NSG 552 STUDY GUIDE FLASHCARDS EXAM 2 | WILKES UNIVERSITY |
COMPREHENSIVE PSYCHOPHARMACOLOGY STUDY GUIDE, PRACTICE
QUESTIONS & ANSWERS 2026/2027
Where is Norepinephrine made in the brain? And what is its' function? - ANS ✔✔Locus Cerulus(Brain
stem, responsible for medicating SYMPATHETIC nervous system and stress responses)
Hyperactivity of the norepinephrine system/increased locus carolus system is common in those with
anxiety.
-Leads to hypervigilance, increased arousal, panic, and exaggerated stress responses.
What is the main function of GABA? - ANS ✔✔Primary function is inhibition at post synaptic neuron
-Induces calmness, relaxation, big role in anxiety disorders
-Acted directly on by BDZ and barbiturates
-Gaba_A and GABA_B
What is agoraphobia and how is it treated? - ANS ✔✔-Fear of public places; where escape or obtaining
help may be difficult
-Tx via CBT and SSRI
GAD Tx? - ANS ✔✔1st Line - SSRI (Escitalopram, Paroxetine, Duloxetine)
2nd line - Buspar (Partial serotonin agonist at pre and post synapses) and SNRI (Venlafaxine)
-Can consider short term course of BDZ Rx
Panic attack initial treatment? - ANS ✔✔Benzodiazepines
Panic Disorder 1st and 2ndline tx? - ANS ✔✔1st line - SSRI or SNRI (Fluoxetine, Sertraline, or Venlafaxine)
2nd line - TCAs (Clomipramine, imipramine)
Adjunct tx- Benzodiazepines, SHORT term only until other medications reach therapeutic efficacy,
Alprazolam SPECIFICALLY is FDA approved)
Social Phobia (Ex. performance Anxiety) - ANS ✔✔Fear of scrutiny by others or fear of acting in a
humiliating or embarrassing way
-CBT
1st line - SSRI or SNRI
, Betablockers (Atenolol 50-100mg) and Propranolol (20-40mg one hour prior to performance or public
speaking) - AVOID in patients with COPD due to bronchospasm risk
-Benzodiazepines can be used scheduled or PRN
Specific Phobia - ANS ✔✔Rx - Fluvoxamine, Paroxetine, Sertraline, or Venlafaxine. (Hence SSRI or SNRI)
CBT (Exposure type specifically)
Obsessive compulsive disorder (OCD) - ANS ✔✔Obsessions and/or compulsions that are time
consuming, distressing and impairing
1st line - Fluvoxamine (50-300mg this one is FDA approved, with common side effects being N/V).
Sertraline, Fluoxetine,
2nd line - SNRI (Venlafaxine), maybe TCA (Clomipramine, this is also approved for OCD treatment)
-Can AUGMENT with atypical antipsychotic in severe cases.
Panic attack treatment - ANS ✔✔Use Benzodiazepine short term, in ADDITION to long term SSRI until
the SSRI kicks in to bridge the gap.
*Patients tend to discontinue SSRIs while taking benzodiazepines. Continuous education is REQUIRED to
continue BOTH SSRI and Benzodiazepine UNTIL Benzodiazepine is tapered.
-Taper Benzodiazepine by reducing ~10% weekly, can also switch to LONG acting Benzodiazepine from
short acting to facilitate taper
Most commonly prescribed Benzodiazepines? - ANS ✔✔Alprazolam (short acting)
Lorazepam (Intermediate acting)
Benzodiazepines - MOA? - ANS ✔✔Potentiates effects of GABA, enhances activity of GABA at GABA-A
Receptor.
-causes drowsiness, cognitive impairment, dampening of fear and anxiety, impaired balance, motor
control, decrease muscle tone, impaired coordination, anterograde amnesia
ELDERLY - Increases fall risk, hip fracture risk, and increases risk of dementia with chronic use.
-Big potential for both abuse and addiction, patient can become physically dependent and build
tolerance easily; used to treat akathisia
-A known limitation of benzodiazepines are rebound insomnia.
How to choose specific Benzodiazepine? - ANS ✔✔Depends on desired time of onset, duration of action,
and method of metabolism.
COMPREHENSIVE PSYCHOPHARMACOLOGY STUDY GUIDE, PRACTICE
QUESTIONS & ANSWERS 2026/2027
Where is Norepinephrine made in the brain? And what is its' function? - ANS ✔✔Locus Cerulus(Brain
stem, responsible for medicating SYMPATHETIC nervous system and stress responses)
Hyperactivity of the norepinephrine system/increased locus carolus system is common in those with
anxiety.
-Leads to hypervigilance, increased arousal, panic, and exaggerated stress responses.
What is the main function of GABA? - ANS ✔✔Primary function is inhibition at post synaptic neuron
-Induces calmness, relaxation, big role in anxiety disorders
-Acted directly on by BDZ and barbiturates
-Gaba_A and GABA_B
What is agoraphobia and how is it treated? - ANS ✔✔-Fear of public places; where escape or obtaining
help may be difficult
-Tx via CBT and SSRI
GAD Tx? - ANS ✔✔1st Line - SSRI (Escitalopram, Paroxetine, Duloxetine)
2nd line - Buspar (Partial serotonin agonist at pre and post synapses) and SNRI (Venlafaxine)
-Can consider short term course of BDZ Rx
Panic attack initial treatment? - ANS ✔✔Benzodiazepines
Panic Disorder 1st and 2ndline tx? - ANS ✔✔1st line - SSRI or SNRI (Fluoxetine, Sertraline, or Venlafaxine)
2nd line - TCAs (Clomipramine, imipramine)
Adjunct tx- Benzodiazepines, SHORT term only until other medications reach therapeutic efficacy,
Alprazolam SPECIFICALLY is FDA approved)
Social Phobia (Ex. performance Anxiety) - ANS ✔✔Fear of scrutiny by others or fear of acting in a
humiliating or embarrassing way
-CBT
1st line - SSRI or SNRI
, Betablockers (Atenolol 50-100mg) and Propranolol (20-40mg one hour prior to performance or public
speaking) - AVOID in patients with COPD due to bronchospasm risk
-Benzodiazepines can be used scheduled or PRN
Specific Phobia - ANS ✔✔Rx - Fluvoxamine, Paroxetine, Sertraline, or Venlafaxine. (Hence SSRI or SNRI)
CBT (Exposure type specifically)
Obsessive compulsive disorder (OCD) - ANS ✔✔Obsessions and/or compulsions that are time
consuming, distressing and impairing
1st line - Fluvoxamine (50-300mg this one is FDA approved, with common side effects being N/V).
Sertraline, Fluoxetine,
2nd line - SNRI (Venlafaxine), maybe TCA (Clomipramine, this is also approved for OCD treatment)
-Can AUGMENT with atypical antipsychotic in severe cases.
Panic attack treatment - ANS ✔✔Use Benzodiazepine short term, in ADDITION to long term SSRI until
the SSRI kicks in to bridge the gap.
*Patients tend to discontinue SSRIs while taking benzodiazepines. Continuous education is REQUIRED to
continue BOTH SSRI and Benzodiazepine UNTIL Benzodiazepine is tapered.
-Taper Benzodiazepine by reducing ~10% weekly, can also switch to LONG acting Benzodiazepine from
short acting to facilitate taper
Most commonly prescribed Benzodiazepines? - ANS ✔✔Alprazolam (short acting)
Lorazepam (Intermediate acting)
Benzodiazepines - MOA? - ANS ✔✔Potentiates effects of GABA, enhances activity of GABA at GABA-A
Receptor.
-causes drowsiness, cognitive impairment, dampening of fear and anxiety, impaired balance, motor
control, decrease muscle tone, impaired coordination, anterograde amnesia
ELDERLY - Increases fall risk, hip fracture risk, and increases risk of dementia with chronic use.
-Big potential for both abuse and addiction, patient can become physically dependent and build
tolerance easily; used to treat akathisia
-A known limitation of benzodiazepines are rebound insomnia.
How to choose specific Benzodiazepine? - ANS ✔✔Depends on desired time of onset, duration of action,
and method of metabolism.
