Final Exam: NR546/ NR 546 (NEW Update 2024/ 2025) Psychopharmacology for the Psychiatric-Mental Health Nurse Practitioner Review |Weeks 5-8 | Questions and Verified Answers| 100% Correct- Chamberlain

Final Exam: NR546/ NR 546 (NEW Update 2024/ 2025) Psychopharmacology for the Psychiatric-Mental Health Nurse Practitioner Review |Weeks 5-8 | Questions and Verified Answers| 100% Correct- Chamberlain QUESTION Tricyclic antidepressants (TCAs) Tricyclic antidepressants (TCAs) possess both SRI and NRI properties, but they also block other receptors, including α1-adrenergic, histamine-1, and muscarinic cholinergic receptors. TCAs are not used first-line because of the high incidence of adverse effects and the risk of potential overdose and death due to overdose QUESTION Tricyclic antidepressants (TCAs) Answer: Drugs: · amitriptyline (Elavil) · desipramine (Norpramin) · doxepin (Sinequan) · imipramine (Tofranil) · nortriptyline (Pamelor) QUESTION Tricyclic antidepressants (TCAs) Answer: Common adverse effects of TCAs Alpha-1 adrenergic effects-Orthostatic hypotension Histamine effects-Sedation Histamine effects-Weight gain Anticholinergic effects-Blurred vision Anticholinergic effects-Urinary retention Anticholinergic effects-Constipation Anticholinergic effects-Dry mouth QUESTION MAOIs Answer: Last choice medication class for depression due to the many potential, serious side effects. MAOIs have specific dietary restrictions that when ignored, may be very uncomfortable or very serious for clients. QUESTION MAOIs Answer: Drugs: · phenelzine (Nardil) · selegiline (Emsam) - MAOI-B · tranylcypromine (Parnate) · isocarboxazid (Marplan) QUESTION MAOI's Key Points Answer: · Clients taking MAOIs are at high risk for hypertensive crisis if tyramine is ingested. · Do not prescribe any serotonergic agents within 2 weeks of MAOI discontinuation due to an increased risk of serotonin syndrome. Wait at least 5 half-lives after discontinuing a serotonergic medication before initiating an MAIO. QUESTION Foods to Avoid When Taking MAO-A Medications Answer: · Red wine (Avoid) · Sauerkraut (Avoid) · Cheese (Avoid) · Soy (Avoid) · Smoked meats (Avoid) QUESTION Foods to Avoid When Taking MAO-A Medications Answer: Rationale: Limiting the consumption of tyramine is necessary for orally available MAOIs due to inhibition of MAO-A in the gut. Dietary restrictions are not required for the transdermal formulation of selegiline. Tyramine is present in many aged or preserved foods including aged cheeses, tap and nonpasteurized beers, aged or smoked meat or fish, sauerkraut, kimchee, soy products, and tofu. Foods to be avoided when taking MAO-A medications include wine, meats, sauerkraut, cheese, and soy. QUESTION Newer Treatments for Resistant Depression · The goal of antidepressant treatment is the remission of symptoms; however, the current treatment response of clients with mood disorders varies widely and is often unsatisfactory. · For example, in clients with MDD, the treatment efficacy of selective serotonin reuptake inhibitors (SSRIs), the most used first-line pharmacological agent is between 48 and 64% with reported remission rates as low as 23.5%. · Treatment-resistant depression occurs when depression persists after the client has adequately trialed at least two antidepressant therapies.