A+ NR546 EXAM QUESTIONS AND ANSWERS LATEST UPDATE
What is the monoamine hypothesis of depression?
It theorizes that depression is caused by a deficiency in monoamine neurotransmission,
while mania is due to an excess.
What is a key prescribing consideration for antidepressants in bipolar disorder?
Antidepressants should not be given as monotherapy; they must be combined with a
mood stabilizer to avoid inducing mania.
What should be monitored when prescribing SNRIs to breastfeeding patients?
Infant irritability.
What factors should be considered when prescribing antidepressants?
Client preference, prior treatment response, anticipated adverse effects, comorbidities,
half-life, interactions, and cost.
What should be done if the initial antidepressant does not work?
First, increase the dose; if that fails, switch to a different drug in the same class, then try
a drug in a different class, and possibly add a second medication.
What is the recommended dose adjustment for older patients taking citalopram
and escitalopram?
They should receive half the usual dose.
Which SSRI has the least CYP interactions?
Escitalopram (Lexapro).
Which SSRI is considered good for forgetful patients?
Fluoxetine, due to its 2-3 day half-life.
What is the longest-acting antidepressant?
Fluoxetine, with a half-life of 1-2 weeks.
What is discontinuation syndrome and which medication is more likely to cause
it?
Discontinuation syndrome occurs when stopping an antidepressant, and paroxetine is
more likely to cause it.
Which antidepressant is safe during nursing and pregnancy?
Sertraline.
What is serotonin syndrome?
, A condition that occurs when two serotonergic drugs are used together, leading to
symptoms such as mental status changes, autonomic instability, neuromuscular
symptoms, seizures, and gastrointestinal symptoms.
What is the treatment for serotonin syndrome?
Stop the medication, provide supportive care, and use benzodiazepines.
What is the black box warning for MAOIs?
They carry a warning for suicidal ideation in children, adolescents, and young adults.
What is the half-life of MAOIs?
2-4 hours.
What is the black box warning for SSRIs?
They carry a warning for suicidal tendencies.
What are MAOIs and what do they inhibit?
MAOIs (monoamine oxidase inhibitors) are antidepressants that inhibit the enzyme that
deactivates dopamine, norepinephrine, and serotonin.
What can happen if MAOIs are taken with tyramine-containing foods?
They can cause a hypertensive crisis.
What can increase lithium levels?
Nonsteroidal anti-inflammatory drugs (NSAIDs) and angiotensin-converting enzyme
(ACE) inhibitors.
What can decrease lithium levels?
Caffeine and mania.
What is the role of L-Methylfolate in depression treatment?
It is necessary for the synthesis of monoamines and is a bioavailable form of folate that
enters the brain.
What are the recommendations for using paroxetine during pregnancy?
Paroxetine is contraindicated due to the risk of congenital defects, including atrial septal
defects.
What should be monitored when SNRIs are prescribed to breastfeeding mothers?
Infant irritability.
How do older adults respond to antidepressants compared to younger
individuals?
What is the monoamine hypothesis of depression?
It theorizes that depression is caused by a deficiency in monoamine neurotransmission,
while mania is due to an excess.
What is a key prescribing consideration for antidepressants in bipolar disorder?
Antidepressants should not be given as monotherapy; they must be combined with a
mood stabilizer to avoid inducing mania.
What should be monitored when prescribing SNRIs to breastfeeding patients?
Infant irritability.
What factors should be considered when prescribing antidepressants?
Client preference, prior treatment response, anticipated adverse effects, comorbidities,
half-life, interactions, and cost.
What should be done if the initial antidepressant does not work?
First, increase the dose; if that fails, switch to a different drug in the same class, then try
a drug in a different class, and possibly add a second medication.
What is the recommended dose adjustment for older patients taking citalopram
and escitalopram?
They should receive half the usual dose.
Which SSRI has the least CYP interactions?
Escitalopram (Lexapro).
Which SSRI is considered good for forgetful patients?
Fluoxetine, due to its 2-3 day half-life.
What is the longest-acting antidepressant?
Fluoxetine, with a half-life of 1-2 weeks.
What is discontinuation syndrome and which medication is more likely to cause
it?
Discontinuation syndrome occurs when stopping an antidepressant, and paroxetine is
more likely to cause it.
Which antidepressant is safe during nursing and pregnancy?
Sertraline.
What is serotonin syndrome?
, A condition that occurs when two serotonergic drugs are used together, leading to
symptoms such as mental status changes, autonomic instability, neuromuscular
symptoms, seizures, and gastrointestinal symptoms.
What is the treatment for serotonin syndrome?
Stop the medication, provide supportive care, and use benzodiazepines.
What is the black box warning for MAOIs?
They carry a warning for suicidal ideation in children, adolescents, and young adults.
What is the half-life of MAOIs?
2-4 hours.
What is the black box warning for SSRIs?
They carry a warning for suicidal tendencies.
What are MAOIs and what do they inhibit?
MAOIs (monoamine oxidase inhibitors) are antidepressants that inhibit the enzyme that
deactivates dopamine, norepinephrine, and serotonin.
What can happen if MAOIs are taken with tyramine-containing foods?
They can cause a hypertensive crisis.
What can increase lithium levels?
Nonsteroidal anti-inflammatory drugs (NSAIDs) and angiotensin-converting enzyme
(ACE) inhibitors.
What can decrease lithium levels?
Caffeine and mania.
What is the role of L-Methylfolate in depression treatment?
It is necessary for the synthesis of monoamines and is a bioavailable form of folate that
enters the brain.
What are the recommendations for using paroxetine during pregnancy?
Paroxetine is contraindicated due to the risk of congenital defects, including atrial septal
defects.
What should be monitored when SNRIs are prescribed to breastfeeding mothers?
Infant irritability.
How do older adults respond to antidepressants compared to younger
individuals?
