NR546 PSYCHOPHARMACOLOGY
FINAL EXAM LATEST UPDATE
VERIFIED QUESTIONS & DETAILED
EXPLANATIONS GRADED A+
Professional Academic Assistance Services
monoamine hypothesis of depression - Answer: depression
occurs as a result of deficiency of 1 or all 3 monoamine NT
-occurs due to too little positive affect or too much negative
affect
(mania will occur from excess of all 3)
what are the three monoamine NT - Answer: NE, DA, 5HT
too little positive affect - Answer: -DA/NE dysfunction
-DA levels low = loss of pleasure, interest, alertness, self-
confidence
-DA levels high = hallucinations seen in schizo
-NE (fight or flight) high = antsy, nervous, affects focus ability
-depressed mood, loss of joy, lack of interest, loss of energy,
,decreased alertness, decreased self-confidence, appetite
changes
too much negative affect - Answer: -5HT = relaxation, comfort,
decreases stress, regulates libido, arousal, sleep, aggression,
pain perception
-5HT/NE dysfunction
-depressed mood, guilt, fear/anxiety, hostility, irritability,
loneliness, appetite changes
prescribing considerations - Answer: -client preference
-prior treatment response
-anticipated adverse effects
-comorbidities
-half-life interactions
-cost
client preference - Answer: if no contraindication, then prescribe
that med to improve adherence
prior treatment response - Answer: if patient had success with a
previous med, prescribe that one first
,anticipated adverse events - Answer: -consider age, family
planning, and anticipated adverse effects.
-use adverse effects to pt's advantage (choose a known
activating medication for a pt with atypical depression or choose
a sedating medication for a patient with sleep disturbances)
Comorbidities - Answer: clients with comorbid anxiety may
experience worsening symptoms when taking medications that
target NE (SNRIs)
-fluoxetine is known to activate clients and cause panic attacks
in clients with comorbid anxiety
half-life interactions - Answer: -choose a medication with a
longer half life to avoid discontinuation syndrome if your client
forgets to take it
-many antidepressants have significant interactions with other
meds due to CYP450 enzyme involvement
cost - Answer: if client cant afford medication, they will not
benefit. keep cost, insurance benefits, and pharmaceutical
assistance programs in mind
, goal of antidepressant medications - Answer: complete
remission of symptoms
antidepressant prescribing schedule - Answer: -start on a single
drug for 4-8 weeks
-if not working:
1. increase dose gradually until efficacy occurs
2. switch to different drug within same drug class after adequate
trial which included higher dosing and a minimum of 8 weeks
3. switch to a drug in a different class after adequate trial and
higher dosing
4. add a second med as adjunct
SSRI MOA - Answer: inhibit 5HT reuptake
first line of treatment for depression
SSRI s/e - Answer: 7 S's of SSRIs
1. Stomach
2. sexual dysfunction
3. serotonin syndrome
4. sleep difficulties
FINAL EXAM LATEST UPDATE
VERIFIED QUESTIONS & DETAILED
EXPLANATIONS GRADED A+
Professional Academic Assistance Services
monoamine hypothesis of depression - Answer: depression
occurs as a result of deficiency of 1 or all 3 monoamine NT
-occurs due to too little positive affect or too much negative
affect
(mania will occur from excess of all 3)
what are the three monoamine NT - Answer: NE, DA, 5HT
too little positive affect - Answer: -DA/NE dysfunction
-DA levels low = loss of pleasure, interest, alertness, self-
confidence
-DA levels high = hallucinations seen in schizo
-NE (fight or flight) high = antsy, nervous, affects focus ability
-depressed mood, loss of joy, lack of interest, loss of energy,
,decreased alertness, decreased self-confidence, appetite
changes
too much negative affect - Answer: -5HT = relaxation, comfort,
decreases stress, regulates libido, arousal, sleep, aggression,
pain perception
-5HT/NE dysfunction
-depressed mood, guilt, fear/anxiety, hostility, irritability,
loneliness, appetite changes
prescribing considerations - Answer: -client preference
-prior treatment response
-anticipated adverse effects
-comorbidities
-half-life interactions
-cost
client preference - Answer: if no contraindication, then prescribe
that med to improve adherence
prior treatment response - Answer: if patient had success with a
previous med, prescribe that one first
,anticipated adverse events - Answer: -consider age, family
planning, and anticipated adverse effects.
-use adverse effects to pt's advantage (choose a known
activating medication for a pt with atypical depression or choose
a sedating medication for a patient with sleep disturbances)
Comorbidities - Answer: clients with comorbid anxiety may
experience worsening symptoms when taking medications that
target NE (SNRIs)
-fluoxetine is known to activate clients and cause panic attacks
in clients with comorbid anxiety
half-life interactions - Answer: -choose a medication with a
longer half life to avoid discontinuation syndrome if your client
forgets to take it
-many antidepressants have significant interactions with other
meds due to CYP450 enzyme involvement
cost - Answer: if client cant afford medication, they will not
benefit. keep cost, insurance benefits, and pharmaceutical
assistance programs in mind
, goal of antidepressant medications - Answer: complete
remission of symptoms
antidepressant prescribing schedule - Answer: -start on a single
drug for 4-8 weeks
-if not working:
1. increase dose gradually until efficacy occurs
2. switch to different drug within same drug class after adequate
trial which included higher dosing and a minimum of 8 weeks
3. switch to a drug in a different class after adequate trial and
higher dosing
4. add a second med as adjunct
SSRI MOA - Answer: inhibit 5HT reuptake
first line of treatment for depression
SSRI s/e - Answer: 7 S's of SSRIs
1. Stomach
2. sexual dysfunction
3. serotonin syndrome
4. sleep difficulties
