NR546 / NR 546 Psychopharmacology 2027 Final Exam - Complete
Study Guide with Questions and Verified Answers - 100% Correct -
Grade A+
Question 1.
What is a key prescribing consideration for antidepressants in bipolar disorder?
Correct Answer: Antidepressants should not be given as monotherapy; they
must be combined with a mood stabilizer to avoid inducing mania.
Question 2.
What should be monitored when prescribing SNRIs to breastfeeding patients?
Correct Answer: Infant irritability.
Question 3.
What factors should be considered when prescribing antidepressants?
Correct Answer: Client preference, prior treatment response, anticipated
adverse effects, comorbidities, half-life, interactions, and cost.
Question 4.
What should be done if the initial antidepressant does not work?
Correct Answer: First, increase the dose; if that fails, switch to a different
drug in the same class, then try a drug in a different class, and possibly add a
second medication.
Question 5.
What is the recommended dose adjustment for older patients taking citalopram and
escitalopram?
Correct Answer: They should receive half the usual dose.
Question 6.
Which SSRI has the least CYP interactions?
Correct Answer: Escitalopram (Lexapro).
Question 7.
Which SSRI is considered good for forgetful patients?
Correct Answer: Fluoxetine, due to its 2-3 day half-life.
‣ What is the longest-acting antidepressant? ✓✓Fluoxetine, with a half-life of
1-2 weeks.
,Question 8.
What is discontinuation syndrome and which medication is more likely to cause it?
Correct Answer: Discontinuation syndrome occurs when stopping an
antidepressant, and paroxetine is more likely to cause it.
Question 9.
Which antidepressant is safe during nursing and pregnancy?
Correct Answer: Sertraline.
Question 10.
What is serotonin syndrome?
Correct Answer: A condition that occurs when two serotonergic drugs are used
together, leading to symptoms such as mental status changes, autonomic
instability, neuromuscular symptoms, seizures, and gastrointestinal
symptoms.
Question 11.
What is the treatment for serotonin syndrome?
Correct Answer: Stop the medication, provide supportive care, and use
benzodiazepines.
Question 12.
What is the black box warning for MAOIs?
Correct Answer: They carry a warning for suicidal ideation in children,
adolescents, and young adults.
Question 13.
What is the half-life of MAOIs?
Correct Answer: 2-4 hours.
Question 14.
What is the black box warning for SSRIs?
Correct Answer: They carry a warning for suicidal tendencies.
‣ What are MAOIs and what do they inhibit? ✓✓MAOIs (monoamine oxidase
inhibitors) are antidepressants that inhibit the enzyme that deactivates
dopamine, norepinephrine, and serotonin.
, Question 15.
What can happen if MAOIs are taken with tyramine-containing foods?
Correct Answer: They can cause a hypertensive crisis.
Question 16.
What can increase lithium levels?
Correct Answer: Nonsteroidal anti-inflammatory drugs (NSAIDs) and
angiotensin-converting enzyme (ACE) inhibitors.
Question 17.
What can decrease lithium levels?
Correct Answer: Caffeine and mania.
Question 18.
What is the role of L-Methylfolate in depression treatment?
Correct Answer: It is necessary for the synthesis of monoamines and is a
bioavailable form of folate that enters the brain.
Question 19.
What are the recommendations for using paroxetine during pregnancy?
Correct Answer: Paroxetine is contraindicated due to the risk of congenital
defects, including atrial septal defects.
Question 20.
What should be monitored when SNRIs are prescribed to breastfeeding mothers?
Correct Answer: Infant irritability.
Question 21.
How do older adults respond to antidepressants compared to younger individuals?
Correct Answer: Older adults may not respond as robustly, especially if the
first episode of depression occurs after age 65.
‣ What is the recommended dosing for citalopram and escitalopram in older
adults? ✓✓They should be dosed at half the normal dose due to the risk of QTc
prolongation.
Question 22.
What does the 2019 American Geriatric Society (AGS) Beers Criteria recommend
regarding paroxetine?
Study Guide with Questions and Verified Answers - 100% Correct -
Grade A+
Question 1.
What is a key prescribing consideration for antidepressants in bipolar disorder?
Correct Answer: Antidepressants should not be given as monotherapy; they
must be combined with a mood stabilizer to avoid inducing mania.
Question 2.
What should be monitored when prescribing SNRIs to breastfeeding patients?
Correct Answer: Infant irritability.
Question 3.
What factors should be considered when prescribing antidepressants?
Correct Answer: Client preference, prior treatment response, anticipated
adverse effects, comorbidities, half-life, interactions, and cost.
Question 4.
What should be done if the initial antidepressant does not work?
Correct Answer: First, increase the dose; if that fails, switch to a different
drug in the same class, then try a drug in a different class, and possibly add a
second medication.
Question 5.
What is the recommended dose adjustment for older patients taking citalopram and
escitalopram?
Correct Answer: They should receive half the usual dose.
Question 6.
Which SSRI has the least CYP interactions?
Correct Answer: Escitalopram (Lexapro).
Question 7.
Which SSRI is considered good for forgetful patients?
Correct Answer: Fluoxetine, due to its 2-3 day half-life.
‣ What is the longest-acting antidepressant? ✓✓Fluoxetine, with a half-life of
1-2 weeks.
,Question 8.
What is discontinuation syndrome and which medication is more likely to cause it?
Correct Answer: Discontinuation syndrome occurs when stopping an
antidepressant, and paroxetine is more likely to cause it.
Question 9.
Which antidepressant is safe during nursing and pregnancy?
Correct Answer: Sertraline.
Question 10.
What is serotonin syndrome?
Correct Answer: A condition that occurs when two serotonergic drugs are used
together, leading to symptoms such as mental status changes, autonomic
instability, neuromuscular symptoms, seizures, and gastrointestinal
symptoms.
Question 11.
What is the treatment for serotonin syndrome?
Correct Answer: Stop the medication, provide supportive care, and use
benzodiazepines.
Question 12.
What is the black box warning for MAOIs?
Correct Answer: They carry a warning for suicidal ideation in children,
adolescents, and young adults.
Question 13.
What is the half-life of MAOIs?
Correct Answer: 2-4 hours.
Question 14.
What is the black box warning for SSRIs?
Correct Answer: They carry a warning for suicidal tendencies.
‣ What are MAOIs and what do they inhibit? ✓✓MAOIs (monoamine oxidase
inhibitors) are antidepressants that inhibit the enzyme that deactivates
dopamine, norepinephrine, and serotonin.
, Question 15.
What can happen if MAOIs are taken with tyramine-containing foods?
Correct Answer: They can cause a hypertensive crisis.
Question 16.
What can increase lithium levels?
Correct Answer: Nonsteroidal anti-inflammatory drugs (NSAIDs) and
angiotensin-converting enzyme (ACE) inhibitors.
Question 17.
What can decrease lithium levels?
Correct Answer: Caffeine and mania.
Question 18.
What is the role of L-Methylfolate in depression treatment?
Correct Answer: It is necessary for the synthesis of monoamines and is a
bioavailable form of folate that enters the brain.
Question 19.
What are the recommendations for using paroxetine during pregnancy?
Correct Answer: Paroxetine is contraindicated due to the risk of congenital
defects, including atrial septal defects.
Question 20.
What should be monitored when SNRIs are prescribed to breastfeeding mothers?
Correct Answer: Infant irritability.
Question 21.
How do older adults respond to antidepressants compared to younger individuals?
Correct Answer: Older adults may not respond as robustly, especially if the
first episode of depression occurs after age 65.
‣ What is the recommended dosing for citalopram and escitalopram in older
adults? ✓✓They should be dosed at half the normal dose due to the risk of QTc
prolongation.
Question 22.
What does the 2019 American Geriatric Society (AGS) Beers Criteria recommend
regarding paroxetine?
