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NURS 660 PSYCHOPHARM EXAM 1,2,3,4, DEATILED QUESTIONS AND VERIFIED ANSWERS WITH RATIONALES V .

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NURS 660 PSYCHOPHARM EXAM 1,2,3,4, DEATILED QUESTIONS AND VERIFIED ANSWERS WITH RATIONALES V .

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NURS 660 PSYCHOPHARM EXAM 1,2,3,4, DEATILED
V V V V V



QUESTIONS AND VERIFIED ANSWERS WITH
V V V V V



RATIONALES 2024-2025.
V V V




Positive VSymptoms Vof VSchizophrenia V- VANSWER-Delusions, Vhallucinations,
Vdistortions, Vagitation, Vdisorganized Vspeech, Vdisorganized Vbehavior




Where Vdo Vpositive Vsymptoms Voriginate? V- VANSWER-Mesolimbic Vdopamine Vpathway

Medications Vto Vtreat Vpositive Vsymptoms V- VANSWER-Antipsychotics

Negative Vsymptoms Vof Vschizophrenia V- VANSWER-Flat Vaffect, Valogia, Vaffective
Vblunting, Vasociality, Vanhedonia, Vavolition.




Where Vdo Vnegative Vsymptoms Voriginate? V- VANSWER-Mesocortical Vdopamine
Vpathway. VMay Valso Vinvolve Vmesolimbic Vregions Vsuch Vas Vnucleus Vaccumbens




Medications Vto Vtreat Vnegative Vsymptoms V- VANSWER-Vraylar, Vamisulpride

Hypotheses Vof VSchizophrenia V- VANSWER--Mesolimbic Vpathway Vis Vhypothesized Vto
Vbe Vhyperactive Vresulting Vin Vexcess Vdopamine Vat Vthe Vsynapse. V

-The Vgluatamate Vactivity Vat VNMDA Vreceptors Vis Vhypofunctional

Mesolimbic VPathway VTheory Vof VSchizophrenia V- VANSWER-Mesolimbic Vpathway Vis
Vhyperactive, Vresulting Vin Vexcess Vdopamine Vat Vthe Vsynapse Vwhich Vleads Vto Vpositive

Vsymptoms. VHyperactivity Vof Vmesolimbic Vdopamine Vneurons Vmay Valso Vplay Va Vrole Vin

Vaggression Vand Vhostile Vsymptoms.




Five VDifferent VDopamine VPathways Vin Vthe Vbrain V- VANSWER--Nigrostriatal VDopamine
VPathway

-Mesolimbic Vdopamine Vpathway
-Mesocorticol Vdopamine Vpathway
-Tuberoinfundibular Vdopamine Vpathway V
-Thalamic Vdopamine Vpathway

Nigrostriatal Vpathway V- VANSWER-Projects Vfrom Vthe Vsubstantia Vnigra Vto Vthe Vbasal
Vganglia Vor Vstriatum.

-Part Vof Vthe Vextrapyramidal Vnervous Vsystem V
-Controls Vmotor Vfunction Vand Vmovement
-When Vdopamine Vis Vdeficient, Vcan Vcause Vparkinsonism Vwith Vtremor, Vrigidity, Vand
Vakinesia/bradykinesia

,-Excess Vdopamine- Vcan Vcause Vhyperkinetic Vmovements, Vsuch Vas Vtics Vand
Vdyskinesias




Mesolimbic Vdopamine Vpathway V- VANSWER-Projects Vfrom Vthe Vmidbrain Vventral
Vtegmental Varea Vto Vthe Vnucleus Vaccumbens V(part Vof Vlimbic Vsystem) Vwhere Vmany

Vbehaviors Vsuch Vas Vpleasurable Vsensations, Vthe Vpowerful Veuphoria Vof Vdrug Vabuse

Vas Vwell Vas Vdelusions Vand Vhallucinations.




Mesocortical Vpathway V- VANSWER-Projects Vfrom Vthe Vventral Vtegmental Varea Vto Vthe
Vprefrontal Vcortex Vand Vis Vimportant Vfor Vcognition




Tuberofundibular Vpathway V- VANSWER-Projects Vfrom Vthe Vhypothalamus Vto Vthe
Vanterior Vpituitary Vgland Vand Vcontrols Vprolaction Vsecretion




Thalamic Vpathway V- VANSWER-Arises Vfrom Vmultiple Vsites. V
-Function Vnot Vwell Vknown, Vmay Vbe Vinvolved Vin Vsleep Vand Varousal Vmechanisms

Major Vneurotransmitters Vinvolved Vin Vschizophrenia V- VANSWER--Dopamine
-Glutamate

Dopamine Vand VSchizophrenia V- VANSWER-Major Vneurotransmitter Vin Vschizophrenia
Some Vatypical Vpsychotics Vblock Vdopamine Vreceptors
Increased Vin Vschizophrenia

Glutamate Vand Vschizophrenia V- VANSWER-Considered Vthe V"master Vswitch" Vof Vthe
Vbrain. VGlutamate Vis Vthe Vmajor Vexcitatory Vneurotransmitter Vof Vthe VCNS Vas Vit Vcan

Vturn Von Vnearly Vall Vof Vthe VCNS Vneurons

Decreased Vin Vschizophrenia

Neuroleptic VMalignant VSyndrome V- VANSWER--Adverse Vreaction Vto Vantipsychotics
Vwith Vsevere V"lead Vpipe" Vrigidity, VFEVER, Vand Vmental Vstatus Vchanges

-Lab Vfindings- Vincreased VCK, Vleukocytosis, Vlow Vserum Viron
-Caused Vby Vdopamine Vantagonists
-Slower Vin Vonset, V1-2 Vweeks Vafter Vstarting/changing Vtherapy. V
-Manage Vby Vstopping Vcausative Vagent, Vsupportive Vcare, VECT, VDantrolene,
Vbromocriptine, Vand Vamantadine.




Serotonin VSyndrome V- VANSWER--Caused Vby Vserotonergic Vagents
-Hyperreflexia, Vmyoclonus, Vocular Vclonus
-Manage Vby Vstopping Vall Vserotonergic Vagents, Vsupportive Vcare Vaimed Vat
Vnormalization Vof Vvitals, Vsedation Vwith Vbenzos, Vadministration Vof Vserotonergic

Vantagonists, Vand Vantidote Vtherapy Vwith Vcyproheptadine

-Assess Vneed Vto Vresume Vuse Vof Vcausative Vserotonergic Vmeds Vafter Vresolution Vof
Vsymptoms V

-Symptoms Vseen Vwithin V24 Vhours Vof Vstarting/changing Vtherapy.

,The V"-pine" Vfamily V- VANSWER-Have V5-HT2A Vand VD2 Vantagonism.
Strong Vpotency Vfor VH1 Vand Vmuscarinic Vreceptors
Clozapine, VOlanzapine, VQuetiapine,

Clozapine V- VANSWER-Atypical VAntipsychotic
SE: VAGRANULOCYTOSIS- VANC Vblood Vtesting Vprior, Vduring. VCan Vbe Vvery Vsedating,
Vexcessive Vsalivation, VIncreased Vrisk Vof Vmyocarditis, VGreatest Vdegree Vof Vweight Vgain

Vand Vpossibly Vgreatest Vcardiometabolic Vrisk V

Indications- Vtreatment Vresistant Vschizophrenia, Vreducing Vsuicidal Vbehavior

Drug Vinteractions Vwith VClozapine V- VANSWER-Potential Vto Vincrease Vlevels: VSSRIS,
Vcipro, Vcimetidine, Vmacrolides, Vcaffeine

Potential Vto Vdecrease Vlevels: VCarbamazepine, Vrifampicin, VSJW, VOmeprazole,
VPhenytoin, VPhenobarbital




Olanzapine V(Zyprexa) V- VANSWER-*class*: VAntipsychotic, Vmood Vstabilizers
*Indication*: Vschizophrenia, Vmania, Vdepression, Vanorexia Vnervosa,
*Action*: VStrongest Vof Vthe Vpines Vat Vthe VH1 Vand V5HT2a Vreceptors V
SE: VObesity, Vdyslipidemia, Vinsulin Vresistance
Baseline Vlabs: VBMI, Vfasting Vglucose, Vlipid Vpanel

Drug Vinteractions Vwith VOlanzapine V- VANSWER-Contraindicated Vto Vuse VIM
VOlanzapine Vwith VIM Vbenzos- Vincreases Vlikelihood Vof Vrespiratory Vdepression Vand

Vexcessive Vsedation.

Fluvoxamine Vis Vinhibitor
Smoking Vis Van Vinducer

Quetiapine V- VANSWER-Prominent VH1 Vpotency, Vmore Vsedating
SE: Vconstipation, Vsedation-strong, Vdizziness, Vdrowsiness, Vdry Vmouth, Vgen Vweakness,
Vheadache, Vindigestion, Vlow Venergy, Vorthostatic Vhypotension, Vweight Vgain

Warnings- VCoadministered Vwith Vkeotconazole Vresults Vin Vincreased Vseroquel
Vexposure. V

Coadministered Vwith Vphenytoin Vincreases Vthe Voral Vclearance Vup Vto V5 Vfold. V
Suicidal Vthoughts/behaviors Vin VYA/adolescents

The V"Pip" VFamily V- VANSWER-5HT1a Vpartial Vagonism, VD2 Vpartial Vagonism, V5HT2a
Vantagonism, Vand V5HT7 Vantagonism.

Aripiprazole, VBrexpiprazole

Aripiprazole V(Abilify) V- VANSWER-Atypical Vantipsychotic
"3rd Vgeneration". VD2 Vpartial Vagonism
Management Vof Vschizophrenia, Vand Vacute Vmanic Vor Vmixed Vepisodes Vin Vbipolar
Vdisorder.

Adjunct Vto Vtreat Vdepression Vor Virritability Vassociated Vwith Vautism V(ages V6-18)
SE: Vdizziness, Vinsomnia, Vakasthisia, Vn/v, Vweight Vgain V(less Vlikely Vto Vcause),
Vsuppresses Vprolactin Vlevels V

, Interactions- Vketoconazole Vand Vother V3a4 Vinhibitors Vincrease Varipiprazole Vlevels.
May Vincrease Veffects Vof Vantihypertensives

Brexpiprazole V(Rexulti) V- VANSWER-Greater Vaffinity Vfor Vd2 Vblockade
Indications: Vschizophrenia Vand Vtreatment Vresistant Vdepression
SE: Vdizziness, Vsedation, Vhypotension, Vrestlessness. Vhyperglycemia Vand VDKA.
Metabolic Vlabs Vbefore, Vmonitor VBMI Vand Vlipids

Conventional VAntipsychotics V- VANSWER-First-Generation Vdrug Vfor VSchizophrenia
-Pure VD2 Vantagonism
-Treats Vpos. Vsymptoms VONLY V(dopamine Vreceptors)
-Less Vexpensive, Vmore Vside Veffects
Disadvantages: VExtrapyramidal Vside Veffects, VAnticholinergic Vside Veffects, Vtardive
Vdyskinesia, Vlower Vseizure Vthreshold*

-Chlorpromazine, VHaloperidol, Vthiordazine, Vperphenazine

Chlorpromazine V(Thorazine) V- VANSWER-Indications: Vschizophrenia, Vpsychoses,
Vmanic-depression, Vand Vsevere Vbehavioral Vproblems Vin Vchildren Vages V1-12.

VChlorpromazine Vis Valso Vused Vto Vtreat Vnausea Vand Vvomiting, Vanxiety Vbefore

Vsurgery, Vchronic Vhiccups, Vacute Vintermittent Vporphyria, Vand Vsymptoms Vof Vtetanus.

SE: Vphotophobia, Vlightheadedness, Vdizziness, Vdrowsiness, Vblurred Vvision, Vweight
Vgain, Vtrouble Vsleeping

Interactions: VFood, Valcohol, Vand Vbenztropine Vcan Vreduce Vabsorption. VAntacids Vcan
Vslow Vabsorption. VLithium Vand Vbarbituates Vcan Vlead Vto Vincreased Vclearance.

TCAs Vdecrease Vclearance
Serious Vadverse Veffects: Vpostural Vhypotension, VEKG Vchanges, Vrespiratory
Vdepression




Haloperidol V- VANSWER-More Vselective Vfor VD2 Vreceptor, Vless Vanticholinergic Veffects,
Vless Vantihistamine, Vand Vanti-adrenergic Veffect

SE: VEPS, Vneuroleptic Vinduced Vsyndrome, Vakathisia, VTD Vwith Vhigh Vdoses,
Vamenorrhea, Vgalactorrhea

Interactions: Vdecreases Veffects Vof Vlevodopa, Vdopamine Vagonists. V
Serious Vadverse Vevents: VIf Vgiven VIV, Vpt Vneeds Vto Vbe Von Vcardiac Vmonitor. VCan
Vprolong Vqtc Vinterval Vand Vlead Vto Vtorsades Vand Vcause Vsudden Vcardiac Vdeath. V

Indications: Vacute Vagitation, VTourette's, Vdelirium

Thioridazine V(Mellaril) V- VANSWER-Dopamine Vreceptor Vantagonist. V

SE: VRetinal Vdeposits, VRPE Vhyperpigmentation, Vdry Veye, Vmydriasis, Vincreased VIOP
V(watch Vin Vnarrow Vangle), Vhypotension, Vweight Vgain VQTc Vprolongation.

Interactions: Vlevodopa, Vdopamine Vagonists, VCNS Vdepressants, Vantihypertensives
Indications: Vschizophrenia Vpts Vwho Vfail Vto Vrespond Vto Vother Vantipsychotics.

Perphenzaine V(Trilafon) V- VANSWER-Potent VD2 Vantagonist V

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