CMN 548 Unit 5 Latest Exam Questions and Correct Answers (All are Correct)
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Course
CMN 548
Institution
CMN 548
CMN 548 Unit 5 Latest Exam Questions and Correct Answers (All are Correct)
When is the CBC indicated for a pt being treated with DRA? - Answer- if a pt reports a sore throat, fever, a CBC should be done immediately to check for serious blood dyscrasia
What are the s/s of peripheral anticholin...
CMN 548 Unit 5 Latest Exam Questions
and Correct Answers (All are Correct)
When is the CBC indicated for a pt being treated with DRA? - Answer- if a pt reports a
sore throat, fever, a CBC should be done immediately to check for serious blood
dyscrasia
What are the s/s of peripheral anticholinergic effects r/t LOW potency DRA use? -
Answer- Peripheral anticholinergic effects:
-dry mouth and nose
-blurred vision
-constipation (severe constipation can progress to paralytic ileus)
-urinary retention
-mydriasis
-some may have N/V
-weight gain
Due to increased prolactin levels caused by D2 blockade, what physical signs can be
seen in both men and women? - Answer- Breast enlargement
galactorrhea
amenorrhea
and inhibited orgasm in women and impotence in men
List severe symptoms of OD of DRAs? - Answer- Delirium
coma
respiratory depression
and seizures
What are the contraindications for using DRAs? - Answer- Hx of serious allergic
reaction
-possible ingestion of a substance that will interact with the antipsychotic to induce CNS
depression or anticholinergic delirium (ex. scopolamine and possibly phencyclidine
<PCP>)
-The presence of a severe cardiac abnormality
-High risk of seizures
-The presence of narrow-angle glaucoma or prostatic hypertrophy if a drug with high
anticholinergic activity is to be used
-The presence or hx of tardive dyskinesia
,Describe tx resistance in pts with psychotic d/o? What is recommended for these pts? -
Answer- -10-35% of persons with schizophrenia don't obtain significant benefit from
antipsychotic drugs
-tx resistance is a failure on at least TWO adequate trials of antipsychotics from TWO
pharmacological classes
-Useful to get plasma concentration b/c it is possible that they are slow or rapid
metabolizers, or are not taking their meds
-Clozapine is a recommended as it has been conclusively shown to be effective when
given to pts who have failed multiple trials of DRAs.
Second generation antipsychotics (SGA) action? - Answer- Atypical or SGAs is
reserved for antipsychotics that REDUCE + symptoms of schizophrenia just as well as
FGAs, but cause less SE.. Atypical antipsychotics have significant effects on both
dopamine and serotonin.
What are the FDA recommendations for monitoring pts who are prescribed SGAs? -
Answer- -personal family hx of obesity, diabetes, dyslipidemia, HTN, and cardiovascular
disease
-weight & height
-waist circumference (@ the level of the umbilicus)
-BP
-Fasting plasma glucose level
-fasting lipid profile
*pts with preexisting diabetes should have regular monitoring, including hemoglobin
A1C (HGA1c) and in some cases insulin levels
Which 2 SGAs responsible for the most cases of weight gain and the development of
diabetes? - Answer- Olanzapine and Clozapine
What are the therapeutic indications for the use of SGAs? - Answer- All SGAs are
indicated for tx of schizophrenia. Most SGAs have also received approval as
monotherapy or adjunctive therapy in the tx of bipolar d/o. Some have also been
approved as adjuncts of major depression.
What is the black box warning for SDAs regarding use in elderly dementia patients? -
Answer- elderly persons with dementia-related psychosis are at increased risk (1.6-1.7
times) of death compared with placebo
What are the benefits of tx with SDAs compared to DRAs for pts with schizophrenia or
schizoaffective d/o? - Answer- persons treated with SDAs have fewer relapses and
require less frequent hospitalization, fewer ED visits, less phone contact with mental
health professionals, and less tx and day programs
Review the SDAs that are approved for the tx of acute mania, bipolar d/o (monotherapy
or adjunctive), and acute tx resistant depression? - Answer- All of the SDAs (except
clozapine) are FDA approved for the tx of acute mania
, -some of the agents, including aripiprazole, olanzapine, quetiapine, and quetiapine XR
are also approved for the maintenance tx in BIPOLAR D/O as monotherapy or
adjunctive therapy.
-Olanzapine in combo with fluoxetine has been approved for tx resistant depression,
and aripiprazole and quetiapine XR are indicated for adjunctive therapy to
antidepressants in MDD.
-Quetiapine and Quetiapine XR are also approved for bipolar depression. A fixed combo
of olanzapine and fluoxetine is approved for tx of acute bipolar depression
Review off label uses for SDAs? - Answer- Aggression or violence in pts with
schizophrenia, AIDS, dementia, autistic spectrum d/o, tourette's d/o, huntingtons
disease, lesch-nyhan syndrome, ADHD comorbid with ODD or conduct d/o when co-
administered with sympathomimetics, severe tardive dyskinesia, psychotic depression,
andfor psychosis secondary to head trauma, dementia or tx drugs
Potency - Answer- refers to the relative dose required to achieve certain effects, not to
the efficacy of a drug
Agonist (full agonist) - Answer- A drug that binds to a specific receptor producing an
effect identical to that usually produced by the neurotransmitter affecting that receptor
Pharmacodynamics - Answer- The time course and intensity of a drug's effect/what the
drug does to the body
Pharmacokinetics - Answer- What the body does to a drug
Tolerance - Answer- Develops over time a need to use increased doses of a
medication/drug to maintain a clinical effect. Or, a decreased sensitivity to adverse
effects of a drug
Stevens-Johnson Syndrome - Answer- A systemic, immune-mediated reaction that can
be fatal or result in permanent scarring or blindness
Antagonist - Answer- A compound that blinds to a receptor that blocks or reduces the
action of another substance at the receptor site
Hyponatremia - Answer- Common symptoms of this medication side effect include
confusion, agitation, and lethargy. (tx with oxcarbazepine & SSRIs)
Therapeutic index - Answer- ratio of the median toxic dose to the median effective dose
Somnolence - Answer- Daytime sleepiness
Black Box Warning - Answer- This warning reflects that a medication may cause a
serious or even life-threatening side effect
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