NR546 / NR 546 Psychopharmacology 2027 Final Exam - Detailed
Review Guide with Exam Questions and Verified Solutions - Grade A+
Question 1.
What is a key prescribing consideration for antidepressants in bipolar disorder?
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?
Answer: Infant irritability.
Question 3.
What factors should be considered when prescribing antidepressants?
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?
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?
Answer: They should receive half the usual dose.
Question 6.
Which SSRI has the least CYP interactions?
Answer: Escitalopram (Lexapro).
Question 7.
Which SSRI is considered good for forgetful patients?
Answer: Fluoxetine, due to its 2-3 day half-life.
• What is the longest-acting antidepressant? Answer: Fluoxetine, with a
half-life of 1-2 weeks.
,Question 8.
What is discontinuation syndrome and which medication is more likely to cause it?
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?
Answer: Sertraline.
Question 10.
What is serotonin syndrome?
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?
Answer: Stop the medication, provide supportive care, and use
benzodiazepines.
Question 12.
What is the black box warning for MAOIs?
Answer: They carry a warning for suicidal ideation in children, adolescents,
and young adults.
Question 13.
What is the half-life of MAOIs?
Answer: 2-4 hours.
Question 14.
What is the black box warning for SSRIs?
Answer: They carry a warning for suicidal tendencies.
Question 15.
What are MAOIs and what do they inhibit?
, Answer: MAOIs (monoamine oxidase inhibitors) are antidepressants that
inhibit the enzyme that deactivates dopamine, norepinephrine, and serotonin.
• What can happen if MAOIs are taken with tyramine-containing foods?
Answer: They can cause a hypertensive crisis.
Question 16.
What can increase lithium levels?
Answer: Nonsteroidal anti-inflammatory drugs (NSAIDs) and
angiotensin-converting enzyme (ACE) inhibitors.
Question 17.
What can decrease lithium levels?
Answer: Caffeine and mania.
Question 18.
What is the role of L-Methylfolate in depression treatment?
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?
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?
Answer: Infant irritability.
Question 21.
How do older adults respond to antidepressants compared to younger individuals?
Answer: Older adults may not respond as robustly, especially if the first
episode of depression occurs after age 65.
Question 22.
What is the recommended dosing for citalopram and escitalopram in older adults?
Answer: They should be dosed at half the normal dose due to the risk of QTc
prolongation.
• What does the 2019 American Geriatric Society (AGS) Beers Criteria
Review Guide with Exam Questions and Verified Solutions - Grade A+
Question 1.
What is a key prescribing consideration for antidepressants in bipolar disorder?
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?
Answer: Infant irritability.
Question 3.
What factors should be considered when prescribing antidepressants?
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?
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?
Answer: They should receive half the usual dose.
Question 6.
Which SSRI has the least CYP interactions?
Answer: Escitalopram (Lexapro).
Question 7.
Which SSRI is considered good for forgetful patients?
Answer: Fluoxetine, due to its 2-3 day half-life.
• What is the longest-acting antidepressant? Answer: Fluoxetine, with a
half-life of 1-2 weeks.
,Question 8.
What is discontinuation syndrome and which medication is more likely to cause it?
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?
Answer: Sertraline.
Question 10.
What is serotonin syndrome?
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?
Answer: Stop the medication, provide supportive care, and use
benzodiazepines.
Question 12.
What is the black box warning for MAOIs?
Answer: They carry a warning for suicidal ideation in children, adolescents,
and young adults.
Question 13.
What is the half-life of MAOIs?
Answer: 2-4 hours.
Question 14.
What is the black box warning for SSRIs?
Answer: They carry a warning for suicidal tendencies.
Question 15.
What are MAOIs and what do they inhibit?
, Answer: MAOIs (monoamine oxidase inhibitors) are antidepressants that
inhibit the enzyme that deactivates dopamine, norepinephrine, and serotonin.
• What can happen if MAOIs are taken with tyramine-containing foods?
Answer: They can cause a hypertensive crisis.
Question 16.
What can increase lithium levels?
Answer: Nonsteroidal anti-inflammatory drugs (NSAIDs) and
angiotensin-converting enzyme (ACE) inhibitors.
Question 17.
What can decrease lithium levels?
Answer: Caffeine and mania.
Question 18.
What is the role of L-Methylfolate in depression treatment?
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?
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?
Answer: Infant irritability.
Question 21.
How do older adults respond to antidepressants compared to younger individuals?
Answer: Older adults may not respond as robustly, especially if the first
episode of depression occurs after age 65.
Question 22.
What is the recommended dosing for citalopram and escitalopram in older adults?
Answer: They should be dosed at half the normal dose due to the risk of QTc
prolongation.
• What does the 2019 American Geriatric Society (AGS) Beers Criteria
