CMN 548 UNIT 5 EXAM HIGH-YIELD
COMMUNICATION THEORY, LEADERSHIP, AND
CONFLICT RESOLUTION SUMMARY 2026
◉ Which TCA is commonly used in the management of pain and in
prophylaxis of migraine headaches?
Answer: Amitriptyline, usually at lower doses
◉ List the indications for use of TCAs in children (keeping in mind
that use in this population is done as a last resort).
Answer: ADHD, sleepwalking disorder, separation anxiety disorder,
sleep terror disorder, compulsive behavior in kids with autism,
movement disorders, premature ejaculation
Enuresis (imipramine), insomnia, and parasomnias, ADHD, MDD,
obsessional disorder, panic disorder, school phobia, separation
anxiety disorder, bulimia, & tourette's syndrome (clomipramine)
◉ What are the prudent diagnostics/labs recommended prior to
treatment, during treatment, and at dosage changes with TCAs?
Answer: -Baseline EKG for children and monitored regularly
-CBC, WBC w/ diff & serum electrolytes
,◉ Anticholinergic effects of TCAs at plasma levels above 300 ng/ml
can cause what?
Answer: Delirium (pts w/ dementia are more vulnerable to this)
◉ What symptoms would a patient present with who was
experiencing anticholinergic side effects?
Answer: • Increased frequency (elderly)
• Dry mouth
• Blurred vision
• Dry eyes
• Constipation
• Urinary retention
• Excessive sweating
• Confusion, disorientation, delirium, delusions, & hallucinations
• hyperthermia
◉ What is one of the most common side effects in young persons
that causes discontinuation of TCAs
Answer: Tachycardia
◉ The most common cardiac autonomic adverse effect of TCAs that
cause discontinuation is?
Answer: Orthostatic hypotension
,◉ Nicotine, as well as oral contraceptives may have what effect on
TCA plasma concentrations?
Answer: -May decrease TCA plasma concentrations through the
induction of hepatic enzymes
◉ List three (3) benefits of using TCAs over SSRIs
Answer: -Less prone to cause sexual dysfunction, less significant
long-term weight gain, and less sleep disturbances
◉ What are the symptoms of overdose for TCAs?
Answer: -Agitation, delirium, convulsions, hyperactive deep tendon
reflexes, bowel and bladder paralysis, dysregulation of BP & temp.,
and mydriasis
◉ What is the recommendation for prescribing a TCA for a patient
who is at risk for suicide?
Answer: Should be nonrefillable and for no longer than 1 week at a
time for pts at risk for suicide
◉ How long after an overdose on TCAs can the risk remain for
cardiac arrhythmias?
Answer: 3-4 days and should be monitored in an intensive care unit
, ◉ Which two (2) SSRIs are the most selective inhibitors of serotonin
reuptake?
Answer: Citalopram (celexa) & Escitalopram (lexapro)
◉ Which SSRI, at higher doses, produces anticholinergic effects?
Answer: Paxil
◉ Discuss what clinical complication can occur with concomitant
use of SSRIs and drugs in the triptan, MAOI class and Lithium.
Include signs/symptoms of this complication.
Answer: Serotonin syndrome-symptoms: diarrhea, diaphoresis,
tremor, ataxia, myoclonus, hyperactive reflexes, disorientation,
lability of mood
◉ What is the FDA issued Black Box Warning associated with SSRIs?
Answer: suicidal thoughts and behaviors in children and young
adults
◉ Which SSRI has the FDA given a Pregnancy category D? What are
the potential risks related to this classification for this medication?
Answer: Paxil-birth defects, particularly heart defects
◉ Post stroke use of SSRIs has been found to be effective on what
specific symptom of depression?
COMMUNICATION THEORY, LEADERSHIP, AND
CONFLICT RESOLUTION SUMMARY 2026
◉ Which TCA is commonly used in the management of pain and in
prophylaxis of migraine headaches?
Answer: Amitriptyline, usually at lower doses
◉ List the indications for use of TCAs in children (keeping in mind
that use in this population is done as a last resort).
Answer: ADHD, sleepwalking disorder, separation anxiety disorder,
sleep terror disorder, compulsive behavior in kids with autism,
movement disorders, premature ejaculation
Enuresis (imipramine), insomnia, and parasomnias, ADHD, MDD,
obsessional disorder, panic disorder, school phobia, separation
anxiety disorder, bulimia, & tourette's syndrome (clomipramine)
◉ What are the prudent diagnostics/labs recommended prior to
treatment, during treatment, and at dosage changes with TCAs?
Answer: -Baseline EKG for children and monitored regularly
-CBC, WBC w/ diff & serum electrolytes
,◉ Anticholinergic effects of TCAs at plasma levels above 300 ng/ml
can cause what?
Answer: Delirium (pts w/ dementia are more vulnerable to this)
◉ What symptoms would a patient present with who was
experiencing anticholinergic side effects?
Answer: • Increased frequency (elderly)
• Dry mouth
• Blurred vision
• Dry eyes
• Constipation
• Urinary retention
• Excessive sweating
• Confusion, disorientation, delirium, delusions, & hallucinations
• hyperthermia
◉ What is one of the most common side effects in young persons
that causes discontinuation of TCAs
Answer: Tachycardia
◉ The most common cardiac autonomic adverse effect of TCAs that
cause discontinuation is?
Answer: Orthostatic hypotension
,◉ Nicotine, as well as oral contraceptives may have what effect on
TCA plasma concentrations?
Answer: -May decrease TCA plasma concentrations through the
induction of hepatic enzymes
◉ List three (3) benefits of using TCAs over SSRIs
Answer: -Less prone to cause sexual dysfunction, less significant
long-term weight gain, and less sleep disturbances
◉ What are the symptoms of overdose for TCAs?
Answer: -Agitation, delirium, convulsions, hyperactive deep tendon
reflexes, bowel and bladder paralysis, dysregulation of BP & temp.,
and mydriasis
◉ What is the recommendation for prescribing a TCA for a patient
who is at risk for suicide?
Answer: Should be nonrefillable and for no longer than 1 week at a
time for pts at risk for suicide
◉ How long after an overdose on TCAs can the risk remain for
cardiac arrhythmias?
Answer: 3-4 days and should be monitored in an intensive care unit
, ◉ Which two (2) SSRIs are the most selective inhibitors of serotonin
reuptake?
Answer: Citalopram (celexa) & Escitalopram (lexapro)
◉ Which SSRI, at higher doses, produces anticholinergic effects?
Answer: Paxil
◉ Discuss what clinical complication can occur with concomitant
use of SSRIs and drugs in the triptan, MAOI class and Lithium.
Include signs/symptoms of this complication.
Answer: Serotonin syndrome-symptoms: diarrhea, diaphoresis,
tremor, ataxia, myoclonus, hyperactive reflexes, disorientation,
lability of mood
◉ What is the FDA issued Black Box Warning associated with SSRIs?
Answer: suicidal thoughts and behaviors in children and young
adults
◉ Which SSRI has the FDA given a Pregnancy category D? What are
the potential risks related to this classification for this medication?
Answer: Paxil-birth defects, particularly heart defects
◉ Post stroke use of SSRIs has been found to be effective on what
specific symptom of depression?
