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NURS 660: PSYCHOPHARM Questions & 100% correct Answers- Latest Test | Graded A+ | Passed $12.79   Add to cart

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NURS 660: PSYCHOPHARM Questions & 100% correct Answers- Latest Test | Graded A+ | Passed

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  • NURS 660

Minimum ANC level to prescribe Clozapine, general population: Ξ -:- 1,500 μL Severe Neutropenia Ξ -:- < 500μL Moderate Neutropenia Ξ -:- 500-999μL Mild Neutropenia Ξ -:- μL BEN patients: Normal ANC range for Clozaril Ξ -:- ≥1,000 μL Clozaril BEN patient: severe neutropenia ...

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  • August 27, 2024
  • 40
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • NURS 660
  • NURS 660
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E x c e l l e n c e i s k e y | 2 0 2 0 2 5 ~ P a g e |1




NURS 660: PSYCHOPHARM Questions &
100% correct Answers- Latest Test |
Graded A+ | Passed
Minimum ANC level to prescribe Clozapine, general population:

Ξ -:- 1,500 μL



Severe Neutropenia

Ξ -:- < 500μL



Moderate Neutropenia

Ξ -:- 500-999μL



Mild Neutropenia

Ξ -:- 1000-1499μL



BEN patients: Normal ANC range for Clozaril

Ξ -:- ≥1,000 μL



Clozaril BEN patient: severe neutropenia

Ξ -:- <500 μL



BEN neutropenia

Ξ -:- 500-999 μL



Lower ANC threshold for starting clozapine: General population

Ξ -:- ≥1,500/μL




26/08/2024 | © Copyright- This work may not be copied for profit.

, E x c e l l e n c e i s k e y | 2 0 2 0 2 5 ~ P a g e |2


Lower ANC threshold for starting clozapine: Benign ethnic neutropenia (BEN)

Ξ -:- 1,000/μL



Medical emergencies when prescribing anti-psychotics

Ξ -:- - NMS

- Agranulocytosis

- Serotonin Syndrome



Clinical findings in agranulocytosis

Ξ -:-



Clozaril: most likely side effect if pt develops fever within 6 weeks

Ξ -:- Myocarditis



Clozaril: if pt develops fever within 6 weeks order a ______, _________ and _______.

Ξ -:- EKG, CRP, Troponin, as this is likely due to myocarditis



Common complaints in patients with neutropenia:

F,P, U, P

Ξ -:- - Fever (low grade)

- painful swallowing (odynophagia)

- URI (sinusitis, otitis, cough)

- Perirectal pain/irritation



Symptoms of neuroleptic malignant syndrome (NMS):

Ξ -:- - High fever

- Tachycardia/irregular pulse

- Increased respiratory rate

- Muscle Rigidity

- altered mental status


26/08/2024 | © Copyright- This work may not be copied for profit.

, E x c e l l e n c e i s k e y | 2 0 2 0 2 5 ~ P a g e |3




Off label TX for NMS

Ξ -:- Amantadine (SYMMETREL)



Serotonin Syndrome onset:

Ξ -:- -24 hours of combining antidepressants



Serotonin Syndrome Cardinal features

Ξ -:- - Myoclonic jerks

- Hyperreflexia

- Mental status changes

- Shivering

- Fever

- Tachycardia, HTN, hypotension (AUTONOMIC instability)

- Confused/ restless/ hyperactive/ unresponsive



Management of Serotonin syndrome

Ξ -:- - Discontinue meds, stablize vitals



Potentially

helpful meds with Serotonin syndrome:

Ξ -:- Benzodiazepines for agitation

Cyproheptadine (anti-serotonergic antihistamine)

Methysergide (anti-serotonergic migraine medication)



5-HT "TWITCHY FROG" Serotonin Syndrome

Ξ -:- -Agitated

-Sweating

-Fever

-Hyperreflexia


26/08/2024 | © Copyright- This work may not be copied for profit.

, E x c e l l e n c e i s k e y | 2 0 2 0 2 5 ~ P a g e |4


-Dilated pupils



Neuroleptic Malignant Syndrome

Ξ -:- a potentially fatal hyperpyrexia with temp of over 104, looks like EPS except for

temp



Neuroleptic Malignant Syndrome- "can't bender(er)"

Ξ -:- Life-threatening muscle rigidity, fever, and rhabdomyolysis.

Mental status changes



Mechanism of NMS.

-What's blocked? Where (2)?

Ξ -:- Dopamine blockade in the hypothalamus (fever)

and nigrostriatal pathway (rigidity



Onset of NMS

Ξ -:- 30 days of starting or increasing antipsychotics or stoping a domaminergic drug



NMS cardinal features

Ξ -:- High fever 100% by definition

Rigidity 100% by definition

Mental status changes 99%

Elevated or labile BP most



NMS motor activity

Ξ -:- Bradykinesia



Brain regions affected by schizophrenia (aggression and impulse control) (2)




26/08/2024 | © Copyright- This work may not be copied for profit.

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