Final exam NU670
Pharmacokinetics (PK) - answer What the body does to the drug; ADME (absorption,
distribution, metabolism, excretion)
ADME - answer A: absorption; D: distribution; M: metabolism; E: excretion
Pharmacodynamics (PD) - answer What the drug does to the body; receptor binding
effects
Agonist - answer Binds + activates receptor → full response
Partial agonist - answer Binds + activates receptor → smaller response than full agonist
Inverse agonist - answer Binds + produces opposite effect of agonist (reduces baseline
receptor activity)
Antagonist - answerBinds receptor but blocks activation (no intrinsic activity)
Inducers effect on drug levels - answer↑ metabolism → ↓ drug level → ↓ efficacy
Inhibitors effect on drug levels - answer↓ metabolism → ↑ drug level → ↑ toxicity risk
Excitatory neurotransmitter (main) - answerGlutamate
Inhibitory neurotransmitter (main) - answerGABA
CYP interaction risk w/ fluoxetine + inhibitor - answer↑ SSRI levels → ↑ serotonin
syndrome risk (ex: ketoconazole)
Sample Q: Fluoxetine + ketoconazole risk? - answerCYP inhibitor increases SSRI level
→ ↑ serotonin syndrome risk
MDD (DSM-5-TR) core criteria - answer≥5 symptoms for ≥2 weeks; one must be
depressed mood OR anhedonia
Persistent Depressive Disorder duration - answer≥2 years of depressed mood + ≥2
other symptoms
PMDD - answerDiagnosed as Premenstrual Dysphoric Disorder
SSRIs first-line for - answerMDD (and commonly anxiety disorders)
, MAOI key safety issue - answerHypertensive crisis with tyramine-containing foods
MAOI washout rule - answerWaIt 2 weeks before starting SSRIs after MAOI (and vice
versa per clinician plan)
High-tyramine foods category - answerAged/fermented/cured/pickled/spoiled foods =
biggest risks
SSRI black box warning - answerSuicidality risk in <25 (up to age 24)
Monitor on antidepressants - answerSerotonin syndrome + discontinuation syndrome
Serotonin syndrome classic signs (from sample stem) - answerConfusion +
hyperreflexia + diaphoresis (esp with serotonergic combos)
Fluoxetine + linezolid complication - answerSerotonin syndrome
SSRIs examples - answerFluoxetine, sertraline, escitalopram
SSRIs key side effects - answerGI upset, insomnia, sexual dysfunction
SSRIs pearl - answer1st-line; watch serotonin syndrome
SNRIs examples - answerVenlafaxine, duloxetine
SNRIs key side effects - answerHTN, withdrawal syndrome
SNRIs pearl - answerGood for pain & anxiety
TCAs examples - answerAmitriptyline, nortriptyline
TCAs key side effects - answerAnticholinergic effects, QT prolongation
TCA pearl - answerLethal in overdose
MAOIs examples - answerPhenelzine, tranylcypromine
MAOIs key side effects - answerHypertensive crisis with tyramine
Atypical antidepressants examples - answerBupropion, mirtazapine
Bupropion key risk - answerSeizures (avoid in seizure disorders)
Mirtazapine key effects - answerWeight gain + sedation
Pharmacokinetics (PK) - answer What the body does to the drug; ADME (absorption,
distribution, metabolism, excretion)
ADME - answer A: absorption; D: distribution; M: metabolism; E: excretion
Pharmacodynamics (PD) - answer What the drug does to the body; receptor binding
effects
Agonist - answer Binds + activates receptor → full response
Partial agonist - answer Binds + activates receptor → smaller response than full agonist
Inverse agonist - answer Binds + produces opposite effect of agonist (reduces baseline
receptor activity)
Antagonist - answerBinds receptor but blocks activation (no intrinsic activity)
Inducers effect on drug levels - answer↑ metabolism → ↓ drug level → ↓ efficacy
Inhibitors effect on drug levels - answer↓ metabolism → ↑ drug level → ↑ toxicity risk
Excitatory neurotransmitter (main) - answerGlutamate
Inhibitory neurotransmitter (main) - answerGABA
CYP interaction risk w/ fluoxetine + inhibitor - answer↑ SSRI levels → ↑ serotonin
syndrome risk (ex: ketoconazole)
Sample Q: Fluoxetine + ketoconazole risk? - answerCYP inhibitor increases SSRI level
→ ↑ serotonin syndrome risk
MDD (DSM-5-TR) core criteria - answer≥5 symptoms for ≥2 weeks; one must be
depressed mood OR anhedonia
Persistent Depressive Disorder duration - answer≥2 years of depressed mood + ≥2
other symptoms
PMDD - answerDiagnosed as Premenstrual Dysphoric Disorder
SSRIs first-line for - answerMDD (and commonly anxiety disorders)
, MAOI key safety issue - answerHypertensive crisis with tyramine-containing foods
MAOI washout rule - answerWaIt 2 weeks before starting SSRIs after MAOI (and vice
versa per clinician plan)
High-tyramine foods category - answerAged/fermented/cured/pickled/spoiled foods =
biggest risks
SSRI black box warning - answerSuicidality risk in <25 (up to age 24)
Monitor on antidepressants - answerSerotonin syndrome + discontinuation syndrome
Serotonin syndrome classic signs (from sample stem) - answerConfusion +
hyperreflexia + diaphoresis (esp with serotonergic combos)
Fluoxetine + linezolid complication - answerSerotonin syndrome
SSRIs examples - answerFluoxetine, sertraline, escitalopram
SSRIs key side effects - answerGI upset, insomnia, sexual dysfunction
SSRIs pearl - answer1st-line; watch serotonin syndrome
SNRIs examples - answerVenlafaxine, duloxetine
SNRIs key side effects - answerHTN, withdrawal syndrome
SNRIs pearl - answerGood for pain & anxiety
TCAs examples - answerAmitriptyline, nortriptyline
TCAs key side effects - answerAnticholinergic effects, QT prolongation
TCA pearl - answerLethal in overdose
MAOIs examples - answerPhenelzine, tranylcypromine
MAOIs key side effects - answerHypertensive crisis with tyramine
Atypical antidepressants examples - answerBupropion, mirtazapine
Bupropion key risk - answerSeizures (avoid in seizure disorders)
Mirtazapine key effects - answerWeight gain + sedation
