NR546 Final Exam Study Guide for Nursing
Study online at https://quizlet.com/_hisuho
1. What is the monoamine hypothesis of depression?: It theorizes that depression is caused
by a deficiency in monoamine neurotransmission, while mania is due to an excess.
2. What is a key prescribing consideration for antidepressants in bipolar disor-
der?: Antidepressants should not be given as monotherapy; they must be combined with a mood stabilizer to avoid
inducing mania.
3. What should be monitored when prescribing SNRIs to breastfeeding pa-
tients?: Infant irritability.
4. What factors should be considered when prescribing antidepressants?: Client
preference, prior treatment response, anticipated adverse effects, comorbidities, half-life, interactions, and cost.
5. What should be done if the initial antidepressant does not work?: First, increase
the dose; if that fails, switch to a different drug in the same class, then try a drug in a different class, and possibly add
a second medication.
6. What is the recommended dose adjustment for older patients taking citalo-
pram and escitalopram?: They should receive half the usual dose.
7. Which SSRI has the least CYP interactions?: Escitalopram (Lexapro).
8. Which SSRI is considered good for forgetful patients?: Fluoxetine, due to its 2-3 day
half-life.
9. What is the longest-acting antidepressant?: Fluoxetine, with a half-life of 1-2 weeks.
10. What is discontinuation syndrome and which medication is more likely to
cause it?: Discontinuation syndrome occurs when stopping an antidepressant, and paroxetine is more likely to
cause it.
11. Which antidepressant is safe during nursing and pregnancy?: Sertraline.
12. What is serotonin syndrome?: A condition that occurs when two serotonergic drugs are used togeth-
er, leading to symptoms such as mental status changes, autonomic instability, neuromuscular symptoms, seizures, and
gastrointestinal symptoms.
13. What is the treatment for serotonin syndrome?: Stop the medication, provide supportive
care, and use benzodiazepines.
14. What is the black box warning for MAOIs?: They carry a warning for suicidal ideation in
children, adolescents, and young adults.
15. What is the half-life of MAOIs?: 2-4 hours.
16. What is the black box warning for SSRIs?: They carry a warning for suicidal tendencies.
1/9
, NR546 Final Exam Study Guide for Nursing
Study online at https://quizlet.com/_hisuho
17. What are MAOIs and what do they inhibit?: MAOIs (monoamine oxidase inhibitors) are
antidepressants that inhibit the enzyme that deactivates dopamine, norepinephrine, and serotonin.
18. What can happen if MAOIs are taken with tyramine-containing foods?: They can
cause a hypertensive crisis.
19. What can increase lithium levels?: Nonsteroidal anti-inflammatory drugs (NSAIDs) and an-
giotensin-converting enzyme (ACE) inhibitors.
20. What can decrease lithium levels?: Caffeine and mania.
21. What is the role of L-Methylfolate in depression treatment?: It is necessary for the
synthesis of monoamines and is a bioavailable form of folate that enters the brain.
22. What are the recommendations for using paroxetine during pregnancy?: -
Paroxetine is contraindicated due to the risk of congenital defects, including atrial septal defects.
23. What should be monitored when SNRIs are prescribed to breastfeeding
mothers?: Infant irritability.
24. How do older adults respond to antidepressants compared to younger indi-
viduals?: Older adults may not respond as robustly, especially if the first episode of depression occurs after age
65.
25. What is the recommended dosing for citalopram and escitalopram in older
adults?: They should be dosed at half the normal dose due to the risk of QTc prolongation.
26. What does the 2019 American Geriatric Society (AGS) Beers Criteria recom-
mend regarding paroxetine?: Avoid paroxetine in clients with a history of falls/fractures.
27. What is the risk associated with antidepressants in children and young
adults?: Antidepressants increase the risk of death by suicide in children and adults younger than 25.
28. What counseling should be provided to women of childbearing age regard-
ing medications?: Pre-conception and contraceptive counseling, discussing the risk-benefit ratio and selecting
medications not contraindicated in pregnancy.
29. How should Lurasidone (Latuda) be taken for maximum absorption?: It should
be taken with food, at least 350 calories.
30. What is the starting dose adjustment for lithium carbonate in clients with
renal impairment?: The starting dose is reduced by at least 50%.
31. What medications are contraindicated during pregnancy due to teratogenic
effects?: Lithium, valproic acid, and carbamazepine.
2/9
Study online at https://quizlet.com/_hisuho
1. What is the monoamine hypothesis of depression?: It theorizes that depression is caused
by a deficiency in monoamine neurotransmission, while mania is due to an excess.
2. What is a key prescribing consideration for antidepressants in bipolar disor-
der?: Antidepressants should not be given as monotherapy; they must be combined with a mood stabilizer to avoid
inducing mania.
3. What should be monitored when prescribing SNRIs to breastfeeding pa-
tients?: Infant irritability.
4. What factors should be considered when prescribing antidepressants?: Client
preference, prior treatment response, anticipated adverse effects, comorbidities, half-life, interactions, and cost.
5. What should be done if the initial antidepressant does not work?: First, increase
the dose; if that fails, switch to a different drug in the same class, then try a drug in a different class, and possibly add
a second medication.
6. What is the recommended dose adjustment for older patients taking citalo-
pram and escitalopram?: They should receive half the usual dose.
7. Which SSRI has the least CYP interactions?: Escitalopram (Lexapro).
8. Which SSRI is considered good for forgetful patients?: Fluoxetine, due to its 2-3 day
half-life.
9. What is the longest-acting antidepressant?: Fluoxetine, with a half-life of 1-2 weeks.
10. What is discontinuation syndrome and which medication is more likely to
cause it?: Discontinuation syndrome occurs when stopping an antidepressant, and paroxetine is more likely to
cause it.
11. Which antidepressant is safe during nursing and pregnancy?: Sertraline.
12. What is serotonin syndrome?: A condition that occurs when two serotonergic drugs are used togeth-
er, leading to symptoms such as mental status changes, autonomic instability, neuromuscular symptoms, seizures, and
gastrointestinal symptoms.
13. What is the treatment for serotonin syndrome?: Stop the medication, provide supportive
care, and use benzodiazepines.
14. What is the black box warning for MAOIs?: They carry a warning for suicidal ideation in
children, adolescents, and young adults.
15. What is the half-life of MAOIs?: 2-4 hours.
16. What is the black box warning for SSRIs?: They carry a warning for suicidal tendencies.
1/9
, NR546 Final Exam Study Guide for Nursing
Study online at https://quizlet.com/_hisuho
17. What are MAOIs and what do they inhibit?: MAOIs (monoamine oxidase inhibitors) are
antidepressants that inhibit the enzyme that deactivates dopamine, norepinephrine, and serotonin.
18. What can happen if MAOIs are taken with tyramine-containing foods?: They can
cause a hypertensive crisis.
19. What can increase lithium levels?: Nonsteroidal anti-inflammatory drugs (NSAIDs) and an-
giotensin-converting enzyme (ACE) inhibitors.
20. What can decrease lithium levels?: Caffeine and mania.
21. What is the role of L-Methylfolate in depression treatment?: It is necessary for the
synthesis of monoamines and is a bioavailable form of folate that enters the brain.
22. What are the recommendations for using paroxetine during pregnancy?: -
Paroxetine is contraindicated due to the risk of congenital defects, including atrial septal defects.
23. What should be monitored when SNRIs are prescribed to breastfeeding
mothers?: Infant irritability.
24. How do older adults respond to antidepressants compared to younger indi-
viduals?: Older adults may not respond as robustly, especially if the first episode of depression occurs after age
65.
25. What is the recommended dosing for citalopram and escitalopram in older
adults?: They should be dosed at half the normal dose due to the risk of QTc prolongation.
26. What does the 2019 American Geriatric Society (AGS) Beers Criteria recom-
mend regarding paroxetine?: Avoid paroxetine in clients with a history of falls/fractures.
27. What is the risk associated with antidepressants in children and young
adults?: Antidepressants increase the risk of death by suicide in children and adults younger than 25.
28. What counseling should be provided to women of childbearing age regard-
ing medications?: Pre-conception and contraceptive counseling, discussing the risk-benefit ratio and selecting
medications not contraindicated in pregnancy.
29. How should Lurasidone (Latuda) be taken for maximum absorption?: It should
be taken with food, at least 350 calories.
30. What is the starting dose adjustment for lithium carbonate in clients with
renal impairment?: The starting dose is reduced by at least 50%.
31. What medications are contraindicated during pregnancy due to teratogenic
effects?: Lithium, valproic acid, and carbamazepine.
2/9
