NR546 Advanced Pharmacology
Psychopharmacology for Psychiatric-
Mental Health Nurse Practitioner
When prescribing medications, what must the psychiatric mental health nurse practitioner (PMHNP)
consider? - Answer: The patients:
symptoms
age
physical health
previous response to treatment
lifestyle
What is the priority data used to determine a treatment plan for mental health disorders? - Answer:
Patient symptoms
Changes or losses in grey matter can be associated with psychiatric diagnoses such as? - Answer:
Alzheimer's disease, schizophrenia, and major depressive disorder.
Many psychotropic medications can cause weight gain. True of False. - Answer: True, caution is taken
when prescribing to obese patients.
Which lifespan group respond differently to drugs than adults, have heightened drug sensitivity, show
greater individual variation, and have increased risk for adverse drug reactions? Dosage selection can be
challenging because their brains and bodies are still developing. - Answer: Pediatric patients
Which lifespan group have several psychotropic drugs that are not safe to use, certain drugs resulting in
birth defects and certain drugs presenting in breastmilk, affecting the breastfed child, or affecting milk
production? - Answer: Pregnancy/breastfeeding patients
The physiologic changes associated with aging impact the drug processes of absorption, distribution,
metabolism, and excretion of medications, so lower than normal dosages may be needed. The most
,recent Beers Criteria should be reviewed to avoid prescribing potentially inappropriate medications to
this lifespan group. - Answer: Older adult patients
Brain tissue composed of gray matter includes? - Answer: The cerebellum, cerebrum, brain stem, and
butterfly-shaped portion of the central spinal cord.
The gray matter of the brain focuses on? - Answer: Psychiatry and neurology and is associated with
learning.
Brain tissue composed of white matter includes? - Answer: Nerve fibers that connect neurons from
different regions into functional circuits.
Why is white matter considered the transit system? - Answer: Necessary for electrical impulse
transmission. If there are breaks in the system, it can affect neural communication, affecting behavior.
Damage to the myelin can impair transmission which can impact not only sensory and motor function,
but also cognition.
White brain matter is associated with which disease processes? - Answer: Autism and vascular
dementia.
Frontal Lobe - Answer: Associated with movement, intelligence, abstract thinking. the ability to organize,
personality, behavior, and emotional control. Traumatic brain injuries can result in personality changes,
difficulty controlling emotions, and other cognitive functions.
Parietal Lobe - Answer: Middle part of the brain
Responsible for proprioception.
Helps a person to identify spatial relationships, interpret pain and touch in the body, and identify and
give meaning to objects.
Damage to the anterior portion of the parietal lobe may cause asterogenesis, the loss of ability to
recognize objects via the sense of touch.
May be experienced post cerebral vascular accidents.
Temporal Lobe - Answer: Located on the sides of the brain
,Involved in short-term memory, speech, auditory signals, and smell recognition.
Identifies "what" things are - object identification.
Contains the limbic system, amygdala, and hippocampus.
A dominant temporal lobe lesion can present as Wernicke's aphasia.
Temporal Lobe Disorders - Answer: Temporal lobe disorders include dementia, affective disorders, and
attention deficit hyperactivity disorders (ADHD).
Occipital Lobe - Answer: Back part of the brain and controls visual processing. Damage to this lobe
results in the inability to form visual memories.
Bilateral lobe damage results in the inability to recognize items by sight even though vision is normal.
Occipital lobe seizures can cause hallucinations, such as lines of color.
Dorsal Striatum - Answer: Complex motor actions and linkage of cognition to motor actions.
Main input area for the basal ganglia and is activated when anticipating or engaging in pleasure.
Corpus Callosum - Answer: Controls the communication between the two brain hemispheres.
Involved in attention, impulse control, and emotion regulation.
Integrates impulses from both sides of the brain.
Persons with an underdeveloped or missing corpus collosum may have intellectual impairment.
Thalamus - Answer: An egg-shaped structure involved in sensory organ and motor command processing.
All sensory systems except for the olfaction process through the thalamus, which is responsible for
processing all external information.
Associated with symptoms related to schizophrenia and post-traumatic stress disorder (PTSD).
Basal Ganglia - Answer: Involved in voluntary motor movements, cognition, and emotion. Involved in
facilitating voluntary movement.
, Basal ganglia movement disorders include? - Answer: Include Parkinson's disease, obsessive-compulsive
disorder (OCD), and Tourette syndrome.
Limbic System - Answer: Associated with pleasure, reward, and reinforcing behavior. Drug abuse affects
the limbic system, disrupting emotions and feelings associated with normal behavior.
Nucleus Accumbens - Answer: This is involved in the reward circuit and reinforces addictive behaviors.
Amygdala - Answer: Located deep in the temporal lobes and involved in emotional regulation and
perception of odors.
All smells travel directly to the amygdala.
Cooking smells can elicit memories of childhood events and holidays.
A traumatic event can result in the formation of the fear response, causing the fight or flight reflex
within the autonomic nervous system and affects the hypothalamic-pituitary-adrenal (HPA) axis causing
the release of stress hormones (e.g. cortisol).
The amygdala also is involved in the interpretation of facial expressions and sexual stimuli.
Hippocampus - Answer: Located deep in the temporal lobes and is involved in anxiety and memory, and
shifting short-term to long-term memory.
Hippocampal function is impaired in schizophrenia and dementia. There is ongoing research into the
role the hippocampus plays in anxiety and decision making.
What are epigenetic modifications - Answer: Affect how genes are turned on or off, influencing the
production of proteins that carry out various functions in the body.
Can be influenced by a variety of factors, including environmental stimuli, lifestyle, and experiences.
Normal and abnormal genes both contribute to disease and drug efficacy.
Epigenetics can contribute to the risk of any disorder or disease.
Psychiatric disorders can also be due to normal genes that are "on" that should be "off."
How does reviewing the genetic makeup of a client help guide the PMHNP in selecting medication for
clients? - Answer: Provide information on:
How clients may respond to certain psychotropic medications
Psychopharmacology for Psychiatric-
Mental Health Nurse Practitioner
When prescribing medications, what must the psychiatric mental health nurse practitioner (PMHNP)
consider? - Answer: The patients:
symptoms
age
physical health
previous response to treatment
lifestyle
What is the priority data used to determine a treatment plan for mental health disorders? - Answer:
Patient symptoms
Changes or losses in grey matter can be associated with psychiatric diagnoses such as? - Answer:
Alzheimer's disease, schizophrenia, and major depressive disorder.
Many psychotropic medications can cause weight gain. True of False. - Answer: True, caution is taken
when prescribing to obese patients.
Which lifespan group respond differently to drugs than adults, have heightened drug sensitivity, show
greater individual variation, and have increased risk for adverse drug reactions? Dosage selection can be
challenging because their brains and bodies are still developing. - Answer: Pediatric patients
Which lifespan group have several psychotropic drugs that are not safe to use, certain drugs resulting in
birth defects and certain drugs presenting in breastmilk, affecting the breastfed child, or affecting milk
production? - Answer: Pregnancy/breastfeeding patients
The physiologic changes associated with aging impact the drug processes of absorption, distribution,
metabolism, and excretion of medications, so lower than normal dosages may be needed. The most
,recent Beers Criteria should be reviewed to avoid prescribing potentially inappropriate medications to
this lifespan group. - Answer: Older adult patients
Brain tissue composed of gray matter includes? - Answer: The cerebellum, cerebrum, brain stem, and
butterfly-shaped portion of the central spinal cord.
The gray matter of the brain focuses on? - Answer: Psychiatry and neurology and is associated with
learning.
Brain tissue composed of white matter includes? - Answer: Nerve fibers that connect neurons from
different regions into functional circuits.
Why is white matter considered the transit system? - Answer: Necessary for electrical impulse
transmission. If there are breaks in the system, it can affect neural communication, affecting behavior.
Damage to the myelin can impair transmission which can impact not only sensory and motor function,
but also cognition.
White brain matter is associated with which disease processes? - Answer: Autism and vascular
dementia.
Frontal Lobe - Answer: Associated with movement, intelligence, abstract thinking. the ability to organize,
personality, behavior, and emotional control. Traumatic brain injuries can result in personality changes,
difficulty controlling emotions, and other cognitive functions.
Parietal Lobe - Answer: Middle part of the brain
Responsible for proprioception.
Helps a person to identify spatial relationships, interpret pain and touch in the body, and identify and
give meaning to objects.
Damage to the anterior portion of the parietal lobe may cause asterogenesis, the loss of ability to
recognize objects via the sense of touch.
May be experienced post cerebral vascular accidents.
Temporal Lobe - Answer: Located on the sides of the brain
,Involved in short-term memory, speech, auditory signals, and smell recognition.
Identifies "what" things are - object identification.
Contains the limbic system, amygdala, and hippocampus.
A dominant temporal lobe lesion can present as Wernicke's aphasia.
Temporal Lobe Disorders - Answer: Temporal lobe disorders include dementia, affective disorders, and
attention deficit hyperactivity disorders (ADHD).
Occipital Lobe - Answer: Back part of the brain and controls visual processing. Damage to this lobe
results in the inability to form visual memories.
Bilateral lobe damage results in the inability to recognize items by sight even though vision is normal.
Occipital lobe seizures can cause hallucinations, such as lines of color.
Dorsal Striatum - Answer: Complex motor actions and linkage of cognition to motor actions.
Main input area for the basal ganglia and is activated when anticipating or engaging in pleasure.
Corpus Callosum - Answer: Controls the communication between the two brain hemispheres.
Involved in attention, impulse control, and emotion regulation.
Integrates impulses from both sides of the brain.
Persons with an underdeveloped or missing corpus collosum may have intellectual impairment.
Thalamus - Answer: An egg-shaped structure involved in sensory organ and motor command processing.
All sensory systems except for the olfaction process through the thalamus, which is responsible for
processing all external information.
Associated with symptoms related to schizophrenia and post-traumatic stress disorder (PTSD).
Basal Ganglia - Answer: Involved in voluntary motor movements, cognition, and emotion. Involved in
facilitating voluntary movement.
, Basal ganglia movement disorders include? - Answer: Include Parkinson's disease, obsessive-compulsive
disorder (OCD), and Tourette syndrome.
Limbic System - Answer: Associated with pleasure, reward, and reinforcing behavior. Drug abuse affects
the limbic system, disrupting emotions and feelings associated with normal behavior.
Nucleus Accumbens - Answer: This is involved in the reward circuit and reinforces addictive behaviors.
Amygdala - Answer: Located deep in the temporal lobes and involved in emotional regulation and
perception of odors.
All smells travel directly to the amygdala.
Cooking smells can elicit memories of childhood events and holidays.
A traumatic event can result in the formation of the fear response, causing the fight or flight reflex
within the autonomic nervous system and affects the hypothalamic-pituitary-adrenal (HPA) axis causing
the release of stress hormones (e.g. cortisol).
The amygdala also is involved in the interpretation of facial expressions and sexual stimuli.
Hippocampus - Answer: Located deep in the temporal lobes and is involved in anxiety and memory, and
shifting short-term to long-term memory.
Hippocampal function is impaired in schizophrenia and dementia. There is ongoing research into the
role the hippocampus plays in anxiety and decision making.
What are epigenetic modifications - Answer: Affect how genes are turned on or off, influencing the
production of proteins that carry out various functions in the body.
Can be influenced by a variety of factors, including environmental stimuli, lifestyle, and experiences.
Normal and abnormal genes both contribute to disease and drug efficacy.
Epigenetics can contribute to the risk of any disorder or disease.
Psychiatric disorders can also be due to normal genes that are "on" that should be "off."
How does reviewing the genetic makeup of a client help guide the PMHNP in selecting medication for
clients? - Answer: Provide information on:
How clients may respond to certain psychotropic medications
