DSSSB 12 August 2024
Pharmacology
Easy
All of the following are selective serotonin inhibitors, EXCEPT:
Appeared in: DSSSB 12 August 2024
Explanation
- Amitriptyline is classified as a Tricyclic Antidepressant (TCA), not a Selective Serotonin Reuptake Inhibitor (SSRI).
- Its primary mechanism of action involves the non-selective inhibition of the reuptake of two neurotransmitters: serotonin and norepinephrine.
- Unlike SSRIs, TCAs also have significant antagonist effects at cholinergic, histaminic, and adrenergic receptors, which leads to a wider array of side effects.
- Due to its different mechanism and broader receptor activity, it is the correct exception in a list of SSRIs.
Why Other Options Were Wrong
- Option A: Fluoxetine is a classic example of an SSRI. It selectively blocks the reuptake of serotonin, fitting the definition of the drug class mentioned in the question.
- Option B: Sertraline is another widely used SSRI. Its primary action is the selective inhibition of serotonin reuptake.
- Option D: Escitalopram is a highly selective SSRI. It is the active enantiomer of citalopram and is known for its potent and specific inhibition of the serotonin transporter.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Classification of antidepressant medications, specifically differentiating Selective Serotonin Reuptake Inhibitors (SSRIs) from Tricyclic Antidepressants (TCAs) as background academic context rather than a clinical decision trigger.
- Differentiating between antidepressant classes is vital for patient safety. TCAs like amitriptyline have a narrow therapeutic index and a high risk of cardiotoxicity in overdose, whereas SSRIs are generally safer and are considered first-line treatment for depression.
- Nurses must educate patients about the different side effect profiles. TCAs often cause anticholinergic effects (dry mouth, constipation, blurred vision), while SSRIs are more commonly associated with gastrointestinal issues (nausea) and sexual dysfunction.
- What if? If a patient has a history of cardiac arrhythmia or is at high risk for suicide, a TCA like amitriptyline would be a high-risk choice. A nurse should anticipate that an SSRI would be the preferred agent due to its superior safety profile.
How to Approach the Question
- First, identify the question's core task: find the one drug that is NOT a Selective Serotonin Reuptake Inhibitor (SSRI). The keyword 'EXCEPT' is critical.
- Scan the options. This is a pharmacology classification question, so recognizing drug classes or common suffixes is the most efficient strategy.
- Recall or identify the suffixes for common antidepressant classes. SSRIs often end in '-pram' (Escitalopram), '-tine' (Fluoxetine), or '-line' (Sertraline).
- Recognize that Tricyclic Antidepressants (TCAs) often end in '-triptyline' (Amitriptyline) or '-ipramine'.
- Compare the options to these patterns. Fluoxetine, Sertraline, and Escitalopram fit the SSRI naming conventions.
- Amitriptyline fits the TCA naming pattern, making it the outlier and the correct answer.
Concept Tested & Keywords
- Concept Tested: Classification of antidepressant medications, specifically differentiating Selective Serotonin Reuptake Inhibitors (SSRIs) from Tricyclic Antidepressants (TCAs).
- Stem keywords: selective serotonin inhibitors, antidepressants, pharmacology
- Lead-in keywords: EXCEPT
- Negative lead-in flag: This question uses negative framing ('EXCEPT'), asking you to identify the option that does not belong to the specified class (Selective Serotonin Reuptake Inhibitors).
Question ID
Q7-bLTqX47H61U9omcuI9J
Reference Book
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) pp. 10168-10170, 10165-10167
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 1975-1977
Practise the full DSSSB 12 August 2024
Attempt every question from this paper in a timed mock, then review the full solution for each one.
More Drugs Acting on Central Nervous System Questions
- Which of the psychiatric drug does not need any test dose before starting routine dose?
- What is the therapeutic blood lithium level in the body?
- Identify the Yellow vaporizer in the following image:
- The normal value of serum lithium test is:
- What is the drug of choice for alcohol withdrawal symptoms?
- Which antipsychotic medications cause amenorrhea?
- The side effects of Tri-cyclic antidepressants (TCA) drugs are:
- A mood stabilising agent:-
- Neuroleptic drugs are also known as
- A patient with Parkinson's syndrome receives continuous levodopa to increase the level of?
More DSSSB 12 August 2024 Questions
- What is the meaning of conation?
- Which of the following is NOT a parameter of the Braden scale?
- Which of the following is a way of dealing with or remembering information by separating it into small groups?
- A common measure of the severity of a disease, based on current physiological parameters, age and previous health conditions, is the
- The formation of sequestrum and involucrum is seen in the pathogenesis of:
- An adult patient was diagnosed with paranoid schizophrenia, and the doctor prescribed him chlorpromazine. After three weeks, the patient developed a…
- World Anti-Tobacco Day is observed on:
- Which of the following pubertal changes is characterised by breast budding in females?
- What is the inability to recognize familiar inanimate objects called?
- Foetal heart rate can be auscultated with a fetoscope at: