NR 545 Exam With Complete Solution 2024/2025 Verified Questions and Answers

Lithium - Answer Action: alters cation transport in the nerve and muscle indication: euphoric mania, rapid cycling, maintenance therapy CKD, AE: GI effects, tremor, polyuria Pearls: monitor plasma levels, reduce dose w/renal failure, use caution w/ concurrent diuretics, use to protect against suicide Lamotrigine (Lamictal) - Answer Action: affects sodium channel ion transport and enhances the effect of GABA indications: maintenance, monotherapy for bipolar disorder AE: benign rash, GI effects, dizziness, HA, SJS!!! Pearls: equal in efficacy to lithium, assess for rash, risk for SJS and multi organ failure, take at bedtime Valporic acid( depakene) - Answer Action: affects ion transport and enhances the activity of GABA indications: acute mania, mixed mood, comomorbid substance abuse, multiple prior episodes AE: weight gain, GI effects 2nd generation antipsychotics - Answer Risperidone Quetiapine Aripriprazole cariprazine lurasidone quetapine actions: DA, NE, 5HT receptor antagonists Indications: acute bipolar depression, acute manic or mixed episodes, bipolar maintenance/adjunct AE: wt gain, sedation, GI effects Pearls: eps, XR May improve adherence, monthly injection may improve adherence, select 2nd gen antipsychotics first to decrease risk of SE and long term adverse effects Carbemazepine(tegretol) - Answer Glutamate voltage gated sodium and calcium blocker inducation: acute mania/ mixed mood AE: weight gain, sedation, hyponatremia, neutropenia, rash(sjs) unipolar depression - Answer depression without a history of mania, most common mental disorder s- sleep i- interest g-guilt e- energy c-concentration a-appetite p- psychomotor/agitation retardation s- suicidal thoughts bipolar depression - Answer A form of depression characterised by periods of heightened moods and periods of despondency and hopelessness Bipolar type1- - Answer One episode of mania for at least 1 week bipolar type 2 criteria - Answer Current or past hypomanic episode and a current or past major depressive disorder. Symptoms last for 4 days but fewer than 7. Hypomanic symptoms are not of sugficient duration or severity to cause impairment Cyclothymia - Answer disorder that consists of mood swings from moderate depression to hypomania and lasts two years or more Decreased positive affect neurotransmitters dysfunction and symptoms - Answer DA, NE dysfunction depressed mood, lack of interest, loss of energy, decreased alertness, decreased self confidence, appetite changes Increased negative affect - Answer 5HT, NE dysfunction depressed mood, guilt, fear/anxiety, hostility, irritability, loneliness, appetite changes monoamine hypothesis of depression - Answer depression is caused by insufficient activity of monoaminergic neurotransmitters(5HT, NE,DA), mania results from excess malfunction of prefrontal cortex - Answer Concentration, mood, mental fatigue Malfunction of prefrontal cortex/amygdala - Answer Guilt, suicidal, worthlessness Striatum malfunction - Answer Physical fatigue Nucleus scum end malfunction - Answer Pleasure/interests Hypothalamus malfunction - Answer Sleep, appetite Thalamus/hypothalamus malfunction - Answer Decreased sleep straitum - Answer Motor/agitation prefrontal cortex - Answer Talkative/pressured speech, risk taking nucleus accumbens and PFC - Answer Racing thoughts, grandiosity PFC/amydgala - Answer Mood SSRIs info - Answer Inhibit 5HT reuptake, adverse effects include wt gain, sexual side effects, HA, diarrhea SNRIs - Answer Inhibit NE reuptake (increase energy, focus) increase DA in prefrontal cortex(increase cognition) inhibit 5HT reuptake adverse effects include anxiety constipation, insomnia, anorexia, elevated blood pressure NDRIs pearls - Answer Inhibit DA reuptake (increase alertness, motivation) inhibit NE reuptake(increase energy) AE: agitation, wt loss, HA, dry mouth, constipation Obesity medications - Answer Phentermine, topiramate, bupropion, lorcaserin, zonisamide anorexia nervosa - Answer Olanzapine May lead to modest weight gain, avoid bupropion due to seizure threshold