NURS
NURS660 PSYCHOPHARM 660 EXAM 1
QUESTIONS WITH CORRECT VERIFIED
SOLUTIONS 100% GUARANTEED PASS
Major neurotransmitters involved in schizophrenia - ANS ✓-Dopamine
-Glutamate
Dopamine and Schizophrenia - ANS ✓Major neurotransmitter in schizophrenia
Some atypical psychotics block dopamine receptors
Increased in schizophrenia
Glutamate and schizophrenia - ANS ✓Considered the "master switch" of the
brain. Glutamate is the major excitatory neurotransmitter of the CNS as it can
turn on nearly all of the CNS neurons
Decreased in schizophrenia
Neuroleptic Malignant Syndrome - ANS ✓-Adverse reaction to antipsychotics
with severe "lead pipe" rigidity, FEVER, and mental status changes
-Lab findings- increased CK, leucocytosis, low serum iron
-Caused by dopamine antagonists
-Slower in onset, 1-2 weeks after starting/changing therapy.
-Manage by stopping causative agent, supportive care, ECT, Dantrolene,
bromocriptine, and amantadine.
Serotonin Syndrome - ANS ✓-Caused by serotonergic agents
-Hyperreflexia, myoclonus, ocular clonus
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-Manage by stopping all serotonergic agents, supportive care aimed at
normalization of vitals, sedation with benzos, administration of serotonergic
antagonists, and antidote therapy with cyproheptadine
-Assess need to resume use of causative serotonergic meds after resolution of
symptoms
-Symptoms seen within 24 hours of starting/changing therapy.
The "-pine" family - ANS ✓Have 5-HT2A and D2 antagonism.
Strong potency for H1 and muscarinic receptors
Clozapine, Olanzapine, Quetiapine,
Clozapine - ANS ✓Atypical Antipsychotic
SE: AGRANULOCYTOSIS- ANC blood testing prior, during. Can be very sedating,
excessive salivation, Increased risk of myocarditis, Greatest degree of weight gain
and possibly greatest cardiometabolic risk
Indications- treatment resistant schizophrenia, reducing suicidal behaviour
Drug interactions with Clozapine - ANS ✓Potential to increase levels: SSRIS,
cipro, cimetidine, macrolides, caffeine
Potential to decrease levels: Carbamazepine, rifampicin, SJW, Omeprazole,
Phenytoin, Phenobarbital
Olanzapine (Zyprexa) - ANS ✓*class*: Antipsychotic, mood stabilizers
*Indication*: schizophrenia, mania, depression, anorexia nervosa,
*Action*: Strongest of the pines at the H1 and 5HT2a receptors
SE: Obesity, dyslipidaemia, insulin resistance
Baseline labs: BMI, fasting glucose, lipid panel
Drug interactions with Olanzapine - ANS ✓Contraindicated to use IM
Olanzapine with IM benzos- increases likelihood of respiratory depression and
excessive sedation.
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