CMN 548 Unit 5
Potency - answer refers to the relative dose required to achieve certain effects, not to
the efficacy of a drug
Agonist (full agonist) - answer A drug that binds to a specific receptor producing an
effect identical to that usually produced by the neurotransmitter affecting that receptor
Pharmacodynamics - answer The time course and intensity of a drug's effect/what the
drug does to the body
Pharmacokinetics - answer What the body does to a drug
Tolerance - answer Develops over time a need to use increased doses of a
medication/drug to maintain a clinical effect. Or, a decreased sensitivity to adverse
effects of a drug
Stevens-Johnson Syndrome - answer A systemic, immune-mediated reaction that can
be fatal or result in permanent scarring or blindness
Antagonist - answerA compound that blind to a receptor that blocks or reduces the
action of another substance at the receptor site
Hyponatremia - answerCommon symptoms of this medication side effect include
confusion, agitation, and lethargy. (tx with oxcarbazepine & SSRIs)
Therapeutic index - answerratio of the median toxic dose to the median effective dose
Somnolence - answerDaytime sleepiness
Black Box Warning - answerThis warning reflects that a medication may cause a
serious or even life-threatening side effect
Partial or Mixed Agonist - answerA compound that elicits a partial pharmacological
response at the receptor site involved
Remission - answerThe degree of improvement to below the syndromal threshold of a
disorder
Paradoxical - answerA response to a drug that represents the clinical effect opposite of
what is expected
,Inverse agonist - answerAn agent that binds to the same receptor site as an agonist but
produces the opposite pharmacological effect
4 major transmitters - answerDopamine, Serotonin, GABA, Norepinephrine
Dopamine transmitter affects? - answeraffects mood, Psychosis, ADHD, Addiction
Serotonin transmitter affects? - answerDepression, aggression, OCD, Panic, GAD,
Social Anxiety, PTSD, Violence, Sexual dysfunction, substance addiction
Norepinephrine affects? - answerAffects mood, anxiety, psychosis, ADHD (part), drug
withdrawal
GABA affects? - answerFear, anxiety, worry
Irreversible MAOIs Types - answerMAOa and MAOb
Irreversible MAOIs medications - answerPhenelzine (Nardil)
isocarboxazid (Marplan)
tranylcypromine (Parnate)
A single dose of MAOIs may persist in its inhibition of MAO for how long? -
answerbecause they irreversibly inactivate MAOs, the therapeutic effect of a single
dose of irreversible MAOIs may persist for as long as 2 weeks
What are the most frequent adverse effects of MAOIs? - answerorthostatic hypotension,
insomnia, weight gain, edema, sexual dysfunction
Reversible MAOIs (RIMAs) medications? - answerMoclobemide (Maerix)
How long will it take to recover MAO activity after a final dose of RIMA? - answerMAO
activity recovers completely 24-48 hrs after the last dose of a RIMA
MAOIs are used to treat what conditions? - answerdepression
panic disorder
social phobia
bulimia nervosa
ptsd
anginal pain
atypical facial pain
migraine
adhd
idiopathic orthostatic hypotension
Depression associated with TBI
Treatment for MAOI induced orthostatic hypotension? - answerAvoid caffeine
, intake of 2L of fluid/day
addition of dietary salt
adjust HTN meds
support stocking
severe cases *tx with fludrocortisone (Florinef) a mineralcorticoid
How long should the NP wait to begin another tx for depression when stopping an MAOI
to begin another MAOI or SSRI? - answerirreversible MAOI-wait 14 days
MAO activity recovers completely 24-48 hrs after last dose of RIMA
How long should the NP wait to begin an MAOI after d/c a pt from fluoxetine (Prozac)? -
answerwhen switching from an antidepressant to an irreversible MAOI-should wait 10-
14 days (or 5 weeks for fluoxetine (Prozac) before starting use of MAOI to avoid drug
interactions
Complications for using MAOIs for pts who have bipolar I and schizophrenia? -
answerinduction of mania in the depressed phase of bipolar I disorder and triggering of
a psychotic decompensation in persons with schizophrenia
Symptoms of tyramine-induced hypertensive crisis? - answerSevere HTN
HA
Stiff neck
diaphoresis
N/V
Tyramine-containing foods should be avoided for how long after d/c an irreversible
MAOI? A reversible MAOI? - answerirreversible MAOI-2 weeks after last dose
reversible-3 days after last dose of RIMA
s/s of the discontinuation syndrome associated with abrupt withdrawal of MAOIs? How
would the NP prevent this? - answerarousal, mood disturbances, and somatic
symptoms
To avoid: dosage should be gradually tapered over several weeks
How long would it be before symptoms appear in a patient with an OD from an MAOI?
symptoms? - answerpts may appear symptom free up to 6 hrs, then progress to:
restlessness
coma-hyperthermia, HTN, tachypnea, tachycardia, dilated pupils, hyperactive deep
tendon reflexes
involuntary movements in face & jaw
death
close medical supervision is indicated for 48 hrs following an OD
Symptoms of MAOI toxicity? - answerCNS (dizzy, drowsy, fatigue, HA, hyperreflexia,
sleep disturbance)
Anticholinergic effects (constipation, dry mouth, urinary retention)
Potency - answer refers to the relative dose required to achieve certain effects, not to
the efficacy of a drug
Agonist (full agonist) - answer A drug that binds to a specific receptor producing an
effect identical to that usually produced by the neurotransmitter affecting that receptor
Pharmacodynamics - answer The time course and intensity of a drug's effect/what the
drug does to the body
Pharmacokinetics - answer What the body does to a drug
Tolerance - answer Develops over time a need to use increased doses of a
medication/drug to maintain a clinical effect. Or, a decreased sensitivity to adverse
effects of a drug
Stevens-Johnson Syndrome - answer A systemic, immune-mediated reaction that can
be fatal or result in permanent scarring or blindness
Antagonist - answerA compound that blind to a receptor that blocks or reduces the
action of another substance at the receptor site
Hyponatremia - answerCommon symptoms of this medication side effect include
confusion, agitation, and lethargy. (tx with oxcarbazepine & SSRIs)
Therapeutic index - answerratio of the median toxic dose to the median effective dose
Somnolence - answerDaytime sleepiness
Black Box Warning - answerThis warning reflects that a medication may cause a
serious or even life-threatening side effect
Partial or Mixed Agonist - answerA compound that elicits a partial pharmacological
response at the receptor site involved
Remission - answerThe degree of improvement to below the syndromal threshold of a
disorder
Paradoxical - answerA response to a drug that represents the clinical effect opposite of
what is expected
,Inverse agonist - answerAn agent that binds to the same receptor site as an agonist but
produces the opposite pharmacological effect
4 major transmitters - answerDopamine, Serotonin, GABA, Norepinephrine
Dopamine transmitter affects? - answeraffects mood, Psychosis, ADHD, Addiction
Serotonin transmitter affects? - answerDepression, aggression, OCD, Panic, GAD,
Social Anxiety, PTSD, Violence, Sexual dysfunction, substance addiction
Norepinephrine affects? - answerAffects mood, anxiety, psychosis, ADHD (part), drug
withdrawal
GABA affects? - answerFear, anxiety, worry
Irreversible MAOIs Types - answerMAOa and MAOb
Irreversible MAOIs medications - answerPhenelzine (Nardil)
isocarboxazid (Marplan)
tranylcypromine (Parnate)
A single dose of MAOIs may persist in its inhibition of MAO for how long? -
answerbecause they irreversibly inactivate MAOs, the therapeutic effect of a single
dose of irreversible MAOIs may persist for as long as 2 weeks
What are the most frequent adverse effects of MAOIs? - answerorthostatic hypotension,
insomnia, weight gain, edema, sexual dysfunction
Reversible MAOIs (RIMAs) medications? - answerMoclobemide (Maerix)
How long will it take to recover MAO activity after a final dose of RIMA? - answerMAO
activity recovers completely 24-48 hrs after the last dose of a RIMA
MAOIs are used to treat what conditions? - answerdepression
panic disorder
social phobia
bulimia nervosa
ptsd
anginal pain
atypical facial pain
migraine
adhd
idiopathic orthostatic hypotension
Depression associated with TBI
Treatment for MAOI induced orthostatic hypotension? - answerAvoid caffeine
, intake of 2L of fluid/day
addition of dietary salt
adjust HTN meds
support stocking
severe cases *tx with fludrocortisone (Florinef) a mineralcorticoid
How long should the NP wait to begin another tx for depression when stopping an MAOI
to begin another MAOI or SSRI? - answerirreversible MAOI-wait 14 days
MAO activity recovers completely 24-48 hrs after last dose of RIMA
How long should the NP wait to begin an MAOI after d/c a pt from fluoxetine (Prozac)? -
answerwhen switching from an antidepressant to an irreversible MAOI-should wait 10-
14 days (or 5 weeks for fluoxetine (Prozac) before starting use of MAOI to avoid drug
interactions
Complications for using MAOIs for pts who have bipolar I and schizophrenia? -
answerinduction of mania in the depressed phase of bipolar I disorder and triggering of
a psychotic decompensation in persons with schizophrenia
Symptoms of tyramine-induced hypertensive crisis? - answerSevere HTN
HA
Stiff neck
diaphoresis
N/V
Tyramine-containing foods should be avoided for how long after d/c an irreversible
MAOI? A reversible MAOI? - answerirreversible MAOI-2 weeks after last dose
reversible-3 days after last dose of RIMA
s/s of the discontinuation syndrome associated with abrupt withdrawal of MAOIs? How
would the NP prevent this? - answerarousal, mood disturbances, and somatic
symptoms
To avoid: dosage should be gradually tapered over several weeks
How long would it be before symptoms appear in a patient with an OD from an MAOI?
symptoms? - answerpts may appear symptom free up to 6 hrs, then progress to:
restlessness
coma-hyperthermia, HTN, tachypnea, tachycardia, dilated pupils, hyperactive deep
tendon reflexes
involuntary movements in face & jaw
death
close medical supervision is indicated for 48 hrs following an OD
Symptoms of MAOI toxicity? - answerCNS (dizzy, drowsy, fatigue, HA, hyperreflexia,
sleep disturbance)
Anticholinergic effects (constipation, dry mouth, urinary retention)
