NU664C Study Guide for Midterm EXAM NEWEST 2025-2026
COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) |ALREADY GRADED A+||BRAND NEW
VERSION!!
Know the route of administration for newer agent asenapine (Saphris) and what
instructions should be given to the patient regarding administration. - CORRECT
ANSWER- Route- Sublingual
Not to eat or drink for 10 minutes after medication administration
Not to swallow or chew the capsule.
Asenapine is an atypical antipsychotic (serotonin-dopamine antagonist, as a mood
stabilizer). Asenapine is not absorbed after swallowing (less than 2% bioavailable
orally) and thus must be administered sublingually (35% bioavailable), as
swallowing would render asenapine inactive.
Patients should be instructed to place the tablet under the tongue and allow it to
dissolve completely, which will occur in seconds; tablet should not be divided,
crushed, chewed, or swallowed.
Patients may not eat or drink for 10 minutes following sublingual administration
so that the drug in the oral cavity can be absorbed locally and not washed into the
stomach (where it would not be absorbed).
Due to rapid onset of action, can be used as a rapid acting "prn" or "as needed"
dose for agitation or transient worsening of psychosis or mania instead of an
injection.
,Treatment should be suspended if absolute neutrophil count falls below
1,000/mm3.
Know and describe the top atypical antipsychotic with greatest incidence of
prolonged QTc interval. - CORRECT ANSWER- Ziprasidone (Geodon).
Normal QTc =450.
>470, Call Cardiologist
>500, stop all meds.
Ziprasidone (Geodon) has been associated with a dose-related prolongation of
the QTc
QTc interval prolongation is greatest with ziprasidone and least with olanzapine.
Ziprasidone (Geodon) an atypical antipsychotic (serotonin-dopamine antagonist;
second-generation antipsychotic; also a mood stabilizer.
Ziprasidone is prescribed for Schizophrenia, delaying relapse in schizophrenia,
acute agitation in schizophrenia (intramuscular), acute mania/mixed mania,
bipolar maintenance, other psychotic d/o, bipolar depression, behavioral
disturbances in dementias, behavioral disturbances in children and adolescents,
and disorders associated with problems with impulse control.
Ziprasidone blocks dopamine 2 receptors, reducing positive symptoms of
psychosis and stabilizing affective symptoms. Blocks serotonin 2A receptors,
causing enhancement of dopamine release in certain brain regions and thus
reducing motor side effects and possible improving cognitive and affective
symptoms.
EKGs may be useful for selected patients (e.g., those with personal or family
history of QTc prolongation; cardiac arrhythmia; recent myocardial infarction;
uncompensated heart failure; or those taking agents that prolong QTc interval
, (such as pimozide, thioridazine, selected antiarrhythmics, moxifloxacin,
sparfloxacin, etc.)
Ziprasidone prolongs QTc interval more than some other antipsychotics.
Ziprasidone is associated with rare but serious skin condition known as Drug
Reaction with Eosinophilia (DRESS). DRESS may begin as a rash but can progress
to other parts of the body and can include symptoms such as fever, swollen lymph
nodes, swollen face, inflammation of organs, and an increase in white blood cells
known as eosinophilia. In some cases, DRESS can lead to death. Clinic
Know which antipsychotics have specific instructions for minimum food intake or
diet restrictions. - CORRECT ANSWER- Geodon because food affects the absorption of
the drug.
Lurasidone - Latuda
Know an alternative atypical antipsychotic for a patient who has developed
diabetes and has a significant weight gain from treatment with olanzapine. -
CORRECT ANSWER- Abilify or Geodon, or Lurasidone (Latuda)
Because they are weight neutral or causes minimal weight gain.
Know whether a patient is demonstrating efficacy to clozapine 500 mg/day if this
week's granulocyte count is less than 500mm3. What is the most appropriate
recommendation for drug therapy? - CORRECT ANSWER- Stop the drug, because of
the risk of agranulocytosis and patient can be infected.
The most appropriate recommendation for drug therapy is to repeat CBC weekly.
> 1500, watch carefully if is at 1000
COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) |ALREADY GRADED A+||BRAND NEW
VERSION!!
Know the route of administration for newer agent asenapine (Saphris) and what
instructions should be given to the patient regarding administration. - CORRECT
ANSWER- Route- Sublingual
Not to eat or drink for 10 minutes after medication administration
Not to swallow or chew the capsule.
Asenapine is an atypical antipsychotic (serotonin-dopamine antagonist, as a mood
stabilizer). Asenapine is not absorbed after swallowing (less than 2% bioavailable
orally) and thus must be administered sublingually (35% bioavailable), as
swallowing would render asenapine inactive.
Patients should be instructed to place the tablet under the tongue and allow it to
dissolve completely, which will occur in seconds; tablet should not be divided,
crushed, chewed, or swallowed.
Patients may not eat or drink for 10 minutes following sublingual administration
so that the drug in the oral cavity can be absorbed locally and not washed into the
stomach (where it would not be absorbed).
Due to rapid onset of action, can be used as a rapid acting "prn" or "as needed"
dose for agitation or transient worsening of psychosis or mania instead of an
injection.
,Treatment should be suspended if absolute neutrophil count falls below
1,000/mm3.
Know and describe the top atypical antipsychotic with greatest incidence of
prolonged QTc interval. - CORRECT ANSWER- Ziprasidone (Geodon).
Normal QTc =450.
>470, Call Cardiologist
>500, stop all meds.
Ziprasidone (Geodon) has been associated with a dose-related prolongation of
the QTc
QTc interval prolongation is greatest with ziprasidone and least with olanzapine.
Ziprasidone (Geodon) an atypical antipsychotic (serotonin-dopamine antagonist;
second-generation antipsychotic; also a mood stabilizer.
Ziprasidone is prescribed for Schizophrenia, delaying relapse in schizophrenia,
acute agitation in schizophrenia (intramuscular), acute mania/mixed mania,
bipolar maintenance, other psychotic d/o, bipolar depression, behavioral
disturbances in dementias, behavioral disturbances in children and adolescents,
and disorders associated with problems with impulse control.
Ziprasidone blocks dopamine 2 receptors, reducing positive symptoms of
psychosis and stabilizing affective symptoms. Blocks serotonin 2A receptors,
causing enhancement of dopamine release in certain brain regions and thus
reducing motor side effects and possible improving cognitive and affective
symptoms.
EKGs may be useful for selected patients (e.g., those with personal or family
history of QTc prolongation; cardiac arrhythmia; recent myocardial infarction;
uncompensated heart failure; or those taking agents that prolong QTc interval
, (such as pimozide, thioridazine, selected antiarrhythmics, moxifloxacin,
sparfloxacin, etc.)
Ziprasidone prolongs QTc interval more than some other antipsychotics.
Ziprasidone is associated with rare but serious skin condition known as Drug
Reaction with Eosinophilia (DRESS). DRESS may begin as a rash but can progress
to other parts of the body and can include symptoms such as fever, swollen lymph
nodes, swollen face, inflammation of organs, and an increase in white blood cells
known as eosinophilia. In some cases, DRESS can lead to death. Clinic
Know which antipsychotics have specific instructions for minimum food intake or
diet restrictions. - CORRECT ANSWER- Geodon because food affects the absorption of
the drug.
Lurasidone - Latuda
Know an alternative atypical antipsychotic for a patient who has developed
diabetes and has a significant weight gain from treatment with olanzapine. -
CORRECT ANSWER- Abilify or Geodon, or Lurasidone (Latuda)
Because they are weight neutral or causes minimal weight gain.
Know whether a patient is demonstrating efficacy to clozapine 500 mg/day if this
week's granulocyte count is less than 500mm3. What is the most appropriate
recommendation for drug therapy? - CORRECT ANSWER- Stop the drug, because of
the risk of agranulocytosis and patient can be infected.
The most appropriate recommendation for drug therapy is to repeat CBC weekly.
> 1500, watch carefully if is at 1000
