Nr546 Week 5 /Nr 546
Week 5 Test Your
Knowledge Exam 2024
5HT, NE Dysfunction causes what mood related symptoms - ✔✔✔ANSWER-
Increased negative affect:
depressed mood
guilt
fear/anxiety
hostility
irritability
loneliness
appetite changes
,90% of serotonin receptors are in the __________ and _________ are within the
brain - ✔✔✔ANSWER-GI tract, only 10%
*which causes GI side effects
Acute agitation in mania may be treated with: - ✔✔✔ANSWER-rapid-acting oral,
inhaled, or IM antimanic agents
Adjunct treatment for depression - ✔✔✔ANSWER-Antipsychotic medications are
sometimes prescribed at low doses as adjunctive medications for severe depression
Antidepressants are used cautiously in clients with bipolar disorder and never as
________________. - ✔✔✔ANSWER-monotherapy
-Antidepressants should be combined with a mood stabilizer to prevent the onset of
a hypomanic or manic episode
Antidepressants Important Prescribing Considerations: Black Box Warning -
✔✔✔ANSWER-Suicide Risk with Antidepressant Drugs
-Clients with depression may consider or attempt suicide
-risk for suicide may increase at the start of treatment
,-Antidepressant-induced suicide is more prevalent in children, adolescents, and
adults younger than 25 years.
Antidepressants Important Prescribing Considerations: Drug-Drug Interactions -
✔✔✔ANSWER-Most antidepressant medications have serious drug-drug
interactions. Carefully review the client's history and current prescriptions before
selecting a medication.
Antidepressants Important Prescribing Considerations: Serotonin Syndrome -
✔✔✔ANSWER-potentially life-threatening condition reported with the use of
serotonergic antidepressants
-especially when they are used concomitantly with other serotonergic drugs (such
as triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan,
buspirone, and St. John's Wort), and with drugs that impair serotonin metabolism
(particularly MAOIs)
If such symptoms occur, clients should discontinue serotonergic agents and initiate
treatment of symptoms.
Clients should be educated about the signs and symptoms of serotonin syndrome
and monitored
, -particularly during treatment initiation and dose increases.
Antidepressants Lifespan Considerations: Breastfeeding - ✔✔✔ANSWER-Infant
irritability should be monitored when SNRIs are prescribed.
Antidepressants Lifespan Considerations: Children - ✔✔✔ANSWER-
Antidepressants increase the risk of death by suicide in children and adults younger
than 25.
Antidepressants Lifespan Considerations: Older Adult - ✔✔✔ANSWER--Older
adults may not respond to antidepressants as robustly as younger people if the first
episode of depression occurs after age 65.
-Citalopram and escitalopram should be dosed at 1/2 dose due to the risk of QTc
prolongation.
-2019 American Geriatric Society (AGS) Beers Criteria include the following
recommendations:
• Avoid paroxetine in clients with a history of falls/fractures.
• Avoid tricyclic antidepressants prescribed with other central nervous system
(CNS) depressants.
Antidepressants Lifespan Considerations: Pregnancy - ✔✔✔ANSWER-Paroxetine
is contraindicated in pregnancy due to the risk of congenital defects, including
atrial septal defects.
Antidepressants: Discontinuing Medications - ✔✔✔ANSWER-Don't suddenly
stop or omit doses due to risk of discontinuation syndrome
-Paroxetine highest risk due to serotonin transporter inhibition and anticholinergic
rebound
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