ExamI2:INURSI660/INURS660I(LatestI2024
/I2025IUpdate)IPsychopharmacologyIandI
AdvancedIMentalIHealthIGuideI|IQsI&IAs|I
100%ICorrect|IGradeIAI(VerifiedIAnswers)-
IMaryville
Q:ICitalopramI(Celexa)
Answer:
-SSRI
-neurotransmittersIinvolved:IserotoninIandIhistamineI1
-UniqueImildIantihistamineIpropertiesImayIcontributeItoIsedationIandIfatigueIinIsomeIpatients
-
SE:IhyponatremiaI(rare),IhigherIdosesI(>40mg)IassociatedIwithIQTcIprolongationI(FDAIBlack
IBoxIwarning),IinIadultsI>60I20mgIisImaxIdose
-Interactions:Idon'tIstartIMAOIIforI5-7IdaysIafterId/cingIcitalopram.I
-
PrescribingItip:IequivalentIdoseIofIlexaproIisI½ItheIdoseIofIcelexaI(e.g.I40mgIofIcelexa=20mg
IofIlexapro)
Q:IEscitolopramI(Lexapro)
Answer:
-SSRII
-NeurotransmittersIinvolved:Iserotonin
-
INoIknownIimportantIsecondaryIpharmacologicIproperties,IitsIsideIeffectsIareIpresumablyIallI
mediatedIbyIitsIserotoninIreuptakeIblockade
-NoIdoseIrestrictions,IbestItoleratedISSRI,I
-
PregnancyIrisk:IcontrolledIstudiesIonIearlyIpregnInotItestedIbutIsoIfarInotIdeemedIharmfulIfor
IfetusIhoweverIwillIincreaseIriskIofIbleeding;ImayIbeIriskIofIfetalIseptalIheartIdefectsIandIpul
,monaryIHTN;IlateIpregIassocIwIgestationalIHTN,Ipre-
eclampsia,InewbornIcomplicationsIreqIprolongedIhospitalization
Q:IFluoxetineI(Prozac)
Answer:
-SSRII
(MDDI(8+Iyrs),IGAD,IBiPolarI(inIcomboIwithIolanzapine)
-LongIhalfIlifeI(2Iweeks),IgreatIforInoncompliantIpts
-MOA:IboostsISEINeurotransmissionIbyIblockingIreuptake,IdesensitizesI5-HT1AIautoreceptors
5HTC2CIreceptorsIwhichIcanIincreaseINEIandIDA
-
Fluoxetine'sIuniqueI5HT2CIantagonistIpropertiesIcouldIcontributeItoIagitation,Ianxiety,IandIun
desirableIactivation,IespeciallyIearlyIinIdosing
FlattenedIaffect,Iapathy,IcognitiveIslowingId/tIdiminishedIDAIrelease
-Suicidality,IespeciallyIinIchildren
Q:IFluoxetineIDrug-drugIiInteractions
Answer:
-VeryIpotentI2D6Iinhibitor
-IncreasesITCAIlevelsI(IincreaseIriskIofIcardiotoxicity)
-
FatalIserotoninIsyndromeIifIcombinedIwithIMAOIs;ImustIdoInotIuseIWITHIMAOIsIforIatIleas
tI14IdaysIAFTERIMAOIIisIstopped
-DoInotISTARTIanIMAOIIforI5IWEEKSIafterIstoppingIfluoxetine
-
RiskIofIbleedingIwithIwarfarin,INSAIDS2D6IinhibitionIwillIinterfereIwithIanalgesicIactionIofI
codeine,IandIwillIincreaseIlevelsIofIbetaIblockersIandIatomoxetine
-2D6IinhibitionIwillIincreaseIthioridazineIandIcauseIdangerousIarrhythmias
-WillIreduceIclearanceIofIdiazepamIorItrazodone
-
ViaI3A4IinhibitionIwillIincreaseIalprazolam,Ibuspirone,Itriazolam,IstatinsI(butInotIpravastatinI
orIflustatin)-->rhabdomyolysis.
-CanIincreaseIQTcIandIcauseIdangerousIarrhythmias
, Q:IFluvoxamineI(Luvox)
Answer:
-SSRI
-OCDIandIsocialIanxiety
-
MOA:IBoostsIserotoninIneurotransmissionIbyIblockingIreuptakeIandIdesensitizingISEIreceptor
s,IespeciallyI5-HT1AIreceptors.
-InhibitsICPYI1A2IandI3A4
-DecreasesImetabolismIforIcaffeine
-
Fluvoxamine'sIsigmaI1IagonistIpropertiesImayIcontributeItoIsedation,Ianxiolytic,IandIfatigueIi
nIsomeIpatients-beneficialIforIpsychoticIdepression
-d/tIincreasedISEIatIreceptorsIotherIthanIthoseIdesired:Iinsomnia,IandIinIgutI--
>diarrhea;IemotionalIflattening,IcognitiveIslowing;IsexIdysfctnIbothImenIandIwomenIlessIthan
IotherISSRIs,IdecreasedIappetite,INausea,Idiarrhea,Iconstipation,IdryImouth;Iagitation,Itremors.
-
CNSIsedationIisImostICOMMONISOISPLITIDOSEITOITWICE/DAYIWITHILARGESTIDOS
EIATIBEDTIME.
-
IncreasingISEImayIdiminishIdopamineIandIleadItoIemotionalIflattening,Iapathy,IandIcognitiveI
slowing.
-food-
drugIinteractions:IsmokeIfromItobacco,IgrilledIfood,IgrapefruitIjuice,ImaybeIpomegranateIjuice
-LiverIpanelItoIstart
Q:IParoxetineI(Paxil)
Answer:
SSRI
-MDD,IpanicIdisorder,IGAD,IPTSD,IhotIflashes-excellent
-
MOA:IParoxetineIhasImildIanticholinergicIactions,ImayIhaveImildInorepinephrineIreuptakeIblo
ckingIactions-whichImayIcontributeItoIfurtherIantidepressantIactions
