NURSE 660 EXAM 1/ NURS 660 ANTIPSYCHOTIC
MEDICATIONS QUESTIONS & ANSWERS
What medication is most associated with increased prolactin - ANSWER-
Risperidal
Which medication is most associated with weight gain - ANSWER-olanzapine
Second Generation is mainly associated with which side effects? - ANSWER-
Weight gain, hypercholesterolemia, altered glucose tolerance insulin secretion
First Generation is mainly associated with which side effects? - ANSWER-TD,
EPS
Why is olanzapine associated with weight gain? - ANSWER-High affinity for 2c
receptors
What are the rating scales used to evaluate abnormal movements associated with
psychotropic medication? - ANSWER-SMARTS, AIMS, PANAS- self report
questionnaire, SAGE,
PHQ-depression, COWS-Opioid withdrawal
What is the black box warning of Clozapine - ANSWER-Agranulocytosis
What is the most common side effect of clozapine - ANSWER-sedation
What labs need to be done before starting clients on antipsychotic medications? -
ANSWER-fasting lipid panel, fasting glucose, weight, bp
When someone with schizophrenia is on an atypical antipsychotic with complaints
of increased fatigue, which antipsychotic would you switch to? - ANSWER-
Abilify
,Patient has been on an atypical antipsychotic for 6weeks with unchanged weight.
Do you think that weight would be a good predictor of fasting triglycerides -
ANSWER-no
What is the pathway responsible for regulation of dopamine in the hypothalamus -
ANSWER-mesolimbic pathway
What antidepressant should be avoided for a patient on clozapine? - ANSWER-
Fluvox, paroxetine, sertraline (in large doses)
If a patient is experiencing breast milk secretion while receiving a med that may
stimulate breast secretions which medication could be switched to that does not
have increased prolactin as a side effect? - ANSWER-Seroquel or zyprexa
What is the pharmacological explanation of the resolution of breast secretion -
ANSWER-decreased dopamine- increased prolactin
Increased serotonin- increased prolactin
Patient gains 25lbs in 6mons. What are the pharmacological properties of this
medication that cause the weight gain? - ANSWER-Blockade of 2a, 2c, d2
receptors
Drug induced parkinsonism is caused by a decrease of dopamine in which pathway
- ANSWER-nigrostriatal dopamine pathway
What Is the neurotransmitter that is needed for the activation of the AMPA
receptors? - ANSWER-Glutamate
What antipsychotic has low risk of metabolic effects - ANSWER-Iloperidone
(Fanapt)
What is the treatment for parkonsonism EPS effects? - ANSWER-Symmetrel and
Artane (amantadine or trihexyphenidyl)
What antipsychotic does not exceed 60% D2 occupancy? - ANSWER-Clozapine
, Individuals who ultimately develop schizophrenia typically exhibit what pattern of
cognitive functioning prior to disorder onset?
A. Normal cognitive functioning during premorbid and prodrome phases
B. Impaired cognitive functioning that is stable across premorbid and prodrome
phases
C. Impaired cognitive functioning premorbid with further decline during the
prodrome phase
D. Progressive decline of cognitive functioning across premorbid and prodrome
phases - ANSWER-Impaired cognitive functioning premorbid with further decline
during the prodrome phase
Which of the following SGA has the greatest effect on dopamine receptors in the
tuberoinfundibular pathway? - ANSWER-Risperidone
What scale do you use to measure abnormal mouth movements? - ANSWER-
DISCUS
The positive symptoms of schizophrenia are hypothesized to result from:
A. Mesocortical dopamine hypoactivity
B. Mesocortical dopamine hyperactivity
C. Mesolimbic dopamine hypoactivity
D. Mesolimbic dopamine hyperactivity - ANSWER-Mesolimbic dopamine
hyperactivity
NMDA receptors exhibit hypo or hyperfunctioning in schizophrenia? - ANSWER-
hypo functioning
Which part of brain is responsible for aggressive symptoms? - ANSWER-orbital
frontal cortex
Which part of brain is responsible for movement and motor symptoms? -
ANSWER-substantia nigra
Which part of brain is responsible for negative symptoms? - ANSWER-nucleus
accumbens
MEDICATIONS QUESTIONS & ANSWERS
What medication is most associated with increased prolactin - ANSWER-
Risperidal
Which medication is most associated with weight gain - ANSWER-olanzapine
Second Generation is mainly associated with which side effects? - ANSWER-
Weight gain, hypercholesterolemia, altered glucose tolerance insulin secretion
First Generation is mainly associated with which side effects? - ANSWER-TD,
EPS
Why is olanzapine associated with weight gain? - ANSWER-High affinity for 2c
receptors
What are the rating scales used to evaluate abnormal movements associated with
psychotropic medication? - ANSWER-SMARTS, AIMS, PANAS- self report
questionnaire, SAGE,
PHQ-depression, COWS-Opioid withdrawal
What is the black box warning of Clozapine - ANSWER-Agranulocytosis
What is the most common side effect of clozapine - ANSWER-sedation
What labs need to be done before starting clients on antipsychotic medications? -
ANSWER-fasting lipid panel, fasting glucose, weight, bp
When someone with schizophrenia is on an atypical antipsychotic with complaints
of increased fatigue, which antipsychotic would you switch to? - ANSWER-
Abilify
,Patient has been on an atypical antipsychotic for 6weeks with unchanged weight.
Do you think that weight would be a good predictor of fasting triglycerides -
ANSWER-no
What is the pathway responsible for regulation of dopamine in the hypothalamus -
ANSWER-mesolimbic pathway
What antidepressant should be avoided for a patient on clozapine? - ANSWER-
Fluvox, paroxetine, sertraline (in large doses)
If a patient is experiencing breast milk secretion while receiving a med that may
stimulate breast secretions which medication could be switched to that does not
have increased prolactin as a side effect? - ANSWER-Seroquel or zyprexa
What is the pharmacological explanation of the resolution of breast secretion -
ANSWER-decreased dopamine- increased prolactin
Increased serotonin- increased prolactin
Patient gains 25lbs in 6mons. What are the pharmacological properties of this
medication that cause the weight gain? - ANSWER-Blockade of 2a, 2c, d2
receptors
Drug induced parkinsonism is caused by a decrease of dopamine in which pathway
- ANSWER-nigrostriatal dopamine pathway
What Is the neurotransmitter that is needed for the activation of the AMPA
receptors? - ANSWER-Glutamate
What antipsychotic has low risk of metabolic effects - ANSWER-Iloperidone
(Fanapt)
What is the treatment for parkonsonism EPS effects? - ANSWER-Symmetrel and
Artane (amantadine or trihexyphenidyl)
What antipsychotic does not exceed 60% D2 occupancy? - ANSWER-Clozapine
, Individuals who ultimately develop schizophrenia typically exhibit what pattern of
cognitive functioning prior to disorder onset?
A. Normal cognitive functioning during premorbid and prodrome phases
B. Impaired cognitive functioning that is stable across premorbid and prodrome
phases
C. Impaired cognitive functioning premorbid with further decline during the
prodrome phase
D. Progressive decline of cognitive functioning across premorbid and prodrome
phases - ANSWER-Impaired cognitive functioning premorbid with further decline
during the prodrome phase
Which of the following SGA has the greatest effect on dopamine receptors in the
tuberoinfundibular pathway? - ANSWER-Risperidone
What scale do you use to measure abnormal mouth movements? - ANSWER-
DISCUS
The positive symptoms of schizophrenia are hypothesized to result from:
A. Mesocortical dopamine hypoactivity
B. Mesocortical dopamine hyperactivity
C. Mesolimbic dopamine hypoactivity
D. Mesolimbic dopamine hyperactivity - ANSWER-Mesolimbic dopamine
hyperactivity
NMDA receptors exhibit hypo or hyperfunctioning in schizophrenia? - ANSWER-
hypo functioning
Which part of brain is responsible for aggressive symptoms? - ANSWER-orbital
frontal cortex
Which part of brain is responsible for movement and motor symptoms? -
ANSWER-substantia nigra
Which part of brain is responsible for negative symptoms? - ANSWER-nucleus
accumbens
