NU664C STUDY GUIDE FOR MIDTERM EXAM
QUESTIONS WITH CORRECT ANSWERS 2025
KnowNtheNrouteNofNadministrationNforNnewerNagentNasenapineN(Saphris)NandNwhatNinstructionsNshouldNbe
NgivenNtoNtheNpatientNregardingNadministration.N-NCORRECTNANSWERN-Route-NSublingual
NotNtoNeatNorNdrinkNforN10NminutesNafterNmedicationNadministration
NotNtoNswallowNorNchewNtheNcapsule.
AsenapineNisNanNatypicalNantipsychoticN(serotonin-
dopamineNantagonist,NasNaNmoodNstabilizer).NAsenapineNisNnotNabsorbedNafterNswallowingN(lessNthanN2%N
bioavailableNorally)NandNthusNmustNbeNadministeredNsublinguallyN(35%Nbioavailable),NasNswallowingNwoul
dNrenderNasenapineNinactive.
PatientsNshouldNbeNinstructedNtoNplaceNtheNtabletNunderNtheNtongueNandNallowNitNtoNdissolveNcompletely,N
whichNwillNoccurNinNseconds;NtabletNshouldNnotNbeNdivided,Ncrushed,Nchewed,NorNswallowed.
PatientsNmayNnotNeatNorNdrinkNforN10NminutesNfollowingNsublingualNadministrationNsoNthatNtheNdrugNinNth
eNoralNcavityNcanNbeNabsorbedNlocallyNandNnotNwashedNintoNtheNstomachN(whereNitNwouldNnotNbeNabsorb
ed).
DueNtoNrapidNonsetNofNaction,NcanNbeNusedNasNaNrapidNactingN"prn"NorN"asNneeded"NdoseNforNagitationNorN
transientNworseningNofNpsychosisNorNmaniaNinsteadNofNanNinjection.
TreatmentNshouldNbeNsuspendedNifNabsoluteNneutrophilNcountNfallsNbelowN1,000/mm3.
KnowNandNdescribeNtheNtopNatypicalNantipsychoticNwithNgreatestNincidenceNofNprolongedNQTcNinterval.N-
NCORRECTNANSWERN-ZiprasidoneN(Geodon).
NormalNQTcN=450.
>470,NCallNCardiologist
>500,NstopNallNmeds.
ZiprasidoneN(Geodon)NhasNbeenNassociatedNwithNaNdose-relatedNprolongationNofNtheNQTc
QTcNintervalNprolongationNisNgreatestNwithNziprasidoneNandNleastNwithNolanzapine.
ZiprasidoneN(Geodon)NanNatypicalNantipsychoticN(serotonin-dopamineNantagonist;Nsecond-
generationNantipsychotic;NalsoNaNmoodNstabilizer.
ZiprasidoneNisNprescribedNforNSchizophrenia,NdelayingNrelapseNinNschizophrenia,NacuteNagitationNinNschizo
phreniaN(intramuscular),NacuteNmania/mixedNmania,NbipolarNmaintenance,NotherNpsychoticNd/o,NbipolarN
depression,NbehavioralNdisturbancesNinNdementias,NbehavioralNdisturbancesNinNchildrenNandNadolescents,
NandNdisordersNassociatedNwithNproblemsNwithNimpulseNcontrol.
, ZiprasidoneNblocksNdopamineN2Nreceptors,NreducingNpositiveNsymptomsNofNpsychosisNandNstabilizingNaffec
tiveNsymptoms.NBlocksNserotoninN2ANreceptors,NcausingNenhancementNofNdopamineNreleaseNinNcertainNbr
ainNregionsNandNthusNreducingNmotorNsideNeffectsNandNpossibleNimprovingNcognitiveNandNaffectiveNsympt
oms.
EKGsNmayNbeNusefulNforNselectedNpatientsN(e.g.,NthoseNwithNpersonalNorNfamilyNhistoryNofNQTcNprolongatio
n;NcardiacNarrhythmia;NrecentNmyocardialNinfarction;NuncompensatedNheartNfailure;NorNthoseNtakingNagen
tsNthatNprolongNQTcNintervalN(suchNasNpimozide,Nthioridazine,NselectedNantiarrhythmics,Nmoxifloxacin,Nspa
rfloxacin,Netc.)
ZiprasidoneNprolongsNQTcNintervalNmoreNthanNsomeNotherNantipsychotics.
ZiprasidoneNisNassociatedNwithNrareNbutNseriousNskinNconditionNknownNasNDrugNReactionNwithNEosinophili
aN(DRESS).NDRESSNmayNbeginNasNaNrashNbutNcanNprogressNtoNotherNpartsNofNtheNbodyNandNcanNincludeNsym
ptomsNsuchNasNfever,NswollenNlymphNnodes,NswollenNface,NinflammationNofNorgans,NandNanNincreaseNinNw
hiteNbloodNcellsNknownNasNeosinophilia.NInNsomeNcases,NDRESSNcanNleadNtoNdeath.NClinic
KnowNwhichNantipsychoticsNhaveNspecificNinstructionsNforNminimumNfoodNintakeNorNdietNrestrictions.N-
NCORRECTNANSWERN-GeodonNbecauseNfoodNaffectsNtheNabsorptionNofNtheNdrug.
LurasidoneN-NLatuda
KnowNanNalternativeNatypicalNantipsychoticNforNaNpatientNwhoNhasNdevelopedNdiabetesNandNhasNaNsignific
antNweightNgainNfromNtreatmentNwithNolanzapine.N-NCORRECTNANSWERN-
AbilifyNorNGeodon,NorNLurasidoneN(Latuda)
BecauseNtheyNareNweightNneutralNorNcausesNminimalNweightNgain.
KnowNwhetherNaNpatientNisNdemonstratingNefficacyNtoNclozapineN500Nmg/dayNifNthisNweek'sNgranulocyteNc
ountNisNlessNthanN500mm3.NWhatNisNtheNmostNappropriateNrecommendationNforNdrugNtherapy?N-
NCORRECTNANSWERN-StopNtheNdrug,NbecauseNofNtheNriskNofNagranulocytosisNandNpatientNcanNbeNinfected.
TheNmostNappropriateNrecommendationNforNdrugNtherapyNisNtoNrepeatNCBCNweekly.
>N1500,NwatchNcarefullyNifNisNatN1000
KnowNtheNcommonNeffectsNofNsmokingNalongNwithNantipsychoticNdrugNtherapyNsuchNasNolanzapine.N-
NCORRECTNANSWERN-
SmokingNreducesNtheNlevelNofNOlanzapineNbecauseNofNitsNmetabolismNatNCYP450Nenzyme.
QUESTIONS WITH CORRECT ANSWERS 2025
KnowNtheNrouteNofNadministrationNforNnewerNagentNasenapineN(Saphris)NandNwhatNinstructionsNshouldNbe
NgivenNtoNtheNpatientNregardingNadministration.N-NCORRECTNANSWERN-Route-NSublingual
NotNtoNeatNorNdrinkNforN10NminutesNafterNmedicationNadministration
NotNtoNswallowNorNchewNtheNcapsule.
AsenapineNisNanNatypicalNantipsychoticN(serotonin-
dopamineNantagonist,NasNaNmoodNstabilizer).NAsenapineNisNnotNabsorbedNafterNswallowingN(lessNthanN2%N
bioavailableNorally)NandNthusNmustNbeNadministeredNsublinguallyN(35%Nbioavailable),NasNswallowingNwoul
dNrenderNasenapineNinactive.
PatientsNshouldNbeNinstructedNtoNplaceNtheNtabletNunderNtheNtongueNandNallowNitNtoNdissolveNcompletely,N
whichNwillNoccurNinNseconds;NtabletNshouldNnotNbeNdivided,Ncrushed,Nchewed,NorNswallowed.
PatientsNmayNnotNeatNorNdrinkNforN10NminutesNfollowingNsublingualNadministrationNsoNthatNtheNdrugNinNth
eNoralNcavityNcanNbeNabsorbedNlocallyNandNnotNwashedNintoNtheNstomachN(whereNitNwouldNnotNbeNabsorb
ed).
DueNtoNrapidNonsetNofNaction,NcanNbeNusedNasNaNrapidNactingN"prn"NorN"asNneeded"NdoseNforNagitationNorN
transientNworseningNofNpsychosisNorNmaniaNinsteadNofNanNinjection.
TreatmentNshouldNbeNsuspendedNifNabsoluteNneutrophilNcountNfallsNbelowN1,000/mm3.
KnowNandNdescribeNtheNtopNatypicalNantipsychoticNwithNgreatestNincidenceNofNprolongedNQTcNinterval.N-
NCORRECTNANSWERN-ZiprasidoneN(Geodon).
NormalNQTcN=450.
>470,NCallNCardiologist
>500,NstopNallNmeds.
ZiprasidoneN(Geodon)NhasNbeenNassociatedNwithNaNdose-relatedNprolongationNofNtheNQTc
QTcNintervalNprolongationNisNgreatestNwithNziprasidoneNandNleastNwithNolanzapine.
ZiprasidoneN(Geodon)NanNatypicalNantipsychoticN(serotonin-dopamineNantagonist;Nsecond-
generationNantipsychotic;NalsoNaNmoodNstabilizer.
ZiprasidoneNisNprescribedNforNSchizophrenia,NdelayingNrelapseNinNschizophrenia,NacuteNagitationNinNschizo
phreniaN(intramuscular),NacuteNmania/mixedNmania,NbipolarNmaintenance,NotherNpsychoticNd/o,NbipolarN
depression,NbehavioralNdisturbancesNinNdementias,NbehavioralNdisturbancesNinNchildrenNandNadolescents,
NandNdisordersNassociatedNwithNproblemsNwithNimpulseNcontrol.
, ZiprasidoneNblocksNdopamineN2Nreceptors,NreducingNpositiveNsymptomsNofNpsychosisNandNstabilizingNaffec
tiveNsymptoms.NBlocksNserotoninN2ANreceptors,NcausingNenhancementNofNdopamineNreleaseNinNcertainNbr
ainNregionsNandNthusNreducingNmotorNsideNeffectsNandNpossibleNimprovingNcognitiveNandNaffectiveNsympt
oms.
EKGsNmayNbeNusefulNforNselectedNpatientsN(e.g.,NthoseNwithNpersonalNorNfamilyNhistoryNofNQTcNprolongatio
n;NcardiacNarrhythmia;NrecentNmyocardialNinfarction;NuncompensatedNheartNfailure;NorNthoseNtakingNagen
tsNthatNprolongNQTcNintervalN(suchNasNpimozide,Nthioridazine,NselectedNantiarrhythmics,Nmoxifloxacin,Nspa
rfloxacin,Netc.)
ZiprasidoneNprolongsNQTcNintervalNmoreNthanNsomeNotherNantipsychotics.
ZiprasidoneNisNassociatedNwithNrareNbutNseriousNskinNconditionNknownNasNDrugNReactionNwithNEosinophili
aN(DRESS).NDRESSNmayNbeginNasNaNrashNbutNcanNprogressNtoNotherNpartsNofNtheNbodyNandNcanNincludeNsym
ptomsNsuchNasNfever,NswollenNlymphNnodes,NswollenNface,NinflammationNofNorgans,NandNanNincreaseNinNw
hiteNbloodNcellsNknownNasNeosinophilia.NInNsomeNcases,NDRESSNcanNleadNtoNdeath.NClinic
KnowNwhichNantipsychoticsNhaveNspecificNinstructionsNforNminimumNfoodNintakeNorNdietNrestrictions.N-
NCORRECTNANSWERN-GeodonNbecauseNfoodNaffectsNtheNabsorptionNofNtheNdrug.
LurasidoneN-NLatuda
KnowNanNalternativeNatypicalNantipsychoticNforNaNpatientNwhoNhasNdevelopedNdiabetesNandNhasNaNsignific
antNweightNgainNfromNtreatmentNwithNolanzapine.N-NCORRECTNANSWERN-
AbilifyNorNGeodon,NorNLurasidoneN(Latuda)
BecauseNtheyNareNweightNneutralNorNcausesNminimalNweightNgain.
KnowNwhetherNaNpatientNisNdemonstratingNefficacyNtoNclozapineN500Nmg/dayNifNthisNweek'sNgranulocyteNc
ountNisNlessNthanN500mm3.NWhatNisNtheNmostNappropriateNrecommendationNforNdrugNtherapy?N-
NCORRECTNANSWERN-StopNtheNdrug,NbecauseNofNtheNriskNofNagranulocytosisNandNpatientNcanNbeNinfected.
TheNmostNappropriateNrecommendationNforNdrugNtherapyNisNtoNrepeatNCBCNweekly.
>N1500,NwatchNcarefullyNifNisNatN1000
KnowNtheNcommonNeffectsNofNsmokingNalongNwithNantipsychoticNdrugNtherapyNsuchNasNolanzapine.N-
NCORRECTNANSWERN-
SmokingNreducesNtheNlevelNofNOlanzapineNbecauseNofNitsNmetabolismNatNCYP450Nenzyme.