N3300 Exam 2 Questions with Correct Answers
Depression Correct Answer ✓✓ most common mental illness,
characterized by depressed moods, feeling of sadness, or emotional
upset
Antidepressants Correct Answer ✓✓ used to regulate mood-affecting
serotonin, norepinephrine, and dopamine
Choice of antidepressant Correct Answer ✓✓ dependent on age,
medical condition, previous Hx, and adverse effects
How long do you have to take an antidepressant before effective Correct
Answer ✓✓ 2-4 weeks
antidepressant discontinuation syndrome Correct Answer ✓✓ Sudden
stopping of antidepressant causes rapid flu-like symptoms, nausea,
imbalance, sensory disturbances, etc
6 Antidepressants Correct Answer ✓✓ -Tricyclic Antidepressants
-Selective-Serotonin Reuptake Inhibitors (SSRIs)
-Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
-Monoamine Oxidase Inhibitors (MAO)
-Atypical Antidepressants
- Mood Stabilizing Agents
,Tricyclic Antidepressants Prototype Correct Answer ✓✓ imipramine
Additional Tricyclic Antidepressants Correct Answer ✓✓ amitriptyline,
amoxapine clomipramine, desipramine, doxepin, nortriptyline,
protriptyline, trimipramine
Action of Tricyclic Antidepressants Correct Answer ✓✓ Blocks the
reuptake of norepinephrine and serotonin at the presynaptic nerve
endings = increasing the action of both NT
Use of Tricyclic Antidepressants Correct Answer ✓✓ Depression
Management of enuresis (bed wetting) in children/adolescents after
physical causes have been ruled out
Tricyclic Antidepressants Black Box Warning Correct Answer ✓✓ risk
of suicidal ideation in children, adolescents, young adults 18-24
Adverse Effects of Tricyclic Antidepressants Correct Answer ✓✓
Sedation, orthostatic hypotension, cardiac dysrhythmias, anticholinergic
symptoms, and weight gain
CNS depression and cardiovascular effects (crosses BBB)
Strong anticholinergic effects
Contraindications of Tricyclic Antidepressants Correct Answer ✓✓
sensitivity to drug
Cannot be given immediately post-acute myocardial infarction
,Imipramine + MAO inhibitor Correct Answer ✓✓ serious effects
(seizures and death)
Alcohol + Imipramine Correct Answer ✓✓ Alcohol may increase
sedative effects
Grapefruit juice + imipramine Correct Answer ✓✓ Grapefruit juice can
inhibit metabolism of imipramine/other TCAs
SSRIs prototype Correct Answer ✓✓ Fluoxetine (Prozac, Sarafem)
Additional SSRIs Correct Answer ✓✓ Citalopram, Escitalopram,
Paroxetine, Sertraline, Vilazodone
SSRIs Action Correct Answer ✓✓ Fluoxetine blocks the reabsorption of
the NT serotonin in the brain which helps elevate the patient's mood
SSRIs Uses Correct Answer ✓✓ Anxiety, OCD, bulimia nervosa, and
premenstrual dysphoric disorder
Antidepressant of choice for older adults Correct Answer ✓✓ SSRIs are
the drug of choice in older adults because they produce fewer sedative,
anticholinergic, cardiotoxic, and psychomotor adverse effects than
TCAs/related antidepressants
, SSRIs contraindications Correct Answer ✓✓ Elimination may be
slower, and smaller or less frequent doses may be prudent in older adults
Weight loss is often associated with SSRIs (undesirable in older adults)
Caution in liver patient
SSRIs adverse effects Correct Answer ✓✓ Dry mouth, GI symptoms,
sexual dysfunction, risk of GI bleeds
CNS stimulation (most prominent with fluoxetine)
For patients with diabetes mellitus, SSRIs may have hypoglycemic
effect
Serotonin Syndrome
SSRIs Black Box Warning Correct Answer ✓✓ suicidal ideation in
young adults
SNRIs prototype Correct Answer ✓✓ Venlafaxine (Effexor XP)
Additional SNRIs Correct Answer ✓✓ Desvenlafaxine, Duloxetine,
Levomilnacipran, Milnacipran, Nefazodone
Use of SNRIs Correct Answer ✓✓ Treatment of depression, generalized
anxiety disorder, social phobia, and panic disorder
Initial dose of SNRIs Correct Answer ✓✓ Providers recommend smaller
initial dosages and then increasing