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NR546 FINAL EXAM 2024/2025 WITH COMPLETE QUESTIONS AND ANSWERS
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NR546 FINAL EXAM 2024/2025 WITHCOMPLETE QUESTIONS AND
ANSWERS
Pharmacologic treatment of bipolar disorder
Lithium
an6convulsants
second genera6on an6psycho6cs
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 ac6vi6es
-irritability
-withdrawal
-problems with sleep, ea6ng, energy, concentra6on, or self-worth
-severe depression: may experience thoughts of suicide or psycho6c
symptoms.
Bipolar disorder (bd)
Chronic condi6on characterized by extreme fluctua6ons in mood, energy, and
ability to func6on
-moods may be manic, hypomanic, or depressed and may include mixed mood
or psycho6c features
,-many have only experienced only one manic episode in their life6me
-mood fluctua6ons 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 ac6vity or
energy, including grandiosity, decreased need for sleep, excessive talka6veness,
racing thoughts, flight of ideas (foi), distrac6bility, psychomotor agita6on, and a
propensity to be involved in high-risk ac6vi6es. Mania leads to significant
func6onal impairment and may include psycho6c features or necessitate
hospitaliza6on
Bipolar type i:
Requires at least one episode of mania for at least one week (or any dura6on if
hospitaliza6on 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 dura6on or severity to cause
significant func6onal impairment, psychosis, or hospitaliza6on.
-anger and irritability are common.
-clients oXen enjoy the eleva6on 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 presenta6on of hypomanic and depressive symptoms that
do not meet the diagnos6c criteria for a major depressive or manic/hypomanic
episode.
If bipolar depression is mistaken for mdd:
An6depressant 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
An6depressants are used cau6ously in clients with bipolar disorder and never
as ________________.
Monotherapy
-an6depressants should be combined with a mood stabilizer to prevent the
onset of a hypomanic or manic episode
Da, ne dysfunc6on causes what mood related symptoms
Decreased posi6ve affect:
depressed mood
loss of joy
lack of interest
loss of energy
decreased alertness
decreased self-confidence
appe6te changes
5ht, ne dysfunc6on causes what mood related symptoms
Increased nega6ve affect:
depressed mood
guilt
, fear/anxiety
hos6lity
irritability
loneliness
appe6te changes
Monoamine hypothesis of depression
-depression occurs as a result of a deficiency of one or all three monoamine
transmi]ers
• serotonin, norepinephrine, and dopamine
-while mania may result from an excess
Medica6on management for depression, first-line treatment:
• selec6ve serotonin reuptake inhibitors (ssris)
• serotonin norepinephrine reuptake inhibitors (snris)
• norepinephrine dopamine reuptake inhibitors (ndri)
• serotonin antagonist and reuptake inhibitors (saris)
Ssri's
Mechanism of ac6on
• inhibit 5-ht reuptake
adverse effects
-diarrhea
-headache
-weight gain
-sexual side effects
Snri's
Mechanism of ac6on
• inhibit 5-ht reuptake
• inhibit ne reuptake (increase energy, focus)
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