NRNP 6630-Psychopharmalogical Approaches
to Treat Psychopathology
Question 1
T. C. is an 88-year-old male who is diagnosed at your clinic with Dementia
with Lewy Bodies. He currently has some debilitating gait issues, which
makes his quality of life very poor. His memory is still intact with minor
deficits. Which medication would likely benefit T. C. as his initial therapy?
Response Feedback:
“Low dosages of levodopa/carbidopa (dopamine replacement) are
sometimes helpful for the motor symptoms of DLB, although higher dosages
of dopamine replacement therapy and direct dopamine agonists may
exacerbate neuropsychiatric symptoms.”
- Motor symptoms = gait issues
Question 2
T. K. is a 72-year-old female who has suffered many strokes in the past, likely
due to uncontrolled hypertension and hyperlipidemia. She has now been
diagnosed with vascular dementia due to memory loss and motor system
slowing. What is the recommended treatment for T. K.?
Response Feedback:
“Treatment for vascular dementia involves control of vascular risk factors
(e.g., hypercholesterolemia, hypertension, inactivity, diabetes, excess
alcohol use, cigarette smoking, hyperhomocysteinemia).” In addition to
treating these causes of CNS vascular disease, some literature indicates that
symptomatic treatments (such as cholinesterase inhibitors or memantine)
may be helpful for cognition.
Question 3
When can buprenorphine be initiated in a patient who is suffering from an
opioid overdose?
,Response Feedback:
“To avoid this problem, the initial buprenorphine dose should not be
administered until
the patient demonstrates mild-to-moderate symptoms of withdrawal.”
Question 4
L. J. is a 55-year-old male who attended a funeral and found himself laughing
during the service, but later that evening he was irritated with himself for
what he had done. His wife said this was abnormal behavior and took him to
his doctor to be evaluated. After L. J.’s MRI was reviewed, he was diagnosed
with frontotemporal dementia. Which medication is recommended to help L.
J. with his emotional outbursts?
Response Feedback:
Under Treatment subtitle: “The behavioral features are sometimes helped by
SSRIs, and
these are the best-studied treatments for these disorders.”
Question 5
What baseline levels should you perform before initiating an anti-ADHD
medication?
Response Feedback:
Under Overview: “Before treatment with medications, it is usually important
to measure
baseline levels of height, weight, blood pressure, and pulse and to monitor
them over the
course of the treatment.”
Question 6
, Disorientation, tremor, hyperactivity, fever, hallucinations, marked
wakefulness, and increased autonomic tone are all features that are
consistent with which part of alcohol withdrawal?
Response Feedback:
"The principal features are disorientation (to time, place, or person), tremor,
hyperactivity, marked wakefulness, fever, increased autonomic tone, and
hallucinations.”
Question 7
T. B. is a 55-year-old male who has diagnosed with type 2 diabetes 10+
years ago. He has since had complications from the disease and is suffering
from severe neuropathy. On top of that, T. B. is struggling with his mental
health and was recently told he could be depressed but he had refused
treatment at that time. Besides getting his blood sugar under control, what
medication(s) can we use that may be useful in helping T. B.?
Nortriptyline
Venlafaxine
Duloxetine
Fluoxetine
Response Feedback:
“Among the antidepressants these include the TCAs and SNRIs (duloxetine
and venlafaxine).”
- SSRIs – page 204: “There is little evidence to support the independent
analgesic activity of SSRIs.”
Question 8
What should our treatment goal be with our patients when it comes to
managing chronic pain?
Response Feedback:
“In general, treatment goals are reports of pain less than 5 out of 10 and an
improvement in function.”
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