NR547 Final Exam Study Guide Review
1.Medications for depression: SSRIs
SNRIs
SDRIs
TCAs
MAOI
s
2.SSRIs: -Action: inhibit 5-HT reuptake
-Examples: citalopram, escitalopram, fluoxetine, paroxetine, sertraline
-Adverse effects:
•nausea
•agitation
•diarrhea
•headache
•weight gain
•sexual side effects
3.SNRIs: -inhibit 5-HT reuptake
-inhibit NE reuptake (‘ energy, focus)
-increase DA in prefrontal cortex (‘ cognition)
-Examples: desvenlafaxine, duloxetine, levomilnacipran, venlafaxine
-Adverse effects:
•elevated blood pressure
•nausea
•sweating
•tremors
•anxiety
•insomnia
•constipation
•anorexia
•sexual dysfunction
4.SDRIs: -inhibit DA reuptake (‘alertness, motivation)
-inhibit NE reuptake (‘energy)
-Adverse effects:
•agitation
•headache
•dry mouth
•constipation
•weight loss
5.TCAs: -Action: inhibits the reuptake of serotonin and
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,norepinephrine; blocks norepinephrine, histamine, and acetylcholine
receptors
-Examples: amitriptyline, clomipramine, desipramine, doxepin
-Common Side Effects:
•dry mouth
•constipation
•blurred vision
•urinary retention
•sedation
•weight gain
•hypotension
•tachycardia
•sexual dysfunction
6.MAOIs: -Action: increases norepinephrine and serotonin by inhibiting
the enzyme that inactivates it
-Examples: isocarboxazid, phenelzine, tranylcypromine
-Common Side Effects:
•sedation
•dizziness
•sexual dysfunction
•hypertensive crisis
7.Prescribing pearls: citalopram (Celexa): mild antihistamine effects
8.Prescribing pearls: escitalopram (Lexapro): no known drug interactions
9.Prescribing pearls: fluoxetine (Prozac): longest half-life
10.Prescribing pearls: paroxetine (Paxil): also treats social anxiety and
insomnia
11.Prescribing pearls: fluvoxamine (Luvox): treats anxious depression
smokers require increased dose
12.Prescribing pearls: sertraline (Zoloft): also treats social anxiety and
hyper- somnolence
13.Prescribing pearls: bupropion (Wellbutrin): NDRI may improve energy,
alert- ness, and motivation; not first line treatment for anxiety;
contraindicated in clients with a history of seizures
14.Prescribing pearls: duloxetine (Cymbalta): effective for atypical pain at
higher doses; appropriate for clients who present with somatic
symptoms of depression; effective for atypical pain, such as
fibromyalgia and diabetic neuropathy
15.Prescribing pearls: venlafaxine (Effexor): treats both depression and
anxiety disorders, ensure trial of higher dose before switching to a
different medication
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,16.Prescribing pearls: desvenlafaxine (Pristiq): effective for
perimenopausal vasomotor symptoms
17.considered when selecting a medication:: -Client preference
-Prior treatment response
-Anticipated adverse effects
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, -Comorbidities
-Half-life and interactions
-Cost
18.if a medication is not achieving efficacy:: -Increase dose gradually
-Switch to a different drug within the same class
-Switch to drug in a different class
-Add a second medication
19.Use to protect against suicide: lithium
20.MDD and BPD genetics: genetic factors contribute 31-42% of the
disease risk in MDD and 59-85% in BPD
21.monoamine hypothesis of depression: -posits that 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
*Emphasis is now shifted from the monoamines to their receptors and
other down- stream events such as the regulation of gene expression,
growth factors, environ- mental factors, and epigenetic changes
22.: Three principal neurotransmitters
-norepinephrine (NE), dopamine (DA), and serotonin 5HT
•comprise the monoamine neurotransmitter system
•implications for the pathophysiology and treatment of mood disorders
•All known pharmacologic treatments for mood disorders act upon one
or more of these three neurotransmitters
-Many of the symptoms of mood disorders are hypothesized to involve
dysfunction of various combinations of the monoamine
neurotransmitters
23.Mood disorders include and
: depressive disorders and bipolar disorders
24.Major depressive disorder (MDD): one of the most prevalent
psychiatric dis- orders
-estimated that more than 300 million people suffer from
-leading cause of disability worldwide
-7.1% of adults and 13.3% of adolescents in the U.S. had at least one
major depressive episode
-An imbalance of specific neurotransmitters, including dopamine,
serotonin, and norepinephrine, can influence brain activity and result in
depression
-decreased neurotransmitter activity in the prefrontal cortex (PFC)
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120
1.Medications for depression: SSRIs
SNRIs
SDRIs
TCAs
MAOI
s
2.SSRIs: -Action: inhibit 5-HT reuptake
-Examples: citalopram, escitalopram, fluoxetine, paroxetine, sertraline
-Adverse effects:
•nausea
•agitation
•diarrhea
•headache
•weight gain
•sexual side effects
3.SNRIs: -inhibit 5-HT reuptake
-inhibit NE reuptake (‘ energy, focus)
-increase DA in prefrontal cortex (‘ cognition)
-Examples: desvenlafaxine, duloxetine, levomilnacipran, venlafaxine
-Adverse effects:
•elevated blood pressure
•nausea
•sweating
•tremors
•anxiety
•insomnia
•constipation
•anorexia
•sexual dysfunction
4.SDRIs: -inhibit DA reuptake (‘alertness, motivation)
-inhibit NE reuptake (‘energy)
-Adverse effects:
•agitation
•headache
•dry mouth
•constipation
•weight loss
5.TCAs: -Action: inhibits the reuptake of serotonin and
1/
120
,norepinephrine; blocks norepinephrine, histamine, and acetylcholine
receptors
-Examples: amitriptyline, clomipramine, desipramine, doxepin
-Common Side Effects:
•dry mouth
•constipation
•blurred vision
•urinary retention
•sedation
•weight gain
•hypotension
•tachycardia
•sexual dysfunction
6.MAOIs: -Action: increases norepinephrine and serotonin by inhibiting
the enzyme that inactivates it
-Examples: isocarboxazid, phenelzine, tranylcypromine
-Common Side Effects:
•sedation
•dizziness
•sexual dysfunction
•hypertensive crisis
7.Prescribing pearls: citalopram (Celexa): mild antihistamine effects
8.Prescribing pearls: escitalopram (Lexapro): no known drug interactions
9.Prescribing pearls: fluoxetine (Prozac): longest half-life
10.Prescribing pearls: paroxetine (Paxil): also treats social anxiety and
insomnia
11.Prescribing pearls: fluvoxamine (Luvox): treats anxious depression
smokers require increased dose
12.Prescribing pearls: sertraline (Zoloft): also treats social anxiety and
hyper- somnolence
13.Prescribing pearls: bupropion (Wellbutrin): NDRI may improve energy,
alert- ness, and motivation; not first line treatment for anxiety;
contraindicated in clients with a history of seizures
14.Prescribing pearls: duloxetine (Cymbalta): effective for atypical pain at
higher doses; appropriate for clients who present with somatic
symptoms of depression; effective for atypical pain, such as
fibromyalgia and diabetic neuropathy
15.Prescribing pearls: venlafaxine (Effexor): treats both depression and
anxiety disorders, ensure trial of higher dose before switching to a
different medication
2/
120
,16.Prescribing pearls: desvenlafaxine (Pristiq): effective for
perimenopausal vasomotor symptoms
17.considered when selecting a medication:: -Client preference
-Prior treatment response
-Anticipated adverse effects
3/
120
, -Comorbidities
-Half-life and interactions
-Cost
18.if a medication is not achieving efficacy:: -Increase dose gradually
-Switch to a different drug within the same class
-Switch to drug in a different class
-Add a second medication
19.Use to protect against suicide: lithium
20.MDD and BPD genetics: genetic factors contribute 31-42% of the
disease risk in MDD and 59-85% in BPD
21.monoamine hypothesis of depression: -posits that 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
*Emphasis is now shifted from the monoamines to their receptors and
other down- stream events such as the regulation of gene expression,
growth factors, environ- mental factors, and epigenetic changes
22.: Three principal neurotransmitters
-norepinephrine (NE), dopamine (DA), and serotonin 5HT
•comprise the monoamine neurotransmitter system
•implications for the pathophysiology and treatment of mood disorders
•All known pharmacologic treatments for mood disorders act upon one
or more of these three neurotransmitters
-Many of the symptoms of mood disorders are hypothesized to involve
dysfunction of various combinations of the monoamine
neurotransmitters
23.Mood disorders include and
: depressive disorders and bipolar disorders
24.Major depressive disorder (MDD): one of the most prevalent
psychiatric dis- orders
-estimated that more than 300 million people suffer from
-leading cause of disability worldwide
-7.1% of adults and 13.3% of adolescents in the U.S. had at least one
major depressive episode
-An imbalance of specific neurotransmitters, including dopamine,
serotonin, and norepinephrine, can influence brain activity and result in
depression
-decreased neurotransmitter activity in the prefrontal cortex (PFC)
4/
120
