A 20-year-old college student presents to the emergency room complaining of insomnia for the past 48 hours. He explains that although his body feels tired, he is "full of energy and focus" after taking a certain drug an hour ago. He now wants to sleep because he is having hallucinations. His vital signs are T 100.0 F, HR 110 bpm, and BP of 150/120 mmHg. The patient states that he was recently diagnosed with "inattentiveness." Which of the following is the mechanism of action of the most likely drug causing the intoxication?
ABlocks NMDA receptors
BActivates mu opioid receptors
CDisplaces norepinephrine from secretory vesicles leading to norepinephrine depletion
DBinds to cannabinoid receptors
EIncreases presynaptic dopamine and norepinephrine release from vesicles
A 25-year-old woman presents to her college campus clinic with the complaint of being unable to get up for her morning classes. She says that, because of this, her grades are being affected. For the past 6 weeks, she says she has been feeling depressed because her boyfriend dumped her. She finds herself very sleepy, sleeping in most mornings, eating more snacks and fast foods, and feeling drained of energy. She is comforted by her friend’s efforts to cheer her up but still feels guarded around any other boy that shows interest in her. The patient says she had similar symptoms 7 years ago for which she was prescribed several selective serotonin reuptake inhibitors (SSRIs) and a tricyclic antidepressant (TCA). However, none of the medications provided any long-term relief. She has prescribed a trial of Phenelzine to treat her symptoms. Past medical history is significant for a long-standing seizure disorder well managed with phenytoin. Which of the following statements would most likely be relevant to this patient’s new medication?
A“This medication is known to cause anorgasmia during treatment.”
B“You will have a risk for cardiotoxicity from this medication.”
C“A common side effect of this medication is sedation.”
D“While taking this medication, you should avoid drinking red wine.”
E“While on this medication, you may have a decreased seizure threshold.”
A 24-year-old male comes into the psychiatric clinic complaining of consistent sadness. He endorses feelings of worthlessness, anxiety, and anhedonia for the past couple months but denies feeling suicidal. He further denies any past episodes of feeling overly energetic with racing thoughts. Confident of the diagnosis, you recommend frequent talk therapy along with a long-term prescription of a known first-line medication for this disorder. What is the drug and what are some of the most frequently encountered side effects?
ASelective serotonin reuptake inhibitor; hypomania, suicidal thoughts
BTricyclic antidepressants; hypomania, suicidal thoughts
CSelective serotonin reuptake inhibitor; anorgasmia, insomnia
DMonoamine oxidase inhibitors; Orthostatic hypotension, weight gain
ETricyclic antidepressants; Orthostatic hypotension, anticholinergic effects
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