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Question 460
Pharmacology → General
Classification
Question
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Two tricyclic antidepressants are compared. Drug X inhibits reuptake of both noradrenaline and 5-hydroxytryptamine, whereas Drug Y predominantly inhibits noradrenaline reuptake. Which pairing is consistent with the classification?
Question Stem
Select the single best answer.
Options
A
Drug X: desipramine; Drug Y: clomipramine
B
Drug X: nortriptyline; Drug Y: amitriptyline
C
Drug X: imipramine; Drug Y: desipramine
D
Drug X: reboxetine; Drug Y: trimipramine
E
Drug X: amoxapine; Drug Y: doxepin
Explanation
Imipramine, amitriptyline, trimipramine, doxepin, dothiepin and clomipramine inhibit reuptake of both noradrenaline and 5-hydroxytryptamine. Desipramine, nortriptyline, amoxapine and reboxetine predominantly inhibit noradrenaline reuptake.
Option Validity
A) Desipramine predominantly inhibits noradrenaline reuptake, whereas clomipramine inhibits reuptake of both noradrenaline and 5-hydroxytryptamine, so the assignments are reversed.
B) Nortriptyline predominantly inhibits noradrenaline reuptake, whereas amitriptyline blocks uptake of both transmitters.
D) Reboxetine predominantly inhibits noradrenaline reuptake, while trimipramine is in the dual-uptake group.
E) Amoxapine predominantly inhibits noradrenaline reuptake, whereas doxepin inhibits uptake of both noradrenaline and 5-hydroxytryptamine.
Further Reading
Saxena R. Textbook for MRCOG-1. Chapter 12: Pharmacology. Antidepressant Drugs, p.346.