NR 566 FINAL EXAM V1

NR 566 FINAL EXAM V1

1. What is the goal of antidepressant treatment?: remission of symptoms

2. What is the mechanism of action for SSRIs?: inhibits reuptake of serotonin

• What is the mechanism of action for SNRIs. (Cymbalta

Desvenlafaxine Venlafaxine Levomilnacipran Milnacipran Citalopram Escitalopram Fetzima

Fluoxetine): Inhibit 5-HT and norepinephrine reuptake

• What is the mechanism of action for NDRIs? Bupropion (Wellbutrin, Zy- ban): blocks

dopamine/NE reuptake

• Which psychoactive drug class has stimulant properties and suppresses appetite?: NDRIs

Bupropion (Wellbutrin, Zyban)

• Why should SSRIs not be stopped abruptly? (Fluoxetine

Citalopram Escitalopram Paroxetine Sertraline Fluvoxamine Vilazodone Duloxetine

Vortioxetine): due to rebound anxiety, serotonin syndrome

• What are the adverse effects of SSRIs? (Fluoxetine

Citalopram Escitalopram Paroxetine Sertraline Fluvoxamine Vilazodone Duloxetine

Vortioxetine): anorexia, diarrhea, headache, weight gain, sexual side effects

• What are the adverse effects of SNRIs? (Cymbalta

Desvenlafaxine Venlafaxine Levomilnacipran Milnacipran Citalopram Escitalopram Fetzima Fluoxetine): elevated blood pressure, sweating, anxiety, dizziness, insomnia constipation

9. In what age groups is antidepressant-induced suicide more prevalent?: -

children, adolescents, adults <25

• Older adults may not respond as robustly to antidepressants as younger people if the first

episode occurs after age 65.: TRUE

• In older adults, these antidepressants should be dosed at 1/2 the dose due to ?: risk of

QT prolongation

• Which antidepressant should be avoided in adults with a history of falls and fractures?:

paroxetine (depression, obsessive-compulsive disorder (OCD), panic disorder, generalized anxiety disorder (GAD), social anxiety disorder (also known as social phobia), premenstrual dysphoric disorder (PMDD), and posttrau- matic stress disorder (PTSD)

• In older adults, tricyclic antidepressants should be avoided in those taking

depressants? (Nortriptyline Clomipramine Desipramine Imipramine Amitriptyline Protriptyline Doxepin Trimipramine 1 / 3

Amoxapine): CNS

• Why is paroxetine contraindicated in pregnancy?: fetal cardiac malforma- tions - USE

SERTRALINE INSTEAD

• When a pregnant woman who is taking an SNRI delivers, the infant should be monitored

for ?: irritability

• What are the 2 first-line drugs used to treat bipolar?: lithium and divalproex
• What lab test should be monitored when one is on Lithium?: serum lithium level (5 days

after start or dose change and every 6 months after)

• What drugs can be used for generalized anxiety disorder?: SSRIs, SNRIs, Buspirone

(therapy for at least 12 months)

• What drugs can be used for panic disorder?: paroxetine, sertraline, fluoxetine (6-9 months)

SSRIs

• What drugs can be used for social anxiety disorder?: sertraline, paroxetine (4 weeks to see

affects) SSRIs

21. What drugs can be used for PTSD?: paroxetine, sertraline SSRIs

• What are the 3 first line drugs (benzodiazepine-like, that are used to treat insomnia?:

zolpidem (ambien), zaleplon (sonata), and eszopiclone (lunesta) - all schedule IV drugs

• What are the uses of St. John's Wort?: mild to moderate depression, pain and inflammation,

local infection

24. What is black cohosh used for?: symptoms of menopause

• How long should one use black cohosh?: 6mths; because long-term studies have not been

done

• How is echinacea used?: stimulate immune function, suppresses inflamma- tion, viral

infections (oral and topical)

• Flaxseed is used for?: constipation, dyslipidemia, menopause, omega-3 sup- plement
• Why should flaxseed be taken 1 hour before or 2 hours after other drugs?-

: because it may reduce the absorption of other drugs

• Why do men have higher hematocrit levels than women?: They produce more testosterone

which results in higher amounts of erythropoietin and erythrocytes.

• What is the Black Box warning for the androgen Oxandrolone? anabolic steroid: Can

cause peliosis hepatitis; blood-filled cysts form in the liver leading to failure or intrabdominal hemorrhage

• What are the disorders that the androgen testosterone can treat?: Hypogonadism (male),

replacement therapy 2 / 3

• What are the disorders that the androgen methyltestosterone can treat? Male Hormone:

Replacement and hypogonadism in males

• What are the disorders that the androgen oxandrolone can treat? anabolic steroid:

Catabolic states (cachexia)

• Testosterone can be used to treat what symptoms in post-menopausal women?: Reduced

genital sensitivity, fatigue, and decreased libido

• What hormones does androgens suppress?: Luteinizing and follicle-stimulat- ing
• Which particle in the life cycle of chlamydia trachomatis is considered infectious and

first infects the host cell?: elementary body

• What is the recommended testing for males suspected to have Chlamydia?-

: first-catch urine for nucleic acid amplification test (NAAT)

• What are the CDC screening recommendations for chlamydia in asympto- matic females?:

annual screening annually in sexually active females 24 years or younger.

• What is the recommend treatment for uncomplicated chlamydia in

non-pregnant females and males?: doxycycline 100mg by mouth twice daily x7 days (alternate azithromycin 1g by mouth x1)

• What is the mechanism of action of donepezil (Aricept)? Alzheimer's dis- ease: inhibits

centrally active acetylcholinesterase

• What are the common side effects of Aricept? Alzheimer's disease: gas- trointestinal

symptoms (nausea and diarrhea), headache, dizziness, muscle weak- ness

• List the precautions for Aricept? Alzheimer's disease: sick sinus syndrome and seizure

disorder

• When combined with and peripheral side effects

and rate of elimination can be increased for Aricept? Alzheimer's disease: - CYP2D6 &

CYP3A4

• What is the mechanism of action of Rivastigmine (Exelon)? mild to moder- ate dementia

(memory loss and mental changes) associated with Alzheimer's disease or Parkinson's disease: acts centrally for both acetylcholinesterase and butyrylcholinesterase, thereby potentially increasing its efficacy

• What are some common side effects of Exelon? mild to moderate dementia (memory loss

and mental changes) associated with Alzheimer's disease or Parkinson's disease: GI symptoms, weakness, dizziness, tremor

• What are some precautions to keep in mind with prescribing Exelon? mild to moderate

dementia (memory loss and mental changes) associated with Alzheimer's disease or Parkinson's disease: Asthm/COPD, sick sinus syndrome, GI bleed, weight less than 50 kg

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