NSG 552/ NSG552 Exam 2 V1 – Psychopharmacology Review | Wilkes (Latest 2026/ 2027 Update) 100% Verified Questions & Answers | Grade A

NSG 552/ NSG552 Exam 2 V1 – Psychopharmacology Review | Wilkes (Latest 2026/ 2027 Update) 100% Verified Questions & Answers | Grade A Adjustment disorders Occurs when a person develops emotional or behavioral symptoms in response to a stressful event or situation; symptoms aren't those of normal bereavement and resolve within 6 months of the stressor SSRIs (sertraline and duloxetine) Which of the following class of meds are used as first-line therapy for PTSD? 3 multiple choice options Blood pressure What do you need to monitor if a patient is on Prazosin? Why are benzodiazepines contraindicated in PTSD treatment? They interfere with the psychological processes needed to benefit from CBT: there is a high rate of comorbid SUD w/PTSD and benzodiazepines are highly addictive What medications are FDA approved to treat PTSD? Sertraline and Paroxetine When would you augment treatment of PTSD with an atypical antipsychotic? Only in SEVERE cases What co-occurring disorder do patients with DID typically have? PTSD What are SSRIs effective for in DID? Co-occurring depressive or PTSD symtpoms What are the suggested treatments for adjustment disorders? Psychotherapy and pharmacology to target associated symptoms like anxiety, depression, insomnia In patients with DID, what medication is used to reduce self-injurous behaviors? Naltrexone Is ECT contraindicated in DID? No- there is often concurrent depression/anxiety and ECT can be effective in treating it especially if symptoms are treatment resistant What are the suggested treatments for excoriation disorder? Psychotherapy; SSRIs to treat concurrent anxiety/depression; antipsychotics; ansiolytics What disorder has the following characteristics: recurrent skin picking that results in lesions despite attempts to stop? excoriation disorder What is the suggested treatment for tricholillomania? Psychotherapy; SSRIs for concurrent anxiety/depression; Clomipramine, Atypical antipsychotics (lithium, N-acetylcyteine What disorder has the characteristic of recurrent pulling out one's hair despite repeated attempts to stop? Trichotillomania What is the suggested treatment for hoarding disorder? CBT specific for hoarding; SSRIs to treat concurrent anxiety/depression What disorder has the following characteristics: persistant difficulty discarding possessions regardless of value resulting in accumulation of possessions that compromise living space/ability to function. Person is resistant to treatment Hoarding disorder What is the suggested treatment for body dysmorphic disorder? Psychotherapy, SSRIs for concurrent anxiety/depression/OCD What disorder has the following characteristics? Preoccupation with one or more perceived defects or flaws in physical appearance; spends significant time trying to correct perceived flaws w/makeup, dermatological procedures, or plastic surgery Body dysmorphia disorder What are the recommended treatments for DID? Psychotherapy, SSRIs to target comorbid depressive/PTSD symptoms, Prazosin for nightmares, Naltrexone to decrease self-injurous behaviors What disorder has the following characteristics? predominantly develops in victims of significant and chronic childhood trauma; often has co-occurring PTSD; fragmented sense of self; 70% suicide attempts/self-harm Dissociative Identity Disorder Are there any medications effective in treating depersonalization/derealization No Patient was recently robbed, for 6 months is easily startled, + nightmares, avoiding street where it occurred. On sertraline. What medication would you add Are there any medications effective in treating dissociative amnesia? No What is a sudden unexpected travel away from home accompanied by amnesia for identity or other autobiographical information? Dissociative fugue In what disorder is the person unable to remember important personal information, history of traumatic in nature, inconsistent w/ordinary forgetfulness? Dissociative amnesia What are some predisposing factors to depersonalization and derealization? Trauma and severe stress What is unreality or detachment from ones surroundings derealization What is a feeling of unreality or detachment from one's body, thoughts, feeling, or actions? Depersonalization What is a lapse in autobigraphical memory? Amnesia What is a defense mechanism that protects a person from overwhelming anxiety by emotionally separating A disruption in the integrated sense of self? Dissociation What part of the brain is implicated in PTSD that is responsible for memory and learning? Hippocampus What disorder presents as: not fixated on body shape/weight, recurrent episodes of binge eating, no compensatory behaviors (vomiting/laxatives/etc), usually obese? Binge-eating disorder What is the treatment for binge-eating disorder? First-line: SSRIs (escitalopram); Psychotherapy; Vyvanse= FDA approved/ topamx associated with weight loss/ orlistat inhibits pancreatic lipase by decreasing the amount of fat absorbed from GI tract What are the treatments for bulimia? CBT + antidepressants/ SSRIs (firstline treatment); Fluoxetine 60-80 mg/day= only FDA approved medication What are characteristics of insomnia? Difficulty falling or remaining asleep/ acute insomnia 3 months, chronic insomnia 3 months What disorder presents as; binge-eating w/behaviors to counteract weight gain (vomit, laxatives, diuretics, etc), embarrassed by binge eating, overly concerned about body weight, usually maintains normal body weight or may be overweight Bulimia nervosa With OTC sedatives/hypnotics- does a tolerance to sedating effects develop rapidly? Yes Which phase of sleep is eszopiclone (lunesta) used? Both- onset and maintenance What is nonrestorative sleep? Waking up feeling fatigued and unrefreshed What is the MOA of Rameltzon (remeron) M1 and M2 agonist (selective melatonin) What are non-pharmacologic treatments for sleep apnea? weight loss, avoidance of ETOH, CPAP, uvulopalatopharyngoplasty What are some side effects of Zolpidem (Ambien)? antegrade amnesia, hallucinations, parasomnias (sleep walking and eating), increased fall risk, GI effects What are treatments for RLS? Remove offending agent, iron replacement; 1st line= dopamine agonists (pramipexole and ropinirole); Gabapentin/pregabalin, benzos What is the MOA of zolpidem? Selectively binds to Omega=1 receptor on GABA-A receptor (responsible for sedation) What are some risk factors for RLS? iron-deficiency anemia, some antidepressants/antipsychotics, age, dopamine blocking antiemetics, antihistamines, family component What meds are used to help with sleep maintenance? Suvorexant, eszopielone, zolpidem, temazepam, doxepin What meds are used to help with sleep onset? Eszopiclone, zaleplon, zolpidem, triazolam, temazepam, ramelteon What is hypersomnia? excessive daytime sleeping What happens during late/sleep offset insomnia? early morning awakening What happens during middle/sleep maintenance insomnia? Frequent nocturnal awakenings What is an example of an activating serotonergic agent? Venlafaxine In waht disorder do people present with one physical symptom that is present 6 months, believe they are ill, and do not intentionally produce symptoms? Somatic Symptom Disorder What is the treatment of anorexia? SSRIs for concurrent depression, alprazolam, and olanzipine, CBT What disorder presents with the following: preoccupation w/weight, body image, being thin; 2 types (restricting and binging/purging), intense fear of gaining weight/being fat, restrict calories, low body weight anorexia nervosa What medication is contraindicated in eating disorders and why? Bupropion bc it lowers seizure thresholds What are some ways to manage narcolepsy? sleep hygiene, daytime naps, no shift work, Modanfinil= 1st line What class of medications can help reduce obsessions and severe fearful preoccupations associated with psychosomatic disorders? SSRIs What are some treatments for insomnia? sleep hygiene, CBT, chronotherapy (bright light therapy), benzos short-term, non-benzos (melatonin, ambien, lunesta, sonata, etc) short-term. Ambien for elderly, antidepressants such as trazadone or low dose remeron What disorder demonstrates the following: Intentional report of physical or psychological symptoms with the goal to achieve personal gain/secondary gain/external reward (avoid police/incarceration, etc.), not considered a mental illness Malingering What is the drug of choice to treat cataplexy? Sodium oxybate What are some considerations when considering sedative hypnotic use in the elderly? sleep hygeine, trazadone is a safer option for medicine, use sedative hypnotics cautiously as they may cause memory impairment, ataxia, paradoxical excitement, rebound excitement Priaprism is commonly associated with which antidepressant commonly used for sleep? Trazadone What are recommended treatments for factitious disorder? Collaboration w/PCP, confrontation in a non-threatening manner What antidepressants may be used for sedating properties? Amitriptyline, doxepin, mirtazapine, trazadone What disorder presents with the following: Falsifying physical and/or psychological signs and symptoms to assume a sick role, absence of external reward, repeated and long hospitalizaitons? Factitious disorder Why should flurazepam be avoided in the elderly ? long half life/ may cause excessive drowsiness What are recommended treatments for illness anxiety disorder SSRIs to treat depression/anxiety, regular visits with PCP, CBT What are recommended treatments for conversion disorder? Education about illness; CBT What are recommended treatments for somatic symptom disorder regular visits with PCP/ slowly address psychological issues What disorder? Preoccupation with having/getting serious illness, somatic symptoms or mild symptoms, persists/= 6 months, performs excessive health related behaviors? Illness anxiety disorder What happens during Initial/Sleep-onset insomnia? Difficulty falling asleep In what disorder do patients present with at least 1 neurobiological symptom that can't be fully explained by a neuro condition, demonstrates La bell indifferene? Conversion disorder What are the 2 stages of the sleep-wake cycle? REM and non-REM Side effects of benzodiazepines anticholinergic effects, unusual. behaviors, hallucinations, daytime drowsiness, amnesia What is the initial treatment for panic attacks? Benzodiazepines Is buspirone (Buspar) a high or low risk for abuse/addiction? low risk What are some common non-benzo anxiolytics? buspirone, hydroxyzine, barbituates, propanolol If a patient is experiencing SSRI sexual dysfunction what medication is a good alternative? Buspirone What are some key things to consider regarding hydroxyzine? wide dosage range b/c it affects people differently, can be sedating, may cause weight gain, may have a paradoxical response, best for patients who are benzo naive What is diazepam most often prescribed for? GAD, severe ETOH withdrawal, seizures What are the risks of benzo use for the elderly? Increased fall risk, Increased risk of hip fracture What is the first-line treatment of chronic anxiety, GAD, and panic disorder and why? SSRIs- treat comorbid depression, lack abuse risk, low risk of side effects What medical conditions can precipitate anxiety? COPD, DM, thyroid disease, Seizures What is the mechanism of action of buspirone? partial 5HT1A agonist- decreases sertonergic activity What are signs of serotonin syndrome? muscle spasm, fever, racing heart, headache, confusion What are some anticonvulsant drugs that may be used? Gabapentin, Pregabalin, Tiagabine, Lamotrigine, Oxycarbazipnine What is lorazepam most often used to treat? Panic attacks and ETOH/sedative-hypnotic detox Buspirone is often used in combination with other agents such as SSRIs- True of False True What are some risks of benzodiazipines? abuse and addiction, physical dependence, tolerance What is a contraindication for clonazepam? Renal dysfunction What is the MOA for beta-blockers such as propranolol in treating anxiety? Beta-adrenergic receptor What are some risks of baribituates (phenobarbital)? very lethal in overdose, significant potential for withdrawal, potential for abuse, side-effect profile What does a panic attack present like? rapid onset, lasts 5-10 minutes, out of the blue Venlafaxine can cause what in patients with anxiety? Can be activating and cause restlessness What are some short-acting benzos? alprazolam, midazolam, triazolam, oxazepam What happens with the neurotransmitters in anxiety? elevated norepinephrine, decreased GABA/serotonin What are the side effects of Luvox when taken for OCD? Nausea and Vomiting What are some intermediate acting benzodiazepines? Lorazepam, Temazepam, Estazolam, Clonazepam What are the most commonly prescribed benzodiazepines? Alprazolam, lorazepam What is the most common treatment for agoraphobia? SSRIs, CBT What are some symptoms of benzo withdrawal? Similar to ETOH withdrawal- tremors, seizures, insomnia, irritability, anorexia, nausea/vomiting, autonomic hyperactivity (diaphoresis, elevated heart rate What are the most common meds used for treatment of OCD? fluvoxamine, clorimpramine What is the biggest risk of stopping a benzodiazepine abruptly? Life threatening risk of seizures What neurotransmitter is the autonomic responses most associated with? norepinephrine What are symptoms of SSRI discontinuation syndrome? FINISH= flu-like symptoms, insomnia, nausea, imbalance, sensory disturbance (tremores and sensation of electrical shock, hyperarousal What is the first-line treatment for panic disorder? SSRIs= fluoxetine, paroxetine, sertraline OR SNRIs= venlafaxine What is the 2nd line treatment of OCD? SNRIs= venlafaxine, clomipramine Which anticonvulsant is most often used in anxiety? gabapentin What is the MOA of GABA Works on voltage-sensitive calcium channels What is an appropriate adjunct treatment for panic disorder? Benzos; Alprazolam is FDA approved for panic disorder Which benzo has the highest risk for abuse due to its short half-life? alprazolam What is haldol most often used for? acute agitation What is the MOA for benzodiazepines? Potentiates effects of GABA -especially at the GABA-A receptor What patients do we need to be cautious of prescribing benzos to d/t high risk of abuse and misuse? Hx SUD, Personality disorder, chronic pain What are some common indicators for benzos? anxiety disorders, muscle spasms, seizures, sleep disorders, ETOH withdrawal, anesthesia induction What is propranolol used for? performance anxiety- social phobias; panic attacks; akathisia What are some long-acting benzodiazepines? flurazepam, diazepam, chlordiazepoxide, clorazepate, What is oxazepam most often used for? ETOH and sedative hypnotic detox What is a known limitation of benzo treatment? rebound insomnia What is the 2nd line treatment for panic attacks? TCAs (limited use) What is the 1st line treatment for GAD? SSRIs (escitalopram, paroxetine, cymbalta What are the common side effects of propranolol? bradycardia and hypotension What is a risk of taking temazepam? high potential for dependence What is midazolam used for? surgical and procedural areas What benzos are not metabolized in the liver? oxazepam, lorazepam, temazepam What is the 1st line treatment for social phobias such as performance anxiety? SSRIs or SNRIs What factors are considered when determining best benzo for a patient? time of onset, duration of action, method of metabolism What medication is given to treat benzo overdose? flumazenil In addition to SSRIs/SNRIs, what treatments can be used for social phobias/performance anxiety? beta blockers (propranolol, atenolol), benzos What is the only TCA thought to be effective in the treatment of OCD? clomipramine How is buspirone dosed? 2-3 times a day What is the first-line treatment for OCD? SSRIs (high doses of sertraline or fluvoxetine_ When should you NOT prescribe propranolol? cocaine overdose- can be fatal; COPD/asthma- risk of bronchospasm