NR546 / NR 546 Final Exam (Latest Update 2024 / 2025): Advanced Pharmacology Psychopharmacology for the Psychiatric-Mental Health Nurse Practitioner | Weeks 5 - 8 Covered | Questions and Verified Answer s| 100% Correct - Chamberlain

Final Exam: NR546 / NR 546 (Latest Update 2024 / 2025) Advanced Pharmacology Psychopharmacology for the Psychiatric-Mental Health Nurse Practitioner Guide | Weeks 5 - 8 Covered | Questions and Verified Answer s| 100% Correct - Chamberlain Q: Medication Management SSRI-Selective Serotonin Reuptake Inhibitors *Inhibit 5 HT reuptake SNRI-Serotonin Norepinephrine Reuptake Inhibitors *inhibit 5-HT reuptake *inhibit NE reuptake (increase energy, focus) *increase DA in prefrontal cortex (increase cognition) NDRI-Norepinephrine Dopamine Reuptake inhibitors *inhibit DA reuptake (increase alertness, motivation) *inhibit NE reuptake (increase energy) SARI-Serotonin Antagonist Reuptake Inhibitors Q: Selective Serotonin Reuptake Inhibitors (SSRIs): Most adverse effects will subside after 4-5 days once the body adjusts to increased serotonin levels. Answer: diarrhea headache weight gain sexual side effects Q: Serotonin Norepinephrine Reuptake Inhibitors (SNRIs): Medications should not be abruptly stopped to avoid discontinuation symptoms. NE effects of the medication may increase anxiety in some clients. Report worsening anxiety to the provider. Answer: elevated blood pressure anxiety insomnia constipation Q: Norepinephrine Dopamine Reuptake Inhibitors (NDRI): Take medication in the morning. Stop taking medication if seizures occur. Stop taking medication if anxiety is noted. Answer: agitation headache dry mouth constipation weight loss Q: escitalopram (Lexapro) SSRI Answer: no known drug interactions best tolerated SSRI 27-32 hour half-life good for forgetful prone clients least CYP reactions Substrate for 3A4 Q: citalopram (Celexa) SSRI Answer: mild antihistamine effects; Half-Life: 23-45 hours Weak Inhibitor of 2D6 Q: fluoxetine (Prozac) SSRI Answer: longest half-life Use caution in patients with comorbid anxiety due to risk for activation and panic attacks Half-Life: 2-3 days parent, 2 week metabolite Inhibits 2D6 and 3A4 Q: paroxetine (Paxil) SSRI Answer: also treats social anxiety and insomnia associated with weight gain will experience withdrawal with missed dose or abrupt stop Half-Life: 24 hours Inhibits 2D6 Q: fluvoxamine (Luvox) SSRI Answer: treats anxious depression smokers require an increased dose Half-Life: 9-28 hours Inhibits 3A4, 2C9, 1A2 Q: sertraline (Zoloft) SSRI Answer: also treats social anxiety and hypersomnolence Half-Life: 22-36 hour parent; 62-104 hour metabolite Inhibits 2D6 and 3A4 weakly at low doses Q: venlafaxine (Effexor) Answer: treats both depression and anxiety disorders, ensure trial of higher dose before switching to a different medication Half-life: Parent drug 3-7 hour; metabolite has 9-13 hour Q: duloxetine (Cymbalta) SNRI Answer: effective for atypical pain at higher doses; appropriate for clients who present with somatic symptoms of depression; effective for atypical pain, such as fibromyalgia and diabetic neuropathy Half-Life: 12 hours Inhibitor of 2D6 Q: bupropion (Wellbutrin) Answer: NDRI may improve energy, alertness, and motivation; not first-line treatment for anxiety; contraindicated in clients with a history of seizures Avoid in patients with comorbid anxiety Half-Life: Parent 10-14 hours; Metabolite 20-27 hours Inhibits 2D6 Q: Serotonin Antagonist and Reuptake Inhibitors (SARIs) SARIs potently block 5-HT2A and 5HT 2C receptors, which allow more 5-HT to interact at postsynaptic 5-HT1A sites. Serotonin blockade and reuptake inhibition is present at higher doses. Q: Trazodone