NUR 660 Exam 1 Review QA - Maryville University

NUR 660 Exam 1 Review – Q&A - Maryville University Quetiapine (Seroquel) Correct Ans - Serotonin-Dopamine Antagonist Atypical antipsychotic How long does it take for quetiapine (Seroquel) to work Correct Ans - Psychotic and manic symptoms can improve within one week. It will take several week to have full effect on behavior. Recommended to wait 4-6 weeks to determine efficacy. May take 16-20 weeks to show good response on cognitive symptoms What does quetiapine do? Correct Ans - Decrease positive symptoms of schizophrenia What should be monitored closely before patients are on atypical antipsychotics? Correct Ans - BMI Waist circumference Blood glucose levels (fasting blood glucose between 100-125) How are side effects of quetiapine caused? Correct Ans - Sedation (by blocking H1 receptors) Dizziness, sedation, hypotension (by blocking alpha 1 adrenergic receptors Dry mouth, constipation, sedation (by blocking muscarinic 1 receptors) Weight gain, increased incidence of diabetes, dislipidemia, (reason for cause unknown) What are the side effects of quetiapine? Correct Ans - Weight gain based on dose Increased risk for diabetes and dyslipidemia Dizziness Sedation Constipation Dry mouth Dyspepsia Orthostatic hypotension (in the beginning trial period) Potentially tardive dyskinesia 1 / 2

What are adverse effects of quetiapine (potentially life threatening) Correct Ans - 1. Hyperglycemia causing ketoacidosis or Hyperosmolar hyperglycemic state (HHS) is a complication of diabetes mellitus in which high blood sugar results in high osmolarity without significant ketoacidosis.(resulting in coma)

2. NMS

• Seizures
• Increased risk of death and cerebral vascular incident

Aripiprazole (Abilify, Aristada) Correct Ans - atypical antipsychotic (sometimes second generation) Aripiprazole is commonly prescribed for Correct Ans - Schizophrenia Maintaining stability in schizophrenia Depression Autism related irritability How does aripiprazole work? Correct Ans - 1. Partial agonism at dopamine 2 receptors

• Reduces dopamine output when dopamine is high thus improving

positive symptoms and mediating antipsychotic actions.

• Increases dopamine output when dopamine levels are low thus

improving cognition, negative, and mood symptoms

• Also acts on dopamine 3 receptors
• Blocks serotonin 2A receptors thus increasing dopamine

How long does it take aripiprazole to work? Correct Ans - May begin working in one week. It is best to wait 4-6 weeks to see full efficacy.How does aripiprazole cause side effects Correct Ans - 1. Blocking alpha 1 adrenergic receptors causing dizziness, sedation, and hypertension

• Partial agonist at dopamine 2 receptors in the striatum can cause motor

side effects such as akathisia

• Partial agonist at dopamine 2 receptor causing nausea, vomiting, and

activation side effects Notable side effects of aripiprazole? Correct Ans - 1.Dizziness

• / 2