NSG 552/ NSG552 Exam 3 V2 – Psychopharmacology Review | Wilkes (Latest 2026/ 2027 Update) 100% Verified Questions & Answers | Grade A

NSG 552/ NSG552 Exam 3 V2 – Psychopharmacology Review | Wilkes (Latest 2026/ 2027 Update) 100% Verified Questions & Answers | Grade A What are ADHD stimulant medications? Methylphenidate (Ritalin); Dextromethylphenidate (Focalin); Dextroamphetamine/Amphetamine (Adderrall); Lisdexamfetamine (Vyvanse) Methylphenidate (Ritalin) 1st line stimulant; Don't give with preexisting heart disease Methylphenidate (Ritalin) Mechanism of Action Boosts DE, NE, SA What ADHD stimulant medication is FDA approved for ages 6 and up? Methylphenidate (Ritalin) Methylphenidate (Ritalin) Signs and Symptoms Loss of appetite; Headache; Insomnia; Weight loss; Stomachache Methylphenidate (Ritalin) short acting hours 3-4 hours Methylphenidate (Ritalin) long acting hours 8-10 hours Methylphenidate (Ritalin) monitoring Height, weight, blood pressure quaterly What can Methylphenidate (Ritalin) restrict? Height and weight Dextromethylphenidate (Focalin) Stimulant medication that may be good for kids with bad side effects from Ritalin Dextromethylphenidate (Focalin) short acting hours 4-6 hours What ADHD stimulant medication is FDA approved for ages 3 and up? Dextromethylphenidate (Focalin) Dextromethylphenidate (Focalin) Side Effects Loss of appetite; Headache; Insomnia; Weight loss; Stomachache; Increased blood pressure; Tics; Psychosis Dextroamphetamine/Amphetamine (Adderrall) short acting hours 4-6 hours Dextroamphetamine/Amphetamine (Adderrall) long acting hours (XL) 8-12 hours Lisdexamfetamine (Vyvanse) long acting hours 8-12 hours What are ADHD non-stimulant medications? Atomoxetine (Streterra); Bupropion (Wellbutrin); Imipramine or Nortriptyline; Clonidine or Guafancine What is the black box warning for Atomoxetine (Streterra)? Suicidal ideation thinking What ADHD non- stimulant medication is FDA approved for ages 6 and up? Atomoxetine (Streterra) What ADHD non- stimulant medication is liver toxic? Atomoxetine (Streterra); Will need LFTs What ADHD non-stimulant medication is not given with a seizure disorder, head trauma, or eating disorder? Bupropion (Wellbutrin) What non-stimulant medication has a decreased seizure threshold? Bupropion (Wellbutrin) What is observed with Imipramine or Nortriptyline? TCA (tricyclics) warnings What non-stimulant medication is lethal in overdose? Imipramine or Nortriptyline What non-stimulant medication is prescribed every week? Imipramine or Nortriptyline What are the 3 C's for Imipramine or Nortriptyline? Cardiotoxic; Convulsions; Coma What ADHD non-stimulant medication is not approved for adults? Clonidine or Guanfacine What is the mechanism of action for Clonidine or Guanfacine? Alpha 2 adrenergic agonist (BP medications) What does clonidine treat? Impulsivity and hyperactivity What do you watch for if clonidine is prescribed? Blood pressure What do you watch for if guanfacine is prescribed? Low blood pressure; Cardiac arrhythmias What is clonidine or guanfacine good for? Patients with preexisting tics. Can be prescribed alone or with other ADHD medications What ADHD non-stimulant medication is FDA approved for ages 6-17? Clonidine or Guanfacine What atypical antipsychotics are used in autism? Risperidone (Risperdal); Aripiporazol (Abilify); Clonidine or Guanfacine; Mirtazapine (Remeron) What atypical antipsychotic increases the risk of EPS with a dose increase greater than 6mg? Risperidone (Risperdal) What atypical antipsychotic increases the risk for prolactin elevation? Risperidone (Risperdal) How does Risperidone (Risperdal) help in autism? Used to reduce disruptive behaviors, aggression, and irritability. What dose is Risperidone (Risperdal) started in autism? Low dose What atypical antipsychotic is FDA approved for autism? Risperidone (Risperdal) What atypical antipsychotic has less potential for weight gain? Aripiporazol (Abilify) How does Aripiporazol (Abilify) help in autism? Used to reduce disruptive behaviors, aggression, and irritabilty What dose is Aripiporazol (Abilify) started in autism? Low dose What is the mechanism of action of Mirtazapine (Remeron)? Alpha 2 adrenergic and 5HT2 antagonist = Increased 5HT and NE What medication is prescribed to patients who have had weight loss and insomnia as primary symptoms of depression and dementia related depression, example the elderly? Mirtazapine (Remeron) Mirtazapine (Remeron) Side Effects Sedation; Weight gain; Dizziness; Tremor; Dry mouth What medication has an inverse relationship between dose and sedation? Mirtazapine (Remeron) What are metabolic syndrome side effects? High blood pressure; High blood sugar Excess body fat around the waist; Abnormal cholesterol levels How is IDD treated? Behavioral therapy. No pharmacological treatments. Pharmacological options can be prescribed for behavioral control. What medications are used for Alzheimer's disease and dementia? Donepezil (Aricept); Rivastigmine (Exelon); Galantamine (Razadyne); Memantine (Manenda) Donepezil (Aricept) Mechanism of action Cholinesterase inhibitor What does Donepezil (Aricept) do? Slows clinical deterioration by 6-12 months What is Donepezil (Aricept) used for? Mild to moderate Alzheimer's What medications are not effective in severe, end stage disease? Donepezil (Aricept); Galantamine (Razadyne) What medications should be discontinued is nausea and vomiting develop? Donepezil (Aricept); Galantamine (Razadyne) Rivastigmine (Exelon) Mechanism of Action Cholinesterase inhibitor What is Rivastigmine (Exelon) used for? Mild to moderate Alzheimer's disease and Parkinson's disease dementia How is Rivastigmine (Exelon) available? Transdermal patch Which Alzheimer's medication has the highest GI side effects? Rivastigmine (Exelon) Galantamine (Razadyne) Mechanism of Action Cholinesterase inhibitor What does Galantamine (Razadyne) do? Slows clinical deterioration by 6-12 months What is Galantamine (Razadyne) used for? Mild to moderate Alzheimer's disease Memantine (Manenda) Mechanism of Action NMDA What is Memantine (Manenda) used for? Moderate to severe Alzheimer's disease What does Memantine (Manenda) do? Promotes synaptic plasticity What Alzheimer's medication can be used in conjunction with cholinesterase inhibitors? Memantine (Manenda) Cluster A Personalities Paranoid; Schizotypal; Schizoid (Sheldon Cooper) Paranoid Treatments Short-term antipsychotics; Psychotherapy Schizotypal Treatments Short-term antipsychotics; Psychotherapy Schizoid (Sheldon Cooper) Treatments Possibly antidepressants Cluster B Personalities Antisocial (serial killer); Borderline; Histrionic; Narcissistic Antisocial (serial killer) Treatments Treat anxiety or depression Borderline Treatments Dialectical behavior therapy (DBT); Mood stabilizers; Antidepressants; Antipsychotics Cluster C Personalities Avoidant; Dependent; Obsessive Compulsive Disorder (OCD) Avoidant Treatments SSRI: Sertaline (Zoloft); Fluozetine (Prozac); Psychotherapy Dependent Treatments SSRI's; Psychotherapy Obsessive Compulsive Personality Disorder (OCD) Treatments SSRIs: Fluvoxamine (Luvox); TCAs: Clomipramine (Anafranil); Psychotherapy What are the Banana Bag ingredients? Thiamine; Multivitamin; Folic acid Administering a banana bag prevents what? Wernicke Korsakoff Encephalopathy What type of medications do you administer for alcohol withdrawal? Benzodiazepines What benzodiazepines can be administered for alcohol withdrawal? Lorazepam (Ativan); Diazepam (Valium); Oxazepam (Serax); Chlordiazepoxide (Librium) What mood stabilizers can be administered if alcohol withdrawal is mild? Carbamazepine (Tegretol); Valproic Acid (Depakote) What medications are first line treatment for alcohol use disorder? Naltrexone (ReVia or Vivitrol); Acamprosate (Campral) Naltrexone (ReVia or Vivitrol) Mechanism of Action Opioid receptor antagonist What does Naltrexone (ReVia or Vivitrol) do? Reduces cravings and "high" associated with being drunk Can you drink when taking Naltrexone (ReVia or Vivitrol)? Can drink mildly but will reduce binging What alcohol use disorder medication can interfere with anesthesia for surgical procedures? Naltrexone (ReVia or Vivitrol) What alcohol use disorder medication can cause LFT elevation? Naltrexone (ReVia or Vivitrol) Acamprosate (Campral) Mechanism of Action NMDA receptor antagonist What alcohol use disorder medication can be used with liver disease? Acamprosate (Campral) What alcohol use disorder medication is contraindicated for severe kidney disease? Acamprosate (Campral) What alcohol use disorder medication is used to prevent relapse once drinking has stopped? Acamprosate (Campral) What medication is second line treatment for alcohol use disorder? Topiramate (Topamax) Topiramate (Topamax) Mechanism of Action Anticonvulsant; Potentiates GABA and inhibits the glutamate receptors What does Topiramate (Topamax) do? Reduces cravings and alcohol use What alcohol use disorder medication gives the patient impaired cognition? Topiramate (Topamax) (dope "a" max) Disulfiram (Antabuse) Mechanism of Action Blocks aldehyde dehydrogenase and causes build up of acetaldehyde What does Disulfiram (Antabuse) do? Negative reinforcement: patient gets very sick from the alcohol if they drink What do you monitor with Disulfiram (Antabuse)? Baseline LFTs and repeat every 6 months What medications interact with Disulfiram (Antabuse)? Warfarin; Phenytoin; Theophylline; Some benzodiazepines What alcohol use disorder medication is contraindicated in severe cardiac disease, psychosis, and pregnancy? Disulfiram (Antabuse) What kind of withdrawal can be life threatening? Alcohol Signs and symptoms of alcohol withdrawal Tremors; Seizures; Elevated LFTs; Delirium tremens: shaking, confusion, high blood pressure, fever, hallucinations What kind of treatment is used for alcohol intoxication? Supportive care Signs and symptoms fo alcohol intoxication Slurred speech; Poor balance; Slowed responses; Slowed reaction time; Vomiting; Impaired judgement How do you treat cocaine/amphetamine/PCP/hallucinogens acute intoxication? Benzodiazepines to keep the patient calm; Haloperidol (Haldol) for agitation Cocaine/amphetamine/PCP/hallucinogens signs and symptoms Agitation; Violent; Muscle twitches; Hypertension; Tachycardia; Hyperthermic; Hallucinations; Mydriasis What medications are used for oipioid use disorder? Methadone (Methadose); Buprenorphine (Probuphine); Naltrexone (ReVia or Vvitrol); Naloxone (Narcan Nasal Spray) Methadone (Methadose) Mechanism of Action Full agonist at mu-opioid receptor What is Methadone (Methadose) used for? Long-term use to prevent relapse What is Methadone (Methadose) considered as? Opioid replacement therapy What does Methadone (Methadose) do? Decreases the risk of HIV or hepatitis Where does Methadone (Methadose) have to be administered? In a clinic What can Methadone (Methadose) cause? QT prolongation; Respiratory depression Buprenorphine (Probuphine) Mechanism of Action Partial opioid receptor agonist How is sublingual Buprenorphine (Probuphine) safer than methadone? It makes overdosing unlikely Which opioid use disorder medication needs a special waver to be able to prescribe? Buprenorphine (Probuphine) What opioid use disorder medication works better because it decreases injection abuse? Buprenorphine/Naloxone How is Buprenorphine/Naloxone taken? Sublingual How can Naltrexone (ReVia or Vivitrol) be taken? PO or IM What opioid use disorder medication is good for highly motivated patient? Naltrexone (ReVia or Vivitrol) Naloxone (Narcan Nasal Spray) Mechanism of Action Opioid antagonist What does Naloxone (Narcan Nasal Spray) treat? Emergency overdose only What is the half-life of Naloxone (Narcan Nasal Spray)? Short half-life that will end before opioid What needs to happen after having administered Naloxone (Narcan Nasal Spray)? Take patient to the emergency room How is Naloxone (Narcan Nasal Spray) adminsitered? Auto injection or nasal spray How is opioid acute intoxication treated? Naloxone Opioid Signs and Symptoms Respiratory depression; Bradycardia; Hypothermic; Miosis Opioid withdrawal signs and symptoms Increased lacrimination; Muscle aches; Abdominal cramps; Diarrhea Nicotine medications Varenicline (Chantix); Bupropion (Zyban); Nicotine replacement Varenicline (Chantix) Mechanism of Action Nicotine receptor partial agonist When is Varenicline (Chantix) started? One week before quit date What does Varenicline (Chantix) do? Reduces reward aspect of smoking What can Varenicline (Chantix) decrease? Withdrawal effects What can Varenicline (Chantix) give? Abnormal dreams or insomnia When is Bupropion (Zyban) started? 1-2 weeks before start date What does Bupropion (Zyban) do? Reduces cravings and withdrawal symptoms What can Bupropion (Zyban) help with? Weight gain associated with quitting smoking Nicotine Replacement Mechanism of Action Nicotinic-cholinergic receptor agonist How can Nicotine Replacement be administered? Transdermal patch; Gum; Lozenge; Nasal spray; Inhaler First Line Treatments for alcohol use disorder (according to Study Guide & Dynamed) naltrexone and acamprosate Second Line Treatments for alcohol use disorder (according to study guide but not dynamed) Disulfuram and Bupropion (not FDA approved for ETOH but second line according to study guide) Second Line Treatment for alcohol use disorder (according to Dynamed) Disulfuram Other off label medications for alcohol use disorder according to Dynamed Topiramate, gabapentin, baclofen Other off label medications for alcohol use disorder according to Stahl's Topiramate, ondansetron MOA of Naltrexone Opioid Receptor Antagonist MOA of Acamprosate - weak GABAa agonist - weak NMDA antagonist (does not prevent withdrawal symptoms) MOA of Disulfuram inhibits enzyme (aldehyde dehydrogenase) in the liver Bupropions role in alcohol use disorder Can diminish cravings for etoh, treat underlying anxiety/depression Safety Risk associated with bupropion and etoh bupropion increases the risk of seizures in those going through etoh withdrawal s/s ETOH intoxication impaired fine motor control, impaired judgement and coordination, ataxic gait, poor balance, lethargy, difficulty sitting upright, difficulty with memory and sitting upright, N/V, coma in levels 300mg/dL and over with respiratory depression and death possible S/S of etoh withdrawal Mild: insomnia, irritability, hand tremor Moderate: autonomic hyperactivity (diaphoresis, tachycardia, HTN), fever Severe: seizures (12-48 hours post consumption), hallucinations, Delirium Tremens Delirium Tremens 48-96 hours after last etoh consumption includes anxiety, anorexia, nausea/vomiting, psychomotor agitation Scale used to measure etoh withdrawal CIWA CIWA assesses: n/v, tremor, paroxysmall sweats, anxiety, agitation, tactile disturbances, auditory disturbances, visual disturbances, headaches, orientation CIWA scoring 10=mild 10-15=moderate 15=severe What medication is FDA approved for both opioid use disorder and alcohol use disorder? Naltrexone What routes of administration exist for Naltrexone PO, monthly injection (Vivitrol), implant What is the First Line medication in maintaining abstinence after alcohol detoxification? Acamprosate What medication can safely be used to treat alcohol use disorder in patients who keep drinking alcohol? Acamprosate What medication used to treat alcohol use disorder can be safely administered to patients with hepatitis and/or liver disease Acamprosate What medication used to treat alcohol use disorder is contraindicated with severe renal disease? Acamprosate Aversion symptoms with Disulfuram flushing, N/V, HA, vertigo, SOB, hypotension, palpitation How long do you need to wait to administer antabuse? Person needs to be alcohol free for 12 hours Important Education for patients taking Disulfuram Do not use anything that contains alcohol: mouthwash, aftershave, perfumes, vinegar, cough medicine for up to two weeks after last dose of disulfuram What is given to prevent Wernicke's encephalopathy? Thiamine (Vit B1) to compensate for Vit B1 deficiency What should be given to pts with alcohol use disorder for nutritional deficiencies thiamine, folate/folic acid, First line treatment in alcohol withdrawal Benzodiazepines Long acting benzo for etoh withdrawal diazepam (Valium) Short acting benzo for etoh withdrawal lorazepam (Ativan) Additional medications to use in mild to moderate alcohol withdrawal carbamazepine (Tegretol), Valproic acid or gabapentin MOA of Naloxone (Narcan) competitive opioid receptor antagonist MOA of naltrexone competitive opioid receptor antagonist MOA of Methadone (Dolophine) long acting FULL opioid receptor agonist (at mu receptor) MOA of Suboxone (buprenorphine and naloxone) partial opioid agonist + competitive opioid antagonist Medication used in opioid overdose naloxone Medication used in patients with chronic pain and opioid use disorder Suboxone (buprenorphine and naloxone) Which medications for opioid use disorder can precipitate withdrawal naloxone, naltrexone, Suboxone (buprenorphine) Which medication used to treat opioid use disorder has a "ceiling effect"? Buprenorphine... increasing the dose does not result in increasing effects Which medication is available sublingual film/tab and buccal film for opioid patients Suboxone Which medication is available as sublingual tab, implant, and subQ injection for opioid patients Buprenorphine Which medication is available as a oral tablet and a monthly IM injection for opioid patients? Naltrexone Which medication is treatment of choice for highly motivated opioid use disorder patients? Naltrexone Inappropriate use of opioids may indicate the patient's pain is not well managed S/S of opioid intoxication miosis (pinpoint pupils), hypotension, bradycardia, low RR, unconsciousness S/S of opioif withdrawal anxiety, lacrimation, muscle aches, abdominal cramps, diarrhea, seizures When detoxing a patient from opioids, which medication is more effective at suppressing and controlling withdrawal symptoms as the taper nears completion- methadone or buprenorphine? Buprenorphine Drugs used in opioid withdrawal Suboxone, Clonidine, bentyl S/S Cocaine Intoxication Auditory hallucinations, agitation, violent behavior, muscle twitching, HTN, bradycardia S/S cocaine overdose can cause acute heart failure, stroke, seizures S/S of cocaine withdrawal extreme fatigue, anhedonia (loss of pleasure), depression, fatigue, brain fog, intense cravings, Medications used to treat cocaine induced chest pain and MI nitroglycerin, aspirin Medication to avoid in cocaine induced chest pain and MI metoprolol (betablockers are contraindicated in this population because it further lowers coronary blood flow thereby increasing ischemia) Medication to treat cocain use disorder Antabuse MOA of antabuse in cocaine use disorder increases synaptic dopamine in the brain reward circuit and act as an agonist treatment Medication used to treat insomnia in patients with SUD gabapentin Drug to treat cocaine intoxication with severe agitation lorazepam Two antipsychotics with FDA approval for severe behavioral issues in ASD Risperidone & aripiprazole Risperidone for ASD can be used in ages 5-18 Aripiprazole for ASD can be used in ages 6-17 What symptoms do the antipsychotics ideally treat in ASD? Autism associated irritability, aggression, temper tantrums, self-injurous behaviors, mood lability First line intervention for ASD ABA (applied behavioral analysis) Side effects of risperidone weight gain, fatigue, increased appetite, drooling Alpha-2 agonists used in ASD clonidine & guanfacine Why are alpha-2 agonists used in ASD? In patients with ASD who have symptoms of ADHD Clonidine in ASD targets This alpha 2 agonist hyperactivity and inattention Guanfacine in ASD targets This alpha2 agonist decreases autonomic arousal, for patients who have poorly responded to stimulants Fluvoxemine in ASD targets This SSRI targets repetitive thoughts, repetitive behaviors, and aggression, and inappropriate language. mirtazepine use in ASD This atypical antidepressant is useful for sleep & anxiety OTC used for sleep in ASD melatonin First line for ADD/ADHD stimulants (study guide)/methylphenidate (DynaMed) MOA of methylphenidate norepinephrine and dopamine reuptake inhibitor (NET & DAT blocker) specifically increasing NE & DA in the PFC Which stimulants are "slow release" extended release stimulants, transdermaml methylphenidate, lisdexamphetamine Selecting a stimulant for each patient should be tailored to: Onset & duration Stimulants increase dopamine in the... prefrontal cortex, nucleus accumbens, and reward circuitry Side effects of stimulants for ADHD insomnia, dry mouth, decreased appetite, increased blood pressure, anxiety or nervousness, headaches, mood swings Second line treatment for ADHD alpha-2 agonists Alpha-2 agonists used in ADHD clonidine, guanfacine Nonpharmacological interventions to manage patient with ADD/ADHD parental education on behavior and techniques, psychosocial therapy, and school based programs Nonstimulants apprporiate for ADD/ADHD atomoxetine, bupropion, alpha-2 agonists Why would a non-stimulant be appropriate to treat ADD/ADHD Poor response to stimulants, evidence of substance abuse, inability to tolerate side effect profiles, medical condition in which stimulants are contraindicated (tic disorder), or as adjunct to stimulant