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July 23, 2009

Exam 2 Pharmacological Influences on Health BBH 451

Part 1. 1 point each, circle your answer. 1. Benzodiazepines _______________ binding at the ___________ receptor and alter conductance of ________ ions. a. b. c. d. facilitate; GABA; Ca++ facilitate; GABA; Clinhibit; GABA; Clinhibit; 5-HT; Ca++

2. At the receptor level, buspirone acts: a. as a partial agonist at the 5-HT3 postsynaptic receptors b. as a partial antagonist at the 5-HT3 postsynaptic receptors c. as a partial agonist at 5-HT1A postsynaptic receptors d. as a partial antagonist at 5-HT1A postsynaptic receptors

3. The SSRI-type antidepressants a. reduce both anxiety and depression b. are the drug of first choice for the treatment of anxiety c. induce neuronal growth d. all of the answers are correct

4. Which of the following is NOT a member of the limbic system? a. hypothalamus b. amygdala c. hippocampus d. all are part of the limbic system

5. The genetic material in a neuron is found in the: a. soma b. dendrite c. axon d. presynaptic terminal

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6. The mechanism of action of the MAO inhibitor (MAOi) antidepressants is: a. blockade of receptors b. blockade of neurotransmitter reuptake c. blockade of enzymatic breakdown of monoamines d. increase in release of monoamines

7.

The most common inhibitory and excitatory neurotransmitters in the brain are, respectively: a. NE and 5-HT b. NE and GABA c. glutamate and GABA d. GABA and glutamate

8. The main reason benzodiazepines are inherently safer than barbiturates is that: a. benzodiazepines can open the ion channel at the GABA receptor in the absence of GABA b. benzodiazepines cannot open the ion channel at the GABA recept in the absence of GABA c. barbiturates act a more receptor subtypes than benzodiazepines d. barbiturates increase GABA neurotransmission

9. The reason barbiturate use declined rapidly after introduction of benzodiazapines is that: a. Barbiturates are usually lethal in overdose. b. The dosage range for effectiveness of barbiturates is very close to the toxic range. c. Barbiturates interact dangerously with other commonly used drugs such as ethanol. d. All of the above are correct. e. Only a and b are correct.

10. Second generation anxiolytics, such as Zolpidem (Ambien) or Zaleplon (Sonata), showed minimal improvement in ability to relieve anxiety, and are largely used for: a. b. c. d. Attention focusing activity. Sedation. Pain relief. Cognitive enhancement.

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11. Dangerous interactions with aged cheese and other food products containing tyramine is associated with: a. tricylclic antidepressants b. selective serotonin reuptake inhibitors c. atypical second-generation antidepressants d. monoamine oxidase inhibitors

12. The mechanism of action of newer antidepressants like Prozac and Zoloft is: a. blockade of postsynaptic receptors b. inhibition of degradation by enzymes c. inhibition of neurotransmitter reuptake d. inhibition of neurotransmitter release

13. The alpha 2 (2) subunit of the GABA-A receptor is probably a target for: a. b. c. d. MAOis Diazepam (Valium) TCA (tricyclics) Phenobarbital

14. An example of a new drug that is actually just a single enantiomer (stereoisomer) of an older drug is: a. b. c. d. Diazepam (Valium) Lorazepam (Ativan) Eszopiclone (Lunesta) Zopiclone (Immovane)

15. Cognitive Behavioral Therapy (CBT) targets _____________ and antidepressant drug therapy targets _____________. a. b. c. d. parasympathetic nervous system; sympathetic nervous system hippocampus; amygdala amygdala; hippocampus prefrontal cortex; limbic system

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16. ____________ is the most formidable obstacle to future progress in the area of mental illness. a. Funding b. Education c. Stigmatization/labels d. Lack of resources

17. True/False: 50% of people with diagnosable mental conditions seek treatment a. True b. False

18. Excretion of St. Johns Wort occurs: a. via the urine b. via the lungs c. via the skin d. through unknown mechanisms

19. Combining St. Johns Wort with certain types of antidepressants can cause: a. Monoamine deficiency b. Serotonin syndrome c. a better combination therapy for depression d. is safe for young people, but not for the elderly

20. Excitoxicity (which can lead to cell death in neurodegenerative diseases) is caused by: a. Too much GABA; too many chloride ions inside the cell b. Serotonin syndrome c. Too much glutamate; too many calcium ions inside the cell d. Ephedrine

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Part 2. Short Answer (5 pts each). Answer only 4 of the 5 following questions. You may use the back of the pages. If all questions are answered the wrong one might be graded. 1. Your father is one of the unlucky 40% of people who dont respond to drug therapy for anxiety. Suggest a non-pharmacological treatment that you learned about in class for him. Explain the different components of the therapy to him and what they focus on. Also tell him about how the therapy works based on the idea behind one cause for anxiety.

2. How do autoreceptors work? Describe how they function normally and how we believe they function in anxiety. Be sure to mention which neurotransmitter and receptor type. Draw a picture to help your description.

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3. How does Buspirone work to treat depression? How does it work to treat anxiety? What neurotransmitter and receptor type(s) does it work on?

4. As you learned, barbiturates are not ideal for treating anxiety. Describe two ways that one could develop a tolerance to these drugs. What pharmacokinetic quality determines drug onset and duration length? Whats alarming about the ED and LD?

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5. There are many theories and hypotheses for depression. Explain either the Monamine Hypothesis, Postsynaptic Receptor Desensitization Theory, or Serotonin Hypothesis and explain how a drug might work on the mechanisms explained in the theory/hypothesis.

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Part 2. Answer only ONE of the following questions for 10 points, and put the answer on the test pages. You may use the back of the pages. If both are answered the wrong one might be graded. 1. Your cousin just confided in you that she was diagnosed with anxiety. Shes done some Internet research on anxiolytics and thinks that a drug like Zoldipem (Ambien) is what she should use because the people on the commercial for it look so peaceful. Give her a reason against using this drug for anxiety and explain to her what these drugs actually treat. Give her a suggestion for a better drug to use and explain how it works at the neuronal level (mechanism of action). Give one advantage of your suggested drug, and one disadvantage.

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2. Youre a budding biochemist and think youve stumbled on an undiscovered neurotransmitter! What are the criteria this chemical must have to be considered a neurotransmitter? Explain the lifecycle of your neurotransmitter from precursor to elimination from the synapse.

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33. (Up to 3 pts.) Provide one, multiple-choice, question in the format used on this test that you expected to be on the test but was not, and what is the answer? The higher the quality of the question and answer the more points you earn. An incorrect answer will result in no points awarded.