NR546 Actual Final Exam Prediction
questions And Answers Verified 100%
Correct
5HT, NE Dysfunction causes what mood related symptoms - ANSWER -Increased
negative affect:
depressed mood
guilt
fear/anxiety
hostility
irritability
loneliness
appetite changes
monoamine hypothesis of depression - ANSWER --depression occurs as a result
of a deficiency of one or all three monoamine transmitters
• serotonin, norepinephrine, and dopamine
-while mania may result from an excess
Medication Management for Depression, First-Line Treatment: - ANSWER -•
Selective Serotonin Reuptake Inhibitors (SSRIs)
• Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)
• Norepinephrine Dopamine Reuptake Inhibitors (NDRI)
• Serotonin Antagonist and Reuptake Inhibitors (SARIs)
SSRI's - ANSWER -Mechanism of action
• inhibit 5-HT reuptake
Adverse effects
-diarrhea
-headache
-weight gain
-sexual side effects
SNRI's - ANSWER -Mechanism of action
• inhibit 5-HT reuptake
• inhibit NE reuptake (increase energy, focus)
• increase DA in prefrontal cortex (increase cognition)
,Adverse effects
-elevated blood pressure
-anxiety
-insomnia
-constipation
NDRI's - ANSWER -Mechanism of action
• inhibit DA reuptake (increase alertness, motivation)
• inhibit NE reuptake (increase energy)
Adverse effects
-agitation
-headache
-dry mouth
-constipation
-weight loss
SSRI Prescribing Pearls: med with mild antihistamine effects - ANSWER -
citalopram (Celexa)
SSRI Prescribing Pearls: med with no known drug interactions - ANSWER -
escitalopram (Lexapro)
SSRI Prescribing Pearls: med with longest half-life - ANSWER -fluoxetine
(Prozac)
SSRI Prescribing Pearls: med that also treats social anxiety and insomnia -
ANSWER -paroxetine (Paxil)
SSRI Prescribing Pearls: med that treats anxious depression; smokers require an
increased dose - ANSWER -fluvoxamine (Luvox)
SSRI Prescribing Pearls: med that also treats social anxiety and hypersomnolence
- ANSWER -sertraline (Zoloft)
venlafaxine (Effexor) - ANSWER -INDICATION
-Depression
-GAD
-Social anxiety disorder
-Panic disorder
,Mechanism of Action
-SNRI (dual serotonin and norepinephrine reuptake inhibitor), Boosts
neurotransmitters serotonin, norepinephrine/noradrenaline, and dopamine.
TESTS
-Check bp before initiating tx & regularly during tx
Starting Dose
-Initial 37.5 mg daily (extended-release) or 25-50 mg divided into 2-3 doses
(immediate-release)
Adverse Effects
-H/A, nervousness, insomnia, sedation, nausea, diarrhea, decreased appetite, sexual
dysfunction, asthenia, sweating, SIADH, hyponatremia, increase BP
PEARLS
-treats both depression and anxiety disorders, ensure trial of higher dose before
switching to a different medication
-preferred treatments for treatment-resistant depression
desvenlafaxine (Pristiq) - ANSWER -INDICATION
-MDD
Mechanism of Action
-SNRI (dual serotonin and norepinephrine reuptake inhibitor), Boosts
neurotransmitters serotonin, norepinephrine/noradrenaline, and dopamine
TESTS
-Monitor BP before and during treatment.
Starting Dose
-50 mg/day
Adverse Effects
-Insomnia, sedation, anxiety, dizziness, nausea, vomiting, constipation, decreased
appetite, sexual dysfunction, sweating, SIADH, hyponatremia, increased BP
PEARLS
-effective for perimenopausal vasomotor symptoms
, duloxetine (Cymbalta) - ANSWER -INDICATION
-MDD
-Diabetic peripheral neuropathic pain
-Fibromyalgia
-GAD
-Chronic musculoskeletal pain
Mechanism of Action
-SNRI (dual serotonin and norepinephrine reuptake inhibitor), Boosts
neurotransmitters serotonin, norepinephrine/noradrenaline, and dopamine
TESTS
-Monitor BP before and during treatment.
Starting Dose
-Depression initial 40 mg/day in 2 doses.
-Anxiety initial 60 mg once daily.
Adverse Effects
-nausea, diarrhea, decreased appetite, dry mouth, constipation, insomnia, sedation,
dizziness, sexual dysfunction, sweating, increased blood pressure, urinary
retention.
PEARLS
-effective for atypical pain at higher doses; fibromyalgia and diabetic neuropathy
-appropriate for clients who present with somatic symptoms of depression
-Drug interactions: Inhibitors of CYP450 2D6, such as paroxetine, fluoxetine, and
quinidine, may increase plasma levels of duloxetine and require a dosage reduction
of duloxetine.
90% of serotonin receptors are in the __________ and _________ are within the
brain - ANSWER -GI tract, only 10%
*which causes GI side effects
client education for specific medication classes: SSRI's - ANSWER -Most adverse
effects will subside after 4-5 days once the body adjusts to increased serotonin
levels
client education for specific medication classes: SNRI's - ANSWER --Medications
should not be abruptly stopped to avoid discontinuation symptoms.
questions And Answers Verified 100%
Correct
5HT, NE Dysfunction causes what mood related symptoms - ANSWER -Increased
negative affect:
depressed mood
guilt
fear/anxiety
hostility
irritability
loneliness
appetite changes
monoamine hypothesis of depression - ANSWER --depression occurs as a result
of a deficiency of one or all three monoamine transmitters
• serotonin, norepinephrine, and dopamine
-while mania may result from an excess
Medication Management for Depression, First-Line Treatment: - ANSWER -•
Selective Serotonin Reuptake Inhibitors (SSRIs)
• Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)
• Norepinephrine Dopamine Reuptake Inhibitors (NDRI)
• Serotonin Antagonist and Reuptake Inhibitors (SARIs)
SSRI's - ANSWER -Mechanism of action
• inhibit 5-HT reuptake
Adverse effects
-diarrhea
-headache
-weight gain
-sexual side effects
SNRI's - ANSWER -Mechanism of action
• inhibit 5-HT reuptake
• inhibit NE reuptake (increase energy, focus)
• increase DA in prefrontal cortex (increase cognition)
,Adverse effects
-elevated blood pressure
-anxiety
-insomnia
-constipation
NDRI's - ANSWER -Mechanism of action
• inhibit DA reuptake (increase alertness, motivation)
• inhibit NE reuptake (increase energy)
Adverse effects
-agitation
-headache
-dry mouth
-constipation
-weight loss
SSRI Prescribing Pearls: med with mild antihistamine effects - ANSWER -
citalopram (Celexa)
SSRI Prescribing Pearls: med with no known drug interactions - ANSWER -
escitalopram (Lexapro)
SSRI Prescribing Pearls: med with longest half-life - ANSWER -fluoxetine
(Prozac)
SSRI Prescribing Pearls: med that also treats social anxiety and insomnia -
ANSWER -paroxetine (Paxil)
SSRI Prescribing Pearls: med that treats anxious depression; smokers require an
increased dose - ANSWER -fluvoxamine (Luvox)
SSRI Prescribing Pearls: med that also treats social anxiety and hypersomnolence
- ANSWER -sertraline (Zoloft)
venlafaxine (Effexor) - ANSWER -INDICATION
-Depression
-GAD
-Social anxiety disorder
-Panic disorder
,Mechanism of Action
-SNRI (dual serotonin and norepinephrine reuptake inhibitor), Boosts
neurotransmitters serotonin, norepinephrine/noradrenaline, and dopamine.
TESTS
-Check bp before initiating tx & regularly during tx
Starting Dose
-Initial 37.5 mg daily (extended-release) or 25-50 mg divided into 2-3 doses
(immediate-release)
Adverse Effects
-H/A, nervousness, insomnia, sedation, nausea, diarrhea, decreased appetite, sexual
dysfunction, asthenia, sweating, SIADH, hyponatremia, increase BP
PEARLS
-treats both depression and anxiety disorders, ensure trial of higher dose before
switching to a different medication
-preferred treatments for treatment-resistant depression
desvenlafaxine (Pristiq) - ANSWER -INDICATION
-MDD
Mechanism of Action
-SNRI (dual serotonin and norepinephrine reuptake inhibitor), Boosts
neurotransmitters serotonin, norepinephrine/noradrenaline, and dopamine
TESTS
-Monitor BP before and during treatment.
Starting Dose
-50 mg/day
Adverse Effects
-Insomnia, sedation, anxiety, dizziness, nausea, vomiting, constipation, decreased
appetite, sexual dysfunction, sweating, SIADH, hyponatremia, increased BP
PEARLS
-effective for perimenopausal vasomotor symptoms
, duloxetine (Cymbalta) - ANSWER -INDICATION
-MDD
-Diabetic peripheral neuropathic pain
-Fibromyalgia
-GAD
-Chronic musculoskeletal pain
Mechanism of Action
-SNRI (dual serotonin and norepinephrine reuptake inhibitor), Boosts
neurotransmitters serotonin, norepinephrine/noradrenaline, and dopamine
TESTS
-Monitor BP before and during treatment.
Starting Dose
-Depression initial 40 mg/day in 2 doses.
-Anxiety initial 60 mg once daily.
Adverse Effects
-nausea, diarrhea, decreased appetite, dry mouth, constipation, insomnia, sedation,
dizziness, sexual dysfunction, sweating, increased blood pressure, urinary
retention.
PEARLS
-effective for atypical pain at higher doses; fibromyalgia and diabetic neuropathy
-appropriate for clients who present with somatic symptoms of depression
-Drug interactions: Inhibitors of CYP450 2D6, such as paroxetine, fluoxetine, and
quinidine, may increase plasma levels of duloxetine and require a dosage reduction
of duloxetine.
90% of serotonin receptors are in the __________ and _________ are within the
brain - ANSWER -GI tract, only 10%
*which causes GI side effects
client education for specific medication classes: SSRI's - ANSWER -Most adverse
effects will subside after 4-5 days once the body adjusts to increased serotonin
levels
client education for specific medication classes: SNRI's - ANSWER --Medications
should not be abruptly stopped to avoid discontinuation symptoms.
