Antipsychotics NURS 752 psychopharmacology EXAM 2 Latest Update 2024 -2025 Actual Exam 120 Questions and 100% Verified Correct Answers Guaranteed A+ Cognitive symptoms include: - CORRECT ANSWER: •Disordered thinking •Reduced ability to focus attention •Prominent learning and memory difficulties •Subtle changes may appear years before symptoms become florid •Florid changes: Thinking and speech may be completely incomprehensible to others Concept of 1st Gen binding thresholds - CORRECT ANSWER: The degree of D2 receptor binding in the mesolimbic system is close to 80% to have best effects for relieving psychosis. PROBLEM - 1st gen don't discriminate and block D2 receptors everywhere in the brain. When D2 increases over 80% in the dorsal striatum EPS effects occur and in the pituitary hyperprolactemia occur. Erectile problems occur in 23 -54% of men. True or False - CORRECT ANSWER: True High metabolic risk meds in 2nd generation atypicals are? - CORRECT ANSWER: •Clozapine •Olanzapine How to monitory for the metabolic risk? - CORRECT ANSWER: . First, increased appetite and weight gain can lead to elevated body mass index (BMI) and ultimately obesity. Thus, weight and BMI should be monitored here. Second, atypical antipsychotics can cause insulin resistance by an unknown mechanism; this can be detected by measuring fasting plasma triglyceride levels. Finally, atypical antipsychotics can cause sudden onset of diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar syndrome (HHS) by unknown mechanisms, possibly including blockade of M3 -
cholinerg ic receptors. This can be detected by informing patients of the symptoms of DKA/HHS and by measuring fasting glucose levels. Negative symptoms include: - CORRECT ANSWER: •Loss or diminution of normal function •Lack•Loss or diminution of normal function •Lack of motivation •Poverty of speech •Blunted affect •Poor self -care •Social withdrawal of motivation Overactivity or Underactivity of the mesocortical dopamine systemmediate the negative, cognitive, and affective symptoms of schizophrenia? - CORRECT ANSWER: Underactivity Positive symptoms include: - CORRECT ANSWER: Delusions, Hallucinations and Thought Disorder. Rare side effect of Chlorpromazine and how to monitor? - CORRECT ANSWER: Agranulocytosis and monitor WBC Receptors associated with weight gain include? - CORRECT ANSWER: H1 histamine receptor and the 5HT2C serotonin receptor, and when these receptors are blocked, particularly at the same time, patients can experience weight gain. symptoms of neuroleptic malignant syndrome - CORRECT ANSWER: •Lead pipe" rigidity, sudden high fever, sweating, autonomic instability, dysrhythmias, fluctuations in blood pressure, altered level of consciousness, and seizures or coma may develop •Death can result from respiratory failure, cardiovascular collapse, dysrhythmias, and other causes The metabolic highway pattern looks like...? - CORRECT ANSWER: increased appetite and weight gain, and progresses to obesity, insulin resistance, and dyslipidemia with increases in fasting triglyceride levels This side effect Occurs in up to 40% of patients, with low -potency agents having higher risk? - CORRECT ANSWER: Weight Gain Three main features of neurolepsis include: - CORRECT ANSWER: Psychomotor slowing, emotional quieting and affective indifference. Treatment of NMS is...? - CORRECT ANSWER: Stop the offending agent and give supportive therapy including fluids and cooling What is the first drug approved for Tardive Dyskinesia? - CORRECT ANSWER: Valbenazine (Ingrezza) Which 1st generation antipsychotics are a risk for QT prolongation? - CORRECT ANSWER: thioridazine, chlorpromazine, haloperidol Which 1st generation antipsychotics are high potency drugs? - CORRECT ANSWER: thioridazine, chlorpromazine, haloperidol Which drugs reverse effects of Parkinsonism? - CORRECT ANSWER: •diphenhydramine, trihexyphenidyl, and benztropine. Which meds have a low metabolic risk? - CORRECT ANSWER: •Ziprasidone •Aripiprazole •Lurasidone •Iloperidone (low - dyslipidemia) •Asenapine •Brexpiprazole •Cariprazine Which two 1st generation antipsychotics have low risk for EPS and high risk for anticholinergic effects? - CORRECT ANSWER: Chlorpromazine and Thioridazine Antidepressants - CORRECT ANSWER: > Tricyclic antidepressants > SSRIs -Fluoxetine, Fluvoxamine, Sertraline have been used in the tx of Social Phobia, Panic D/O, GAD, and PTSD. > MAOIs - Advantage: not associated with dependency - Disadvantages: takes 4 -6 weeks to relieve anxiety Anxiety Disorders - CORRECT ANSWER: > A heterogeneous group of psychiatric disorders > Have multiple and diverse etiologies > Currently seen as serious, chronic mental illnesses > In severe cases: - High suicide rates - Up to 30% assoc. w/ alcohol abuse - Medical services inappropriately overutilized - Cardiac -death rate higher than average > Anxiety disorders occur in 30 -40% of the population. > Generalized anxiety occurs in 5% of the population. > Affects women with twice the frequency of men. Anxiety vs. Fear - CORRECT ANSWER: Anxiety can be distinguished from fear: Fear is associated with: - A response to an identifiable stimulus - Rapid Response - Appropriate to the circumstances Anxiolytics - CORRECT ANSWER: - Benzodiazepines
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