NURS 663 Exam 1 (Answered) Complete
Verified Solution 2023/2024
Bipolar one disorder DSM five criteria
Manic episode: 1+ week of a colon elevated, expansive or irritable mood and increase
energy. 3+ symptoms from B: distractibility, indiscretion, irresponsible, grandiosity, flight
of ideas, activity(Increase goal-orient), decreased need for sleep, talkativeness or
pressured speech.
Bipolar two DSM five criteria
Hypo mania and major depressive disorder: hypo mania same as mania with decreased
severity and duration and no functional impairment for episode of four or more days and
no psychosis
Mixed episodes (bipolar)
Manic and depressive symptoms time by side usually with comorbid substance abuse
increased risk of suicide and psychosis
rapid cycling
Four or more cycles per year no greater than a week well period
Cyclothymia DSM-V Criteria
Two or more years of mood cycling with dysthymia and hypo mania decreased intensity
than bipolar disorder meets criteria for hypo mania but does not meet criteria for major
depressive disorder
Dysthymia DSM five criteria
HE'S 2 SAD depressive symptoms lasting two or more years that is subsydromal
characterized by hopelessness decreased energy, decrease self-esteem for two years,
abnormal sleep, abnormal appetite impaired decision-making.
MAOÍ Mechanism of action generally
Catalyzes the deamination of monoamines intracellularly and MAO transport Reuptake
extracellular monoamines
MAO-A Mechanism of action
MAO-A Oxidizes serotonin norepinephrine and epinephrine
MAO-B Mechanism of action
Oxidizes phenylalanine
MAO-A and MAO-B mechanism of action
Oxidizes dopamine non-preferentially
MAOs Neumonic -2
Date with Tyra banks with wine and cheese in Maui— can cause hypertensive crisis
related to tyramine from aged food.
MAWIs= my arms weight increased= effective for atypical depression
MAOs adverse effects-6
Hypertensive crisis, diet restriction, avoid meds, five week after Prozac, two week after
other antidepressants, no other medications for two weeks after discontinuing
MAOs diet restriction-4 compounds
Tyrosine, high tyramine, tryptophan, phenylalanine
, Tyrosine foods-10
Aged cheese, aged wine, fava or broad bean pods, sauerkraut, soy sauce, tap or draft
beer, overripe fruit, cured meat, spoiled food
MAOs drugs to avoid- 6
Antidepressants, Dextromethorphan, stimulants, sympathomimetics, meperidine,
disulfiram
MAOs side effects 11
Increased weight, drowsy, dizzy, orthostatic hypotension, tremor, headache, dry mouth,
constipation, change in sexual drive, peripheral Edema, sweating
Tricyclic mechanism of action
Inhibit 5HT2, norepinephrine, dopamine and reuptake slows. Amino group interferes
with ASP - 98 in HSERT. Causing down regulation of receptors.
Tricyclic side effects
Anticholinergic effects (dry mouth, blurred vision, constipation, urine retention,
impotence). Histamine effects (sedation, increased weight). Adrenergic alpha receptor
(postural hypotension). Direct membrane effects (decrease seizure threshold and
arrhythmias). 5HT2 receptor (increase weight and decrease anxiety).
Amitriptyline dosing/Class
Start at 25 to 50 mg per day, titrate 25 to 50 mg per day per week, Max dose is 300 mg
per day/TCA
Names of tricyclics 10
Amitriptyline, nortriptyline, clomipramine, imipramine, protriptyline, doxepin, amoxapine,
desipramine, mapratiline, tripramine
Tricyclics are useful-2
Pain, migraine
Tricyclics adverse effects-2
Overdoses are cardiotoxic, high potency increases the risk of mania
Nortriptyline mnemonic
No-triptyline equals less sedation and hypotension
Tricyclics mnemonic-2
Think car goes over tricycle to remember that an overdose is cardiotoxic. Do you
remember mechanism think trans =serotonin and norepinephrine Chans= Na+ and Ca+
Ans= ACH and histamine
Clomipramine mnemonic/class
TCA- think comipramine for obsessive compulsive disorder
Imipramine- pneumonic and class
I'm peeingamine- nocturnal enuresis
Unilateral electrode in ECT indications
Typically first line because it has less cognitive side effects but has less efficacy
What is ECT?
The use of electrical shock current delivered to the brain to induce a seizure that treats
depression. Goal is to reverse atrophy.
ECT is FDA approved for what
Bipolar disorder, schizophrenia, schizoaffective disorder, catatonia, neuroleptic
malignant syndrome, treatment resistant refractory major depressive disorder
What is ECT schedule
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