Nurs 660 Exam 1 With Correct
Verified and Well Analyzed Answers
Graded A+
Mesolimbic region symptoms Positive symptoms
mesocortical/prefrontal cortex
symptoms Negative symptoms
nucleus accumbens symptoms
reward and addiction Negative
symptoms dorsolateral prefrontal
cortex symptoms in schizophrenia,
hypoactive resulting in cognitive
symptoms
planning ahead and controlling impulses
Amygdala function A limbic
system memory and emotion fear
and aggression. ventromedial
prefrontal cortex function
Affective symptoms
controlling emotional responses from the amygdala decision-
making orbitofrontal cortex function
prefrontal cortex
impulse control
List the positive symptoms of schizophrenia
hallucinations, and delusions
disorganized thoughts,
distortions and exaggerations in language and
communication disorganized speech and behavior
catatonic behavior
List the negative symptoms of schizophrenia
5A
,Affective
Alogia-poverty of speech
Asociality
Apathy
Anhedonia-decreased social drive
less than normal behavior or an
absence Aripiprazole MOA partial
agonism of D2 and some
antagonism for 5HT1A receptors
Aripiprazole on positive
symptoms
reduces dopamine output when
concentrations are high Aripiprazole on
negative symptoms increases dopamine
output when concentrations low
Common length of time for efficacy of antipsychotic
medication? Symptom improvement 1 week. 4-6 week
to determine efficacy
rare 16-20 weeks
Best drugs to augment aripiprazole when partial response or
treatment resistance Valproic acid (valproate, divalproex)
Other mood stabilizing anticonvulsants (carbamazepine,
oxcarbazepine, lamotrigine) Lithium
Benzodiazepines
Best augmenting agent to reduce side effects of aripiprazole
Benzodiazepines
Trihexyphenidyl -akathisia
Aripiprazole metabolism
CYP2D6 and CYP3A4
Risk of Carbamazepine with aripiprazole
CYP3A4 inducer, decrease plasma levels
Monitoring for aripiprazole
Weight
Hx & Fam hx-diabetes, obesity, dyslipidemia, hypertension,
cardiovascular disease
Waist circumference, BP, FBS, fasting lipid profile, WBC-hx
low WBC counts BMI monthly x 3 mo., then quarterly Why
, less EPS risk with Aripiprazole? Partial agonist in striatum-
Less EPS, N/V akathisia, weight loss when switched to
Adverse response of alpha 1 adrenergic receptor in
aripiprazole dizziness, sedation, hypotension Drug
interactions with aripiprazole Ketoconazole enhance
hypertensives Aripiprazole warning
impulsivity
Clozapine use
treatment-resistant schizophrenia
associated w/ suicidality Clozapine
monitoring parameters ANC >1500 u/L
BEN - ANC >1000 u/L
Purpose of ANC monitoring with Clozapine treatment
agranulocytosis
What niche symptoms does Clozapine treat?
aggression and violence
What is the first atypical antipsychotic?
Clozapine
What is an awakening after starting Clozapine
Response of a return to near normal along with improvement of
positive symptoms
Hope for cure
What antipsychotic has been proven to reduce the risk of suicide?
Clozapine
Clozapine induced myocarditis-causes &
monitoring hypersensitivity reaction occurs
in first 4 weeks
Troponin and C-reactive protein at initiation and weekly for first 4
weeks
What antipsychotic has the greatest risk of life threatening
complications?
Clozapine
Clozapine side effects
Side effects: NEUROLEPTIC MALIGNANT SYNDROME, sedation,
salivation, dizzy, H/A, tremors, sleep problems, akinesia, fever,
seizures, confusion, insomnia, slurred speech, dystonia, tachycardia,
hypo/hypertension, blurred vision, drooling, constipation, Abd pain,
Verified and Well Analyzed Answers
Graded A+
Mesolimbic region symptoms Positive symptoms
mesocortical/prefrontal cortex
symptoms Negative symptoms
nucleus accumbens symptoms
reward and addiction Negative
symptoms dorsolateral prefrontal
cortex symptoms in schizophrenia,
hypoactive resulting in cognitive
symptoms
planning ahead and controlling impulses
Amygdala function A limbic
system memory and emotion fear
and aggression. ventromedial
prefrontal cortex function
Affective symptoms
controlling emotional responses from the amygdala decision-
making orbitofrontal cortex function
prefrontal cortex
impulse control
List the positive symptoms of schizophrenia
hallucinations, and delusions
disorganized thoughts,
distortions and exaggerations in language and
communication disorganized speech and behavior
catatonic behavior
List the negative symptoms of schizophrenia
5A
,Affective
Alogia-poverty of speech
Asociality
Apathy
Anhedonia-decreased social drive
less than normal behavior or an
absence Aripiprazole MOA partial
agonism of D2 and some
antagonism for 5HT1A receptors
Aripiprazole on positive
symptoms
reduces dopamine output when
concentrations are high Aripiprazole on
negative symptoms increases dopamine
output when concentrations low
Common length of time for efficacy of antipsychotic
medication? Symptom improvement 1 week. 4-6 week
to determine efficacy
rare 16-20 weeks
Best drugs to augment aripiprazole when partial response or
treatment resistance Valproic acid (valproate, divalproex)
Other mood stabilizing anticonvulsants (carbamazepine,
oxcarbazepine, lamotrigine) Lithium
Benzodiazepines
Best augmenting agent to reduce side effects of aripiprazole
Benzodiazepines
Trihexyphenidyl -akathisia
Aripiprazole metabolism
CYP2D6 and CYP3A4
Risk of Carbamazepine with aripiprazole
CYP3A4 inducer, decrease plasma levels
Monitoring for aripiprazole
Weight
Hx & Fam hx-diabetes, obesity, dyslipidemia, hypertension,
cardiovascular disease
Waist circumference, BP, FBS, fasting lipid profile, WBC-hx
low WBC counts BMI monthly x 3 mo., then quarterly Why
, less EPS risk with Aripiprazole? Partial agonist in striatum-
Less EPS, N/V akathisia, weight loss when switched to
Adverse response of alpha 1 adrenergic receptor in
aripiprazole dizziness, sedation, hypotension Drug
interactions with aripiprazole Ketoconazole enhance
hypertensives Aripiprazole warning
impulsivity
Clozapine use
treatment-resistant schizophrenia
associated w/ suicidality Clozapine
monitoring parameters ANC >1500 u/L
BEN - ANC >1000 u/L
Purpose of ANC monitoring with Clozapine treatment
agranulocytosis
What niche symptoms does Clozapine treat?
aggression and violence
What is the first atypical antipsychotic?
Clozapine
What is an awakening after starting Clozapine
Response of a return to near normal along with improvement of
positive symptoms
Hope for cure
What antipsychotic has been proven to reduce the risk of suicide?
Clozapine
Clozapine induced myocarditis-causes &
monitoring hypersensitivity reaction occurs
in first 4 weeks
Troponin and C-reactive protein at initiation and weekly for first 4
weeks
What antipsychotic has the greatest risk of life threatening
complications?
Clozapine
Clozapine side effects
Side effects: NEUROLEPTIC MALIGNANT SYNDROME, sedation,
salivation, dizzy, H/A, tremors, sleep problems, akinesia, fever,
seizures, confusion, insomnia, slurred speech, dystonia, tachycardia,
hypo/hypertension, blurred vision, drooling, constipation, Abd pain,
