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NR547 Final Exam Questions & Answers 100% Correct!!
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Medications for depression - ANSWERSSRIs SNRIs SDRIs TCAs MAOIs SSRIs - ANSWER-Action: inhibit 5-HT reuptake -Examples: citalopram, escitalopram, fluoxetine, paroxetine, sertraline -Adverse effects: • nausea • agitation • diarrhea • headache • weight gain • sexual side effe...

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  • October 12, 2024
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NR547 Final Exam Questions &
Answers 100% Correct!!

Medications for depression - ANSWERSSRIs

SNRIs

SDRIs

TCAs

MAOIs

SSRIs - ANSWER-Action: inhibit 5-HT reuptake

-Examples: citalopram, escitalopram, fluoxetine, paroxetine, sertraline

-Adverse effects:

• nausea

• agitation

• diarrhea

• headache

• weight gain

• sexual side effects

SNRIs - ANSWER-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

• tremors

• anxiety

,• insomnia

• constipation

• anorexia

• sexual dysfunction

SDRIs - ANSWER-inhibit DA reuptake (↑alertness, motivation)

-inhibit NE reuptake (↑energy)

-Adverse effects:

• agitation

• headache

• dry mouth

• constipation

• weight loss

TCAs - ANSWER-Action: inhibits the reuptake of serotonin and norepinephrine; blocks
norepinephrine, histamine, and acetylcholine receptors

-Examples: amitriptyline, clomipramine, desipramine, doxepin

-Common Side Effects:

• dry mouth

• constipation

• blurred vision

• urinary retention

• sedation

• weight gain

• hypotension

• tachycardia

• sexual dysfunction

MAOIs - ANSWER-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) - ANSWERmild antihistamine effects

Prescribing pearls: escitalopram (Lexapro) - ANSWERno known drug interactions

Prescribing pearls: fluoxetine (Prozac) - ANSWERlongest half-life

Prescribing pearls: paroxetine (Paxil) - ANSWERalso treats social anxiety and insomnia

Prescribing pearls: fluvoxamine (Luvox) - ANSWERtreats anxious depression smokers require
increased dose

Prescribing pearls: sertraline (Zoloft) - ANSWERalso treats social anxiety and hypersomnolence

Prescribing pearls: bupropion (Wellbutrin) - ANSWERNDRI may improve energy, alertness, and
motivation; not first line treatment for anxiety; contraindicated in clients with a history of seizures

Prescribing pearls: duloxetine (Cymbalta) - ANSWEReffective for atypical pain at higher doses;
appropriate for clients who present with somatic symptoms of depression; effective for atypical pain,
such as fibromyalgia and diabetic neuropathy

Prescribing pearls: venlafaxine (Effexor) - ANSWERtreats both depression and anxiety disorders,
ensure trial of higher dose before switching to a different medication

Prescribing pearls: desvenlafaxine (Pristiq) - ANSWEReffective for perimenopausal vasomotor
symptoms

considered when selecting a medication: - ANSWER-Client preference

-Prior treatment response

-Anticipated adverse effects

-Comorbidities

-Half-life and interactions

-Cost

if a medication is not achieving efficacy: - ANSWER-Increase dose gradually

-Switch to a different drug within the same class

-Switch to drug in a different class

-Add a second medication

Use to protect against suicide - ANSWERlithium

MDD and BPD genetics - ANSWERgenetic factors contribute 31-42% of the disease risk in MDD and
59-85% in BPD

monoamine hypothesis of depression - ANSWER-posits that depression occurs as a result of a
deficiency of one or all three monoamine transmitters

• serotonin, norepinephrine, and dopamine

-while mania may result from an excess

, *Emphasis is now shifted from the monoamines to their receptors and other downstream events
such as the regulation of gene expression, growth factors, environmental factors, and epigenetic
changes

- ANSWERThree principal neurotransmitters

-norepinephrine (NE), dopamine (DA), and serotonin 5HT

• comprise the monoamine neurotransmitter system

• implications for the pathophysiology and treatment of mood disorders

• All known pharmacologic treatments for mood disorders act upon one or more of these three
neurotransmitters

-Many of the symptoms of mood disorders are hypothesized to involve dysfunction of various
combinations of the monoamine neurotransmitters

Mood disorders include ____________________ and ___________________ - ANSWERdepressive
disorders and bipolar disorders

Major depressive disorder (MDD) - ANSWERone of the most prevalent psychiatric disorders

-estimated that more than 300 million people suffer from

-leading cause of disability worldwide

-7.1% of adults and 13.3% of adolescents in the U.S. had at least one major depressive episode

-An imbalance of specific neurotransmitters, including dopamine, serotonin, and norepinephrine, can
influence brain activity and result in depression

-decreased neurotransmitter activity in the prefrontal cortex (PFC)

MDD dx - ANSWER-occurrence of at least one episode of major depression lasting at least two
weeks.

-must experience 5 or more of the following symptoms in two weeks to be diagnosed with a major
depressive episode:

• feeling low most of the day for most days

• decreased interest in activities

• substantial weight loss, significant change in appetite

• fidgeting, random movement (i.e. pacing)

• decreased energy

• sense of guilt or worthlessness

• lack of focus or ability to make decisions

• repeated thoughts of death and suicide

risk factors associated with major depressive disorder (MDD) - ANSWERfemale gender

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