NU664C Study Guide for Midterm Exam
2025 complete questions ( frequently
tested) and answers
Route- Sublingual
Not to eat or drink for 10 minutes after medication administration
Not to swallow or chew the capsule.
Asenapine is an atypical antipsychotic (serotonin-dopamine antagonist, as a mood stabilizer).
Asenapine is not absorbed after swallowing (less than 2% bioavailable orally) and thus must be
administered sublingually (35% bioavailable), as swallowing would render asenapine inactive.
Patients should be instructed to place the tablet under the tongue and allow it to dissolve
completely, which will occur in seconds; tablet should not be divided, crushed, chewed, or
swallowed.
Patients may not eat or drink for 10 minutes following sublingual administration so that the drug
in the oral cavity can be absorbed locally and not washed into the stomach (where it would not
be absorbed).
Due to rapid onset of action, can be used as a rapid acting "prn" or "as needed" dose for
agitation or transient worsening of - CORRECT ANSWER- Know the route of administration for
newer agent asenapine (Saphris) and what instructions should be given to the patient regarding
administration.
Ziprasidone (Geodon).
Normal QTc =450.
>470, Call Cardiologist
>500, stop all meds.
Ziprasidone (Geodon) has been associated with a dose-related prolongation of the QTc
QTc interval prolongation is greatest with ziprasidone and least with olanzapine.
Ziprasidone (Geodon) an atypical antipsychotic (serotonin-dopamine antagonist;
second-generation antipsychotic; also a mood stabilizer.
Ziprasidone is prescribed for Schizophrenia, delaying relapse in schizophrenia, acute agitation
in schizophrenia (intramuscular), acute mania/mixed mania, bipolar maintenance, other
psychotic d/o, bipolar depression, behavioral disturbances in dementias, behavioral
disturbances in children and adolescents, and disorders associated with problems with impulse
control.
Ziprasidone blocks dopamine 2 receptors, reducing positive symptoms of psychosis and
stabilizing affective symptoms. Blocks serotonin 2A receptors, causing enhancement of dop -
CORRECT ANSWER- Know and describe the top atypical antipsychotic with greatest incidence
of prolonged QTc interval.
Geodon because food affects the absorption of the drug.
Lurasidone - Latuda - CORRECT ANSWER- Know which antipsychotics have specific
instructions for minimum food intake or diet restrictions.
Abilify or Geodon, or Lurasidone (Latuda)
Because they are weight neutral or causes minimal weight gain. - CORRECT ANSWER- Know
an alternative atypical antipsychotic for a patient who has developed diabetes and has a
significant weight gain from treatment with olanzapine.
Stop the drug, because of the risk of agranulocytosis and patient can be infected.
, Smoking reduces the level of Olanzapine because of its metabolism at CYP450 enzyme. -
CORRECT ANSWER- Know the common effects of smoking along with antipsychotic drug
therapy such as olanzapine.
Positive symptoms-Delusions, Hallucinations, Ideas of reference, Catatonic, Disorganized
speech, thinking or behavior
Negative symptoms-Flat affect, Asocial, Monotone, Anhedonia, Avolition, Isolation, Poverty of
Speech, Decreased self-care - CORRECT ANSWER- Be able to describe three positive
symptoms and three negative symptoms of schizophrenia.
·Torticollis or Acute Dystonic
The common drug therapy is Cogentin (Benztropine) relieves the symptoms
Benadryl or Ativan can also be used. - CORRECT ANSWER- Know what a painful muscle
spasm with neck muscles pulling a patient's head to the side called and Name a common drug
therapy to relieve this symptom.
Management of anxiety; Binds to serotonin and dopamine receptors in the brain. Increases
norepinephrine metabolism in the brain.
Recommended dose 5 mg 3 times daily; Usual dose 20-30 mg/day. - CORRECT ANSWER-
Know the role of buspirone in the treatment of anxiety and the recommended dose and time for
onset of action.
Fluphenazine and haloperidol have been formulated as long-acting injectables (LAI)s.
Long-acting forms of risperidone, paliperidone, aripiprazole, and olanzapine are also available. -
CORRECT ANSWER- Know what medication may be an option for patients noncompliant on
antipsychotics resulting in multiple hospital stays
A1C, Lipids, CBC, CMP, LFT Weight, HR, B/P = monitoring for metabolic syndrome -
CORRECT ANSWER- Know baseline labs and vital measurements tests for the patient who will
be prescribed an antipsychotic such as quetiepine (Seroquel).
·Antihistamines are commonly associated with sedation, dizziness, and hypotension, all of
which can experience the anticholinergic effects of those drugs.
Other common adverse effects include epigastric distress, nausea, vomiting, diarrhea, and
constipation. Because of mild anticholinergic activity, some people experience dry mouth,
urinary retention, blurred vision, and constipation. For this reason, antihistamines should be
used only as very low doses. - CORRECT ANSWER- Describe common side
effects/disadvantages of antihistamines.
· Acute Alcohol withdrawal
· Acute Benzo withdrawal
· Acute Agitation associated with substance use
· Acute Panic Attack - CORRECT ANSWER- Identify 3-4 disorders/situations when
benzodiazepines may be indicated.
· Weight gain
· Sedation
· Metabolic Syndrome
· EPS
(unlikely to cause ? QTc Prolongation) - CORRECT ANSWER- Describe 2-3 common side
effects of atypical antipsychotics.
Zyprexa Relprevv
2025 complete questions ( frequently
tested) and answers
Route- Sublingual
Not to eat or drink for 10 minutes after medication administration
Not to swallow or chew the capsule.
Asenapine is an atypical antipsychotic (serotonin-dopamine antagonist, as a mood stabilizer).
Asenapine is not absorbed after swallowing (less than 2% bioavailable orally) and thus must be
administered sublingually (35% bioavailable), as swallowing would render asenapine inactive.
Patients should be instructed to place the tablet under the tongue and allow it to dissolve
completely, which will occur in seconds; tablet should not be divided, crushed, chewed, or
swallowed.
Patients may not eat or drink for 10 minutes following sublingual administration so that the drug
in the oral cavity can be absorbed locally and not washed into the stomach (where it would not
be absorbed).
Due to rapid onset of action, can be used as a rapid acting "prn" or "as needed" dose for
agitation or transient worsening of - CORRECT ANSWER- Know the route of administration for
newer agent asenapine (Saphris) and what instructions should be given to the patient regarding
administration.
Ziprasidone (Geodon).
Normal QTc =450.
>470, Call Cardiologist
>500, stop all meds.
Ziprasidone (Geodon) has been associated with a dose-related prolongation of the QTc
QTc interval prolongation is greatest with ziprasidone and least with olanzapine.
Ziprasidone (Geodon) an atypical antipsychotic (serotonin-dopamine antagonist;
second-generation antipsychotic; also a mood stabilizer.
Ziprasidone is prescribed for Schizophrenia, delaying relapse in schizophrenia, acute agitation
in schizophrenia (intramuscular), acute mania/mixed mania, bipolar maintenance, other
psychotic d/o, bipolar depression, behavioral disturbances in dementias, behavioral
disturbances in children and adolescents, and disorders associated with problems with impulse
control.
Ziprasidone blocks dopamine 2 receptors, reducing positive symptoms of psychosis and
stabilizing affective symptoms. Blocks serotonin 2A receptors, causing enhancement of dop -
CORRECT ANSWER- Know and describe the top atypical antipsychotic with greatest incidence
of prolonged QTc interval.
Geodon because food affects the absorption of the drug.
Lurasidone - Latuda - CORRECT ANSWER- Know which antipsychotics have specific
instructions for minimum food intake or diet restrictions.
Abilify or Geodon, or Lurasidone (Latuda)
Because they are weight neutral or causes minimal weight gain. - CORRECT ANSWER- Know
an alternative atypical antipsychotic for a patient who has developed diabetes and has a
significant weight gain from treatment with olanzapine.
Stop the drug, because of the risk of agranulocytosis and patient can be infected.
, Smoking reduces the level of Olanzapine because of its metabolism at CYP450 enzyme. -
CORRECT ANSWER- Know the common effects of smoking along with antipsychotic drug
therapy such as olanzapine.
Positive symptoms-Delusions, Hallucinations, Ideas of reference, Catatonic, Disorganized
speech, thinking or behavior
Negative symptoms-Flat affect, Asocial, Monotone, Anhedonia, Avolition, Isolation, Poverty of
Speech, Decreased self-care - CORRECT ANSWER- Be able to describe three positive
symptoms and three negative symptoms of schizophrenia.
·Torticollis or Acute Dystonic
The common drug therapy is Cogentin (Benztropine) relieves the symptoms
Benadryl or Ativan can also be used. - CORRECT ANSWER- Know what a painful muscle
spasm with neck muscles pulling a patient's head to the side called and Name a common drug
therapy to relieve this symptom.
Management of anxiety; Binds to serotonin and dopamine receptors in the brain. Increases
norepinephrine metabolism in the brain.
Recommended dose 5 mg 3 times daily; Usual dose 20-30 mg/day. - CORRECT ANSWER-
Know the role of buspirone in the treatment of anxiety and the recommended dose and time for
onset of action.
Fluphenazine and haloperidol have been formulated as long-acting injectables (LAI)s.
Long-acting forms of risperidone, paliperidone, aripiprazole, and olanzapine are also available. -
CORRECT ANSWER- Know what medication may be an option for patients noncompliant on
antipsychotics resulting in multiple hospital stays
A1C, Lipids, CBC, CMP, LFT Weight, HR, B/P = monitoring for metabolic syndrome -
CORRECT ANSWER- Know baseline labs and vital measurements tests for the patient who will
be prescribed an antipsychotic such as quetiepine (Seroquel).
·Antihistamines are commonly associated with sedation, dizziness, and hypotension, all of
which can experience the anticholinergic effects of those drugs.
Other common adverse effects include epigastric distress, nausea, vomiting, diarrhea, and
constipation. Because of mild anticholinergic activity, some people experience dry mouth,
urinary retention, blurred vision, and constipation. For this reason, antihistamines should be
used only as very low doses. - CORRECT ANSWER- Describe common side
effects/disadvantages of antihistamines.
· Acute Alcohol withdrawal
· Acute Benzo withdrawal
· Acute Agitation associated with substance use
· Acute Panic Attack - CORRECT ANSWER- Identify 3-4 disorders/situations when
benzodiazepines may be indicated.
· Weight gain
· Sedation
· Metabolic Syndrome
· EPS
(unlikely to cause ? QTc Prolongation) - CORRECT ANSWER- Describe 2-3 common side
effects of atypical antipsychotics.
Zyprexa Relprevv
