NURS 663 Exam 1 Questions and Answers (Graded A)

NURS 663 Exam 1 Questions and Answers (Graded A) Bipolar one disorder DSM five criteria - ANSWER Manic episode: 1+ week of a colon elevated, expansive or irritable mood and increase energy. 3+ symptoms from B: distractibility, indiscretion, irresponsible, grandiosity, flight of ideas, activity(Increase goal-orient), decreased need for sleep, talkativeness or pressured speech. Bipolar two DSM five criteria - ANSWER Hypo mania and major depressive disorder: hypo mania same as mania with decreased severity and duration and no functional impairment for episode of four or more days and no psychosis Mixed episodes (bipolar) - ANSWER Manic and depressive symptoms time by side usually with comorbid substance abuse increased risk of suicide and psychosis rapid cycling - ANSWER Four or more cycles per year no greater than a week well period Cyclothymia DSM-V Criteria - ANSWER Two or more years of mood cycling with dysthymia and hypo mania decreased intensity than bipolar disorder meets criteria for hypo mania but does not meet criteria for major depressive disorder Dysthymia DSM five criteria - ANSWER HE'S 2 SAD depressive symptoms lasting two or more years that is subsydromal characterized by hopelessness decreased energy, decrease self-esteem for two years, abnormal sleep, abnormal appetite impaired decision-making. MAOÍ Mechanism of action generally - ANSWER Catalyzes the deamination of monoamines intracellularly and MAO transport Reuptake extracellular monoamines MAO-A Mechanism of action - ANSWER MAO-A Oxidizes serotonin norepinephrine and epinephrine MAO-B Mechanism of action - ANSWER Oxidizes phenylalanine MAO-A and MAO-B mechanism of action - ANSWER Oxidizes dopamine non-preferentially MAOs Neumonic -2 - ANSWER Date with Tyra banks with wine and cheese in Maui— can cause hypertensive crisis related to tyramine from aged food. MAWIs= my arms weight increased= effective for atypical depression MAOs adverse effects-6 - ANSWER Hypertensive crisis, diet restriction, avoid meds, five week after Prozac, two week after other antidepressants, no other medications for two weeks after discontinuing MAOs diet restriction-4 compounds - ANSWER Tyrosine, high tyramine, tryptophan, phenylalanine Tyrosine foods-10 - ANSWER Aged cheese, aged wine, fava or broad bean pods, sauerkraut, soy sauce, tap or draft beer, overripe fruit, cured meat, spoiled food MAOs drugs to avoid- 6 - ANSWER Antidepressants, Dextromethorphan, stimulants, sympathomimetics, meperidine, disulfiram MAOs side effects 11 - ANSWER Increased weight, drowsy, dizzy, orthostatic hypotension, tremor, headache, dry mouth, constipation, change in sexual drive, peripheral Edema, sweating Tricyclic mechanism of action - ANSWER Inhibit 5HT2, norepinephrine, dopamine and reuptake slows. Amino group interferes with ASP - 98 in HSERT. Causing down regulation of receptors. Tricyclic side effects - ANSWER Anticholinergic effects (dry mouth, blurred vision, constipation, urine retention, impotence). Histamine effects (sedation, increased weight). Adrenergic alpha receptor (postural hypotension). Direct membrane effects (decrease seizure threshold and arrhythmias). 5HT2 receptor (increase weight and decrease anxiety). Amitriptyline dosing/Class - ANSWER Start at 25 to 50 mg per day, titrate 25 to 50 mg per day per week, Max dose is 300 mg per day/TCA Names of tricyclics 10 - ANSWER Amitriptyline, nortriptyline, clomipramine, imipramine, protriptyline, doxepin, amoxapine, desipramine, mapratiline, tripramine Tricyclics are useful-2 - ANSWER Pain, migraine Tricyclics adverse effects-2 - ANSWER Overdoses are cardiotoxic, high potency increases the risk of mania Nortriptyline mnemonic - ANSWER No-triptyline equals less sedation and hypotension Tricyclics mnemonic-2 - ANSWER Think car goes over tricycle to remember that an overdose is cardiotoxic. Do you remember mechanism think trans =serotonin and norepinephrine Chans= Na+ and Ca+ Ans= ACH and histamine Clomipramine mnemonic/class - ANSWER TCA- think comipramine for obsessive compulsive disorder Imipramine- pneumonic and class - ANSWER I'm peeingamine- nocturnal enuresis Unilateral electrode in ECT indications - ANSWER Typically first line because it has less cognitive side effects but has less efficacy