NR546 Final Psychopharmacology Exam
Question and Answer (2026) | A+ Verified |
Accurate Solutions
• major depressive disorder (MDD)
one of the most common mental disorders
-Approximately 7.1% of adults in the U.S. had episode in last year, prevalence
highest (13.1%) among individuals aged 18-25
S/S
-depressed mood
-loss of interest or pleasure in daily activities
-irritability
-withdrawal
-problems with sleep, eating, energy, concentration, or self-worth
-severe depression: may experience thoughts of suicide or psychotic symptoms. -
✓✓Unipolar depression
• Chronic condition characterized by extreme fluctuations in mood, energy, and
ability to function
-Moods may be manic, hypomanic, or depressed and may include mixed mood or
psychotic features
-many have only experienced only one manic episode in their lifetime
-Mood fluctuations may be separated by periods of high stability or may cycle
rapidly
-diagnosed when a client has one or more episodes of mania or hypomania with a
history of one or more major depressive episodes
-high risk for suicide -✓✓Bipolar disorder (BD)
• characterized by a persistently elevated, expansive, or irritable mood. Related
symptoms may include inflated self-esteem, increased goal-directed activity or
energy, including grandiosity, decreased need for sleep, excessive talkativeness,
racing thoughts, flight of ideas (FOI), distractibility, psychomotor agitation, and a
propensity to be involved in high-risk activities. Mania leads to significant
functional impairment and may include psychotic features or necessitate
hospitalization -✓✓mania
,• requires at least one episode of mania for at least one week (or any duration if
hospitalization due to symptoms is required) -✓✓Bipolar Type I:
• diagnosis requires a current or past hypomanic episode and a current or past
major depressive episode. Symptoms last for at least 4 days but fewer than seven.
-Hypomanic symptoms are not of sufficient duration or severity to cause
significant functional impairment, psychosis, or hospitalization.
-Anger and irritability are common.
-Clients often enjoy the elevation of mood and are reluctant to report these
symptoms, making bipolar more difficult to diagnose if the client presents in the
depression phase. -✓✓Bipolar Type II:
• involves the chronic presentation of hypomanic and depressive symptoms that do
not meet the diagnostic criteria for a major depressive or manic/hypomanic
episode. -✓✓Cyclothymia:
• antidepressant therapy may precipitate a manic episode or induce rapid-cycling
bipolar depression
-may contribute to the increased incidence of death by suicide in children and
adults younger than 25 -✓✓If bipolar depression is mistaken for MDD:
• monotherapy
-Antidepressants should be combined with a mood stabilizer to prevent the onset of
a hypomanic or manic episode -✓✓Antidepressants are used cautiously in clients
with bipolar disorder and never as ________________.
• Decreased positive affect:
depressed mood
loss of joy
lack of interest
loss of energy
decreased alertness
decreased self-confidence
appetite changes -✓✓DA, NE Dysfunction causes what mood related symptoms
• Increased negative affect:
depressed mood
guilt
fear/anxiety
,hostility
irritability
loneliness
appetite changes -✓✓5HT, NE Dysfunction causes what mood related symptoms
• -depression occurs as a result of a deficiency of one or all three monoamine
transmitters
• serotonin, norepinephrine, and dopamine
-while mania may result from an excess -✓✓monoamine hypothesis of depression
• • Selective Serotonin Reuptake Inhibitors (SSRIs)
• Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)
• Norepinephrine Dopamine Reuptake Inhibitors (NDRI)
• Serotonin Antagonist and Reuptake Inhibitors (SARIs) -✓✓Medication
Management for Depression, First-Line Treatment:
• Mechanism of action
• inhibit 5-HT reuptake
Adverse effects
-diarrhea
-headache
-weight gain
-sexual side effects -✓✓SSRI's
• Mechanism of action
• inhibit 5-HT reuptake
• inhibit NE reuptake (increase energy, focus)
• increase DA in prefrontal cortex (increase cognition)
Adverse effects
-elevated blood pressure
-anxiety
-insomnia
-constipation -✓✓SNRI's
• Mechanism of action
• inhibit DA reuptake (increase alertness, motivation)
• inhibit NE reuptake (increase energy)
Adverse effects
-agitation
, -headache
-dry mouth
-constipation
-weight loss -✓✓NDRI's
• citalopram (Celexa) -✓✓SSRI Prescribing Pearls: med with mild antihistamine
effects
• escitalopram (Lexapro) -✓✓SSRI Prescribing Pearls: med with no known drug
interactions
• fluoxetine (Prozac) -✓✓SSRI Prescribing Pearls: med with longest half-life
• paroxetine (Paxil) -✓✓SSRI Prescribing Pearls: med that also treats social
anxiety and insomnia
• fluvoxamine (Luvox) -✓✓SSRI Prescribing Pearls: med that treats anxious
depression; smokers require an increased dose
• sertraline (Zoloft) -✓✓SSRI Prescribing Pearls: med that also treats social
anxiety and hypersomnolence
• INDICATION
-Depression
-GAD
-Social anxiety disorder
-Panic disorder
Mechanism of Action
-SNRI (dual serotonin and norepinephrine reuptake inhibitor), Boosts
neurotransmitters serotonin, norepinephrine/noradrenaline, and dopamine.
TESTS
-Check bp before initiating tx & regularly during tx
Starting Dose
-Initial 37.5 mg daily (extended-release) or 25-50 mg divided into 2-3 doses
(immediate-release)
Question and Answer (2026) | A+ Verified |
Accurate Solutions
• major depressive disorder (MDD)
one of the most common mental disorders
-Approximately 7.1% of adults in the U.S. had episode in last year, prevalence
highest (13.1%) among individuals aged 18-25
S/S
-depressed mood
-loss of interest or pleasure in daily activities
-irritability
-withdrawal
-problems with sleep, eating, energy, concentration, or self-worth
-severe depression: may experience thoughts of suicide or psychotic symptoms. -
✓✓Unipolar depression
• Chronic condition characterized by extreme fluctuations in mood, energy, and
ability to function
-Moods may be manic, hypomanic, or depressed and may include mixed mood or
psychotic features
-many have only experienced only one manic episode in their lifetime
-Mood fluctuations may be separated by periods of high stability or may cycle
rapidly
-diagnosed when a client has one or more episodes of mania or hypomania with a
history of one or more major depressive episodes
-high risk for suicide -✓✓Bipolar disorder (BD)
• characterized by a persistently elevated, expansive, or irritable mood. Related
symptoms may include inflated self-esteem, increased goal-directed activity or
energy, including grandiosity, decreased need for sleep, excessive talkativeness,
racing thoughts, flight of ideas (FOI), distractibility, psychomotor agitation, and a
propensity to be involved in high-risk activities. Mania leads to significant
functional impairment and may include psychotic features or necessitate
hospitalization -✓✓mania
,• requires at least one episode of mania for at least one week (or any duration if
hospitalization due to symptoms is required) -✓✓Bipolar Type I:
• diagnosis requires a current or past hypomanic episode and a current or past
major depressive episode. Symptoms last for at least 4 days but fewer than seven.
-Hypomanic symptoms are not of sufficient duration or severity to cause
significant functional impairment, psychosis, or hospitalization.
-Anger and irritability are common.
-Clients often enjoy the elevation of mood and are reluctant to report these
symptoms, making bipolar more difficult to diagnose if the client presents in the
depression phase. -✓✓Bipolar Type II:
• involves the chronic presentation of hypomanic and depressive symptoms that do
not meet the diagnostic criteria for a major depressive or manic/hypomanic
episode. -✓✓Cyclothymia:
• antidepressant therapy may precipitate a manic episode or induce rapid-cycling
bipolar depression
-may contribute to the increased incidence of death by suicide in children and
adults younger than 25 -✓✓If bipolar depression is mistaken for MDD:
• monotherapy
-Antidepressants should be combined with a mood stabilizer to prevent the onset of
a hypomanic or manic episode -✓✓Antidepressants are used cautiously in clients
with bipolar disorder and never as ________________.
• Decreased positive affect:
depressed mood
loss of joy
lack of interest
loss of energy
decreased alertness
decreased self-confidence
appetite changes -✓✓DA, NE Dysfunction causes what mood related symptoms
• Increased negative affect:
depressed mood
guilt
fear/anxiety
,hostility
irritability
loneliness
appetite changes -✓✓5HT, NE Dysfunction causes what mood related symptoms
• -depression occurs as a result of a deficiency of one or all three monoamine
transmitters
• serotonin, norepinephrine, and dopamine
-while mania may result from an excess -✓✓monoamine hypothesis of depression
• • Selective Serotonin Reuptake Inhibitors (SSRIs)
• Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)
• Norepinephrine Dopamine Reuptake Inhibitors (NDRI)
• Serotonin Antagonist and Reuptake Inhibitors (SARIs) -✓✓Medication
Management for Depression, First-Line Treatment:
• Mechanism of action
• inhibit 5-HT reuptake
Adverse effects
-diarrhea
-headache
-weight gain
-sexual side effects -✓✓SSRI's
• Mechanism of action
• inhibit 5-HT reuptake
• inhibit NE reuptake (increase energy, focus)
• increase DA in prefrontal cortex (increase cognition)
Adverse effects
-elevated blood pressure
-anxiety
-insomnia
-constipation -✓✓SNRI's
• Mechanism of action
• inhibit DA reuptake (increase alertness, motivation)
• inhibit NE reuptake (increase energy)
Adverse effects
-agitation
, -headache
-dry mouth
-constipation
-weight loss -✓✓NDRI's
• citalopram (Celexa) -✓✓SSRI Prescribing Pearls: med with mild antihistamine
effects
• escitalopram (Lexapro) -✓✓SSRI Prescribing Pearls: med with no known drug
interactions
• fluoxetine (Prozac) -✓✓SSRI Prescribing Pearls: med with longest half-life
• paroxetine (Paxil) -✓✓SSRI Prescribing Pearls: med that also treats social
anxiety and insomnia
• fluvoxamine (Luvox) -✓✓SSRI Prescribing Pearls: med that treats anxious
depression; smokers require an increased dose
• sertraline (Zoloft) -✓✓SSRI Prescribing Pearls: med that also treats social
anxiety and hypersomnolence
• INDICATION
-Depression
-GAD
-Social anxiety disorder
-Panic disorder
Mechanism of Action
-SNRI (dual serotonin and norepinephrine reuptake inhibitor), Boosts
neurotransmitters serotonin, norepinephrine/noradrenaline, and dopamine.
TESTS
-Check bp before initiating tx & regularly during tx
Starting Dose
-Initial 37.5 mg daily (extended-release) or 25-50 mg divided into 2-3 doses
(immediate-release)
