NURSE 660 EXAM 1 – QUESTIONS & FULL SOLUTIONS What medication is most associated with increased prolactin ✔️Ans - Risperidal Which medication is most associated with weight gain ✔️Ans - olanzapine Second Generation is mainly associated with which side effects? ✔️Ans - Weight gain, hypercholesterolemia, altered glucose tolerance insulin secretion First Generation is mainly associated with which side effects? ✔️Ans -
TD, EPS
Why is olanzapine associated with weight gain? ✔️Ans - High affinity for 2c receptors What are the rating scales used to evaluate abnormal movements associated with psychotropic medication? ✔️Ans - SMARTS , AIMS, PANAS- self report questionnaire, SAGE, PHQ-depression, COWS-Opioid withdrawl What is the black box warning of Clozapine ✔️Ans - Agranulocytosis What is the most common side effect of clozapine ✔️Ans - sedation What labs need to be done before starting clients on antipsychotic medications? ✔️Ans - fasting lipid panel, fasting glucose, weight, bp When someone with schizophrenia is on an atypical antipsychotic with complaints of increased fatigue, which antipsychotic would you switch to?✔️Ans - Abilify Patient has been on an atypical antipsychotic for 6weeks with unchanged weight. Do you think that weight would be a good predictor of fasting triglycerides ✔️Ans - no 1 / 2
What is the pathway responsible for regulation of dopamine in the hypothalamus ✔️Ans - mesolimbic pathway What antidepressant should be avoided for a patient on clozapine? ✔️Ans
- Fluvox, paroxetine, sertraline (in large doses)
- Normal cognitive functioning during premorbid and prodrome phases
- Impaired cognitive functioning that is stable across premorbid and
- / 2
If a patient is experiencing breast milk secretion while receiving a med that may stimulate breast secretions which medication could be switched to that does not have increased prolactin as a side effect? ✔️Ans - Seroquel or zyprexa What is the pharmacological explanation of the resolution of breast secretion ✔️Ans - decreased dopamine- increased prolactin Increased serotonin- increased prolactin Patient gains 25lbs in 6mons. What are the pharmacological properties of this medication that cause the weight gain? ✔️Ans - Blockade of 2a, 2c, d2 receptors Drug induced parkinsonism is caused by a decrease of dopamine in which pathway ✔️Ans - nigrostriatal dopamine pathway What Is the neurotransmitter that is needed for the activation of the AMPA receptors? ✔️Ans - Glutamate What antipsychotic has low risk of metabolic effects ✔️Ans - Iloperidone (Fanapt) What is the treatment for parkonsonism EPS effects? ✔️Ans - Symmetrel and Artane (amantadine or trihexyphenidyl) What antipsychotic does not exceed 60% D2 occupancy? ✔️Ans - Clozapine Individuals who ultimately develop schizophrenia typically exhibit what pattern of cognitive functioning prior to disorder onset?
prodrome phases