NURS 663 EXAM 1 COMPREHENSIVE EXAM
QUESTIONS AND SOLUTIONS
◉ MAOs side effects 11.
Answer: Increased weight, drowsy, dizzy, orthostatic hypotension,
tremor, headache, dry mouth, constipation, change in sexual drive,
peripheral Edema, sweating
◉ Tricyclic mechanism of action.
Answer: Inhibit 5HT2, norepinephrine, dopamine and reuptake
slows. Amino group interferes with ASP - 98 in HSERT. Causing
down regulation of receptors.
◉ Tricyclic side effects.
Answer: Anticholinergic effects (dry mouth, blurred vision,
constipation, urine retention, impotence). Histamine effects
(sedation, increased weight). Adrenergic alpha receptor (postural
hypotension). Direct membrane effects (decrease seizure threshold
and arrhythmias). 5HT2 receptor (increase weight and decrease
anxiety).
◉ Amitriptyline dosing/Class.
Answer: Start at 25 to 50 mg per day, titrate 25 to 50 mg per day per
week, Max dose is 300 mg per day/TCA
,◉ Names of tricyclics 10.
Answer: Amitriptyline, nortriptyline, clomipramine, imipramine,
protriptyline, doxepin, amoxapine, desipramine, mapratiline,
tripramine
◉ Tricyclics are useful-2.
Answer: Pain, migraine
◉ Tricyclics adverse effects-2.
Answer: Overdoses are cardiotoxic, high potency increases the risk
of mania
◉ Nortriptyline mnemonic.
Answer: No-triptyline equals less sedation and hypotension
◉ Tricyclics mnemonic-2.
Answer: Think car goes over tricycle to remember that an overdose
is cardiotoxic. Do you remember mechanism think trans =serotonin
and norepinephrine Chans= Na+ and Ca+ Ans= ACH and histamine
◉ Clomipramine mnemonic/class.
Answer: TCA- think comipramine for obsessive compulsive disorder
, ◉ Imipramine- pneumonic and class.
Answer: I'm peeingamine- nocturnal enuresis
◉ Unilateral electrode in ECT indications.
Answer: Typically first line because it has less cognitive side effects
but has less efficacy
◉ What is ECT?.
Answer: The use of electrical shock current delivered to the brain to
induce a seizure that treats depression. Goal is to reverse atrophy.
◉ ECT is FDA approved for what.
Answer: Bipolar disorder, schizophrenia, schizoaffective disorder,
catatonia, neuroleptic malignant syndrome, treatment resistant
refractory major depressive disorder
◉ What is ECT schedule.
Answer: Typically Monday Wednesday Friday for 6 to 12 sessions
◉ Bilateral electrode placement in ECT indications.
QUESTIONS AND SOLUTIONS
◉ MAOs side effects 11.
Answer: Increased weight, drowsy, dizzy, orthostatic hypotension,
tremor, headache, dry mouth, constipation, change in sexual drive,
peripheral Edema, sweating
◉ Tricyclic mechanism of action.
Answer: Inhibit 5HT2, norepinephrine, dopamine and reuptake
slows. Amino group interferes with ASP - 98 in HSERT. Causing
down regulation of receptors.
◉ Tricyclic side effects.
Answer: Anticholinergic effects (dry mouth, blurred vision,
constipation, urine retention, impotence). Histamine effects
(sedation, increased weight). Adrenergic alpha receptor (postural
hypotension). Direct membrane effects (decrease seizure threshold
and arrhythmias). 5HT2 receptor (increase weight and decrease
anxiety).
◉ Amitriptyline dosing/Class.
Answer: Start at 25 to 50 mg per day, titrate 25 to 50 mg per day per
week, Max dose is 300 mg per day/TCA
,◉ Names of tricyclics 10.
Answer: Amitriptyline, nortriptyline, clomipramine, imipramine,
protriptyline, doxepin, amoxapine, desipramine, mapratiline,
tripramine
◉ Tricyclics are useful-2.
Answer: Pain, migraine
◉ Tricyclics adverse effects-2.
Answer: Overdoses are cardiotoxic, high potency increases the risk
of mania
◉ Nortriptyline mnemonic.
Answer: No-triptyline equals less sedation and hypotension
◉ Tricyclics mnemonic-2.
Answer: Think car goes over tricycle to remember that an overdose
is cardiotoxic. Do you remember mechanism think trans =serotonin
and norepinephrine Chans= Na+ and Ca+ Ans= ACH and histamine
◉ Clomipramine mnemonic/class.
Answer: TCA- think comipramine for obsessive compulsive disorder
, ◉ Imipramine- pneumonic and class.
Answer: I'm peeingamine- nocturnal enuresis
◉ Unilateral electrode in ECT indications.
Answer: Typically first line because it has less cognitive side effects
but has less efficacy
◉ What is ECT?.
Answer: The use of electrical shock current delivered to the brain to
induce a seizure that treats depression. Goal is to reverse atrophy.
◉ ECT is FDA approved for what.
Answer: Bipolar disorder, schizophrenia, schizoaffective disorder,
catatonia, neuroleptic malignant syndrome, treatment resistant
refractory major depressive disorder
◉ What is ECT schedule.
Answer: Typically Monday Wednesday Friday for 6 to 12 sessions
◉ Bilateral electrode placement in ECT indications.
