Medication Mechanisms - Eppp Knowledge

Which nonstimulant ADHD medication is a selective norepinephrine reuptake inhibitor?

Atomoxetine. Selective NE reuptake inhibition increases prefrontal norepinephrine, improving attention without stimulant abuse potential.
What is the primary mechanism of action of SNRIs in treating major depressive disorder and some anxiety disorders?

Inhibit reuptake of serotonin and norepinephrine. SNRIs elevate synaptic levels of both neurotransmitters, modulating mood and anxiety pathways in the brain for therapeutic effect.
Which medication class is first-line for obsessive-compulsive disorder due to serotonergic reuptake inhibition?

SSRIs (and clomipramine as a TCA option). Potent serotonin reuptake blockade enhances serotonergic activity, reducing obsessions and compulsions effectively as primary pharmacotherapy.
Which medication is a long-acting injectable antipsychotic commonly used to improve adherence in schizophrenia?

Haloperidol decanoate. As a depot formulation, it ensures sustained D $_2$ blockade, maintaining therapeutic levels to prevent relapse in nonadherent patients.
Which antidepressant acts as an $b1_2$ -adrenergic antagonist to increase NE and 5-HT release, often used when insomnia is present?

Mirtazapine. $alpha_2$ antagonism disinhibits NE and 5-HT neurons, enhancing release, with sedating antihistamine effects beneficial for comorbid sleep issues.
Which antidepressant is a norepinephrine-dopamine reuptake inhibitor (NDRI) often used for depression and smoking cessation?

Bupropion. As an NDRI, it boosts dopamine and norepinephrine activity, improving mood and motivation while aiding nicotine dependence by modulating reward pathways.
Which antidepressant class primarily inhibits reuptake of serotonin (5-HT) to treat depression and anxiety?

SSRIs (selective serotonin reuptake inhibitors). This class enhances serotonergic neurotransmission by blocking serotonin reuptake, increasing its synaptic availability to alleviate depressive and anxiety symptoms.
Which anxiolytic class potentiates GABA-A receptor activity and is used for acute anxiety and status epilepticus?

Benzodiazepines (positive allosteric modulators at GABA-A). They enhance GABAergic inhibition by increasing chloride influx, rapidly reducing neuronal excitability for anxiety relief and seizure control.
Which antidepressant class irreversibly inhibits monoamine oxidase and requires tyramine dietary precautions?

MAOIs (monoamine oxidase inhibitors). By inhibiting MAO, this class prevents monoamine breakdown, increasing neurotransmitter levels, but risks hypertensive crisis with tyramine ingestion.
Which agent is a partial agonist at 5-HT $_{1A}$ with SRI properties used for major depressive disorder?

Vilazodone. Combining SRI with 5-HT $_{1A}$ agonism enhances serotonergic signaling, providing rapid antidepressant effects in major depressive disorder.
Which hypnotic class binds the benzodiazepine site on GABA-A (BZ $_1$ preference) for insomnia with less anxiolysis?

Nonbenzodiazepine Z-drugs (e.g., zolpidem). Selective binding to BZ $_1$ subtype enhances GABA effects primarily for sleep induction, minimizing broader anxiolytic or muscle relaxant actions.
Which antipsychotic class primarily blocks D $_2$ receptors and is used for schizophrenia and acute psychosis?

First-generation (typical) antipsychotics. D $_2$ antagonism reduces dopaminergic hyperactivity in psychosis, though it risks extrapyramidal symptoms due to strong receptor blockade.
Which antipsychotic class blocks 5-HT $_2$ and D $_2$ receptors and is used for schizophrenia with fewer EPS?

Second-generation (atypical) antipsychotics. Dual blockade balances dopamine inhibition with serotonin modulation, reducing positive symptoms while lowering extrapyramidal side effect risk.
Which stimulant class increases synaptic dopamine and norepinephrine and is first-line for ADHD?

Amphetamines and methylphenidate (DA/NE increase). They promote catecholamine release and block reuptake, enhancing focus and impulse control in prefrontal cortex for ADHD management.
What is the primary mechanism of action of TCAs as antidepressants?

Inhibit 5-HT and NE reuptake; also anticholinergic/antihistamine. TCAs boost monoamine levels via reuptake inhibition while their additional receptor blockades contribute to side effects like sedation and dry mouth.
Which ADHD medication is an $b1_2$ -adrenergic agonist used for hyperactivity/impulsivity and tics?

Guanfacine (also clonidine). $alpha_2$ agonism modulates prefrontal activity, reducing hyperactivity and impulsivity, with benefits for comorbid tic disorders.
Which anticonvulsant mood stabilizer increases GABA and is used for acute mania and bipolar maintenance?

Valproate (divalproex/valproic acid). By enhancing GABA transmission and inhibiting glutamate, it rapidly controls manic symptoms and prevents mood episode recurrence.
Which antipsychotic is uniquely indicated for treatment-resistant schizophrenia and reduces suicidal behavior?

Clozapine. Its broad receptor antagonism, including unique D $_4$ affinity, provides efficacy in refractory cases and mitigates suicidality in schizophrenia.
Which medication class is first-line for acute bipolar depression and treatment-resistant depression as augmentation?

Second-generation antipsychotics (selected agents, e.g., quetiapine). Selected agents modulate serotonin and dopamine to alleviate depressive symptoms in bipolar and augment SSRIs in resistant unipolar depression.
Which antidepressant class is primarily 5-HT $_2$ antagonist and weak SRI, commonly used for depression with insomnia?

Serotonin antagonist and reuptake inhibitors (e.g., trazodone). 5-HT $_2$ antagonism combined with mild reuptake inhibition modulates serotonin activity, promoting sedation useful for insomnia in depression.
Which medication is a 5-HT $_{1A}$ partial agonist indicated for generalized anxiety disorder rather than acute panic?

Buspirone. Partial agonism at 5-HT $_{1A}$ receptors reduces anxiety over time without sedative or dependence risks associated with benzodiazepines.
Which mood stabilizer blocks voltage-gated Na $^+$ channels and is used for bipolar disorder and trigeminal neuralgia?

Carbamazepine. Na $^+$ channel blockade stabilizes neuronal membranes, reducing manic excitability and alleviating neuropathic pain in trigeminal neuralgia.
Which mood stabilizer is first-line for acute mania and bipolar maintenance, with a narrow therapeutic index?

Lithium. It modulates intracellular signaling pathways to stabilize mood, requiring close monitoring due to toxicity risks at supratherapeutic levels.
Which mood stabilizer is most associated with prevention of bipolar depression and risk of serious rash?

Lamotrigine. It inhibits glutamate release, preferentially preventing depressive relapses, though slow titration is needed to minimize Stevens-Johnson syndrome risk.

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