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NR546 psychopharmacology Final exam questions with complete solution . £7.16   Add to cart

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NR546 psychopharmacology Final exam questions with complete solution .

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NR546 psychopharmacology Final exam questions with complete solution .

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  • May 25, 2024
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  • 2023/2024
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NR546 psychopharmacology Final exam
questions with complete solution



monoamine hypothesis of depression
depression occurs as a result of deficiency of 1 or all 3 monoamine NT
-occurs due to too little positive affect or too much negative affect

(mania will occur from excess of all 3)


what are the three monoamine NT
NE, DA, 5HT


too little positive affect
-DA/NE dysfunction

-DA levels low = loss of pleasure, interest, alertness, self-confidence

-DA levels high = hallucinations seen in schizo

-NE (fight or flight) high = antsy, nervous, affects focus ability

-depressed mood, loss of joy, lack of interest, loss of energy, decreased
alertness, decreased self-confidence, appetite changes




too much negative affect
-5HT = relaxation, comfort, decreases stress, regulates libido, arousal, sleep,
aggression, pain perception
-5HT/NE dysfunction

,-depressed mood, guilt, fear/anxiety, hostility, irritability, loneliness, appetite
changes


prescribing considerations
-client preference
-prior treatment response
-anticipated adverse effects
-comorbidities
-half-life interactions
-cost


client preference
if no contraindication, then prescribe that med to improve adherence


prior treatment response
if patient had success with a previous med, prescribe that one first


anticipated adverse events
-consider age, family planning, and anticipated adverse effects.
-use adverse effects to pt's advantage (choose a known activating medication for
a pt with atypical depression or choose a sedating medication for a patient with
sleep disturbances)


Comorbidities
clients with comorbid anxiety may experience worsening symptoms when taking
medications that target NE (SNRIs)
-fluoxetine is known to activate clients and cause panic attacks in clients with
comorbid anxiety


half-life interactions

,-choose a medication with a longer half life to avoid discontinuation syndrome if
your client forgets to take it
-many antidepressants have significant interactions with other meds due to
CYP450 enzyme involvement


cost
if client cant afford medication, they will not benefit. keep cost, insurance
benefits, and pharmaceutical assistance programs in mind


goal of antidepressant medications
complete remission of symptoms


antidepressant prescribing schedule
-start on a single drug for 4-8 weeks
-if not working:
1. increase dose gradually until efficacy occurs
2. switch to different drug within same drug class after adequate trial which
included higher dosing and a minimum of 8 weeks
3. switch to a drug in a different class after adequate trial and higher dosing
4. add a second med as adjunct


SSRI MOA
inhibit 5HT reuptake
first line of treatment for depression


SSRI s/e
7 S's of SSRIs
1. Stomach
2. sexual dysfunction
3. serotonin syndrome
4. sleep difficulties
5. suicidal thoughts

, 6. stress
7. size (weight)


serotonin s/e
head, red, fed
head = decreased anxiety, impulsivity, sex drive
red = platelets and bleeding
fed = gi motility and nausea


SSRI pt education
most adverse affects will subside after 4-5 days once body adjusts to increased
serotonin levels


SSRI drugs
citalopram
fluoxetine
paroxetine
sertraline
fluvoxamine
bupropion


citalopram
*has a mild antihistamine effect

*causes QT prolongation

citalopram = celexa, think of cel LEXUS (car) = car - get an electrocardiogram if
on this drug




escitalopram
*no known drug interactions, used with polypharmacy

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