NURS 546 EXAM 2 ASSESSMENT SCRIPT 2026
VERIFIED ANSWERS COMPREHENSIVE REVIEW
◉ INDICATION
-MDD
Mechanism of Action
-Serotonin norepinephrine receptor agonist, alpha2 receptor
agonist. Boosts neurotransmitters serotonin and
norepinephrine/noradrenaline.
TESTS
-Monitor weight and BMI during tx
Starting Dose
-15 mg/day in the evening
Adverse Effects
-Sedation, weight gain, dry mouth, constipation, abnormal dreams,
confusion, hypotension, Changes in urinary function.
Flu-like symptoms may indicate low white blood cell or granulocyte
count.
,PEARLS
-sedation/drowsiness, useful for clients with insomnia.
-increased appetite/weight gain, useful for clients with depression-
related weight loss
-Precautions: May cause photosensitivity, avoid alcohol (increase
sedation).
Answer: Mirtazapine (Remeron)
◉ INDICATION
-MDD
Mechanism of Action
-Dual-acting serotonin reuptake inhibitor plus 5HT1A partial
agonist. Boosts neurotransmitter serotonin.
TESTS
-None for healthy individuals
Starting Dose
-10 mg/day
,Adverse Effects
-Nausea, diarrhea, vomiting, insomnia, dizziness, bruising, sexual
dysfunction, SIADH.
-Rare: Bleeding, hyponatremia.
PEARLS
-Appropriate for depression/comorbid anxiety, action similar to
combination of SSRI and buspirone.
-Precautions: Not approved in children.
Answer: Vilazodone (Viibryd)
◉ INDICATION
-MDD
Mechanism of Action
-Multimodal antidepressant, Serotonin multimodal (SMM)
-Increases release of serotonin, norepinephrine, dopamine,
glutamate, acetylcholine, and histamine and reduces the release of
GABA
TESTS
-None for healthy individuals
, Starting Dose
-10 mg/day
Adverse Effects
-nausea, vomiting, constipation, sexual dysfuction.
PEARLS
-Improves depression-related cognition
-Long half-life means vortioxetine can generally be abruptly
discontinued.
-Not approved in children.
Answer: Vortioxetine (Trintellix)
◉ INDICATION
-Depression
Mechanism of Action
-SARI (serotonin 2 antagonist/reuptake inhibitor). Blocks serotonin
2A receptors.
TESTS
-None for healthy individuals
VERIFIED ANSWERS COMPREHENSIVE REVIEW
◉ INDICATION
-MDD
Mechanism of Action
-Serotonin norepinephrine receptor agonist, alpha2 receptor
agonist. Boosts neurotransmitters serotonin and
norepinephrine/noradrenaline.
TESTS
-Monitor weight and BMI during tx
Starting Dose
-15 mg/day in the evening
Adverse Effects
-Sedation, weight gain, dry mouth, constipation, abnormal dreams,
confusion, hypotension, Changes in urinary function.
Flu-like symptoms may indicate low white blood cell or granulocyte
count.
,PEARLS
-sedation/drowsiness, useful for clients with insomnia.
-increased appetite/weight gain, useful for clients with depression-
related weight loss
-Precautions: May cause photosensitivity, avoid alcohol (increase
sedation).
Answer: Mirtazapine (Remeron)
◉ INDICATION
-MDD
Mechanism of Action
-Dual-acting serotonin reuptake inhibitor plus 5HT1A partial
agonist. Boosts neurotransmitter serotonin.
TESTS
-None for healthy individuals
Starting Dose
-10 mg/day
,Adverse Effects
-Nausea, diarrhea, vomiting, insomnia, dizziness, bruising, sexual
dysfunction, SIADH.
-Rare: Bleeding, hyponatremia.
PEARLS
-Appropriate for depression/comorbid anxiety, action similar to
combination of SSRI and buspirone.
-Precautions: Not approved in children.
Answer: Vilazodone (Viibryd)
◉ INDICATION
-MDD
Mechanism of Action
-Multimodal antidepressant, Serotonin multimodal (SMM)
-Increases release of serotonin, norepinephrine, dopamine,
glutamate, acetylcholine, and histamine and reduces the release of
GABA
TESTS
-None for healthy individuals
, Starting Dose
-10 mg/day
Adverse Effects
-nausea, vomiting, constipation, sexual dysfuction.
PEARLS
-Improves depression-related cognition
-Long half-life means vortioxetine can generally be abruptly
discontinued.
-Not approved in children.
Answer: Vortioxetine (Trintellix)
◉ INDICATION
-Depression
Mechanism of Action
-SARI (serotonin 2 antagonist/reuptake inhibitor). Blocks serotonin
2A receptors.
TESTS
-None for healthy individuals
