MSN 621 FINAL EXAM 3 2026 COMPLETE
ANSWERS PATIENT CARE MANAGEMENT
PRACTICE RESOURCE
◉ How can antipsychotics cause breast discharge.
Answer: · By blocking the tuberoinfundibular pathway (projects
from hypothalamus to pituitary gland), which is normally tonically
active and inhibits prolactin release
· This blockade causes a rise in prolactin--> galactorrhea
◉ Metabolic monitoring/labs for antipsychotics.
Answer: · Weight/BMI
· Fasting triglycerides
· Fasting glucose
· BP
Liver fnt
◉ Treatments approved for bipolar depression.
Answer: · Lamotrigine- approved to prevent recurrence of
depression, not treatment
· Quetiapine
· Lurasidone
,· Olanzapine + fluoxetine
· Cariprazine
◉ Approved augmenting agents for SSRIs/SNRIs in unipolar
depression.
Answer: · Buproprion
o Olanzapine-fluoxetine
o Quetiapine
o Aripiprazole
o Brexpiprazole
o Ketamine
o Lithium
o Buspirone
o Mirtazapine
◉ Buproprion as augmenting agent for unipolar depression.
Answer: · weak NET and DAT inhib, decreases sexual dysfunction
and improves the symptoms associated with "reduced positive
affect" (loss of happiness, joy, interest, pleasure, energy etc.)
◉ Olanzapine as augmenting agent for unipolar depression.
Answer: Olanzapine-fluoxetine: olanzapine as a D2/5HT2A/5HT2C
antagonists--> actions most likely due to SERT/5HT2C antagonism
, Weight gain/metabolic disturbances SE
◉ Quetiapine as augmenting agent for unipolar depression.
Answer: 5HT2C/NET/5HT1A antagonism actions
Sedation, weight gain, and metabolic disturbances SE
◉ Aripiprazole as augmenting agent for unipolar depression.
Answer: D2/5HT1A partial agonist
Akathisia SE
◉ Brexpiprazole as augmenting agent for unipolar depression.
Answer: D2/5HT1A partial agonist
Decreased akathisia risk
◉ Ketamine as augmenting agent for unipolar depression.
Answer: NMDA antagonist
ANSWERS PATIENT CARE MANAGEMENT
PRACTICE RESOURCE
◉ How can antipsychotics cause breast discharge.
Answer: · By blocking the tuberoinfundibular pathway (projects
from hypothalamus to pituitary gland), which is normally tonically
active and inhibits prolactin release
· This blockade causes a rise in prolactin--> galactorrhea
◉ Metabolic monitoring/labs for antipsychotics.
Answer: · Weight/BMI
· Fasting triglycerides
· Fasting glucose
· BP
Liver fnt
◉ Treatments approved for bipolar depression.
Answer: · Lamotrigine- approved to prevent recurrence of
depression, not treatment
· Quetiapine
· Lurasidone
,· Olanzapine + fluoxetine
· Cariprazine
◉ Approved augmenting agents for SSRIs/SNRIs in unipolar
depression.
Answer: · Buproprion
o Olanzapine-fluoxetine
o Quetiapine
o Aripiprazole
o Brexpiprazole
o Ketamine
o Lithium
o Buspirone
o Mirtazapine
◉ Buproprion as augmenting agent for unipolar depression.
Answer: · weak NET and DAT inhib, decreases sexual dysfunction
and improves the symptoms associated with "reduced positive
affect" (loss of happiness, joy, interest, pleasure, energy etc.)
◉ Olanzapine as augmenting agent for unipolar depression.
Answer: Olanzapine-fluoxetine: olanzapine as a D2/5HT2A/5HT2C
antagonists--> actions most likely due to SERT/5HT2C antagonism
, Weight gain/metabolic disturbances SE
◉ Quetiapine as augmenting agent for unipolar depression.
Answer: 5HT2C/NET/5HT1A antagonism actions
Sedation, weight gain, and metabolic disturbances SE
◉ Aripiprazole as augmenting agent for unipolar depression.
Answer: D2/5HT1A partial agonist
Akathisia SE
◉ Brexpiprazole as augmenting agent for unipolar depression.
Answer: D2/5HT1A partial agonist
Decreased akathisia risk
◉ Ketamine as augmenting agent for unipolar depression.
Answer: NMDA antagonist