NR 547
NR 547 Final Exam Questions And
Answers Newest Solution
Prescribing pearls: citalopram (Celexa) - ANS ✔✔ - mild antihistamine effects
Prescribing pearls: escitalopram (Lexapro) - ANS ✔✔ - no known drug interactions
Prescribing pearls: fluoxetine (Prozac) - ANS ✔✔ - longest half-life
Prescribing pearls: paroxetine (Paxil) - ANS ✔✔ - also treats social anxiety and insomnia
Prescribing pearls: fluvoxamine (Luvox) - ANS ✔✔ - treats anxious depression smokers require increased
dose
Prescribing pearls: sertraline (Zoloft) - ANS ✔✔ - also treats social anxiety and hypersomnolence
Prescribing pearls: bupropion (Wellbutrin) - ANS ✔✔ - NDRI may improve energy, alertness, and
motivation; not first line treatment for anxiety; contraindicated in clients with a history of seizures
Prescribing pearls: duloxetine (Cymbalta) - ANS ✔✔ - effective for atypical pain at higher doses;
appropriate for clients who present with somatic symptoms of depression; effective for atypical pain,
such as fibromyalgia and diabetic neuropathy
1
, NR 547
Prescribing pearls: venlafaxine (Effexor) - ANS ✔✔ - treats both depression and anxiety disorders, ensure
trial of higher dose before switching to a different medication
Prescribing pearls: desvenlafaxine (Pristiq) - ANS ✔✔ - effective for perimenopausal vasomotor
symptoms
Considered when selecting a medication: - ANS ✔✔ - -Client preference
-Prior treatment response
-Anticipated adverse effects
-Comorbidities
-Half-life and interactions
-Cost
If a medication is not achieving efficacy: - ANS ✔✔ - -Increase dose gradually
-Switch to a different drug within the same class
-Switch to drug in a different class
-Add a second medication
Use to protect against suicide - ANS ✔✔ - lithium
MDD and BPD genetics - ANS ✔✔ - genetic factors contribute 31-42% of the disease risk in MDD and 59-
85% in BPD
Monoamine hypothesis of depression - ANS ✔✔ - -posits that depression occurs as a result of a
deficiency of one or all three monoamine transmitters
2
, NR 547
• Serotonin, norepinephrine, and dopamine
-while mania may result from an excess
*Emphasis is now shifted from the monoamines to their receptors and other downstream events such
as the regulation of gene expression, growth factors, environmental factors, and epigenetic changes
- ANS ✔✔ - Three principal neurotransmitters
-norepinephrine (NE), dopamine (DA), and serotonin 5HT
• comprise the monoamine neurotransmitter system
• implications for the pathophysiology and treatment of mood disorders
• All known pharmacologic treatments for mood disorders act upon one or more of these three
neurotransmitters
-Many of the symptoms of mood disorders are hypothesized to involve dysfunction of various
combinations of the monoamine neurotransmitters
Mood disorders include ____________________ and ___________________ - ANS ✔✔ - depressive
disorders and bipolar disorders
Major depressive disorder (MDD) - ANS ✔✔ - one of the most prevalent psychiatric disorders
-estimated that more than 300 million people suffer from
-leading cause of disability worldwide
-7.1% of adults and 13.3% of adolescents in the U.S. had at least one major depressive episode
-An imbalance of specific neurotransmitters, including dopamine, serotonin, and norepinephrine, can
influence brain activity and result in depression
-decreased neurotransmitter activity in the prefrontal cortex (PFC)
3
, NR 547
MDD dx - ANS ✔✔ - -occurrence of at least one episode of major depression lasting at least two weeks.
-must experience 5 or more of the following symptoms in two weeks to be diagnosed with a major
depressive episode:
• feeling low most of the day for most days
• decreased interest in activities
• substantial weight loss, significant change in appetite
• fidgeting, random movement (i.e. pacing)
• decreased energy
• sense of guilt or worthlessness
• lack of focus or ability to make decisions
• repeated thoughts of death and suicide
Risk factors associated with major depressive disorder (MDD) - ANS ✔✔ - female gender
older adults with multiple health problems and disabilities
non-white populations
family history of MDD, suicide attempts and completion, substance abuse
history of abuse/neglect
financial, job loss, divorce, or other life stressors
low socioeconomic status
lack of relationships and support systems
Certain conditions are associated with depression, including: - ANS ✔✔ - epilepsy
post-stroke
Parkinson's disease
multiple sclerosis
4
NR 547 Final Exam Questions And
Answers Newest Solution
Prescribing pearls: citalopram (Celexa) - ANS ✔✔ - mild antihistamine effects
Prescribing pearls: escitalopram (Lexapro) - ANS ✔✔ - no known drug interactions
Prescribing pearls: fluoxetine (Prozac) - ANS ✔✔ - longest half-life
Prescribing pearls: paroxetine (Paxil) - ANS ✔✔ - also treats social anxiety and insomnia
Prescribing pearls: fluvoxamine (Luvox) - ANS ✔✔ - treats anxious depression smokers require increased
dose
Prescribing pearls: sertraline (Zoloft) - ANS ✔✔ - also treats social anxiety and hypersomnolence
Prescribing pearls: bupropion (Wellbutrin) - ANS ✔✔ - NDRI may improve energy, alertness, and
motivation; not first line treatment for anxiety; contraindicated in clients with a history of seizures
Prescribing pearls: duloxetine (Cymbalta) - ANS ✔✔ - effective for atypical pain at higher doses;
appropriate for clients who present with somatic symptoms of depression; effective for atypical pain,
such as fibromyalgia and diabetic neuropathy
1
, NR 547
Prescribing pearls: venlafaxine (Effexor) - ANS ✔✔ - treats both depression and anxiety disorders, ensure
trial of higher dose before switching to a different medication
Prescribing pearls: desvenlafaxine (Pristiq) - ANS ✔✔ - effective for perimenopausal vasomotor
symptoms
Considered when selecting a medication: - ANS ✔✔ - -Client preference
-Prior treatment response
-Anticipated adverse effects
-Comorbidities
-Half-life and interactions
-Cost
If a medication is not achieving efficacy: - ANS ✔✔ - -Increase dose gradually
-Switch to a different drug within the same class
-Switch to drug in a different class
-Add a second medication
Use to protect against suicide - ANS ✔✔ - lithium
MDD and BPD genetics - ANS ✔✔ - genetic factors contribute 31-42% of the disease risk in MDD and 59-
85% in BPD
Monoamine hypothesis of depression - ANS ✔✔ - -posits that depression occurs as a result of a
deficiency of one or all three monoamine transmitters
2
, NR 547
• Serotonin, norepinephrine, and dopamine
-while mania may result from an excess
*Emphasis is now shifted from the monoamines to their receptors and other downstream events such
as the regulation of gene expression, growth factors, environmental factors, and epigenetic changes
- ANS ✔✔ - Three principal neurotransmitters
-norepinephrine (NE), dopamine (DA), and serotonin 5HT
• comprise the monoamine neurotransmitter system
• implications for the pathophysiology and treatment of mood disorders
• All known pharmacologic treatments for mood disorders act upon one or more of these three
neurotransmitters
-Many of the symptoms of mood disorders are hypothesized to involve dysfunction of various
combinations of the monoamine neurotransmitters
Mood disorders include ____________________ and ___________________ - ANS ✔✔ - depressive
disorders and bipolar disorders
Major depressive disorder (MDD) - ANS ✔✔ - one of the most prevalent psychiatric disorders
-estimated that more than 300 million people suffer from
-leading cause of disability worldwide
-7.1% of adults and 13.3% of adolescents in the U.S. had at least one major depressive episode
-An imbalance of specific neurotransmitters, including dopamine, serotonin, and norepinephrine, can
influence brain activity and result in depression
-decreased neurotransmitter activity in the prefrontal cortex (PFC)
3
, NR 547
MDD dx - ANS ✔✔ - -occurrence of at least one episode of major depression lasting at least two weeks.
-must experience 5 or more of the following symptoms in two weeks to be diagnosed with a major
depressive episode:
• feeling low most of the day for most days
• decreased interest in activities
• substantial weight loss, significant change in appetite
• fidgeting, random movement (i.e. pacing)
• decreased energy
• sense of guilt or worthlessness
• lack of focus or ability to make decisions
• repeated thoughts of death and suicide
Risk factors associated with major depressive disorder (MDD) - ANS ✔✔ - female gender
older adults with multiple health problems and disabilities
non-white populations
family history of MDD, suicide attempts and completion, substance abuse
history of abuse/neglect
financial, job loss, divorce, or other life stressors
low socioeconomic status
lack of relationships and support systems
Certain conditions are associated with depression, including: - ANS ✔✔ - epilepsy
post-stroke
Parkinson's disease
multiple sclerosis
4
