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NR 566 Final Study Guide
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NR 566 Final Study Guide NR 566 Final Study Guide NR 566 Final Study Guide
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NR 566 Final Study Guide(SNRI) Venlafaxine
1. the first SNRI available, is approved for
2. MOA - verified answer1. major depression, generalized anxiety disorder, social anxiety disorder,
and panic disorder; SSRIs are equally effective & probably safer.
2. The drug produces powerful blockade of NE and 5-HT reuptake and weak blockade of dopamine
reuptake; does not block cholinergic, histaminergic, or α1-adrenergic receptors
1. A panic attack is characterized by
2. Panic symptoms reach a peak - verified answer1. is an abrupt surge of intense fear or intense
discomfort during which four or more of the following are present:
• Palpitations, pounding heart, racing heartbeat
• Sweating
• Trembling or shaking
• Sensation of shortness of breath or smothering
• Feeling of choking
• Chest pain or discomfort
• Nausea or abdominal distress
• Feeling dizzy, unsteady, lightheaded, or faint
• Chills or heat sensations
• Paresthesias (numbness or tingling sensations)
• Derealization (feelings of unreality) or depersonalization (feeling detached from oneself)
• Fear of losing control or going crazy
• Fear of dying
2. in a few minutes and then dissipate within 30 minutes. Many patients go to an emergency
department because they think they are having a heart attack.
1. Alzheimer's Disease is a progressive neurodegenerative disease that accounts for
2. The major known risk factor for AD is advancing age. In 90% of
3. 10 early warning signs and symptoms which include: - verified answer1. 70% of dementia cases
2. patients, the age of onset is 65 years or older; though it can occur as early as 40
,3. memory loss, challenges in planning or solving problems, trouble understanding visual and spatial
relationships, difficulty completing familiar tasks, disorientation, problems with word finding,
misplacing things, impaired judgment, social withdrawal, and changes in mood
1. Black Box Warning for Divalproex Sodium (Valproate)
2. Black Box Warning Carbamazepine/Lamotrigine
3. Black Box Warning antipsychotic drugs have an increased mortality in - verified answer1. Serious
or fatal hepatic failure has occurred with use of Depakote ER. In addition, life-threatening
pancreatitis has been reported. Depakote is also linked to increased fetal risk (neural tube defects,
major malformations, IQ)
2. fatal dermatologic reactions—toxic epidermal necrolysis & SJS—have been reported. Also w/
carbamazepine aplastic anemia and agranulocytosis have occurred
3. Elderly patients with dementia-related psychosis
1. BPH is a common condition that develops in more than
2. BPH is a nonmalignant prostate enlargement cells
3. Overgrowth of epithelial cells causes - verified answer1. 50% of men by age 60 years and 90% by
age 85 years.
2. caused by excessive growth of epithelial (glandular) cells and smooth muscle
3. mechanical obstruction of the urethra, whereas overgrowth of smooth muscle causes dynamic
obstruction of the urethra.
1. Drugs for ED fall into two major groups: oral and nonoral. The oral agents include
2. The nonoral agents include
3. Four PDE-5 inhibitors are available:
4. MOA of PDE-5 inhibitors causes selective inhibition of PDE-5. By doing so,
5. Benefits of PDE-5 inhibitors can - verified answer1. PDE-5 inhibitors—are by far the most common
treatments for ED.
2. include papaverine plus phentolamine & alprostadil
3. sildenafil, tadalafil, vardenafil, and avanafil. All are considered first-line therapy for ED.
4. it increases and preserves cGMP levels in the penis, thereby making the erection harder and
longer lasting.
5. help a wide range of patients, including those with diabetes, spinal cord injury, and transurethral
prostate resection as well as ED of no known physical cause
,1. List other rare but serious SE of Conventional antipsychotics
2. Black Box Warning-Antipsychotic Drugs - verified answer1. Neuroleptic malignant syndrome (lead
pipe" rigidity, sudden high fever >41°C), Orthostatic hypotension-not rare, Seizures, Agranulocytosis
2. When used to tx dementia-related psychosis in elderly pts, all FGAs & SGAs approx double the
rate of mortality. Most deaths result from heart-related events (e.g., heart failure, sudden death) or
pneumonia
1. List the Adverse effects for PDE-5 inhibitors
2. What are the most COMMON adverse effects - verified answer1. - Hypotension-especially when
combined with alpha blockers
- Priapism: (painful erection lasting more than 6 hours)
- Nonarteritic ischemic optic neuropathy: resulting in irreversible blurring or loss of vision. The cause
is blockage of blood flow to the optic nerve
- Sudden hearing loss.
2. headache, flushing, and dyspepsia, may also cause nasal congestion, diarrhea, rash, and dizziness.
About 3% of patients experience mild transient visual disturbances (a blue tinge to vision, increased
sensitivity to light, blurring)
1. OCD is characterized by
2. An obsession is defined as a
3. Treatment; (blank) is probably more important in OCD than in any other psychiatric disorder
4. DOC for OCD
5. Therapy of an initial episode - verified answer1. persistent obsessions and compulsions that cause
marked distress, consume at least 1 hour a day, and significantly interfere with daily living
2. recurrent, persistent thought, impulse (need for cleanliness or orderliness); whereas a compulsion
a ritualized behavior or mental act in response to the obsession
3. Behavioral therapy
4. SSRIs are first-line drugs for OCD
5. should continue for at least 1 year; withdrawal should be done slowly; relapse is common
1. Preferred administration route of alprostadil and why
Because of the inconvenient method of dosing, these drugs are second-line agents for ED. - verified
answer1. Alprostadil has the same chemical structure as prostaglandin E1, which causes vasodilation
When injected into the Intracavernous penile tissue it causes relaxation of smooth muscle (arterial,
venous, and trabecular), causing a rapid inflow of arterial blood.
, The blood fills the vascular sinusoidal spaces of the corpus cavernosum, resulting in an erection
1. Tx goals for AD
2. No single drug is more effective than the others, so
3. The current gold standard of treatment for cognitive symptoms - verified answer1. slow loss of
memory and cognition and prolong independent function (delay symptom progression)
2. selection should be based on tolerability, ease of use, and cost
3. includes pharmacologic management with a cholinesterase (ChE) inhibitor and an NMDA
antagonist.
6. Minimizing Adverse Effects of Estrogen:
• Nausea is common early in treatment. Advise patients that this adverse effect - verified answer6.
diminishes with time. In the meantime, avoidance of cooking odors and warm, stuffy environments
may help. Dry foods and raw fruits and vegetables help as well as Guided imagery with muscle
relaxation, yoga, and music therapy
• Menopausal HT with estrogen alone increases the risk for endometrial carcinoma. Adding a
progestin lowers this risk to the pretreatment level.
• Adverse effects similar to those caused by OCs (abnormal vaginal bleeding, hypertension, benign
hepatic adenoma, reduced glucose tolerance)
A patient diagnosed with Alzheimer's disease has decided to stop treatment. The NP has educated
the client that medication discontinuation will result in the return of cognitive symptoms and the
medication may not work as well if restarted. The client would still like to stop the medication due to
the gastrointestinal side effects. Which of the following medications requires tapering?
a. donepezil
b. rivastigmine
c. galantamine - verified answera. donepezil req tapering the others DO NOT
Abortive Therapy/When to use abortive therapy
1. The objective of abortive therapy is to
2. Treatment should commence at the
3. oral therapy may be ineffective after an attack d/t N/V. Hence
4. For mild to moderate symptoms,
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