NR546 PSYCHOPHARMACOLOGY FINAL EXAM QUESTIONS WITH CORRECT VERIFIED ANSWERS | 100% PASS (A+ CERTIFIED)

NR546 PSYCHOPHARMACOLOGY FINAL EXAM QUESTIONS WITH CORRECT VERIFIED ANSWERS | 100% PASS (A+ CERTIFIED) 1. monoamine hypothesis of depression Correct Answer depression occurs as a result of deficiency of 1 or all 3 monoamine NT -occurs due to too little positive affect or too much negative affect (mania will occur from excess of all 3) 2. what are the three monoamine NT Correct Answer NE, DA, 5HT 3. too little positive affect Correct Answer DA/NE dysfunction -DA levels low = loss of pleasure, interest, alertness, self confidence -DA levels high = hallucinations seen in schizo -NE (fight or flight) high = antsy, nervous, affects focus ability -depressed mood, loss of joy, lack of interest, loss of energy, decreased alertness, decreased self-confidence, appetite changes 4. too much negative affect Correct Answer 5HT = relaxation, comfort, decreases stress, regulates libido, arousal, sleep, aggression, pain perception -5HT/NE dysfunction -depressed mood, guilt, fear/anxiety, hostility, irritability, loneliness, appetite changes 5. prescribing considerations Correct Answer client preference -prior treatment response -anticipated adverse effects -comorbidities -half-life interactions -cost 6. client preference Correct Answer if no contraindication, then prescribe that med to improve adherence 7. prior treatment response Correct Answer if patient had success with a previous med, prescribe that one first 8. anticipated adverse events Correct Answer consider age, family planning, and anticipated adverse effects. -use adverse effects to pt's advantage (choose a known activating medication for a pt with atypical depression or choose a sedating medication for a patient with sleep disturbances) 9. Comorbidities Correct Answer clients with comorbid anxiety may experience worsening symptoms when taking medications that target NE (SNRIs) -fluoxetine is known to activate clients and cause panic attacks in clients with comorbid anxiety 10. half-life interactions Correct Answer choose a medication with a longer half life to avoid discontinuation syndrome if your client forgets to take it -many antidepressants have significant interactions with other meds due to CYP450 enzyme involvement 11. cost Correct Answer if client cant afford medication, they will not benefit. keep cost, insurance benefits, and pharmaceutical assistance programs in mind 12. goal of antidepressant medications Correct Answer complete remission of symptoms 13. antidepressant prescribing schedule Correct Answer start on a single drug for 4-8 weeks -if not working: 1. increase dose gradually until efficacy occurs 2. switch to different drug within same drug class after adequate trial which included higher dosing and a minimum of 8 weeks 3. switch to a drug in a different class after adequate trial and higher dosing 4. add a second med as adjunct 14. SSRI MOA: inhibit 5HT reuptake first line of treatment for depression 15. SSRI s/e Correct Answer 7 S's of SSRIs 1. Stomach 2. sexual dysfunction 3. serotonin syndrome 4. sleep difficulties 5. suicidal thoughts 6. stress 7. size (weight) 16. serotonin s/e Correct Answer head, red, fed head = decreased anxiety, impulsivity, sex drive red = platelets and bleeding fed = gi motility and nausea 17. SSRI pt education Correct Answer most adverse affects will subside after 4-5 days once body adjusts to increased serotonin levels 18. SSRI drugs Correct Answer citalopram fluoxetine paroxetine sertraline fluvoxamine bupropion 19. citalopram Correct Answer *has a mild antihistamine effect *causes QT prolongation citalopram = celexa, think of cel LEXUS (car) = car - get an electrocardiogram if on this drug 20. escitalopram Correct Answer *no known drug interactions, used with polypharmacy *best tolerated SSRI *27-32 hr half life 21. fluoxetine Correct Answer *longest half life - prescribe to patient who may forget to take their meds THINK fluoxetine - when you spent a long week in bed with the FLU (referring to the long half life) *use with caution if pt has comorbid anxiety due to risk of activation and panic attacks 22. paroxetine Correct Answer *also treats social anxiety disorder *highest risk of discontinuation syndrome due to serotonin transporter inhibition and anticholinergic rebound *patient will experience withdrawal symptoms if with a missed dose or late dose *contraindicated in pregnancy due to risk of congenital defects *avoid in hx of falls/fractures *associated with weight gain 23. sertraline Correct Answer *treats social anxiety *27-36 hr half life *THINK sertraline = "squirt" traline - harsher GI effects, safe for breastfeeding