NURS 660: PSYCHOPHARM / NURS
660: PSYCHOPHARM (Exam 1)
QUESTIONS WITH COMPLETE
SOLUTIONS
,Minimum ANC level to prescribe Clozapine, general
population: - CORRECT ANSWER-1,500 μL
Severe Neutropenia - CORRECT ANSWER-< 500μL
Moderate Neutropenia - CORRECT ANSWER-500-999μL
Mild Neutropenia - CORRECT ANSWER-1000-1499μL
BEN patients: Normal ANC range for Clozaril - CORRECT
ANSWER-≥1,000 μL
Clozaril BEN patient: severe neutropenia - CORRECT
ANSWER-<500 μL
BEN neutropenia - CORRECT ANSWER-500-999 μL
Lower ANC threshold for starting clozapine: General
population - CORRECT ANSWER-≥1,500/μL
Lower ANC threshold for starting clozapine: Benign ethnic
neutropenia (BEN) - CORRECT ANSWER-1,000/μL
,Medical emergencies when prescribing anti-psychotics -
CORRECT ANSWER-- NMS
- Agranulocytosis
- Serotonin Syndrome
Clinical findings in agranulocytosis - CORRECT ANSWER-
Clozaril: most likely side effect if pt develops fever within 6
weeks - CORRECT ANSWER-Myocarditis
Clozaril: if pt develops fever within 6 weeks order a ______,
_________ and _______. - CORRECT ANSWER-EKG, CRP,
Troponin, as this is likely due to myocarditis
Common complaints in patients with neutropenia:
F,P, U, P - CORRECT ANSWER-- Fever (low grade)
- painful swallowing (odynophagia)
- URI (sinusitis, otitis, cough)
- Perirectal pain/irritation
, Symptoms of neuroleptic malignant syndrome (NMS): -
CORRECT ANSWER-- High fever
- Tachycardia/irregular pulse
- Increased respiratory rate
- Muscle Rigidity
- altered mental status
Off label TX for NMS - CORRECT ANSWER-Amantadine
(SYMMETREL)
Serotonin Syndrome onset: - CORRECT ANSWER--24 hours
of combining antidepressants
Serotonin Syndrome Cardinal features - CORRECT ANSWER-
- Myoclonic jerks
- Hyperreflexia
- Mental status changes
- Shivering
- Fever
- Tachycardia, HTN, hypotension (AUTONOMIC instability)
- Confused/ restless/ hyperactive/ unresponsive
660: PSYCHOPHARM (Exam 1)
QUESTIONS WITH COMPLETE
SOLUTIONS
,Minimum ANC level to prescribe Clozapine, general
population: - CORRECT ANSWER-1,500 μL
Severe Neutropenia - CORRECT ANSWER-< 500μL
Moderate Neutropenia - CORRECT ANSWER-500-999μL
Mild Neutropenia - CORRECT ANSWER-1000-1499μL
BEN patients: Normal ANC range for Clozaril - CORRECT
ANSWER-≥1,000 μL
Clozaril BEN patient: severe neutropenia - CORRECT
ANSWER-<500 μL
BEN neutropenia - CORRECT ANSWER-500-999 μL
Lower ANC threshold for starting clozapine: General
population - CORRECT ANSWER-≥1,500/μL
Lower ANC threshold for starting clozapine: Benign ethnic
neutropenia (BEN) - CORRECT ANSWER-1,000/μL
,Medical emergencies when prescribing anti-psychotics -
CORRECT ANSWER-- NMS
- Agranulocytosis
- Serotonin Syndrome
Clinical findings in agranulocytosis - CORRECT ANSWER-
Clozaril: most likely side effect if pt develops fever within 6
weeks - CORRECT ANSWER-Myocarditis
Clozaril: if pt develops fever within 6 weeks order a ______,
_________ and _______. - CORRECT ANSWER-EKG, CRP,
Troponin, as this is likely due to myocarditis
Common complaints in patients with neutropenia:
F,P, U, P - CORRECT ANSWER-- Fever (low grade)
- painful swallowing (odynophagia)
- URI (sinusitis, otitis, cough)
- Perirectal pain/irritation
, Symptoms of neuroleptic malignant syndrome (NMS): -
CORRECT ANSWER-- High fever
- Tachycardia/irregular pulse
- Increased respiratory rate
- Muscle Rigidity
- altered mental status
Off label TX for NMS - CORRECT ANSWER-Amantadine
(SYMMETREL)
Serotonin Syndrome onset: - CORRECT ANSWER--24 hours
of combining antidepressants
Serotonin Syndrome Cardinal features - CORRECT ANSWER-
- Myoclonic jerks
- Hyperreflexia
- Mental status changes
- Shivering
- Fever
- Tachycardia, HTN, hypotension (AUTONOMIC instability)
- Confused/ restless/ hyperactive/ unresponsive
