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NR547 Final Exam Practice Questions and Answers (100% Pass)
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©PREP4EXAMS@2024 [REAL EXAM DUMPS] Tuesday, July 23, 2024 10:52 AMNR547 Final Exam Practice Questions and Answers (100% Pass)
Medications for depression - ✔️✔️SSRIs
SNRIs
SDRIs
TCAs
MAOIs
SSRIs - ✔️✔️-Action: inhibit 5-HT reuptake
-Examples: citalopram, escitalopram, fluoxetine, paroxetine, sertraline
-Adverse effects:
• nausea
• agitation
• diarrhea
• headache
• weight gain
• sexual side effects
SNRIs - ✔️✔️-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
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,©PREP4EXAMS@2024 [REAL EXAM DUMPS] Tuesday, July 23, 2024 10:52 AM
• sexual dysfunction
SDRIs - ✔️✔️-inhibit DA reuptake (↑alertness, motivation)
-inhibit NE reuptake (↑energy)
-Adverse effects:
• agitation
• headache
• dry mouth
• constipation
• weight loss
TCAs - ✔️✔️-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 - ✔️✔️-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) - ✔️✔️mild antihistamine effects
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,©PREP4EXAMS@2024 [REAL EXAM DUMPS] Tuesday, July 23, 2024 10:52 AM
Prescribing pearls: escitalopram (Lexapro) - ✔️✔️no known drug interactions
Prescribing pearls: fluoxetine (Prozac) - ✔️✔️longest half-life
Prescribing pearls: paroxetine (Paxil) - ✔️✔️also treats social anxiety and insomnia
Prescribing pearls: fluvoxamine (Luvox) - ✔️✔️treats anxious depression smokers require
increased dose
Prescribing pearls: sertraline (Zoloft) - ✔️✔️also treats social anxiety and hypersomnolence
Prescribing pearls: bupropion (Wellbutrin) - ✔️✔️NDRI may improve energy, alertness, and
motivation; not first line treatment for anxiety; contraindicated in clients with a history of
seizures
Prescribing pearls: duloxetine (Cymbalta) - ✔️✔️effective 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) - ✔️✔️treats both depression and anxiety disorders,
ensure trial of higher dose before switching to a different medication
Prescribing pearls: desvenlafaxine (Pristiq) - ✔️✔️effective for perimenopausal vasomotor
symptoms
considered when selecting a medication: - ✔️✔️-Client preference
-Prior treatment response
-Anticipated adverse effects
-Comorbidities
-Half-life and interactions
-Cost
if a medication is not achieving efficacy: - ✔️✔️-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 - ✔️✔️lithium
MDD and BPD genetics - ✔️✔️genetic factors contribute 31-42% of the disease risk in MDD and
59-85% in BPD
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, ©PREP4EXAMS@2024 [REAL EXAM DUMPS] Tuesday, July 23, 2024 10:52 AM
monoamine hypothesis of depression - ✔️✔️-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
- ✔️✔️Three 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 ___________________ - ✔️✔️depressive
disorders and bipolar disorders
Major depressive disorder (MDD) - ✔️✔️one 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 - ✔️✔️-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
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