A+ NR546 EXAM QUESTIONS AND ANSWERS LATEST UPDATE
match each symptom to hypothetically malfunctioning brain circuits: aggressive
symptoms
orbitofrontal cortex
amygdala
match each symptom to hypothetically malfunctioning brain circuits: affective
symptoms
ventromedial prefrontal cortex
polygenic risk score
add up all the abnormal genes an individual has amongst the known few hundred risk
genes, suggesting how much risk there might be for developing schizophrenia.
Barnes Akathisia Rating Scale (BARS)
rating scale to assess the severity of drug-induced akathisia.
-includes objective and subjective items such as the level of the patient's restlessness
Abnormal Involuntary Movement Scale (AIMS)
tool used to monitor involuntary movements and tardive dyskinesia in clients who take
antipsychotic medication
-best practice/recommendation to document the AIMS at minimum every 6 months for
patients taking an antipsychotic agent/dopamine blocker
Low-potency medications
-require higher doses to achieve efficacy
-have more anticholinergic, antihistaminic, and α1- properties, can result in more
sedation
Targeting mesolimbic/mesostriatal dopamine D2 receptors causes:
antipsychotic actions
Targeting dopamine D2 receptors in Mesolimbic/mesostriatal and mesocortical
pathways causes:
secondary negative symptoms
Targeting tuberoinfudibular dopamine D2 receptors causes:
,elevation of prolactin
-associated with gynecomastia, galactorrhea, amenorrhea
Targeting nigrostriatal dopamine D2 receptors causes:
motor side effects
-can cause drug induced parkinsonism
overactivity of the mesolimbic dopamine system
may mediate the positive symptoms of psychosis
any abnormal motor symptoms caused by D2 receptor blockers are lumped
together and called collectively:
extrapyramidal symptsom (EPS)
-motor side effects of D2 antagonists
caused by chronic blockade of D2 receptors in the nigrostriatal dopamine
pathway
tardive dyskinesia (TD)
-tx: interventions that lower dopamine neurotransmission, inhibiting the vesicular
monoamine transporter type 2 (VMAT2) lowers the "go" signals - deuterated
tetrabenazine (deutetrabenazine), Valbenazine (most selective and potent) ,
the most common side effect of drugs that target D2 receptors for psychosis
Drug induced parkinsonism (DIP)
-akinesia, bradykinesia, rigidity, and tremor
*anticholinergics-drugs that block muscarinic cholinergic receptors
adding 5HT2A antagonism:
improve side effects of D2 blockade and enhance the antipsychotic efficacy of D2
blockade
Sedative-hypnotic agents
benzodiazepine & barbiturates, clinical indications for use:
-sedation & anxiolysis
-treatment of insomnia
-general anesthesia
-seizures
-alcohol withdrawal states
, -as adjunctive management with neuromuscular blockage/muscle relaxation
-to induce or maintain sleep
sedative-hypnotic medications: use
-1 in 8 adults
-Higher incidence in older adults
-Often co-prescribed with opioids
sedative-hypnotic medications: misuse
-Taken outside of prescriptive guidelines
-Taken without prescription
-polysubstance Abuse
-Are common as second drugs of abuse, often taken with opioids and/or alcohol
-Increased respiratory and CNS depression
-Increased risk of emergency department visits
sedative-hypnotic medications: Withdrawal
-May be severe
-Signs and symptoms include psychosis, hallucinations, delirium, seizures
-Mild signs and symptoms: irritability, tremor, anxiety, palpitations, insomnia, nausea,
vomiting, diaphoresis, headache
Benzodiazepine intoxication
Can resemble alcohol intoxication: unsteady gait, cognitive impairment, discoordination,
slurred speech
-Overdose may lead to respiratory depression and stupor/coma
Anxiety
response to situations that are perceived as stressful or dangerous
-increases alertness, heart rate, and respirations, preparing the body to respond to
perceived threatening environmental stimuli
*when symptoms of anxiety persist and become intense or excessive, a diagnosis of an
anxiety disorder may be warranted, and treatment is required
anxiety disorder
-affects more women than men
-one of the most common mental health concerns in the United States
match each symptom to hypothetically malfunctioning brain circuits: aggressive
symptoms
orbitofrontal cortex
amygdala
match each symptom to hypothetically malfunctioning brain circuits: affective
symptoms
ventromedial prefrontal cortex
polygenic risk score
add up all the abnormal genes an individual has amongst the known few hundred risk
genes, suggesting how much risk there might be for developing schizophrenia.
Barnes Akathisia Rating Scale (BARS)
rating scale to assess the severity of drug-induced akathisia.
-includes objective and subjective items such as the level of the patient's restlessness
Abnormal Involuntary Movement Scale (AIMS)
tool used to monitor involuntary movements and tardive dyskinesia in clients who take
antipsychotic medication
-best practice/recommendation to document the AIMS at minimum every 6 months for
patients taking an antipsychotic agent/dopamine blocker
Low-potency medications
-require higher doses to achieve efficacy
-have more anticholinergic, antihistaminic, and α1- properties, can result in more
sedation
Targeting mesolimbic/mesostriatal dopamine D2 receptors causes:
antipsychotic actions
Targeting dopamine D2 receptors in Mesolimbic/mesostriatal and mesocortical
pathways causes:
secondary negative symptoms
Targeting tuberoinfudibular dopamine D2 receptors causes:
,elevation of prolactin
-associated with gynecomastia, galactorrhea, amenorrhea
Targeting nigrostriatal dopamine D2 receptors causes:
motor side effects
-can cause drug induced parkinsonism
overactivity of the mesolimbic dopamine system
may mediate the positive symptoms of psychosis
any abnormal motor symptoms caused by D2 receptor blockers are lumped
together and called collectively:
extrapyramidal symptsom (EPS)
-motor side effects of D2 antagonists
caused by chronic blockade of D2 receptors in the nigrostriatal dopamine
pathway
tardive dyskinesia (TD)
-tx: interventions that lower dopamine neurotransmission, inhibiting the vesicular
monoamine transporter type 2 (VMAT2) lowers the "go" signals - deuterated
tetrabenazine (deutetrabenazine), Valbenazine (most selective and potent) ,
the most common side effect of drugs that target D2 receptors for psychosis
Drug induced parkinsonism (DIP)
-akinesia, bradykinesia, rigidity, and tremor
*anticholinergics-drugs that block muscarinic cholinergic receptors
adding 5HT2A antagonism:
improve side effects of D2 blockade and enhance the antipsychotic efficacy of D2
blockade
Sedative-hypnotic agents
benzodiazepine & barbiturates, clinical indications for use:
-sedation & anxiolysis
-treatment of insomnia
-general anesthesia
-seizures
-alcohol withdrawal states
, -as adjunctive management with neuromuscular blockage/muscle relaxation
-to induce or maintain sleep
sedative-hypnotic medications: use
-1 in 8 adults
-Higher incidence in older adults
-Often co-prescribed with opioids
sedative-hypnotic medications: misuse
-Taken outside of prescriptive guidelines
-Taken without prescription
-polysubstance Abuse
-Are common as second drugs of abuse, often taken with opioids and/or alcohol
-Increased respiratory and CNS depression
-Increased risk of emergency department visits
sedative-hypnotic medications: Withdrawal
-May be severe
-Signs and symptoms include psychosis, hallucinations, delirium, seizures
-Mild signs and symptoms: irritability, tremor, anxiety, palpitations, insomnia, nausea,
vomiting, diaphoresis, headache
Benzodiazepine intoxication
Can resemble alcohol intoxication: unsteady gait, cognitive impairment, discoordination,
slurred speech
-Overdose may lead to respiratory depression and stupor/coma
Anxiety
response to situations that are perceived as stressful or dangerous
-increases alertness, heart rate, and respirations, preparing the body to respond to
perceived threatening environmental stimuli
*when symptoms of anxiety persist and become intense or excessive, a diagnosis of an
anxiety disorder may be warranted, and treatment is required
anxiety disorder
-affects more women than men
-one of the most common mental health concerns in the United States
