MARYVILLE NURS660
PSYCHOPHARMACOLOGY EXAM 3 ACTUAL
PAPER 2026 QUESTIONS SOLUTIONS GRADED
A+
◉ Fluoxetine (Prozac)
Major Side Effect. Answer: Activating (UPPER); AGITATION,
INSOMNIA, nausea, vomiting, sex dysfunction, GI, serotonin
syndrome
◉ Paraoxetine (Paxil)
Major Side Effects. Answer: Anticholinergic (can't see, can't sleep,
can't shit, can't spit), CYP2D6 inhibitor, increases TCA,
phenothiazines, Type 1C antiarrhythmics, weight gain, GI, sex
dysfunction, insomnia, serotonin syndrome
◉ Lithium
Major Side Effects. Answer: increased thirst & urination, impaired
concentration/memory, fatigue, tremor, weight gain.
,Toxicity: cramps, v/d, kidney dysfunction, coarse tremor, confusion,
irritability. Severe toxicity: seizures, coma, death.
◉ Fluvoxamine (Luvox)
Major Side Effects. Answer: nausea, vomiting, weight gain, sex
dysfunction; BIG BBW for SI on this drug
◉ Major side effects for sertraline, fluoxetine, paroxetine, and
fluvoxamine (generals for all)
•Most side effects are immediate and go away with time. Answer:
sexual dysfunction (dose dependent- men: delayed ejaculation, ED;
men and women: decreased sexual desire, anorgasmia)
GI: decreased appetite, nausea, diarrhea, constipation, dry mouth
Mostly CNS: insomnia, sedation, agitation, tremors, headache,
dizziness
Autonomic: sweating
Bruising and rare bleeding
,Rare hyponatremia (mostly in elderly)
Rare hypotension
SIADH
Weight gain
Rare: seizures, induction of mania, activation of suicidal ideation and
behavior
◉ Major side effects for sertraline, fluoxetine, paroxetine, and
fluvoxamine (generals for all) r/t to increased serotonin. Answer:
concentrations at serotonin receptors in parts of brain and body
other than those that cause therapeutic actions (e.g. unwanted
actions of serotonin in sleep centers causing insomnia or in gut
causing diarrhea)
can cause diminished dopamine release and might contribute to
emotional flattening, cognitive slowing, and apathy in some patients
◉ Major side effects for sertraline, fluoxetine, paroxetine, and
fluvoxamine (generals for all)
, Patients with diagnosed or undiagnosed bipolar or psychotic
disorders. Answer: may be more vulnerable to CNS-activating
actions of SSRIs
◉ Know major side effects for lithium (typically dose related).
Answer: Ataxia, dysarthria, delirium, tremor, memory problems
Polyuria, polydipsia (nephrogenic diabetes insipidus)
Diarrhea, nausea
Weight gain
Euthyroid goiter or hypothyroid goiter, possibly with increased TSH
and reduced thyroxine levels
Acne, rash, alopecia
Leukocytosis
Life Threatening: TOXICITY: TREMOR, ATAXIA, N/V/D, SEDATION,
DI, INTESTINAL NEPHRITIS, T WAVE FLATTENING, SEIZURES
PSYCHOPHARMACOLOGY EXAM 3 ACTUAL
PAPER 2026 QUESTIONS SOLUTIONS GRADED
A+
◉ Fluoxetine (Prozac)
Major Side Effect. Answer: Activating (UPPER); AGITATION,
INSOMNIA, nausea, vomiting, sex dysfunction, GI, serotonin
syndrome
◉ Paraoxetine (Paxil)
Major Side Effects. Answer: Anticholinergic (can't see, can't sleep,
can't shit, can't spit), CYP2D6 inhibitor, increases TCA,
phenothiazines, Type 1C antiarrhythmics, weight gain, GI, sex
dysfunction, insomnia, serotonin syndrome
◉ Lithium
Major Side Effects. Answer: increased thirst & urination, impaired
concentration/memory, fatigue, tremor, weight gain.
,Toxicity: cramps, v/d, kidney dysfunction, coarse tremor, confusion,
irritability. Severe toxicity: seizures, coma, death.
◉ Fluvoxamine (Luvox)
Major Side Effects. Answer: nausea, vomiting, weight gain, sex
dysfunction; BIG BBW for SI on this drug
◉ Major side effects for sertraline, fluoxetine, paroxetine, and
fluvoxamine (generals for all)
•Most side effects are immediate and go away with time. Answer:
sexual dysfunction (dose dependent- men: delayed ejaculation, ED;
men and women: decreased sexual desire, anorgasmia)
GI: decreased appetite, nausea, diarrhea, constipation, dry mouth
Mostly CNS: insomnia, sedation, agitation, tremors, headache,
dizziness
Autonomic: sweating
Bruising and rare bleeding
,Rare hyponatremia (mostly in elderly)
Rare hypotension
SIADH
Weight gain
Rare: seizures, induction of mania, activation of suicidal ideation and
behavior
◉ Major side effects for sertraline, fluoxetine, paroxetine, and
fluvoxamine (generals for all) r/t to increased serotonin. Answer:
concentrations at serotonin receptors in parts of brain and body
other than those that cause therapeutic actions (e.g. unwanted
actions of serotonin in sleep centers causing insomnia or in gut
causing diarrhea)
can cause diminished dopamine release and might contribute to
emotional flattening, cognitive slowing, and apathy in some patients
◉ Major side effects for sertraline, fluoxetine, paroxetine, and
fluvoxamine (generals for all)
, Patients with diagnosed or undiagnosed bipolar or psychotic
disorders. Answer: may be more vulnerable to CNS-activating
actions of SSRIs
◉ Know major side effects for lithium (typically dose related).
Answer: Ataxia, dysarthria, delirium, tremor, memory problems
Polyuria, polydipsia (nephrogenic diabetes insipidus)
Diarrhea, nausea
Weight gain
Euthyroid goiter or hypothyroid goiter, possibly with increased TSH
and reduced thyroxine levels
Acne, rash, alopecia
Leukocytosis
Life Threatening: TOXICITY: TREMOR, ATAXIA, N/V/D, SEDATION,
DI, INTESTINAL NEPHRITIS, T WAVE FLATTENING, SEIZURES
