NR546 Midterm Exam Questions And
Answers Verified 100% Correct
Incidence of mental illness-what factors are increasing the incidence - ANSWER -
Psychological and sociological factors
Lifestyle factors such as a client's smoking status, diet, exercise, history of
medication adherence, or history of addiction should be considered when
prescribing psychotropic medications
Adherence - ANSWER -Persistence
-taking med over intended time period
Compliance
-taking med as prescribed
left hemisphere - ANSWER --speech comprehension
-word recognition
-grammar
-sequential processing
-recognition of detail
-conscious mental processing
right hemisphere - ANSWER --prosody of speech
-emotional modulation
-visual-spatial skills
-recognition of facial expression
-music
-abstract mathematical skills
-holistic processing
-unconscious mental processing
Pharmacokinetics - ANSWER -the study of what happens to a drug from the time
of administration until the parent drug and all metabolites leave the body
, CYP450 - ANSWER -CYP450 enzymes in the gut wall or liver convert drug
substrate into a biotransformed product in the bloodstream, responsible for
degradating of a large # of psychotropic drugs
-Not all ind. have same genetic form of CYP450 enzymes, determined with
pharmacogenetic testing
*Most individuals have "normal" rates of drug metabolism from the major
CYP450 enzymes and are said to be "extensive metabolizers", most drug doses are
set for these individuals.
*genetic variants of these enzymes can make poor metabolizers or ultra rapid
metabolizers
Five of the most important:
CYP450 1A2, 2B6, 2D6, 2C9, 2C19, and 3A4.
ultra rapid metabolizers - ANSWER -elevated enzyme activity
subtherapeutic drug levels
poor efficacy with standard doses
genotyping - ANSWER -the patient for pharmacogenomic use
-genes for these CYP450 enzymes can now be readily measured and used to
predict which patients might need to have dosage adjustments
-measurement of genes for drug metabolism
most common targets of psychotropic drugs - ANSWER -G-protein receptors
-Drug actions at these receptors occur in a spectrum, from full agonist actions, to
partial agonist actions, to antagonism, and even to inverse agonism.
Pharmacokinetics concepts - ANSWER -absorption
distribution
metabolism
excretion
Flockhart Table - ANSWER -drug interactions that are mediated by cytochrome
P450 enzymes
,comprehensive list of drugs and the interactions related to the cytochrome P450
system
Neurotransmitters - ANSWER -chemicals released by neurons to send
communication across synaptic clefts to other neurons
-impact human emotion and behavior
Neurotransmission: - ANSWER -the chemical transmission of information
between neurons and their target cells
-the chemicals, or neurotransmitters, are released from their transport vesicles to
bind with receptor sites to perform their duties, which are excitatory or inhibitory
-neurotransmitter then either returned and stored for future use (reuptake) or
inactivated and dissolved by enzymes
-Types: Classic, Retrograde, Volume
Classic neurotransmission - ANSWER -neurons send electrical impulses from one
part of the cell to another part of the same cell via their axons
-one neuron hurling a chemical messenger, or neurotransmitter, at the receptors of
a second neuron
-electrical impulse converted chemical signal at the synapse in a process known as
excitation-secretion coupling, the first stage of chemical neurotransmission, then
back into electrical impulse in second neuron
-chemical information from the first neuron triggering a cascade of further
chemical messages within the second neuron to change that neuron's molecular and
genetic functioning
Retrograde neurotransmission - ANSWER -postsynaptic neurons "talk back" to
their presynaptic neurons
-second neuron to the first at the synapse between them
-Chemicals produced specifically as retrograde neurotransmitters at some synapses
include: endocannabinoids, gaseous neurotransmitter nitric oxide (NO), nerve
growth factor (NGF).
Volume neurotransmission - ANSWER -Neurotransmission without a synapse or
nonsynaptic diffusion neurotransmission
, -Chemical messengers sent by one neuron to another can spill over to sites distant
to the synapse by diffusion
-neurotransmission can occur at any compatible receptor within the diffusion
radius of the neurotransmitter
-neurotransmission occurs in chemical "puffs"
-sophisticated "chemical soup."
-example: dopamine action in the prefrontal cortex, at the sites of autoreceptors on
monoamine neurons
Excitatory neurotransmitters: - ANSWER -increase the likelihood that the neuron
will fire an action potential
inhibitory neurotransmitters: - ANSWER -decrease the likelihood that a neuron
will fire an action
neurotransmitters that most impact mental health can be classified into four major
categories: - ANSWER -cholinergics
-acetylcholine
monoamines
-norepinephrine, dopamine, serotonin, histamine
amino acids
-gamma- amino-butyric acid and glutamate
neuropeptides
Inhibitors: VISA CKGQ - ANSWER -Valproate
Isoniazid
Sulfonamides
Amiodarone
Chloramphenicol
Ketoconazole
Grapefruit Juice
Quinidine
Answers Verified 100% Correct
Incidence of mental illness-what factors are increasing the incidence - ANSWER -
Psychological and sociological factors
Lifestyle factors such as a client's smoking status, diet, exercise, history of
medication adherence, or history of addiction should be considered when
prescribing psychotropic medications
Adherence - ANSWER -Persistence
-taking med over intended time period
Compliance
-taking med as prescribed
left hemisphere - ANSWER --speech comprehension
-word recognition
-grammar
-sequential processing
-recognition of detail
-conscious mental processing
right hemisphere - ANSWER --prosody of speech
-emotional modulation
-visual-spatial skills
-recognition of facial expression
-music
-abstract mathematical skills
-holistic processing
-unconscious mental processing
Pharmacokinetics - ANSWER -the study of what happens to a drug from the time
of administration until the parent drug and all metabolites leave the body
, CYP450 - ANSWER -CYP450 enzymes in the gut wall or liver convert drug
substrate into a biotransformed product in the bloodstream, responsible for
degradating of a large # of psychotropic drugs
-Not all ind. have same genetic form of CYP450 enzymes, determined with
pharmacogenetic testing
*Most individuals have "normal" rates of drug metabolism from the major
CYP450 enzymes and are said to be "extensive metabolizers", most drug doses are
set for these individuals.
*genetic variants of these enzymes can make poor metabolizers or ultra rapid
metabolizers
Five of the most important:
CYP450 1A2, 2B6, 2D6, 2C9, 2C19, and 3A4.
ultra rapid metabolizers - ANSWER -elevated enzyme activity
subtherapeutic drug levels
poor efficacy with standard doses
genotyping - ANSWER -the patient for pharmacogenomic use
-genes for these CYP450 enzymes can now be readily measured and used to
predict which patients might need to have dosage adjustments
-measurement of genes for drug metabolism
most common targets of psychotropic drugs - ANSWER -G-protein receptors
-Drug actions at these receptors occur in a spectrum, from full agonist actions, to
partial agonist actions, to antagonism, and even to inverse agonism.
Pharmacokinetics concepts - ANSWER -absorption
distribution
metabolism
excretion
Flockhart Table - ANSWER -drug interactions that are mediated by cytochrome
P450 enzymes
,comprehensive list of drugs and the interactions related to the cytochrome P450
system
Neurotransmitters - ANSWER -chemicals released by neurons to send
communication across synaptic clefts to other neurons
-impact human emotion and behavior
Neurotransmission: - ANSWER -the chemical transmission of information
between neurons and their target cells
-the chemicals, or neurotransmitters, are released from their transport vesicles to
bind with receptor sites to perform their duties, which are excitatory or inhibitory
-neurotransmitter then either returned and stored for future use (reuptake) or
inactivated and dissolved by enzymes
-Types: Classic, Retrograde, Volume
Classic neurotransmission - ANSWER -neurons send electrical impulses from one
part of the cell to another part of the same cell via their axons
-one neuron hurling a chemical messenger, or neurotransmitter, at the receptors of
a second neuron
-electrical impulse converted chemical signal at the synapse in a process known as
excitation-secretion coupling, the first stage of chemical neurotransmission, then
back into electrical impulse in second neuron
-chemical information from the first neuron triggering a cascade of further
chemical messages within the second neuron to change that neuron's molecular and
genetic functioning
Retrograde neurotransmission - ANSWER -postsynaptic neurons "talk back" to
their presynaptic neurons
-second neuron to the first at the synapse between them
-Chemicals produced specifically as retrograde neurotransmitters at some synapses
include: endocannabinoids, gaseous neurotransmitter nitric oxide (NO), nerve
growth factor (NGF).
Volume neurotransmission - ANSWER -Neurotransmission without a synapse or
nonsynaptic diffusion neurotransmission
, -Chemical messengers sent by one neuron to another can spill over to sites distant
to the synapse by diffusion
-neurotransmission can occur at any compatible receptor within the diffusion
radius of the neurotransmitter
-neurotransmission occurs in chemical "puffs"
-sophisticated "chemical soup."
-example: dopamine action in the prefrontal cortex, at the sites of autoreceptors on
monoamine neurons
Excitatory neurotransmitters: - ANSWER -increase the likelihood that the neuron
will fire an action potential
inhibitory neurotransmitters: - ANSWER -decrease the likelihood that a neuron
will fire an action
neurotransmitters that most impact mental health can be classified into four major
categories: - ANSWER -cholinergics
-acetylcholine
monoamines
-norepinephrine, dopamine, serotonin, histamine
amino acids
-gamma- amino-butyric acid and glutamate
neuropeptides
Inhibitors: VISA CKGQ - ANSWER -Valproate
Isoniazid
Sulfonamides
Amiodarone
Chloramphenicol
Ketoconazole
Grapefruit Juice
Quinidine
