Medical Pharmacology: Antidepressant Drugs

May induce a condition similar to endogenous depression:
1. opioids
2. corticosteroids
3. alcohol
4. all of the above
Dexamethasone-suppression test for depression: Correct statements about test results:
1. The result is "positive" if plasma cortisol levels rise above 5 mg%
2. False-positives occur in Cushing's disease.
3. False-positives occur in Addison's disease.
4. A & B
Anxiety associated with depression:
1. diazepam
2. paroxetine
3. oxazepam
4. methylphenidate
Treatment of anxiety not secondary to depression or other illness.
1. fluoxetine
2. lorazepam
3. triazolam
4. all of the above
Most likely to be prescribed first for management of mild to moderate depression:
1. imipramine
2. amoxapine
3. sertraline
4. phenelzine
Antidepressant drugs that might be used in a patient not responding to serotonin-specific reuptake inhibitors or to tricyclic antidepressants
1. tranylcypromine
2. bupropion
3. venlafaxine
4. all of the above
An elderly male with a history of coronary vascular disease (myocardial infarction and second degree heart block) presents with endogenous depression. Appropriate antidepressant medication would be:
1. imipramine
2. fluoxetine
3. phenelzine
4. amitriptyline
A depressed patient treated with tranylcypromine presents to the emergency department with a pounding headache. The patient had just eaten dinner, enjoying a red wine with the meal. Suggest possible cause for these symptoms:
1. Normally, tranylcypromine causes hypertension
2. Tranylcypromine, a beta-blocker, unmasked essential hypertension.
3. Tranylcypromine, an MAO inhibitor, can cause hypertensive reactions in patients who have ingested tyramine-containing foods.
4. Tyanylcypromine, a first-generation tricyclic antdepressant, produces hypertensive responses as a side effect.
Pharmacological management of hypertensive crisis secondary to ingestion of typramine-containing foods by a patient treated with phenelzine:
1. nitroprusside
2. phentolamine
3. both
4. neither
Drug treatment for obsessive-compulsive disorder in a patient with significant myocardial disease.
1. clomipramine
2. fluvoxamine
3. imipramine
4. phenelzine
Physiological effects associated with lithium treatment:
1. fine hand tremor
2. G.I. upset
3. muscle weakness
4. all of the above
Polyuria associated with lithium caused by:
1. lithium-induced osmotic diuresis, similar to mannitor
2. lithium inhibits sodium exchange in the ascending loop of Henle
3. lithium activates carbonic anhydrase
4. lithium inhibits ADH receptor.
Effects associated with chronic lithium treatment:
1. leukocytosis
2. prerenal azeotemia
3. lowered TSH serum levels
4. A & B
Drugs that affect plasma lithium levels:
1. chlorothiazide
2. indomethacin
3. both
4. neither
Lithium in managing bipolar disorder in pregnancy:
1. Due to changes in renal function during pregnancy, lithium clearance would decrease, necessitating an increase in dosage.
2. A restricted salt diet will help insure safe lithium levels.
3. Lithium can cross the placental barrrier and cause Ebstein's anomaly in the newborn.
4. B & C