NR 546 FINAL STUDY GUIDE QUESTIONS WITH COMPLETE SOLUTION

NR 546 FINAL STUDY GUIDE QUESTIONS WITH COMPLETE SOLUTION Prefrontal Cortex Symptoms of MDD - CORRECT ANSWERS Concentration Mental Fatigue Mood PFC & Amygdala Symptoms of MDD - CORRECT ANSWERS Guilt Suicidality Worthlessness Striatum Symptoms of MDD - CORRECT ANSWERS Physical fatigue Nucleus Accumbens Symptoms of MDD - CORRECT ANSWERS Pleasure interests Hypothalamus Symptoms of MDD - CORRECT ANSWERS Sleep Appetite Thalamus & Hypothalamus Symptoms of Mania - CORRECT ANSWERS Decreased sleep/arousal Striatum Symptoms of Mania - CORRECT ANSWERS Motor/agitation Prefrontal cortex (PFC) Symptoms of Mania - CORRECT ANSWERS Risk-taking Talkative/pressured speech Nucleus Accumbens & PFC Symptoms of Mania - CORRECT ANSWERS Racing thoughts, grandiosity PFC & Amygdala Symptoms of Mania - CORRECT ANSWERS Mood Medication Management - CORRECT ANSWERS SSRI-Selective Serotonin Reuptake Inhibitors *Inhibit 5 HT reuptake SNRI-Serotonin Norepinephrine Reuptake Inhibitors *inhibit 5-HT reuptake *inhibit NE reuptake (increase energy, focus) *increase DA in prefrontal cortex (increase cognition) NDRI-Norepinephrine Dopamine Reuptake inhibitors *inhibit DA reuptake (increase alertness, motivation) *inhibit NE reuptake (increase energy) SARI-Serotonin Antagonist Reuptake Inhibitors Selective Serotonin Reuptake Inhibitors (SSRIs): Most adverse effects will subside after 4-5 days once the body adjusts to increased serotonin levels. - CORRECT ANSWERS diarrhea headache weight gain sexual side effects Serotonin Norepinephrine Reuptake Inhibitors (SNRIs): Medications should not be abruptly stopped to avoid discontinuation symptoms. NE effects of the medication may increase anxiety in some clients. Report worsening anxiety to the provider. - CORRECT ANSWERS elevated blood pressure anxiety insomnia constipation Norepinephrine Dopamine Reuptake Inhibitors (NDRI): Take medication in the morning. Stop taking medication if seizures occur. Stop taking medication if anxiety is noted. - CORRECT ANSWERS agitation headache dry mouth constipation weight loss escitalopram (Lexapro) SSRI - CORRECT ANSWERS no known drug interactions best tolerated SSRI 27-32 hour half-life good for forgetful prone clients least CYP reactions Substrate for 3A4 citalopram (Celexa) SSRI - CORRECT ANSWERS mild antihistamine effects; Half-Life: 23-45 hours Weak Inhibitor of 2D6 fluoxetine (Prozac) SSRI - CORRECT ANSWERS longest half-life Use caution in patients with comorbid anxiety due to risk for activation and panic attacks Half-Life: 2-3 days parent, 2 week metabolite Inhibits 2D6 and 3A4 paroxetine (Paxil) SSRI - CORRECT ANSWERS also treats social anxiety and insomnia associated with weight gain will experience withdrawal with missed dose or abrupt stop Half-Life: 24 hours Inhibits 2D6 fluvoxamine (Luvox) SSRI - CORRECT ANSWERS treats anxious depression smokers require an increased dose Half-Life: 9-28 hours Inhibits 3A4, 2C9, 1A2