NR668 Week 4 Psychopharmacology
(Latest ) Psychiatric-Mental
Health Capstone Practicum & Intensive
Questions and Answers 100% Correct
{Grade A}
A patient who is in renal failure would have a increased or decreased Vd? - correct
answer Increased because of fluid retention
Plasma protein binding - correct answer -cannot leave the circulation easily
-Free (unbound) crosses membranes
-Two drugs that are both highly protein bound will compete with each other
• The unbound fraction goes through metabolism and is responsible for the
pharmacologic effects
-rapid weight loss may result in drugs being released from fat cells
Drugs that are highly protein bound and have a narrow therapeutic index can be
dangerous because: - correct answer margin of error between therapeutic and toxic is
narrow
,Metabolism - correct answer -Mostly in the liver
-Biotransformation or change it to inactive form or make it more water soluble to
facilitate excretion
• transformed substance is called the metabolite.
The rate of metabolism is affected by: - correct answer -age, liver & drug tolerance
• Body may produce more enzymes & the liver becomes faster at breaking that
particular drug down
Half life - correct answer this is the time it takes the peak level to fall by ½
Steady state of a drug: - correct answer -When the rate of drug administration &
elimination are equal
-can be achieved in 4 - 5 half lives
Phase I reactions: - correct answer Transforms drug, CYP450 Oxidases. Make it
available for the body to use
,Phase II reactions: - correct answer Conjugation reactions or attach drug with
something. End products tend to be less active than their substrates
Excretion: - correct answer -Kidneys are the main excretory gland.
-Other modes include feces, bile, respiration, milk, perspiration and tears
Glomerular Filtration: - correct answer Removes drugs or metabolites not bound to
proteins present in the blood plasma.
-Metabolite excreted in the urine
Duloxetine - correct answer -On label for MDD, GAD, Fibromyalgia, Diabetic peripheral
neuropathic pain, Chronic musculoskeletal pain
-Metabolism via CYP1A2, CYP2D6
Antidepressant medications: TCA's - correct answer -Class side effects: • Dry mouth,
urinary retention, cognitive impairment, weight gain, LETHAL IN OVERDOSE,
, arrhythmias, hyperthermia, sedation, suicidality especially amongst adolescents and
young adults
-Mechanism of action (MOA):
• Blocking the Serotonin & Norepinephrine reuptake, in addition to blocking muscarinic,
Alpha 1 adrenergic & histamine receptors (explaining side effect profile)
-Examples:
• Amitriptyline
• Doxepin
• Nortriptyline
• Clomipramine
Antidepressant medications: MAOI's - correct answer -additional to the US boxed
warning regarding suicidality, the MAOI's have distinct concerns r/t DIETARY
RESTRICTIONS & drug-drug interactions
-Mechanism of Action (MOA):
(Latest ) Psychiatric-Mental
Health Capstone Practicum & Intensive
Questions and Answers 100% Correct
{Grade A}
A patient who is in renal failure would have a increased or decreased Vd? - correct
answer Increased because of fluid retention
Plasma protein binding - correct answer -cannot leave the circulation easily
-Free (unbound) crosses membranes
-Two drugs that are both highly protein bound will compete with each other
• The unbound fraction goes through metabolism and is responsible for the
pharmacologic effects
-rapid weight loss may result in drugs being released from fat cells
Drugs that are highly protein bound and have a narrow therapeutic index can be
dangerous because: - correct answer margin of error between therapeutic and toxic is
narrow
,Metabolism - correct answer -Mostly in the liver
-Biotransformation or change it to inactive form or make it more water soluble to
facilitate excretion
• transformed substance is called the metabolite.
The rate of metabolism is affected by: - correct answer -age, liver & drug tolerance
• Body may produce more enzymes & the liver becomes faster at breaking that
particular drug down
Half life - correct answer this is the time it takes the peak level to fall by ½
Steady state of a drug: - correct answer -When the rate of drug administration &
elimination are equal
-can be achieved in 4 - 5 half lives
Phase I reactions: - correct answer Transforms drug, CYP450 Oxidases. Make it
available for the body to use
,Phase II reactions: - correct answer Conjugation reactions or attach drug with
something. End products tend to be less active than their substrates
Excretion: - correct answer -Kidneys are the main excretory gland.
-Other modes include feces, bile, respiration, milk, perspiration and tears
Glomerular Filtration: - correct answer Removes drugs or metabolites not bound to
proteins present in the blood plasma.
-Metabolite excreted in the urine
Duloxetine - correct answer -On label for MDD, GAD, Fibromyalgia, Diabetic peripheral
neuropathic pain, Chronic musculoskeletal pain
-Metabolism via CYP1A2, CYP2D6
Antidepressant medications: TCA's - correct answer -Class side effects: • Dry mouth,
urinary retention, cognitive impairment, weight gain, LETHAL IN OVERDOSE,
, arrhythmias, hyperthermia, sedation, suicidality especially amongst adolescents and
young adults
-Mechanism of action (MOA):
• Blocking the Serotonin & Norepinephrine reuptake, in addition to blocking muscarinic,
Alpha 1 adrenergic & histamine receptors (explaining side effect profile)
-Examples:
• Amitriptyline
• Doxepin
• Nortriptyline
• Clomipramine
Antidepressant medications: MAOI's - correct answer -additional to the US boxed
warning regarding suicidality, the MAOI's have distinct concerns r/t DIETARY
RESTRICTIONS & drug-drug interactions
-Mechanism of Action (MOA):
