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NR 547 FINAL EXAM 2024 /2025 FALL QTR STUDY GUIDE PRACTICE QUESTIONS AND ANSWERS (ALL YOU NEED)
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NR 547 FINAL EXAM 2024 /2025 FALL QTR STUDY GUIDE PRACTICE QUESTIONS AND ANSWERS (ALL YOU NEED)
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NR 547 FINAL EXAM 2024 /2025NR 547 FINAL EXAM 2024 /2025 FALL QTR STUDY
GUIDE PRACTICE QUESTIONS AND ANSWERS (ALL
YOU NEED)
Ameeta, a 42-year-old female, presents to the primary care clinic with a three-month history of
"feeling low and sad" with poor energy, inability to concentrate, and irritability. She indicates
that the symptoms were initially present once per week but have increased to 4-5 times per week.
She reports making an error last week at the grocery store where she works as a cashier and
snapping at the customer when the error was brought to her attention. She is concerned about her
loss of interest in her usual social activities and a 20-pound weight gain. She also reports
frequent headaches, difficulty getting out of bed in the morning, feeling worthless, and low
libido. She acknowledges that she feels guilty daily as she has not visited her son in 6 months
and believes that she has "let him down". Thinking about it keeps her "up at night". She has
difficulty falling and staying asleep every night. She denies suicidal ideation. Overall, she reports
that the sad feelings have made it somewhat difficult to take care of things at home and get along
with other people.
Which of the following medications is the first-line choice for Ameeta?
citalopram 20 mg po daily
selegiline transdermal: Initia
citalopram 20 mg po daily
Rationale: Although all three drugs are appropriate to use when treating unipolar depression,
Citalopram is an SSRI and is considered a first-line choice.
What are the Medications for depression?
SSRIs
SNRIs
SDRIs
,NR 547 FINAL EXAM 2024 /2025
TCAs
MAOIs
SSRIs
-Action: inhibit 5-HT reuptake
-Examples: citalopram, escitalopram, fluoxetine, paroxetine, sertraline
-Adverse effects:
• nausea
• agitation
• diarrhea
• headache
• weight gain
• sexual side effects
SNRIs
-inhibit 5-HT reuptake
-inhibit NE reuptake (↑ energy, focus)
-increase DA in prefrontal cortex (↑ cognition)
-Examples: desvenlafaxine, duloxetine, levomilnacipran, venlafaxine
-Adverse effects:
• elevated blood pressure
• nausea
• sweating
,NR 547 FINAL EXAM 2024 /2025
• tremors
• anxiety
• insomnia
• constipation
• anorexia
• sexual dysfunction
SDRIs
-inhibit DA reuptake (↑alertness, motivation)
-inhibit NE reuptake (↑energy)
-Adverse effects:
• agitation
• headache
• dry mouth
• constipation
• weight loss
TCAs
-Action: inhibits the reuptake of serotonin and norepinephrine; blocks norepinephrine, histamine,
and acetylcholine receptors
-Examples: amitriptyline, clomipramine, desipramine, doxepin
-Common Side Effects:
• dry mouth
, NR 547 FINAL EXAM 2024 /2025
• constipation
• blurred vision
• urinary retention
• sedation
• weight gain
• hypotension
• tachycardia
• sexual dysfunction
MAOIs
-Action: increases norepinephrine and serotonin by inhibiting the enzyme that inactivates it
-Examples: isocarboxazid, phenelzine, tranylcypromine
-Common Side Effects:
• sedation
• dizziness
• sexual dysfunction
• hypertensive crisis
Prescribing pearls: citalopram (Celexa)
mild antihistamine effects
Prescribing pearls: escitalopram (Lexapro)
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