BRAINSCAPE1
CMN 548 Unit 5 Exam with complete
solutions latest version
Potency - CORRECT ANSWER-refers to the relative dose required to achieve certain
effects, not to the efficacy of a drug
Agonist (full agonist) - CORRECT ANSWER-A drug that binds to a specific receptor
producing an effect identical to that usually produced by the neurotransmitter affecting
that receptor
Pharmacodynamics - CORRECT ANSWER-The time course and intensity of a drug's
effect/what the drug does to the body
Pharmacokinetics - CORRECT ANSWER-What the body does to a drug
Tolerance - CORRECT ANSWER-Develops over time a need to use increased doses of
a medication/drug to maintain a clinical effect. Or, a decreased sensitivity to adverse
effects of a drug
Stevens-Johnson Syndrome - CORRECT ANSWER-A systemic, immune-mediated
reaction that can be fatal or result in permanent scarring or blindness
Antagonist - CORRECT ANSWER-A compound that blinds to a receptor that blocks or
reduces the action of another substance at the receptor site
Hyponatremia - CORRECT ANSWER-Common symptoms of this medication side effect
include confusion, agitation, and lethargy. (tx with oxcarbazepine & SSRIs)
Therapeutic index - CORRECT ANSWER-ratio of the median toxic dose to the median
effective dose
Somnolence - CORRECT ANSWER-Daytime sleepiness
Black Box Warning - CORRECT ANSWER-This warning reflects that a medication may
cause a serious or even life-threatening side effect
BRAINSCAPE1
, BRAINSCAPE1
Partial or Mixed Agonist - CORRECT ANSWER-A compound that elicits a partial
pharmacological response at the receptor site involved
Remission - CORRECT ANSWER-The degree of improvement to below the syndromal
threshold of a disorder
Paradoxical - CORRECT ANSWER-A response to a drug that represents the clinical
effect opposite of what is expected
Inverse agonist - CORRECT ANSWER-An agent that binds to the same receptor site as
an agonist but produces the opposite pharmacological effect
4 major transmitters - CORRECT ANSWER-Dopamine, Serotonin, GABA,
Norepinephrine
Dopamine transmitter affects? - CORRECT ANSWER-affects mood, Psychosis, ADHD,
Addiction
Serotonin transmitter affects? - CORRECT ANSWER-Depression, aggression, OCD,
Panic, GAD, Social Anxiety, PTSD, Violence, Sexual dysfunction, substance addiction
Norepinephrine affects? - CORRECT ANSWER-Affects mood, anxiety, psychosis,
ADHD (part), drug withdrawal
GABA affects? - CORRECT ANSWER-Fear, anxiety, worry
Irreversible MAOIs Types - CORRECT ANSWER-MAOa and MAOb
Irreversible MAOIs medications - CORRECT ANSWER-Phenelzine (Nardil)
isocarboxazid (Marplan)
tranylcypromine (Parnate)
A single dose of MAOIs may persist in its inhibition of MAO for how long? - CORRECT
ANSWER-because they irreversibly inactivate MAOs, the therapeutic effect of a single
dose of irreversible MAOIs may persist for as long as 2 weeks
What are the most frequent adverse effects of MAOIs? - CORRECT ANSWER-
orthostatic hypotension, insomnia, weight gain, edema, sexual dysfunction
Reversible MAOIs (RIMAs) medications? - CORRECT ANSWER-Moclobemide (Maerix)
How long will it take to recover MAO activity after a final dose of RIMA? - CORRECT
ANSWER-MAO activity recovers completely 24-48 hrs after the last dose of a RIMA
MAOIs are used to treat what conditions? - CORRECT ANSWER-depression
panic disorder
BRAINSCAPE1
, BRAINSCAPE1
social phobia
bulimia nervosa
ptsd
anginal pain
atypical facial pain
migraine
adhd
idiopathic orthostatic hypotension
Depression associated with TBI
Treatment for MAOI induced orthostatic hypotension? - CORRECT ANSWER-Avoid
caffeine
intake of 2L of fluid/day
addition of dietary salt
adjust HTN meds
support stocking
severe cases *tx with fludrocortisone (Florinef) a mineralcorticoid
How long should the NP wait to begin another tx for depression when stopping an MAOI
to begin another MAOI or SSRI? - CORRECT ANSWER-irreversible MAOI-wait 14 days
MAO activity recovers completely 24-48 hrs after last dose of RIMA
How long should the NP wait to begin an MAOI after d/c a pt from fluoxetine (Prozac)? -
CORRECT ANSWER-when switching from an antidepressant to an irreversible MAOI-
should wait 10-14 days (or 5 weeks for fluoxetine (Prozac) before starting use of MAOI
to avoid drug interactions
Complications for using MAOIs for pts who have bipolar I and schizophrenia? -
CORRECT ANSWER-induction of mania in the depressed phase of bipolar I disorder
and triggering of a psychotic decompensation in persons with schizophrenia
Symptoms of tyramine-induced hypertensive crisis? - CORRECT ANSWER-Severe
HTN
HA
Stiff neck
diaphoresis
N/V
Tyramine-containing foods should be avoided for how long after d/c an irreversible
MAOI? A reversible MAOI? - CORRECT ANSWER-irreversible MAOI-2 weeks after last
dose
reversible-3 days after last dose of RIMA
s/s of the discontinuation syndrome associated with abrupt withdrawal of MAOIs? How
would the NP prevent this? - CORRECT ANSWER-arousal, mood disturbances, and
somatic symptoms
To avoid: dosage should be gradually tapered over several weeks
BRAINSCAPE1
CMN 548 Unit 5 Exam with complete
solutions latest version
Potency - CORRECT ANSWER-refers to the relative dose required to achieve certain
effects, not to the efficacy of a drug
Agonist (full agonist) - CORRECT ANSWER-A drug that binds to a specific receptor
producing an effect identical to that usually produced by the neurotransmitter affecting
that receptor
Pharmacodynamics - CORRECT ANSWER-The time course and intensity of a drug's
effect/what the drug does to the body
Pharmacokinetics - CORRECT ANSWER-What the body does to a drug
Tolerance - CORRECT ANSWER-Develops over time a need to use increased doses of
a medication/drug to maintain a clinical effect. Or, a decreased sensitivity to adverse
effects of a drug
Stevens-Johnson Syndrome - CORRECT ANSWER-A systemic, immune-mediated
reaction that can be fatal or result in permanent scarring or blindness
Antagonist - CORRECT ANSWER-A compound that blinds to a receptor that blocks or
reduces the action of another substance at the receptor site
Hyponatremia - CORRECT ANSWER-Common symptoms of this medication side effect
include confusion, agitation, and lethargy. (tx with oxcarbazepine & SSRIs)
Therapeutic index - CORRECT ANSWER-ratio of the median toxic dose to the median
effective dose
Somnolence - CORRECT ANSWER-Daytime sleepiness
Black Box Warning - CORRECT ANSWER-This warning reflects that a medication may
cause a serious or even life-threatening side effect
BRAINSCAPE1
, BRAINSCAPE1
Partial or Mixed Agonist - CORRECT ANSWER-A compound that elicits a partial
pharmacological response at the receptor site involved
Remission - CORRECT ANSWER-The degree of improvement to below the syndromal
threshold of a disorder
Paradoxical - CORRECT ANSWER-A response to a drug that represents the clinical
effect opposite of what is expected
Inverse agonist - CORRECT ANSWER-An agent that binds to the same receptor site as
an agonist but produces the opposite pharmacological effect
4 major transmitters - CORRECT ANSWER-Dopamine, Serotonin, GABA,
Norepinephrine
Dopamine transmitter affects? - CORRECT ANSWER-affects mood, Psychosis, ADHD,
Addiction
Serotonin transmitter affects? - CORRECT ANSWER-Depression, aggression, OCD,
Panic, GAD, Social Anxiety, PTSD, Violence, Sexual dysfunction, substance addiction
Norepinephrine affects? - CORRECT ANSWER-Affects mood, anxiety, psychosis,
ADHD (part), drug withdrawal
GABA affects? - CORRECT ANSWER-Fear, anxiety, worry
Irreversible MAOIs Types - CORRECT ANSWER-MAOa and MAOb
Irreversible MAOIs medications - CORRECT ANSWER-Phenelzine (Nardil)
isocarboxazid (Marplan)
tranylcypromine (Parnate)
A single dose of MAOIs may persist in its inhibition of MAO for how long? - CORRECT
ANSWER-because they irreversibly inactivate MAOs, the therapeutic effect of a single
dose of irreversible MAOIs may persist for as long as 2 weeks
What are the most frequent adverse effects of MAOIs? - CORRECT ANSWER-
orthostatic hypotension, insomnia, weight gain, edema, sexual dysfunction
Reversible MAOIs (RIMAs) medications? - CORRECT ANSWER-Moclobemide (Maerix)
How long will it take to recover MAO activity after a final dose of RIMA? - CORRECT
ANSWER-MAO activity recovers completely 24-48 hrs after the last dose of a RIMA
MAOIs are used to treat what conditions? - CORRECT ANSWER-depression
panic disorder
BRAINSCAPE1
, BRAINSCAPE1
social phobia
bulimia nervosa
ptsd
anginal pain
atypical facial pain
migraine
adhd
idiopathic orthostatic hypotension
Depression associated with TBI
Treatment for MAOI induced orthostatic hypotension? - CORRECT ANSWER-Avoid
caffeine
intake of 2L of fluid/day
addition of dietary salt
adjust HTN meds
support stocking
severe cases *tx with fludrocortisone (Florinef) a mineralcorticoid
How long should the NP wait to begin another tx for depression when stopping an MAOI
to begin another MAOI or SSRI? - CORRECT ANSWER-irreversible MAOI-wait 14 days
MAO activity recovers completely 24-48 hrs after last dose of RIMA
How long should the NP wait to begin an MAOI after d/c a pt from fluoxetine (Prozac)? -
CORRECT ANSWER-when switching from an antidepressant to an irreversible MAOI-
should wait 10-14 days (or 5 weeks for fluoxetine (Prozac) before starting use of MAOI
to avoid drug interactions
Complications for using MAOIs for pts who have bipolar I and schizophrenia? -
CORRECT ANSWER-induction of mania in the depressed phase of bipolar I disorder
and triggering of a psychotic decompensation in persons with schizophrenia
Symptoms of tyramine-induced hypertensive crisis? - CORRECT ANSWER-Severe
HTN
HA
Stiff neck
diaphoresis
N/V
Tyramine-containing foods should be avoided for how long after d/c an irreversible
MAOI? A reversible MAOI? - CORRECT ANSWER-irreversible MAOI-2 weeks after last
dose
reversible-3 days after last dose of RIMA
s/s of the discontinuation syndrome associated with abrupt withdrawal of MAOIs? How
would the NP prevent this? - CORRECT ANSWER-arousal, mood disturbances, and
somatic symptoms
To avoid: dosage should be gradually tapered over several weeks
BRAINSCAPE1
