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NR546 Final Exam | Questions & Answers (100 %Score) Latest Updated 2024/2025 Comprehensive Questions A+ Graded Answers | With Expert Solutions $13.48   Add to cart

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NR546 Final Exam | Questions & Answers (100 %Score) Latest Updated 2024/2025 Comprehensive Questions A+ Graded Answers | With Expert Solutions

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NR546 Final Exam | Questions & Answers (100 %Score) Latest Updated 2024/2025 Comprehensive Questions A+ Graded Answers | With Expert Solutions

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NR546 Final Exam | Questions & Answers (100 %Score) Latest Updated 2024/2025
Comprehensive Questions A+ Graded Answers | With Expert Solutions


Pharmacologic Treatment of Bipolar Disorder - Lithium

Anticonvulsants

Second generation antipsychotics



Unipolar depression - major depressive disorder (MDD)

one of the most common mental disorders

-Approximately 7.1% of adults in the U.S. had episode in last year, prevalence highest (13.1%) among
individuals aged 18-25



S/S

-depressed mood

-loss of interest or pleasure in daily activities

-irritability

-withdrawal

-problems with sleep, eating, energy, concentration, or self-worth

-severe depression: may experience thoughts of suicide or psychotic symptoms.



Bipolar disorder (BD) - Chronic condition characterized by extreme fluctuations in mood, energy, and
ability to function

-Moods may be manic, hypomanic, or depressed and may include mixed mood or psychotic features

-many have only experienced only one manic episode in their lifetime

-Mood fluctuations may be separated by periods of high stability or may cycle rapidly

-diagnosed when a client has one or more episodes of mania or hypomania with a history of one or
more major depressive episodes

-high risk for suicide



mania - characterized by a persistently elevated, expansive, or irritable mood. Related symptoms may
include inflated self-esteem, increased goal-directed activity or energy, including grandiosity, decreased

,need for sleep, excessive talkativeness, racing thoughts, flight of ideas (FOI), distractibility, psychomotor
agitation, and a propensity to be involved in high-risk activities. Mania leads to significant functional
impairment and may include psychotic features or necessitate hospitalization



Bipolar Type I: - requires at least one episode of mania for at least one week (or any duration if
hospitalization due to symptoms is required)



Bipolar Type II: - diagnosis requires a current or past hypomanic episode and a current or past major
depressive episode. Symptoms last for at least 4 days but fewer than seven.

-Hypomanic symptoms are not of sufficient duration or severity to cause significant functional
impairment, psychosis, or hospitalization.

-Anger and irritability are common.

-Clients often enjoy the elevation of mood and are reluctant to report these symptoms, making bipolar
more difficult to diagnose if the client presents in the depression phase.



Cyclothymia: - involves the chronic presentation of hypomanic and depressive symptoms that do not
meet the diagnostic criteria for a major depressive or manic/hypomanic episode.



If bipolar depression is mistaken for MDD: - antidepressant therapy may precipitate a manic episode or
induce rapid-cycling bipolar depression

-may contribute to the increased incidence of death by suicide in children and adults younger than 25



Antidepressants are used cautiously in clients with bipolar disorder and never as ________________. -
monotherapy

-Antidepressants should be combined with a mood stabilizer to prevent the onset of a hypomanic or
manic episode



DA, NE Dysfunction causes what mood related symptoms - Decreased positive affect:

depressed mood

loss of joy

lack of interest

loss of energy

,decreased alertness

decreased self-confidence

appetite changes



5HT, NE Dysfunction causes what mood related symptoms - Increased negative affect:

depressed mood

guilt

fear/anxiety

hostility

irritability

loneliness

appetite changes



monoamine hypothesis of depression - -depression occurs as a result of a deficiency of one or all three
monoamine transmitters

• serotonin, norepinephrine, and dopamine

-while mania may result from an excess



Medication Management for Depression, First-Line Treatment: - • Selective Serotonin Reuptake
Inhibitors (SSRIs)

• Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)

• Norepinephrine Dopamine Reuptake Inhibitors (NDRI)

• Serotonin Antagonist and Reuptake Inhibitors (SARIs)



SSRI's - Mechanism of action

• inhibit 5-HT reuptake

Adverse effects

-diarrhea

-headache

, -weight gain

-sexual side effects



SNRI's - Mechanism of action

• inhibit 5-HT reuptake

• inhibit NE reuptake (increase energy, focus)

• increase DA in prefrontal cortex (increase cognition)

Adverse effects

-elevated blood pressure

-anxiety

-insomnia

-constipation



NDRI's - Mechanism of action

• inhibit DA reuptake (increase alertness, motivation)

• inhibit NE reuptake (increase energy)

Adverse effects

-agitation

-headache

-dry mouth

-constipation

-weight loss



SSRI Prescribing Pearls: med with mild antihistamine effects - citalopram (Celexa)



SSRI Prescribing Pearls: med with no known drug interactions - escitalopram (Lexapro)



SSRI Prescribing Pearls: med with longest half-life - fluoxetine (Prozac)

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