NURS 660 PSYCHOPHARMACOLOGY AND ADVANCED
PATIENT ASSESS ACTUAL EXAM LATEST 2024/2025
QUESTIONS AND VERIFIED CORRECT ANSWERS/ALREADY
GRADED A++
Typical antipsychotics - ANSWER What class of antipsychotic are these
Neuroleptics, Conventional, First Generation, Dopamine Receptor
Antagonists?
Atypical Antipsychotics - ANSWER What class of antipsychotic are these
Second Generation, Serotonin-Dopamine Receptor Antagonists
Dopamine D2 receptor - ANSWER This receptor has the benefit of
reducing positive symptoms.
Possible side effects include: Parkinsonism, akathisia, tardive dyskinesia,
endocrine effects such as prolactin secretion, menstrual changes and
sexual dysfunction.
Serotonin 5-H2a receptor - ANSWER This receptor has the benefit of
reducing EPS
Possible side effects: Sexual dysfunction
Serotonin 5HT2c receptor - ANSWER The benefit of this receptor is
unknown
Side effect is weight gain
Histamine H-1 receptor - ANSWER The benefit of this receptor is sedation
Side effects are sedation, increased appetite, weight gain and hypotension
Muscarinic cholinergic receptors - ANSWER The benefit of the receptor is
that it reduces EPS
Side effects are autonomic changes such as blurry vision, dry mouth,
constipation, urinary retention, tachycardia and memory dysfunction.
a1-adrenergic receptors - ANSWER Benefit of receptor unknown
Side effects are orthostatic hypertension, dizziness and reflex tachycardia.
a2-adrenergic receptors - ANSWER Benefit of receptor unknown
Side effects are drug interactions
,D2-Agonist actions? - ANSWER What makes an antipsychotic
conventional?
D2 antagonist/First generation antipsychotics/Conventional
antipsychotics/Typical antipsychotics - ANSWER These antipsychotics
share the primary pharmacological property of D2 antagonism, which is
responsible not only for their antipsychotic efficacy, but also for many of
their side effects.
Conventional Antipsychotic - ANSWER These drugs have pharmacological
properties in addition to D2 antagonism, they block muscarinic cholinergic
receptors, histamine h-1 receptors and/or a1-adrenergic receptors.
60-80% - ANSWER Antipsychotic properties happen when how much of
the D2 receptor is blocked?
80% - ANSWER The degree of binding in the mesolimbic pathway needed
for antipsychotic effects is?
extrapyramidal side effects - ANSWER When greater that 80% of D2
receptors are occupied in the dorsal striatum what happens?
Pituitary gland - ANSWER Which organ is associated with
hyperprolactinemia?
Aliphatic Phenothiazines (Chlorpromazine, Levomepromazine, Promazine
and Triflupromazine) - ANSWER These group of Phenothiazine
medications are low/medium potency agents, with high sedation, medium
anti-muscarinic effects, and medium extrapyramidal side effects.
Piperidine (Mesoridazine, Pericyazine, Pipotiazine, and Thiordiazine) -
ANSWER This group of Phenothiazine medications are low-medium
potency agents, with medium sedation, high antimuscarinic effects, and low
extrapyramidal side effects.
Piperazine (Perphenazine, Fluphenazine, Trifluoperazine) - ANSWER This
group of Phenothiazine medications are medium-high potency agents, with
low sedation, low antimuscarinic effects, and high extrapyramidal side
effects.
,Butyrophenones - ANSWER This class of antipsychotics are high potency
agents, they include (Benperidol, droperidol, and haldoperidol)
Thioxanthenes - ANSWER This class of antipsychotics are low-medium
potency agents, they include (Clopenthixol, Flupentixol, Thiothixene,
Zuclopenthixol)
Dihydroindolone - ANSWER This class of antipsychotic is a low-medium
potency agent it includes the drug molindone
Dibenzazepine - ANSWER This class of antipsychotic is a low-medium
potency agent it includes the drugs Clotiapine and Loxapine
Diphenylbutylpiperidines - ANSWER This class of antipsychotic is a high
potency agent it includes the drugs Fluspirilene, Pimozide
Low potency first generation antipsychotics - ANSWER •high histaminic
and muscarinic activity
•increased sedation and anticholinergic effects
•lower risk of extrapyramidal side effects.
High potency first generation antipsychotics - ANSWER •low activity at
histaminic and muscarinic receptors
•little sedation, weight gain, or anticholinergic activity
•high risk for extrapyramidal side effects.
Potency - ANSWER Is referring to the affinity a drug has for binding to the
D2 receptor
Low potency first generation antipsychotics: Chlorpromazine,
chlorprothixene, fluphenazine, Hydroxyzine, mesoridazine, Molindone,
PPerphenazine, Prochlorperazine, Promethazine and Thiordazine -
ANSWER D2(moderate affinity in mesolimbic and nigrostriatal areas)
Acetycholine muscarinic (Generally strong affinity), Alpha-adrenergic
(moderate affinity) D1, D3, D4, D5 (variable affinity)
Control positive symptoms of psychotic disorders: Hallucinations,
Delusions, Agitation and disordered thoughts.
Adverse effects: Extrapyramidal syndromes(common), Tardive dyskinesia
(common), Sedation (Common), Anticholinergic symptoms (common) dry
, mouth, blurred vision, impaired sweating , constipation, weight gain, urinary
retention, angle-closure glaucoma
High potency first generation antipsychotics - ANSWER D2 (strong affinity
in mesolimbic and nigrostriatal areas) Acetylcholine muscarinic, histamine
H-1 and alpha-adrenergic (weak affinity), Dopamine D1, D3, D4, D5
variable affinity.
Controls positive symptoms of psychotic disorders
Extrapyramidial syndromes (common), Tardive dyskinesia (common),
Sedation, orthostatic hypotension and anticholinergic symptoms
(uncommon in usual clinical doses)
Side effects of antipsychotics - ANSWER EPS, TD-cumulative risk of
5%/year, metabolic syndrome, anticholinergic side effects, QTC
prolongation, orthostatic hypotension, agranulocytosis, cholestatic jaundice,
neuroleptic malignant syndrome(NMS), pegmentary retinopathy (tetinitis
pegmentosa, deposits in the lens or cornea leading to cataracts, prolactin
elevation, sedation, and seizures.
QTC prolongation - ANSWER These antipsychotics (Chlorpromazine,
thioridazine and IV haldol) are known to cause this
Neuroleptic Malignant Syndrome - ANSWER Mental status: Delirum,
lethargy, stupor, coma
Muscle tone: Severe rigidity, psychomotor agitation, tremor, shuffling gait,
dysphagia, incontinence
Autonomic dysregulation: Diaphoresis, tachycardia, tachypnea and
dyspnea, hypoxemia, drooling, hyperthermia, increased or labile blood
pressure.
Serotonin syndrome - ANSWER This is caused from serotonergic agents,
exam findings will include hyperrefexia, myoclonus, ocular clonus, there are
no lab findings, symptoms are generally seen within 24 hours of
starting/changing therapy and resolves within a few days of treatment.
Neuroleptic malignant syndrome - ANSWER Causative medications are
dopamine antagonists, exam findings will show severe rigidity (lead pipe),
hyporeflexia, laboratory findings most commonly increased creatine kinase,
leukocytosis, low serum iron, slower in onset (1-2 weeks after starting or
changing therapy) and resolves within 9-14 days of treatment.
