CMN 548 UNIT 5 QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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Course
CMN 548 UNIT 5
Institution
CMN 548 UNIT 5
CMN 548 UNIT 5 QUESTIONS AND ANSWERS
WITH SOLUTIONS 2024
List THREE benefits of using TCAs over SSRIs? - ANSWER -less prone to:
1. cause sexual dysfunction
2. cause significant long term weight gain
3. cause sleep disturbances
What are the s/s of OD for TCAs? - ANSWER --Arrhythomgenic (R ven...
CMN 548 UNIT 5 QUESTIONS AND ANSWERS
WITH SOLUTIONS 2024
List THREE benefits of using TCAs over SSRIs? - ANSWER -less prone to:
1. cause sexual dysfunction
2. cause significant long term weight gain
3. cause sleep disturbances
What are the s/s of OD for TCAs? - ANSWER --Arrhythomgenic (R ventricular
cardiomyopathy)
-Agitation
-Delirium
-Convulsions
-Hyperactive deep tendon reflexes
-Bowel/bladder paralysis
-Dysregulation of BP + Temp
-Mydriasis (dilated pupils)
-Coma
-Respiratory depression
What is the recommendation for prescribing a TCA for a pt who is at risk for
suicide? - ANSWER --Make RX non-refillable, and for no longer than 1 week at a
time
-avoid AMOXAPINE as this is more likely than other TCAs to result in death
when taken in OD
-monitor for at least 3-4 days after OD in an intensive care medical setting
How long after an OD on TCAs can the risk remain for cardiac arrhythmias? -
ANSWER -3-4 DAYS after OD
Why are SSRIs first choice among antidepressants? - ANSWER --greater safety
-eliminating cardiovascular + anticholingergic effects
-still elevate levels of 5-HT
-SSRIs do NOT alter NE, histamine, or Ach
,Which 2 SSRIs are the most selective inhibitors of serotonin reuptake? -
ANSWER -1. Citalopram
2. Escitalopram
Which SSRIs at higher doses produces anticholinergic effects? - ANSWER -
Paroxetine
What clinical complication can occur with concomitant use of SSRIs and drugs in
the triptan class, MAOI class, and lithium? - ANSWER --raise plasma serotonin
concentrations to toxic levels producing SEROTONIN SYNDROME
-Diarrhea
-restlessness
-extreme agitation, hyperreflexia, an autonomic instability w/possible rapid
fluctuations in VS
-Myclonus, seizures, hyperthermia, uncontrollable shivering, rigidity
-Delirium, coma, status epilepticus, cardiovascular collapse, death
What is the FDA issued Black box warning with SSRIs? - ANSWER -Suicidal
thoughts and behaviors more so in younger people
Which SSRI has the FDA given a Pregnancy category D? - ANSWER -Paroxetine
(Paxil) increases risk of birth defects, particularly heart issues when women take it
in the first 3 months of pregnancy
Post stroke use of SSRIs have been found to be effective on what specific
symptom of depression? - ANSWER -Reduce symptoms of crying
Which is approved by the FDA for use in children and adolescents for depression?
- ANSWER -Fluoxetine (Prozac)
Sertraline (Zoloft)
Children with OCD may be prescribed one of two SSRIs? - ANSWER -
Fluvoxamine (favelin, Luvox)
Sertraline (zoloft)
, Which SSRI is indicated for the tx of bulimia nervosa? - ANSWER -Fluoxetine
(prozac)
Discuss the incidence rate, common pt complaints, and strategies to mitigate
SSRI-induced sexual dysfunction? - ANSWER -Incidence rate: all SSRI cause
sexual dysfunction, and its the most common AE of SSRIs associated with long
term tx. incidence rate 50-80%
Pt complaints: Anorgasmia, inhibited orgasm, and decreased libido
Strategies: none proven to be very effective..
-decrease dosage or add Bupropion (wellbutrin) or add amphetamine
-add sildenafil (viagra)
* ultimately pt may need to switch to antidepressants that don't interfere w/sexual
functioning-
1. mirtazapine
2. bupropion
Antagonist - ANSWER -A compound that blinds to a receptor that blocks or
reduces the action of another substance at the receptor site
Hyponatremia - ANSWER -Common symptoms of this medication side effect
include confusion, agitation, and lethargy. (tx with oxcarbazepine & SSRIs)
Therapeutic index - ANSWER -ratio of the median toxic dose to the median
effective dose
Somnolence - ANSWER -Daytime sleepiness
Black Box Warning - ANSWER -This warning reflects that a medication may
cause a serious or even life-threatening side effect
Partial or Mixed Agonist - ANSWER -A compound that elicits a partial
pharmacological response at the receptor site involved
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