NURS 615 Exam 2 Maryville University of Saint Louis | Questions with 100% Verified Answers | Latest Update

NURS 615 Exam 2 Maryville University of Saint Louis | Questions with 100%
Verified Answers | Latest Update
Question: Tricyclic Antidepressent Uses
Answer:
depression, anxiety, enuresis, neuopathic pain, insomnia, eating disorders

Question: Tricyclic Antidepressent MOA
Answer:
inhibit reuptake of NE & 5-HT at presynaptic neuron; also act on histamine & ACh receptors

Question: Tricyclic Antidepressent Examples
Answer:
imipramine (Tofranil) amitriptyline (Elavil) doxepin (Silenor)

Question: Tricyclic Antidepressent Adverse Effects
Answer:
Anticholinergic Orthostatic hypotension Sedation (histamine effect) Cardiac conduction abnormalities,
sinus tachycardia (cardiotoxicity), prolonger QT interval ↓ seizure threshold, narrow TI (overdose fatal)
Tardive dyskinesia, neuroleptic malignant syndrome (rare)

Question: Tricyclic Antidepressent Key Points
Answer:
Contraindicated: cardiovascular disorders, glaucoma, BPH, urinary retention, conduction disorders,
anyone with suicide risk, uncontrolled epilepsy Avoid in elderly (falls, confusion) and suicidal patients
(fatal in overdose).

Question: what baseline test is needed before starting a TCA
Answer:
EKG

Question: Monamine Oxidase Ihhibitor (MAOI) Uses
Answer:
treatment of resistent depression

Question: Monamine Oxidase Ihhibitor (MAOI) MOA
Answer:

,Inhibit MAO enzyme (irreversible inactivation)→ prevents breakdown of NE, DA, 5-HT (inc
bioavailability) also prevent breakdown of tyramine (which is a precursor to neurotransmitters)

Question: Monamine Oxidase Ihhibitor (MAOI) Examples
Answer:
phenelzine (Nardil), tranylcypromine (Parnate)

Question: Monamine Oxidase Ihhibitor (MAOI) Risk
Answer:
Danger: Hypertensive crisis with tyramine-containing foods (aged cheese, dried/aged meats, pickles, soy
sauce, fermented foods, alcohol) or drugs that rise BP

Question: Monamine Oxidase Ihhibitor (MAOI) Key Points
Answer:
Not first-line (many restrictions & risks) but works quickly Contraindicated: noncompliance, cognitive
dysfunction, cardiovascular disease(heart failure or arteriosclerotic disease)—may suppress myocardial
pain, hepatic/renal disease, pregnancy Avoid caffeine Requires washout period before SSRIs/SNRIs

Question: s/s of hypertensive crisis
Answer:
Severe headache, stiff neck, chest pain/tightness, palpitations, sweating, photophobia/dilated pupils,
severe hypertension= pt needs to remain standing until treated

Question: selective seratonin reuptake inhibitors (SSRIs) uses
Answer:
major Depressive disorder, anxiety, OCD, PTSD, panic disorder, bulimia

Question: selective seratonin reuptake inhibitors (SSRIs) examples
Answer:
citalopram (Celexa), fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), Escitalopram (Lexapro)

Question: selective seratonin reuptake inhibitors (SSRIs) MOA
Answer:
Block/inhibit presynaptic 5-HT reuptake (blocks serotonin transporter) → ↑ serotonin availability at post
synaptic receptor

Question: selective seratonin reuptake inhibitors (SSRIs) Adverse effects
Answer:

, do not miss a dose or stop suddenly--can cause withdrawl syndrome (flu-like, dizziness, insomnia)
contraindicated with MAOI (2-3 wk wash out)

Question: selective seratonin reuptake inhibitors (SSRIs) Key Points
Answer:
Nausea/vomiting, headache, dizziness, sweating, insomnia= initial side effects usually go away in a few
weeks; take with food and in morning to dec SE Weight changes (paroxetine → gain; sertraline →
diarrhea) Sexual dysfunction (↓ libido, ED, delayed orgasm) Suicidal ideation (esp. <20 yrs) first 3
weeks, can be used in children Serotonin syndrome (if combined with other serotonergic drugs like St
johns wort) CNS depression can occur with etoh, antihistamines, and opiods Withdrawal if not tapered
(except fluoxetine, long half-life—can give 1 dose when tapering off others)

Question: s/s of seratonin syndrome
Answer:
N/V/chills, sweating, hyperthermia, HTN, myoclonic jerking, tremor, agitation, ataxia, disorientation,
confusion, delirium)

Question: Seratonin Norepinephrine Reuptake Inhibitors (SNRIs) uses
Answer:
Depression, anxiety, social phobia, PTSD, neuropathic pain, fibromyalgia, overactive bladder

Question: Seratonin Norepinephrine Reuptake Inhibitors (SNRIs) examples
Answer:
duloxetine (Cymbalta), venlafaxine (Effexor)

Question: Seratonin Norepinephrine Reuptake Inhibitors (SNRIs) MOA
Answer:
Block reuptake of 5-HT & NE (block serotonin and norepinephrine transportors, inhibiting reuptake and
inc bioavailability)→ ↑ levels for postsynaptic receptors At lower doses Effexor acts mostly on seratonin

Question: Seratonin Norepinephrine Reuptake Inhibitors (SNRIs) Key Points
Answer:
monitor BP helps in pts with lethargy/fatigue duloxetine--avoid in liver dysfunction and glaucoma

Question: Bupropion (Wellbutrin) MOA
Answer:
weak inhibitor of norepinephrine and dopamine reuptake

Question: Bupropion (Wellbutrin) uses