NURS 660 PSYCHOPHARM EXAM 1-WITH RETIONALES
QUESTIONS & ANSWERS,NEWEST 2024-2025.
Mesolimbic dopamine pathways are responsible for (adding something to the behavior):
- CORRECT ANSWERS -Positive symptoms - Delusions - bizarre behavior -
hallucinations - disorganized speech
Most antipsychotics treat ___________ symptoms. - CORRECT ANSWERS -positive
Mesocortical pathway: Responsible for a _______ in dopamine activity in ______
condition. - CORRECT ANSWERS -decreased dopamine activity in schizophrenia
mesocortical pathway are responsible for ____ symptoms, such as (3) - CORRECT
ANSWERS -Negative Symptoms
1. Flat affect 2. Poverty of Speech 3. Adhedonia Apathy
Tuberoinfundibular pathways: Antipsychotics Decrease _______ causing side effects
thru this pathway - CORRECT ANSWERS -dopamine
In the Tuberinfundibular pathway, dopamine inhibits ________. - CORRECT
ANSWERS -Prolactin
Tuberoinfundibular pathway: Less dopamine means more ______, more _______
causes less ________
< D = >P = <G - CORRECT ANSWERS -Less dopamine = more prolactin = less
Gonadotropins (GnRH)
Tuberoinfundibular pathway: decreased _______ (a result of decreased dopamine and
increased prolactin causes these side effects: - CORRECT ANSWERS -GnRH =
- Decreased labido
- Sex dysfunction
- galactohrrea
- gynecomastia
Tuberoinfundibular pathway: GNRH - CORRECT ANSWERS -SEX and Boobs
Nigrostriatal pathway is responsible for - CORRECT ANSWERS -EPS symptoms
Patients with agranulocytosis SUDDENLY present with the following:
M.F.S.P. - CORRECT ANSWERS -- Malaise
- Fever
- Stomatitis
- Pharyngitis (difficulty swallowing).
,Fatal results due to clozapine - CORRECT ANSWERS -1. Bowel obstruction (most
common) 2. Agranulocytosis
Start _________, ___________, and PRN _____________ prior to initiating clozapine. -
CORRECT ANSWERS -fiber, docusate and
PRN milk of magnesia
Avoid
__________________ when prescribing clozapine. - CORRECT ANSWERS -
anticholinergics
Minimum ANC level to prescribe Clozapine, general population: - CORRECT
ANSWERS -1,500 μL
Severe Neutropenia - CORRECT ANSWERS -< 500μL
Moderate Neutropenia - CORRECT ANSWERS -500-999μL
Mild Neutropenia - CORRECT ANSWERS -1000-1499μL
BEN patients: Normal ANC range for Clozaril - CORRECT ANSWERS -≥1,000 μL
Clozaril BEN patient: severe neutropenia - CORRECT ANSWERS -<500 μL
BEN neutropenia - CORRECT ANSWERS -500-999 μL
Lower ANC threshold for starting clozapine: General population - CORRECT
ANSWERS -≥1,500/μL
Medical emergencies when prescribing anti-psychotics - CORRECT ANSWERS -- NMS
- Agranulocytosis
- Serotonin Syndrome
Clinical findings in agranulocytosis - CORRECT ANSWERS -
Clozaril: most likely side effect if pt develops fever within 6 weeks - CORRECT
ANSWERS -Myocarditis
Clozaril: if pt develops fever within 6 weeks order a ______, _________ and _______. -
CORRECT ANSWERS -EKG, CRP, Troponin, as this is likely due to myocarditis
Common complaints in patients with neutropenia:
F,P, U, P - CORRECT ANSWERS -- Fever (low grade)
Neuroleptic Malignant Syndrome - CORRECT ANSWERS -a potentially fatal
hyperpyrexia with temp of over 104, looks like EPS except for temp
Neuroleptic Malignant Syndrome- "can't bender(er)" - CORRECT ANSWERS -Life-
threatening muscle rigidity, fever, and rhabdomyolysis.
Mental status changes
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