NR 546 / NR546 Final Exam
Psychopharmacology for
PMHNP: Most Comprehensive
Qs & Ans - to, Latest
2025/2026 Exams of
Community Health|Graded A+|
Reliable A+ Certified Pass
monoamine hypothesis of depression - ANSWERS-depression occurs as a result of
deficiency of 1 or all 3 monoamine NT
-occurs due to too little positive affect or too much negative affect
(mania will occur from excess of all 3)
what are the three monoamine NT - ANSWERS-NE, DA, 5HT
too little positive affect - ANSWERS--DA/NE dysfunction
-DA levels low = loss of pleasure, interest, alertness, self-confidence
-DA levels high = hallucinations seen in schizo
,-NE (fight or flight) high = antsy, nervous, affects focus ability
-depressed mood, loss of joy, lack of interest, loss of energy, decreased alertness,
decreased self-confidence, appetite changes
too much negative affect - ANSWERS--5HT = relaxation, comfort, decreases stress,
regulates libido, arousal, sleep, aggression, pain perception
-5HT/NE dysfunction
-depressed mood, guilt, fear/anxiety, hostility, irritability, loneliness, appetite
changes
prescribing considerations - ANSWERS--client preference
-prior treatment response
-anticipated adverse effects
-comorbidities
-half-life interactions
-cost
client preference - ANSWERS-if no contraindication, then prescribe that med to
improve adherence
prior treatment response - ANSWERS-if patient had success with a previous med,
prescribe that one first
,anticipated adverse events - ANSWERS--consider age, family planning, and
anticipated adverse effects.
-use adverse effects to pt's advantage (choose a known activating medication for
a pt with atypical depression or choose a sedating medication for a patient with
sleep disturbances)
Comorbidities - ANSWERS-clients with comorbid anxiety may experience
worsening symptoms when taking medications that target NE (SNRIs)
-fluoxetine is known to activate clients and cause panic attacks in clients with
comorbid anxiety
half-life interactions - ANSWERS--choose a medication with a longer half life to
avoid discontinuation syndrome if your client forgets to take it
-many antidepressants have significant interactions with other meds due to
CYP450 enzyme involvement
cost - ANSWERS-if client cant afford medication, they will not benefit. keep cost,
insurance benefits, and pharmaceutical assistance programs in mind
goal of antidepressant medications - ANSWERS-complete remission of symptoms
antidepressant prescribing schedule - ANSWERS--start on a single drug for 4-8
weeks
-if not working:
1. increase dose gradually until efficacy occurs
, 2. switch to different drug within same drug class after adequate trial which
included higher dosing and a minimum of 8 weeks
3. switch to a drug in a different class after adequate trial and higher dosing
4. add a second med as adjunct
SSRI MOA - ANSWERS-inhibit 5HT reuptake
first line of treatment for depression
SSRI s/e - ANSWERS-7 S's of SSRIs
1. Stomach
2. sexual dysfunction
3. serotonin syndrome
4. sleep difficulties
5. suicidal thoughts
6. stress
7. size (weight)
serotonin s/e - ANSWERS-head, red, fed
head = decreased anxiety, impulsivity, sex drive
red = platelets and bleeding
fed = gi motility and nausea
Psychopharmacology for
PMHNP: Most Comprehensive
Qs & Ans - to, Latest
2025/2026 Exams of
Community Health|Graded A+|
Reliable A+ Certified Pass
monoamine hypothesis of depression - ANSWERS-depression occurs as a result of
deficiency of 1 or all 3 monoamine NT
-occurs due to too little positive affect or too much negative affect
(mania will occur from excess of all 3)
what are the three monoamine NT - ANSWERS-NE, DA, 5HT
too little positive affect - ANSWERS--DA/NE dysfunction
-DA levels low = loss of pleasure, interest, alertness, self-confidence
-DA levels high = hallucinations seen in schizo
,-NE (fight or flight) high = antsy, nervous, affects focus ability
-depressed mood, loss of joy, lack of interest, loss of energy, decreased alertness,
decreased self-confidence, appetite changes
too much negative affect - ANSWERS--5HT = relaxation, comfort, decreases stress,
regulates libido, arousal, sleep, aggression, pain perception
-5HT/NE dysfunction
-depressed mood, guilt, fear/anxiety, hostility, irritability, loneliness, appetite
changes
prescribing considerations - ANSWERS--client preference
-prior treatment response
-anticipated adverse effects
-comorbidities
-half-life interactions
-cost
client preference - ANSWERS-if no contraindication, then prescribe that med to
improve adherence
prior treatment response - ANSWERS-if patient had success with a previous med,
prescribe that one first
,anticipated adverse events - ANSWERS--consider age, family planning, and
anticipated adverse effects.
-use adverse effects to pt's advantage (choose a known activating medication for
a pt with atypical depression or choose a sedating medication for a patient with
sleep disturbances)
Comorbidities - ANSWERS-clients with comorbid anxiety may experience
worsening symptoms when taking medications that target NE (SNRIs)
-fluoxetine is known to activate clients and cause panic attacks in clients with
comorbid anxiety
half-life interactions - ANSWERS--choose a medication with a longer half life to
avoid discontinuation syndrome if your client forgets to take it
-many antidepressants have significant interactions with other meds due to
CYP450 enzyme involvement
cost - ANSWERS-if client cant afford medication, they will not benefit. keep cost,
insurance benefits, and pharmaceutical assistance programs in mind
goal of antidepressant medications - ANSWERS-complete remission of symptoms
antidepressant prescribing schedule - ANSWERS--start on a single drug for 4-8
weeks
-if not working:
1. increase dose gradually until efficacy occurs
, 2. switch to different drug within same drug class after adequate trial which
included higher dosing and a minimum of 8 weeks
3. switch to a drug in a different class after adequate trial and higher dosing
4. add a second med as adjunct
SSRI MOA - ANSWERS-inhibit 5HT reuptake
first line of treatment for depression
SSRI s/e - ANSWERS-7 S's of SSRIs
1. Stomach
2. sexual dysfunction
3. serotonin syndrome
4. sleep difficulties
5. suicidal thoughts
6. stress
7. size (weight)
serotonin s/e - ANSWERS-head, red, fed
head = decreased anxiety, impulsivity, sex drive
red = platelets and bleeding
fed = gi motility and nausea
