APPROACH TO PSYCHOTROPICS

Which CYP enzyme is primarily responsible for metabolizing phenytoin and valproate?

• CYP2C9

• CYP2D6

• CYP3A4

• CYP1A2

Which drug is preferred in hepatic impairment due to glucuronidation metabolism?

• Diazepam

• Lorazepam

• Amitiptyline

• fluoxetine

What is the required D2 receptor occupancy for antipsychotic efficacy?

• 30-40%

• 90-100%

• 10-20%

• 60-80%

Which second-generation antipsychotic is known for ‘fast-off’ D2 receptor binding?

• Quetiapine

• Risperidone

• Aripiprazole

• Haloperidol

What is the effect of 5-HT2A antagonism in antipsychotics?

• Decreases serotonin levels

• Improves negative symptoms

• Increases prolactin release

• Causes sedation

Zaleplon is preferred for which situation?

• Early morning awakenings

• Middle-of-the-night awakening

• Chronic insomnia

• Delayed sleep phase

Which ADHD medication acts primarily as a norepinephrine reuptake inhibitor?

• Amphetamine

• Methylphenidate

• Atomoxetine

• Modafinil

In the elderly, which factor most alters psychotropic pharmacokinetics?

• CYP polymorphism

• Slow GI motility

• Renal impairment

• Increased metabolism

Which class of antidepressants is most affected by CYP2D6 genetic polymorphisms?

• MAOI

• SSRI

• SNRI

• TCA

5-HT2A antagonism enhances dopamine transmission in which brain region?

• Mesolimbic

• Nigrostriatal

• Tuberoinfundibular

• Cerebellum