Nurs 663- Exam 1
all antidepressants carry what 5 warnings? - correct answer- increased risk of suicide
(especially in children and young adults)
- mania activation
- serotonin syndrome
-discontinuation syndrome
- bleeding risk
behavioral therapy - correct answerfocuses on changing behavior by identifying problem
behaviors, replacing them with appropriate behaviors, and using rewards or other
consequences to make the changes
•Behavioural therapy is based on the concept that a deficit of 'reinforcers', such as
pleasant activities and positive interpersonal contacts, leaves patients vulnerable to
depression
•Sample interventions: increase activity level, structured goal setting, interpersonal skills
training
Carbamazepine (Tegretol) - correct answermood stabilizer
indication: bipolar disorder
major side effects:
CYP 450: (inducer- speeds up metabolism of other drugs)
patient education:
Case: 26 year old woman without a psychiatric history who presents for treatment of
depression after her mother died. It has been over a year but she is still struggling with
frequent bouts of sadness, has lost 15 lbs in the last four months, is unable to sleep
past 4am, and is getting poor performance reviews at work due to impaired
concentration and memory. She feels like nothing in life is enjoyable anymore.
diagnosis and medications to consider? - correct answerMDD
-Sertraline
-Escitalopram
-Fluoxetine
, -Mirtazapine
case: 35 year old woman with a history of major depressive disorder who presents
complaining of persistent depression despite treatment with maximum dose sertraline
and escitalopram in the past. She has been depressed for over eight months, and
spends up to 16 hours per day lying in bed. She reports that she doesn't have the
energy to get up in the morning, and that there is nothing that she enjoys doing,
anyway. She has gained 35 lbs in the last eight months, reports feeling like she has
failed everyone in her life, and states that she only leaves the house about once a week
to shop for groceries. Recently, she has begun hearing vague voices when she feels
especially badly, although she cannot make out specific words.
diagnosis and medications? - correct answerMDD
-Bupropion
-Venlafaxine
-Duloxetine
-Maybe fluoxetine
case: 39 year old man with a history of PTSD and depression who presents after
returning from a recent deployment to Afghanistan. He is having trouble sleeping
because of nightmares about combat, is unable to tolerate being in crowded places, and
visibly jumps at small noises during your interview. His unwillingness to leave the house
is exacerbated by a lower spinal injury that has left him with chronic leg pain and a limp
that he thinks makes him look "like an easy target." He also reports that he has difficulty
sleeping through the night, is having trouble enjoying doing anything with his family,
feels extremely guilty for the time that he was away from them while deployed, has low
energy and concentration, but adamantly denies suicidal thoughts. He has tried
maximum dose sertraline and venlafaxine, but neither were helpful. He also tried
mirtazapine, but it was far too sedating and didn't work either.
diagnosis - correct answerPTSD, MDD, Chronic Pain
-Nortriptyline or another TCA
-Duloxetine
-Escitalopram
-Prazosin
cognitive-behavioral therapy (CBT) - correct answera popular integrative therapy that
combines cognitive therapy (changing self-defeating thinking) with behavior therapy
(changing behavior)
•Cognitive therapy is based on the concept that habitual negative thinking patterns
leave patients vulnerable to depression in response to specific situations. Therefore, the
patient is taught to challenge the beliefs and assumptions that contribute to depression
all antidepressants carry what 5 warnings? - correct answer- increased risk of suicide
(especially in children and young adults)
- mania activation
- serotonin syndrome
-discontinuation syndrome
- bleeding risk
behavioral therapy - correct answerfocuses on changing behavior by identifying problem
behaviors, replacing them with appropriate behaviors, and using rewards or other
consequences to make the changes
•Behavioural therapy is based on the concept that a deficit of 'reinforcers', such as
pleasant activities and positive interpersonal contacts, leaves patients vulnerable to
depression
•Sample interventions: increase activity level, structured goal setting, interpersonal skills
training
Carbamazepine (Tegretol) - correct answermood stabilizer
indication: bipolar disorder
major side effects:
CYP 450: (inducer- speeds up metabolism of other drugs)
patient education:
Case: 26 year old woman without a psychiatric history who presents for treatment of
depression after her mother died. It has been over a year but she is still struggling with
frequent bouts of sadness, has lost 15 lbs in the last four months, is unable to sleep
past 4am, and is getting poor performance reviews at work due to impaired
concentration and memory. She feels like nothing in life is enjoyable anymore.
diagnosis and medications to consider? - correct answerMDD
-Sertraline
-Escitalopram
-Fluoxetine
, -Mirtazapine
case: 35 year old woman with a history of major depressive disorder who presents
complaining of persistent depression despite treatment with maximum dose sertraline
and escitalopram in the past. She has been depressed for over eight months, and
spends up to 16 hours per day lying in bed. She reports that she doesn't have the
energy to get up in the morning, and that there is nothing that she enjoys doing,
anyway. She has gained 35 lbs in the last eight months, reports feeling like she has
failed everyone in her life, and states that she only leaves the house about once a week
to shop for groceries. Recently, she has begun hearing vague voices when she feels
especially badly, although she cannot make out specific words.
diagnosis and medications? - correct answerMDD
-Bupropion
-Venlafaxine
-Duloxetine
-Maybe fluoxetine
case: 39 year old man with a history of PTSD and depression who presents after
returning from a recent deployment to Afghanistan. He is having trouble sleeping
because of nightmares about combat, is unable to tolerate being in crowded places, and
visibly jumps at small noises during your interview. His unwillingness to leave the house
is exacerbated by a lower spinal injury that has left him with chronic leg pain and a limp
that he thinks makes him look "like an easy target." He also reports that he has difficulty
sleeping through the night, is having trouble enjoying doing anything with his family,
feels extremely guilty for the time that he was away from them while deployed, has low
energy and concentration, but adamantly denies suicidal thoughts. He has tried
maximum dose sertraline and venlafaxine, but neither were helpful. He also tried
mirtazapine, but it was far too sedating and didn't work either.
diagnosis - correct answerPTSD, MDD, Chronic Pain
-Nortriptyline or another TCA
-Duloxetine
-Escitalopram
-Prazosin
cognitive-behavioral therapy (CBT) - correct answera popular integrative therapy that
combines cognitive therapy (changing self-defeating thinking) with behavior therapy
(changing behavior)
•Cognitive therapy is based on the concept that habitual negative thinking patterns
leave patients vulnerable to depression in response to specific situations. Therefore, the
patient is taught to challenge the beliefs and assumptions that contribute to depression
