NR547 Final Exam questions and
answers(latest update ,graded A+
Medications for depression - answer SSRIs
SNRIs
SDRIs
TCAs
MAOIs
SSRIs - answer -Action: inhibit 5-HT reuptake
-Examples: citalopram, escitalopram, fluoxetine, paroxetine, sertraline
-Adverse effects:
• nausea
• agitation
• diarrhea
• headache
• weight gain
• sexual side effects
SNRIs - answer -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
SDRIs - answer -inhibit DA reuptake (↑alertness, motivation)
-inhibit NE reuptake (↑energy)
-Adverse effects:
• agitation
• headache
• dry mouth
• constipation
• weight loss
TCAs - answer -Action: inhibits the reuptake of serotonin and 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
MAOIs - answer -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
Prescribing pearls: citalopram (Celexa) - answer mild antihistamine effects
Prescribing pearls: escitalopram (Lexapro) - answer no known drug interactions
Prescribing pearls: fluoxetine (Prozac) - answer longest half-life
Prescribing pearls: paroxetine (Paxil) - answer also treats social anxiety and insomnia
Prescribing pearls: fluvoxamine (Luvox) - answer treats anxious depression smokers require
increased dose
Prescribing pearls: sertraline (Zoloft) - answer also treats social anxiety and hypersomnolence
, Prescribing pearls: bupropion (Wellbutrin) - answer NDRI may improve energy, alertness, and
motivation; not first line treatment for anxiety; contraindicated in clients with a history of
seizures
Prescribing pearls: duloxetine (Cymbalta) - answer 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
Prescribing pearls: venlafaxine (Effexor) - answer treats both depression and anxiety disorders,
ensure trial of higher dose before switching to a different medication
Prescribing pearls: desvenlafaxine (Pristiq) - answer effective for perimenopausal vasomotor
symptoms
considered when selecting a medication: - answer -Client preference
-Prior treatment response
-Anticipated adverse effects
-Comorbidities
-Half-life and interactions
-Cost
if a medication is not achieving efficacy: - answer -Increase dose gradually
-Switch to a different drug within the same class
-Switch to drug in a different class
-Add a second medication
Use to protect against suicide - answer lithium
answers(latest update ,graded A+
Medications for depression - answer SSRIs
SNRIs
SDRIs
TCAs
MAOIs
SSRIs - answer -Action: inhibit 5-HT reuptake
-Examples: citalopram, escitalopram, fluoxetine, paroxetine, sertraline
-Adverse effects:
• nausea
• agitation
• diarrhea
• headache
• weight gain
• sexual side effects
SNRIs - answer -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
SDRIs - answer -inhibit DA reuptake (↑alertness, motivation)
-inhibit NE reuptake (↑energy)
-Adverse effects:
• agitation
• headache
• dry mouth
• constipation
• weight loss
TCAs - answer -Action: inhibits the reuptake of serotonin and 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
MAOIs - answer -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
Prescribing pearls: citalopram (Celexa) - answer mild antihistamine effects
Prescribing pearls: escitalopram (Lexapro) - answer no known drug interactions
Prescribing pearls: fluoxetine (Prozac) - answer longest half-life
Prescribing pearls: paroxetine (Paxil) - answer also treats social anxiety and insomnia
Prescribing pearls: fluvoxamine (Luvox) - answer treats anxious depression smokers require
increased dose
Prescribing pearls: sertraline (Zoloft) - answer also treats social anxiety and hypersomnolence
, Prescribing pearls: bupropion (Wellbutrin) - answer NDRI may improve energy, alertness, and
motivation; not first line treatment for anxiety; contraindicated in clients with a history of
seizures
Prescribing pearls: duloxetine (Cymbalta) - answer 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
Prescribing pearls: venlafaxine (Effexor) - answer treats both depression and anxiety disorders,
ensure trial of higher dose before switching to a different medication
Prescribing pearls: desvenlafaxine (Pristiq) - answer effective for perimenopausal vasomotor
symptoms
considered when selecting a medication: - answer -Client preference
-Prior treatment response
-Anticipated adverse effects
-Comorbidities
-Half-life and interactions
-Cost
if a medication is not achieving efficacy: - answer -Increase dose gradually
-Switch to a different drug within the same class
-Switch to drug in a different class
-Add a second medication
Use to protect against suicide - answer lithium
