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NURS 660: PSYCHOPHARM Exam Questions Complete Solutions Current Update (A+ Pass) $12.99
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NURS 660: PSYCHOPHARM Exam Questions Complete Solutions Current Update (A+ Pass)

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NURS 660: PSYCHOPHARM Exam Questions Complete Solutions Current Update (A+ Pass) Minimum ANC level to prescribe Clozapine, general population: - Answers -1,500 μL Severe Neutropenia - Answers -< 500μL Moderate Neutropenia - Answers -500-999μL Mild Neutropenia - Answers -μL BEN...

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  • September 27, 2024
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  • NURS 660
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NURS 660: PSYCHOPHARM Exam
Questions Complete Solutions Current
Update (A+ Pass)
Minimum ANC level to prescribe Clozapine, general population: - Answers -1,500 μL

Severe Neutropenia - Answers -< 500μL

Moderate Neutropenia - Answers -500-999μL

Mild Neutropenia - Answers -1000-1499μL

BEN patients: Normal ANC range for Clozaril - Answers -≥1,000 μL

Clozaril BEN patient: severe neutropenia - Answers -<500 μL

BEN neutropenia - Answers -500-999 μL

Lower ANC threshold for starting clozapine: General population - Answers -≥1,500/μL

Lower ANC threshold for starting clozapine: Benign ethnic neutropenia (BEN) - Answers
-1,000/μL

Medical emergencies when prescribing anti-psychotics - Answers -- NMS
- Agranulocytosis
- Serotonin Syndrome

Clinical findings in agranulocytosis - Answers -

Clozaril: most likely side effect if pt develops fever within 6 weeks - Answers -
Myocarditis

Clozaril: if pt develops fever within 6 weeks order a ______, _________ and _______. -
Answers -EKG, CRP, Troponin, as this is likely due to myocarditis

Common complaints in patients with neutropenia:
F,P, U, P - Answers -- Fever (low grade)
- painful swallowing (odynophagia)
- URI (sinusitis, otitis, cough)
- Perirectal pain/irritation

Symptoms of neuroleptic malignant syndrome (NMS): - Answers -- High fever
- Tachycardia/irregular pulse
- Increased respiratory rate

,- Muscle Rigidity
- altered mental status

Off label TX for NMS - Answers -Amantadine (SYMMETREL)

Serotonin Syndrome onset: - Answers --24 hours of combining antidepressants

Serotonin Syndrome Cardinal features - Answers -- Myoclonic jerks
- Hyperreflexia
- Mental status changes
- Shivering
- Fever
- Tachycardia, HTN, hypotension (AUTONOMIC instability)
- Confused/ restless/ hyperactive/ unresponsive

Management of Serotonin syndrome - Answers -- Discontinue meds, stablize vitals

Potentially
helpful meds with Serotonin syndrome: - Answers -Benzodiazepines for agitation
Cyproheptadine (anti-serotonergic antihistamine)
Methysergide (anti-serotonergic migraine medication)

5-HT "TWITCHY FROG" Serotonin Syndrome - Answers --Agitated
-Sweating
-Fever
-Hyperreflexia
-Dilated pupils

Neuroleptic Malignant Syndrome - Answers -a potentially fatal hyperpyrexia with temp
of over 104, looks like EPS except for temp

Neuroleptic Malignant Syndrome- "can't bender(er)" - Answers -Life-threatening muscle
rigidity, fever, and rhabdomyolysis.
Mental status changes

Mechanism of NMS.
-What's blocked? Where (2)? - Answers -Dopamine blockade in the hypothalamus
(fever)
and nigrostriatal pathway (rigidity

Onset of NMS - Answers -30 days of starting or increasing antipsychotics or stoping a
domaminergic drug

NMS cardinal features - Answers -High fever 100% by definition
Rigidity 100% by definition
Mental status changes 99%

, Elevated or labile BP most

NMS motor activity - Answers -Bradykinesia

Brain regions affected by schizophrenia (aggression and impulse control) (2) - Answers
-Orbitofrontal cortex and amygdala

Pathways affected by schizophrenia (4):
MMTN - Answers --Mesolimbic
- Mesocortical
-Tuberoinfundibular
-Nigrostriatal

Mesolimbic DOPAMINE pathway:

Increased dopamine activity in the: ___, ____, and ____. - Answers -Nucleus
accumbuns, amygdala, hippocampus

Mesolimbic dopamine pathways are responsible for (adding something to the behavior):
- Answers -Positive symptoms - Delusions - bizarre behavior - hallucinations -
disorganized speech

Most antipsychotics treat ___________ symptoms. - Answers -positive

Mesocortical pathway: Responsible for a _______ in dopamine activity in ______
condition. - Answers -decreased dopamine activity in schizophrenia

mesocortical pathway are responsible for ____ symptoms, such as (3) - Answers -
Negative Symptoms
1. Flat affect 2. Poverty of Speech 3. Adhedonia Apathy

Tuberoinfundibular pathways: Antipsychotics Decrease _______ causing side effects
thru this pathway - Answers -dopamine

In the Tuberinfundibular pathway, dopamine inhibits ________. - Answers -Prolactin

Tuberoinfundibular pathway: Less dopamine means more ______, more _______
causes less ________
< D = >P = <G - Answers -Less dopamine = more prolactin = less Gonadotropins
(GnRH)

Tuberoinfundibular pathway: decreased _______ (a result of decreased dopamine and
increased prolactin causes these side effects: - Answers -GnRH =
- Decreased labido
- Sex dysfunction
- galactohrrea

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