nurs 6630 final exam prep psychopharmacologic appr
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NURS 6630 FINAL
EXAM PREP
Psychopharmacologic
approaches to treatment
for psychopathology
ANSWERED
2023/2024
,1. What are the main classes of antidepressants and how do they work? Provide an example of a
drug for each class.
Answer: The main classes of antidepressants are selective serotonin reuptake inhibitors (SSRIs),
serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs),
monoamine oxidase inhibitors (MAOIs), and atypical antidepressants. They work by increasing the
availability of neurotransmitters such as serotonin, norepinephrine, and dopamine in the brain,
which are involved in mood regulation. Examples of drugs for each class are fluoxetine (SSRI),
venlafaxine (SNRI), amitriptyline (TCA), phenelzine (MAOI), and bupropion (atypical).
2. What are the common side effects and contraindications of antipsychotics? How can they be
managed?
Answer: The common side effects of antipsychotics include extrapyramidal symptoms (EPS), such
as dystonia, akathisia, parkinsonism, and tardive dyskinesia; metabolic syndrome, such as weight
gain, diabetes, and dyslipidemia; sedation, orthostatic hypotension, anticholinergic effects, such
as dry mouth, blurred vision, constipation, and urinary retention; and neuroleptic malignant
syndrome (NMS), which is a rare but life-threatening condition characterized by fever, muscle
rigidity, altered mental status, and autonomic instability. The contraindications of antipsychotics
include hypersensitivity to the drug, severe cardiovascular or cerebrovascular disease, blood
dyscrasias, liver or kidney impairment, and history of seizures. The management of side effects
and contraindications depends on the type and severity of the adverse reaction. Some general
strategies are dose adjustment, switching to a different drug or class, adding an adjunctive
medication, monitoring vital signs and laboratory tests, providing education and counseling, and
implementing lifestyle modifications.
3. What are the indications and mechanisms of action of mood stabilizers? Name two examples of
mood stabilizers and their therapeutic ranges.
Answer: The indications of mood stabilizers are bipolar disorder, cyclothymia, schizoaffective
disorder, and other conditions that involve mood swings or instability. The mechanisms of action
of mood stabilizers are not fully understood, but they may involve modulating the activity of
neurotransmitters, ion channels, second messengers, and gene expression in the brain. Two
examples of mood stabilizers are lithium and valproic acid. The therapeutic range of lithium is
0.6 to 1.2 mEq/L and the therapeutic range of valproic acid is 50 to 125 mcg/mL.
4. What are the benefits and risks of benzodiazepines in the treatment of anxiety disorders? How
can benzodiazepine dependence and withdrawal be prevented or treated?
,Answer: The benefits of benzodiazepines in the treatment of anxiety disorders are rapid onset of
action, high efficacy, low toxicity, and wide safety margin. The risks of benzodiazepines in the
treatment of anxiety disorders are tolerance, dependence, withdrawal, rebound anxiety,
cognitive impairment, sedation, respiratory depression, and potential for abuse or overdose.
Benzodiazepine dependence and withdrawal can be prevented or treated by using the lowest
effective dose for the shortest duration possible, tapering off the drug gradually under medical
supervision, avoiding abrupt discontinuation or dose reduction, using non-benzodiazepine
alternatives when appropriate, and providing psychotherapy and support.
5. What are the principles and goals of pharmacogenomics in psychiatry? How can
pharmacogenomic testing help optimize psychotropic drug selection and dosing?
Answer: The principles and goals of pharmacogenomics in psychiatry are to identify genetic
variations that affect the response to psychotropic drugs in terms of efficacy, safety, tolerability,
and adherence; and to use this information to guide individualized treatment decisions that
maximize benefits and minimize harms. Pharmacogenomic testing can help optimize psychotropic
drug selection and dosing by predicting the likelihood of response or non-response to a specific
drug or class; identifying potential drug-drug interactions or adverse reactions; estimating the
optimal dose or range for a given patient; and monitoring treatment outcomes or adverse events.
• Question 2
The PMHNP is meeting with a new mother who would like to begin
taking medication again to treat her bipolar depression; she is
breastfeeding her 2-month old daughter. The PMHNP recognizes
that which of the following medications is contraindicated for this
patient?
Selected C.
Answer: Lithium
(Lithobid)
• Question 3
0 out of 1 points
Mr. Gordon is a middle-aged client who was started on antidepressant
monotherapy for depression. After beginning this medication, the PMHNP
noticed that this client seemed to swing into a hypomanic episode. What can
the PMHNP infer from this behavior change?
Selected A.
Answer: This client may have Bipolar III disorder
• Question 4
1 out of 1 points
A patient presents with frequent episodes of mania. Which
, statement describes an appropriate treatment approach for this
patient?
Selected B.
Answer: “The patient could benefit from an
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