ANWSER
Question 1 (a):
Answer:
Five types of unipolar depression/major depression are:
1. Melancholic Depression – Characterized by severe symptoms, lack of reactivity to pleasurable stimuli, and physical symptoms like weight loss.
2. Psychotic Depression – Accompanied by psychosis, such as delusions or hallucinations.
3. Postpartum Depression – Occurs after childbirth, with symptoms like extreme sadness and fatigue.
4. Seasonal Affective Disorder (SAD) – Linked to seasonal changes, typically worsening in winter.
5. Catatonic Depression – Involves motor disturbances, such as immobility or excessive movement.
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Question 1 (b):
Answer:
Atypical Antidepressants are a class of antidepressants that do not fit into the traditional categories (e.g., SSRIs, TCAs). Their five major characteristics are:
1. They target multiple neurotransmitter systems (e.g., dopamine, serotonin, norepinephrine).
2. They often have fewer side effects compared to TCAs.
3. They may improve symptoms like fatigue and hypersomnia.
4. Examples include bupropion and mirtazapine.
5. They are used when patients do not respond to first-line treatments.
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Question 1 (c):
Answer:
| Specific Class of Antidepressant Agent | Examples of Drugs |
|—|—|
| I (Tricyclic Antidepressants, TCAs) | Doxepin |
| II (Monoamine Oxidase Inhibitors, MAOIs) | Phenelzine (Note: “Staphylococcus” is incorrect; likely a typo) |
| III (Selective Serotonin Reuptake Inhibitors, SSRIs) | Citalopram |
| IV (Typical Antipsychotics, e.g., Phenothiazines) | Chlorpromazine (CPZ) |
| V (Tetracyclic Antidepressants) | Mianserine |
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Question 2 (i):
Answer:
Five reasons benzodiazepines replaced barbiturates:
1. Safer Overdose Profile – Benzodiazepines have a higher therapeutic index.
2. Less Respiratory Depression – Lower risk of fatal respiratory suppression.
3. Reduced Abuse Potential – Barbiturates are more addictive.
4. Fewer Drug Interactions – Benzodiazepines interact less with other medications.
5. More Predictable Metabolism – Barbiturates induce liver enzymes, altering drug efficacy.
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Question 2 (ii):
Answer:
Clinical uses of barbiturates:
1. Anesthesia – Ultra-short-acting barbiturates like thiopental are used for induction.
2. Sedation/Hypnosis – For severe insomnia (rarely used now).
3. Anticonvulsant – Phenobarbital treats epilepsy.
4. Emergency Seizure Control – In status epilepticus.
5. Euthanasia/Palliative Care – In some countries for assisted dying.
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Question 2 (iii):
Answer:
– Ramelteon: A melatonin receptor agonist (MT1/MT2) regulating the sleep-wake cycle.
– Eszopiclone: A non-benzodiazepine hypnotic that enhances GABA activity at the GABA-A receptor, promoting sedation.
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Question 2 (iv):
Answer:
– Drug Abuse: Intentional, harmful use of substances for recreational purposes (e.g., heroin for euphoria).
– Drug Misuse: Incorrect or non-prescribed use of medications (e.g., taking a friend’s antibiotics).
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