ADVANCED PSYCHOPHARMACOLOGY NR
546 CERTIFICATION EVALUATION 2026
EXAM Q&A STUDY SHEET
◉Lithium. Answer: ACTION:
alters cation transport in the nerve and muscle (downstream signal
transduction cascades) Lithium may work by affecting signal
transduction, perhaps through its inhibition of second messenger
enzymes such as inositol monophosphatase, by modulation of G
proteins, or by interaction at various sites within downstream signal
transduction cascades, including glycogen synthetase kinase 3
(GSK3).
◉Lithium. Answer: INDICATIONS:
-euphoric mania
-rapid cycling
-maintenance therapy
HALF-LIFE: 18-30 hours
◉Lithium Therapeutic Levels. Answer: Therapeutic levels:
,1.0 and 1.5 mEq/L for acute treatment, 0.6 and 1.2 mEq/L for
chronic treatment)
◉Lamotrigine (Lamictal). Answer: ACTION:
affects sodium channel ion transport and enhances the activity of y-
aminobutyric acid (GABA)
◉Lamotrigine (Lamictal). Answer: INDICATION:
-maintenance therapy
-monotherapy for bipolar disorder
HALF LIFE: 33 hours
◉Lamotrigine (Lamictal). Answer: PRESCRIBING PEARLS:
This drug is equal in efficacy to lithium.
Educate clients and assess for rash at each visit. Ten percent of
rashes are benign.
There is a risk for rare Stevens-Johnson Syndrome rash and multi-
organ failure.
Take at bedtime due to sedation side effect.
◉Lamotrigine (Lamictal). Answer: Therapeutic levels:
Not monitored
,◉Valproic acid (Depakene). Answer: ACTION:
affects ion transport and enhances the activity of y-aminobutyric
acid (GABA)
◉Valproic acid (Depakene). Answer: INDICATION:
acute mania
mixed mood
comorbid substance use
multiple prior episodes
HALF LIFE: 9-16 hours
◉Valproic acid (Depakene). Answer: Therapeutic levels:
50-100mcg/mL; Toxic Levels: >175 mcg/mL
◉Valproic acid (Depakene). Answer: If using with Lamitrogine
decrease dose by 50%
◉Second generation antipsychotics. Answer: aripiprazole (Abilify)
cariprazine (Vraylar)
lurasidone (Latuda)
quetiapine (Seroquel)
asenapine (Saphris)
, risperidone (Risperdal)
olanzapine (Zyprexa)
ziprazadone (Geodon)
◉Second generation antipsychotics. Answer: ACTION:
DA, NE, and 5-HT receptor antagonists
◉Second generation antipsychotics. Answer: INDICATION:
acute bipolar depression
acute manic or mixed episodes
bipolar maintenance/adjunct
◉Second generation antipsychotics. Answer: ADVERSE EFFECTS:
weight gain
sedation
GI effects
◉Second generation antipsychotics. Answer: PRESCRIBING PEARLS:
Indications vary with each medication.
Check for monotherapy vs. adjunct indication.
Monitor for extrapyramidal effects.
XR form may improve adherence.
546 CERTIFICATION EVALUATION 2026
EXAM Q&A STUDY SHEET
◉Lithium. Answer: ACTION:
alters cation transport in the nerve and muscle (downstream signal
transduction cascades) Lithium may work by affecting signal
transduction, perhaps through its inhibition of second messenger
enzymes such as inositol monophosphatase, by modulation of G
proteins, or by interaction at various sites within downstream signal
transduction cascades, including glycogen synthetase kinase 3
(GSK3).
◉Lithium. Answer: INDICATIONS:
-euphoric mania
-rapid cycling
-maintenance therapy
HALF-LIFE: 18-30 hours
◉Lithium Therapeutic Levels. Answer: Therapeutic levels:
,1.0 and 1.5 mEq/L for acute treatment, 0.6 and 1.2 mEq/L for
chronic treatment)
◉Lamotrigine (Lamictal). Answer: ACTION:
affects sodium channel ion transport and enhances the activity of y-
aminobutyric acid (GABA)
◉Lamotrigine (Lamictal). Answer: INDICATION:
-maintenance therapy
-monotherapy for bipolar disorder
HALF LIFE: 33 hours
◉Lamotrigine (Lamictal). Answer: PRESCRIBING PEARLS:
This drug is equal in efficacy to lithium.
Educate clients and assess for rash at each visit. Ten percent of
rashes are benign.
There is a risk for rare Stevens-Johnson Syndrome rash and multi-
organ failure.
Take at bedtime due to sedation side effect.
◉Lamotrigine (Lamictal). Answer: Therapeutic levels:
Not monitored
,◉Valproic acid (Depakene). Answer: ACTION:
affects ion transport and enhances the activity of y-aminobutyric
acid (GABA)
◉Valproic acid (Depakene). Answer: INDICATION:
acute mania
mixed mood
comorbid substance use
multiple prior episodes
HALF LIFE: 9-16 hours
◉Valproic acid (Depakene). Answer: Therapeutic levels:
50-100mcg/mL; Toxic Levels: >175 mcg/mL
◉Valproic acid (Depakene). Answer: If using with Lamitrogine
decrease dose by 50%
◉Second generation antipsychotics. Answer: aripiprazole (Abilify)
cariprazine (Vraylar)
lurasidone (Latuda)
quetiapine (Seroquel)
asenapine (Saphris)
, risperidone (Risperdal)
olanzapine (Zyprexa)
ziprazadone (Geodon)
◉Second generation antipsychotics. Answer: ACTION:
DA, NE, and 5-HT receptor antagonists
◉Second generation antipsychotics. Answer: INDICATION:
acute bipolar depression
acute manic or mixed episodes
bipolar maintenance/adjunct
◉Second generation antipsychotics. Answer: ADVERSE EFFECTS:
weight gain
sedation
GI effects
◉Second generation antipsychotics. Answer: PRESCRIBING PEARLS:
Indications vary with each medication.
Check for monotherapy vs. adjunct indication.
Monitor for extrapyramidal effects.
XR form may improve adherence.
