combined with as the combo
product of Auvelity? What property enables this combination to work?



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, MAOI (Phenelzine)



phenyl ring + hydrazinyl link - ANS Identify:



MAOI (Isocarboxazid)



phenyl ring + hydrazinyl link - ANS Identify:



MAOI (Tranylcypromine)



phenyl ring + cyclopropyl link - ANS Identify:



SNRI (Desipramine)



tricyclic ring + secondary amine + 3C link - ANS Identify:



SNRI (Nortriptyline)



tricyclic ring + secondary amine + 3C link - ANS Identify:



SNRI (Protriptyline)



tricyclic ring + secondary amine + 3C link - ANS Identify:



SNRI (Maprotiline)


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