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NR546 MIDTERM EXAM EXAM QUESTIONS AND ANSWERS
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NR546 MIDTERM EXAM EXAM QUESTIONS AND ANSWERS
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NR 546 EXAMQUESTIONS ANDANSWERS
PrefrontalsCortexsSymptomssofsMDDs-sans--Concentration
MentalsFatigue
Mood
PFCs&sAmygdalasSymptomssofsMDDs-sans--Guilt
Suicidality
Worthlessness
StriatumsSymptomssofsMDDs-sans--Physicalsfatigue
NucleussAccumbenssSymptomssofsMDDs-sans--Pleasuresinterests
HypothalamussSymptomssofsMDDs-sans--Sleep
Appetite
Thalamuss&sHypothalamussSymptomssofsManias-sans--Decreasedssleep/arousal
StriatumsSymptomssofsManias-sans--Motor/agitation
Prefrontalscortexs(PFC)sSymptomssofsManias-sans--Risk-taking
Talkative/pressuredsspeech
NucleussAccumbenss&sPFCsSymptomssofsManias-sans--Racingsthoughts,sgrandiosity
PFCs&sAmygdalasSymptomssofsManias-sans--Mood
MedicationsManagements-sans--SSRI-SelectivesSerotoninsReuptakesInhibitors
*Inhibits5sHTsreuptake
SNRI-SerotoninsNorepinephrinesReuptakesInhibitorss
*inhibits5-HTsreuptake
*inhibitsNEsreuptakes(increasesenergy,sfocus)
*increasesDAsinsprefrontalscortexs(increasescognition)
NDRI-NorepinephrinesDopaminesReuptakesinhibitors
*inhibitsDAsreuptakes(increasesalertness,smotivation)
*inhibitsNEsreuptakes(increasesenergy)
SARI-SerotoninsAntagonistsReuptakesInhibitors
SelectivesSerotoninsReuptakesInhibitorss(SSRIs):sMostsadverseseffectsswillssubsidesafters
4-5sdayssoncesthesbodysadjustsstosincreasedsserotoninslevels.s-sans--diarrhea
headache
,weightsgain
sexualssideseffects
SerotoninsNorepinephrinesReuptakesInhibitorss(SNRIs):sMedicationssshouldsnotsbesabrup
tlysstoppedstosavoidsdiscontinuationssymptoms.sNEseffectssofsthesmedicationsmaysincreas
esanxietysinssomesclients.sReportsworseningsanxietystosthesprovider.s-sans--
elevatedsbloodspressure
anxiety
insomnia
constipation
NorepinephrinesDopaminesReuptakesInhibitorss(NDRI):sTakesmedicationsinsthesmorning.s
Stopstakingsmedicationsifsseizuressoccur.sStopstakingsmedicationsifsanxietysissnoted.s-
sans--agitation
headache
drysmouth
constipation
weightsloss
escitaloprams(Lexapro)sSSRIs-sans--nosknownsdrugsinteractions
beststoleratedsSSRI
27-32shourshalf-lifesgoodsforsforgetfulspronesclients
leastsCYPsreactions
Substratesfors3A4
citaloprams(Celexa)sSSRIs-sans--mildsantihistamineseffects;sHalf-Life:s23-45shours
WeaksInhibitorsofs2D6
fluoxetines(Prozac)sSSRIs-sans--longestshalf-life
Usescautionsinspatientsswithscomorbidsanxietysduestosrisksforsactivationsandspanicsattacks
Half-Life:s2-3sdayssparent,s2sweeksmetabolite
Inhibitss2D6sands3A4
paroxetines(Paxil)sSSRIs-sans--alsostreatsssocialsanxietysandsinsomnia
associatedswithsweightsgain
willsexperienceswithdrawalswithsmissedsdosesorsabruptsstop
Half-Life:s24shours
Inhibitss2D6
fluvoxamines(Luvox)sSSRIs-sans--
treatssanxioussdepressionssmokerssrequiresansincreasedsdose
Half-Life:s9-28shours
Inhibitss3A4,s2C9,s1A2
sertralines(Zoloft)sSSRIs-sans--alsostreatsssocialsanxietysandshypersomnolence
Half-Life:s22-36shoursparent;s62-104shoursmetabolite
,Inhibitss2D6sands3A4sweaklysatslowsdoses
venlafaxines(Effexor)s-sans--
treatssbothsdepressionsandsanxietysdisorders,sensurestrialsofshighersdosesbeforesswitching
stosasdifferentsmedication
Half-life:sParentsdrugs3-7shour;smetaboliteshass9-13shour
duloxetines(Cymbalta)sSNRIs-sans--
effectivesforsatypicalspainsatshighersdoses;sappropriatesforsclientsswhospresentswithssomati
cssymptomssofsdepression;seffectivesforsatypicalspain,ssuchsassfibromyalgiasandsdiabeticsn
europathy
Half-Life:s12shours
Inhibitorsofs2D6
bupropions(Wellbutrin)s-sans--
NDRIsmaysimprovesenergy,salertness,sandsmotivation;snotsfirst-
linestreatmentsforsanxiety;scontraindicatedsinsclientsswithsashistorysofsseizures
Avoidsinspatientsswithscomorbidsanxiety
Half-Life:sParents10-14shours;sMetabolites20-27shours
Inhibitss2D6
SerotoninsAntagonistsandsReuptakesInhibitorss(SARIs)s-sans--SARIsspotentlysblocks5-
HT2Asands5HTs2Csreceptors,swhichsallowsmores5-HTstosinteractsatspostsynaptics5-
HT1Assites.sSerotoninsblockadesandsreuptakesinhibitionsisspresentsatshighersdoses.
Trazodones-sans--ThesmostscommonsSARI,salsosblocksshistaminergicsandsα-
adrenergicsreceptors.
Half-Life:s3-6shours
SerotoninsAntagonistsandsReuptakesInhibitorss(SARIs)s-sans--CommonsAdversesEffects
·ssedation
·sdrowsiness
·sblurredsvision
·sconstipation
·sdrysmouth
SerioussAdversesEffect
priapism
Serotoninsnorepinephrinesreceptorsagonist,salpha2sreceptorsagonists-sans--Mirtazapine
Serotoninsmultimodals(SMM)/serotoninspartialsagonistsreuptakesinhibitors(SPARI)s-sans--
Vilazodones(Viibryd)
·sInhibitssserotoninsreuptakeswithspartials5HT1Asagonism
Appropriatesforsdepression/comorbidsanxiety,sitssactionsisssimilarstosascombinationsofsSS
RIsandsbuspirone
, Serotoninsmultimodals(SMM)s-sans--Vortioxetines(Trintellix)
·sActssassSSRIspluss5HT1Aspartialsagonism
·sImprovessdepression-relatedscognition
Tricyclicsantidepressantss(TCAs)s-sans--
Tricyclicsantidepressantss(TCAs)spossesssbothsSRIsandsNRIsproperties,sbutstheysalsosblo
cksothersreceptors,sincludingsα1-adrenergic,shistamine-
1,sandsmuscarinicscholinergicsreceptors.sTCAssaresnotsusedsfirst-
linesbecausesofstheshighsincidencesofsadverseseffectssandsthesrisksofspotentialsoverdosesa
ndsdeathsduestosoverdose
Tricyclicsantidepressantss(TCAs)s-sans--Drugs:
·samitriptylines(Elavil)
·sdesipramines(Norpramin)
·sdoxepins(Sinequan)
·simipramines(Tofranil)
·snortriptylines(Pamelor)
Tricyclicsantidepressantss(TCAs)s-sans--CommonsadverseseffectssofsTCAs
Alpha-1sadrenergicseffects-Orthostaticshypotension
Histamineseffects-Sedation
Histamineseffects-Weightsgain
Anticholinergicseffects-Blurredsvision
Anticholinergicseffects-Urinarysretention
Anticholinergicseffects-Constipation
Anticholinergicseffects-Drysmouth
MAOIss-sans--
Lastschoicesmedicationsclasssforsdepressionsduestosthesmanyspotential,sseriousssideseffec
ts.sMAOIsshavesspecificsdietarysrestrictionssthatswhensignored,smaysbesverysuncomfortabl
esorsverysserioussforsclients.
MAOIss-sans--Drugs:
·sphenelzines(Nardil)
·sselegilines(Emsam)s-sMAOI-B
·stranylcypromines(Parnate)
·sisocarboxazids(Marplan)
MAOI'ssKeysPointss-sans--
·sClientsstakingsMAOIssaresatshighsrisksforshypertensivescrisissifstyraminesissingested.s
·sDosnotsprescribesanysserotonergicsagentsswithins2sweekssofsMAOIsdiscontinuationsduest
osansincreasedsrisksofsserotoninssyndrome.
Waitsatsleasts5shalf-
livessaftersdiscontinuingsasserotonergicsmedicationsbeforesinitiatingsansMAIO.
FoodsstosAvoidsWhensTakingsMAO-AsMedicationss-sans--·sRedswines(Avoid)
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