NR 546 Psychopharmacology for the Psychiatric-Mental Health Nurse Practitioner Final Exam Review
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NR 546 Psychopharmacology for the Psychiatric
Institution
NR 546 Psychopharmacology For The Psychiatric
NR 546 Psychopharmacology for the Psychiatric-Mental Health Nurse Practitioner Final Exam Review
Prefrontal Cortex Symptoms of MDD < Answer> Concentration
Mental Fatigue
Mood
PFC & Amygdala Symptoms of MDD < Answer> Guilt
Suicidality
Worthlessness
Striatum Symptoms of M...
*increase DA in prefrontal cortex (increase cognition)
NDRI-Norepinephrine Dopamine Reuptake inhibitors
*inhibit DA reuptake (increase alertness, motivation)
*inhibit NE reuptake (increase energy)
SARI-Serotonin Antagonist Reuptake Inhibitors
Selective Serotonin Reuptake Inhibitors (ssris): Most adverse effects will subside after 4-5 days once the body adjusts to
increased serotonin levels. < Answer> diarrhea
Headache
Weight gain
Sexual side effects
Serotonin Norepinephrine Reuptake Inhibitors (snris): Medications should not be abruptly stopped to avoid discontinuation
symptoms. NE effects of the medication may increase anxiety in some clients. Report worsening anxiety to the provider. <
Answer> elevated blood pressure
Anxiety
Insomnia
Constipation
Norepinephrine Dopamine Reuptake Inhibitors (NDRI): Take medication in the morning. Stop taking medication if seizures
,occur. Stop taking medication if anxiety is noted. < Answer> agitation
Headache
Dry mouth
Constipation
Weight loss
Escitalopram (Lexapro) SSRI < Answer> no known drug interactions
Best tolerated SSRI
27-32 hour half-life good for forgetful prone clients
Least CYP reactions
Substrate for 3A4
Fluoxetine (Prozac) SSRI < Answer> longest half-life
Use caution in patients with comorbid anxiety due to risk for activation and panic attacks
Half-Life: 2-3 days parent, 2 week metabolite
Inhibits 2D6 and 3A4
Paroxetine (Paxil) SSRI < Answer> also treats social anxiety and insomnia
Associated with weight gain
Will experience withdrawal with missed dose or abrupt stop
Half-Life: 24 hours
Inhibits 2D6
Sertraline (Zoloft) SSRI < Answer> also treats social anxiety and hypersomnolence
Half-Life: 22-36 hour parent; 62-104 hour metabolite
, Inhibits 2D6 and 3A4 weakly at low doses
Venlafaxine (Effexor) < Answer> treats both depression and anxiety disorders, ensure trial of higher dose before switching
to a different medication
Half-life: Parent drug 3-7 hour; metabolite has 9-13 hour
Duloxetine (Cymbalta) SNRI < Answer> effective for atypical pain at higher doses; appropriate for clients who present with
somatic symptoms of depression; effective for atypical pain, such as fibromyalgia and diabetic neuropathy
Half-Life: 12 hours
Inhibitor of 2D6
Bupropion (Wellbutrin) < Answer> NDRI may improve energy, alertness, and motivation; not first-line treatment for anxiety
contraindicated in clients with a history of seizures
Avoid in patients with comorbid anxiety
Half-Life: Parent 10-14 hours; Metabolite 20-27 hours
Inhibits 2D6
Serotonin Antagonist and Reuptake Inhibitors (saris) < Answer> saris potently block 5-HT2A and 5HT 2C receptors, which
allow more 5-HT to interact at postsynaptic 5-HT1A sites. Serotonin blockade and reuptake inhibition is present at higher
doses.
Trazodone < Answer> The most common SARI, also blocks histaminergic and α-adrenergic receptors.
Half-Life: 3-6 hours
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