NRl 546/l NR546l Finall Exam:l Advancedl
Pharmacology:l Psychopharmacologyl forl
thel Psychiatric-Mentall Healthl Nursel
Practitionerl Guidel (Latestl 2026/l 2027l
Update)l |l Qsl &l As|l Gradel A|l 100%l
Correctl (Verifiedl Answers)-l Chamberlain
QUESTION
l valproicl acidl (Depakene)
Answer:
Forl BP
INDICATION
-Acutel manial &l mixedl episodes
-Seizures
-Migrainel prophylaxis
ACTION
-affectsl ionl transportl andl enhancesl thel activityl ofl GABA
STARTINGl DOSE
-15l mg/kgl inl 2l dividedl dosesl (oncel QDl forl extended-release).
ADVERSEl EFFECTS
-GIl effects
-weightl gain
-Rare:l Pancreatitis,l hepatotoxicityl withl liverl failure
TESTS
-Beforel startingl treatment,l getl weight,l CBCs,l coagulationl tests,l andl LFTs.
Duringl treatment,l monitorl weightl andl BMI,l getl regularl LFTsl andl plateletl countsl firstl
fewl months,l thenl oncel orl twicel al year.
,PEARLS:
-Monitorl plasmal levels.
-Ifl usingl withl lamotriginel decreasel valporatel levelsl byl 50%.
QUESTION
l Secondl generationl antipsychoticsl forl BD
Answer:
aripiprazolel (Abilify)
cariprazinel (Vraylar)
lurasidonel (Latuda)
quetiapinel (Seroquel)
asenapinel (Saphris)
risperidonel (Risperdol)
olanzapinel (Zyprexa)
ziprazadonel (Geodon)
ACTION
-DA,l NE,l andl 5-HTl receptorl antagonists
INDICATION
-acutel bipolarl depression
-acutel manicl orl mixedl episodes
-bipolarl maintenance/adjunct
ADVERSEl EFFECTS
-weightl gain
-sedation
-GIl effects
PEARLS:
-Indicationsl varyl withl eachl medication.l Checkl forl monotherapyl vs.l adjunctl indication.
-Monitorl forl extrapyramidall effects.
-XRl forml mayl improvel adherence.
-Monthlyl injectionl mayl improvel adherence.
-Selectl SGAsl firstl tol decreasel riskl ofl sidel effectsl andl long-terml adversel effects.
QUESTION
l carbemazepinel (Tegretol)
Answer:
INDICATION
-Seizures
-Painl associatedl withl truel tigeminall neuralgia
,-Acutel mania/mixedl mania
ACTION
-glutamatel voltagel gatedl sodiuml andl calciuml channell blockerl (Glu-CB)
STARTINGl DOSE
-200l mgl BIDl (tablet),l orl 100mgl QIDl (suspension)
ADVERSEl EFFECTS
-GIl effects
-sedation
-hyponatremia
-neutopenia
-rashl (Stevens-Johnsonl Syndrome)
TESTS
-Beforel startingl getl bloodl count,l liver,l kidney,l andl thyroidl functionl tests.
-Duringl treatmentl getl bloodl countl everyl 2-4l weeksl forl 2l months,l thenl everyl 3-6l
months.l Andl liver,l kidney,l andl tyroidl functionl testsl everyl 6-12l months
PEARLS:
-Monitorl plasmal levels.
-Considerl genotypingl clientsl withl Asianl ancestry;l thel HLA-Bl 1502l allelel increasesl riskl
ofl Steven-Johnsonl Syndrome.
-Drugl interactions:l CYP450l 3A4l inhibitors,l suchl asl nefazodone,l fluvoxamine,l andl
fluoxetine,l canl increasel plasmal levelsl ofl carbamazepine.
QUESTION
l Citalopraml (Celexa)
Answer:
INDICATION
-Depression
Mechanisml ofl Action
-SSRIl (selectivel serotoninl reuptakel inhibitor);l Boostsl neurotransmitterl serotonin.
TESTS
-Nonel forl healthyl individuals
, Startingl Dose
-20mg/day
Adversel Effects
-Diarrhea,l constipation,l nausea,l sexuall dysfuction,l activation,l insomnia,l agitation,l tremors,l
headache,l dizziness,l sweating,l bruising,l SIADH.
Rare:l bleeding,l hyponatremia.
PEARLS
-mildl antihistaminel propertiesl thatl mayl contributel tol sedationl andl fatigue
QUESTION
l Escitalopraml (Lexapro)
Answer:
INDICATION
-MDDl (agesl 12+)
-GAD
Mechanisml ofl Action
-SSRIl (selectivel serotoninl reuptakel inhibitor);l Boostsl neurotransmitterl serotonin.
TESTS
-Nonel forl healthyl individuals
Startingl Dose
-10l mg/day
Adversel Effects
-sexuall dysfunction,l nausea,l diarrhea,l constipation,l insomnia,l sedation,l agitation,l tremors,l
headache,l dizziness,l sweating,l bruising,l SIADH.
Rare:l bleeding,l hyponatremia
PEARLS
-Mayl bel amongl thel best-toleratedl antidepressants
QUESTION
l Fluoxetinel (Prozac)
Answer:
Pharmacology:l Psychopharmacologyl forl
thel Psychiatric-Mentall Healthl Nursel
Practitionerl Guidel (Latestl 2026/l 2027l
Update)l |l Qsl &l As|l Gradel A|l 100%l
Correctl (Verifiedl Answers)-l Chamberlain
QUESTION
l valproicl acidl (Depakene)
Answer:
Forl BP
INDICATION
-Acutel manial &l mixedl episodes
-Seizures
-Migrainel prophylaxis
ACTION
-affectsl ionl transportl andl enhancesl thel activityl ofl GABA
STARTINGl DOSE
-15l mg/kgl inl 2l dividedl dosesl (oncel QDl forl extended-release).
ADVERSEl EFFECTS
-GIl effects
-weightl gain
-Rare:l Pancreatitis,l hepatotoxicityl withl liverl failure
TESTS
-Beforel startingl treatment,l getl weight,l CBCs,l coagulationl tests,l andl LFTs.
Duringl treatment,l monitorl weightl andl BMI,l getl regularl LFTsl andl plateletl countsl firstl
fewl months,l thenl oncel orl twicel al year.
,PEARLS:
-Monitorl plasmal levels.
-Ifl usingl withl lamotriginel decreasel valporatel levelsl byl 50%.
QUESTION
l Secondl generationl antipsychoticsl forl BD
Answer:
aripiprazolel (Abilify)
cariprazinel (Vraylar)
lurasidonel (Latuda)
quetiapinel (Seroquel)
asenapinel (Saphris)
risperidonel (Risperdol)
olanzapinel (Zyprexa)
ziprazadonel (Geodon)
ACTION
-DA,l NE,l andl 5-HTl receptorl antagonists
INDICATION
-acutel bipolarl depression
-acutel manicl orl mixedl episodes
-bipolarl maintenance/adjunct
ADVERSEl EFFECTS
-weightl gain
-sedation
-GIl effects
PEARLS:
-Indicationsl varyl withl eachl medication.l Checkl forl monotherapyl vs.l adjunctl indication.
-Monitorl forl extrapyramidall effects.
-XRl forml mayl improvel adherence.
-Monthlyl injectionl mayl improvel adherence.
-Selectl SGAsl firstl tol decreasel riskl ofl sidel effectsl andl long-terml adversel effects.
QUESTION
l carbemazepinel (Tegretol)
Answer:
INDICATION
-Seizures
-Painl associatedl withl truel tigeminall neuralgia
,-Acutel mania/mixedl mania
ACTION
-glutamatel voltagel gatedl sodiuml andl calciuml channell blockerl (Glu-CB)
STARTINGl DOSE
-200l mgl BIDl (tablet),l orl 100mgl QIDl (suspension)
ADVERSEl EFFECTS
-GIl effects
-sedation
-hyponatremia
-neutopenia
-rashl (Stevens-Johnsonl Syndrome)
TESTS
-Beforel startingl getl bloodl count,l liver,l kidney,l andl thyroidl functionl tests.
-Duringl treatmentl getl bloodl countl everyl 2-4l weeksl forl 2l months,l thenl everyl 3-6l
months.l Andl liver,l kidney,l andl tyroidl functionl testsl everyl 6-12l months
PEARLS:
-Monitorl plasmal levels.
-Considerl genotypingl clientsl withl Asianl ancestry;l thel HLA-Bl 1502l allelel increasesl riskl
ofl Steven-Johnsonl Syndrome.
-Drugl interactions:l CYP450l 3A4l inhibitors,l suchl asl nefazodone,l fluvoxamine,l andl
fluoxetine,l canl increasel plasmal levelsl ofl carbamazepine.
QUESTION
l Citalopraml (Celexa)
Answer:
INDICATION
-Depression
Mechanisml ofl Action
-SSRIl (selectivel serotoninl reuptakel inhibitor);l Boostsl neurotransmitterl serotonin.
TESTS
-Nonel forl healthyl individuals
, Startingl Dose
-20mg/day
Adversel Effects
-Diarrhea,l constipation,l nausea,l sexuall dysfuction,l activation,l insomnia,l agitation,l tremors,l
headache,l dizziness,l sweating,l bruising,l SIADH.
Rare:l bleeding,l hyponatremia.
PEARLS
-mildl antihistaminel propertiesl thatl mayl contributel tol sedationl andl fatigue
QUESTION
l Escitalopraml (Lexapro)
Answer:
INDICATION
-MDDl (agesl 12+)
-GAD
Mechanisml ofl Action
-SSRIl (selectivel serotoninl reuptakel inhibitor);l Boostsl neurotransmitterl serotonin.
TESTS
-Nonel forl healthyl individuals
Startingl Dose
-10l mg/day
Adversel Effects
-sexuall dysfunction,l nausea,l diarrhea,l constipation,l insomnia,l sedation,l agitation,l tremors,l
headache,l dizziness,l sweating,l bruising,l SIADH.
Rare:l bleeding,l hyponatremia
PEARLS
-Mayl bel amongl thel best-toleratedl antidepressants
QUESTION
l Fluoxetinel (Prozac)
Answer:
