Exam 3: NSG552/ NSG 552 (New 2023/2024) Psychopharmacology Exam Review| Complete Guide with Verified Answers| 100% Correct
Exam 3: NSG552/ NSG 552 (New 2023/2024)
Psychopharmacology Exam Review|
Complete Guide with Verified Answers|
100% Correct
QUESTION
Only deals with physical dependence, does not address the psychological component of smoking.
Answer:
NRT
QUESTION
Oral stop-smoking aids, remember Very Bad Cancer
Answer:
varenicline, bupropion, clonidine
QUESTION
Patients on what medication for smoking cessation treatment should be observed for
neuropsychiatric symptoms including changes in behavior, hostility, agitation, depressed mood,
and suicide-related events, including ideation, behavior, and attempted suicide.
Answer:
buproprion
QUESTION
How would you treat cocaine induced chest pain/myocardial infarction?
Answer:
IV BZD
QUESTION
What substance use disorders have FDA approved pharmacological treatment?
Answer:
AUD, OUD, nicotine
QUESTION
What substance abuse disorder remains the #1 cause of premature death in the United States?
Answer:
smoking
QUESTION
What type of psychosocial interventions would you consider for substance abuse disorders?
Answer:
psychotherapy
QUESTION
Treatment for agitation in patients with dementia.
Answer:
atypical antipsychotics
QUESTION
Used only for short term and acute episodes of aggression, agitation, and psychosis in patients
with dementia.
Answer:
BZD
QUESTION
In the elderly, this leads to more free medication in the body, increasing the risk of toxicity.
Answer:
decreased protein levels
QUESTION
TCAs, Anticholinergics, Benzos, Non-benzos, Corticosteroids, H2 blockers, opioids cause what
medical emergency in elderly patients?
Answer:
delirium
QUESTION
What is the most telling sign when trying to differentiate dementia from delirium?
Answer:
speed of onset
QUESTION
Most common type of dementia.
Answer:
Alzheimers
QUESTION
3 A’s of Alzheimer’s
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naloxone
MOA: Pure opioid antagonist that competes and displaces opioids at opioid receptor sites.
methadone, buprenorphine, buprenorphine+naloxone
Treatments for opioid use disorder.
buprenorphine+naloxone
Treatment for opioid use disorder with comorbid pain.
opioids
Inappropriate use of what substance may be due to uncontrolled pain?
tablet, injectable, implant
Naltrexone delivery methods.
implant
Form of naltrexone limited to inpatient use.
buprenorphine
Mu receptor partial agonist for opioid withdrawal.
buprenorphine
Taking this medication too soon after last opioid use increases the chances of intense withdrawal that comes on very quickly (precipitated withdrawal).
opioid intoxication
Symptoms include nausea and vomiting, respiratory depression, constipation, itching, mioisis (small pupil). Patient will experience euphoria and sedation.
opioid withdrawal
Symptoms include N/V/D and dehydration, irritability, restlessness, yawning, and twitching, increased HR/BP, chills, increased temperature, rhinorrhea, lacrimation, dilated pupils.
naloxone
Treatment for opioid intoxication during which cardiac or respiratory depression is a concern.
cocaine intoxication
Symptoms include dilated pupils, HA, tremor, hyper-reflexia, twitching, seizures, or coma, increased HR/BP, arrhythmias, and MI, N/V, incontinence/ARF, or rhabdomyolysis
cocaine intoxication
Treatment includes BZD, antipsychotics, and management of medical problems including HTN, stroke, cardiac arrhythmias, hyperthermia, and seizures.
cocaine
The use of beta blockers for treatment of chest pain and MI during this intoxication is to be avoided due to unopposed a adrenergic stimulation.
alcohol intoxication
Signs vary with blood levels, from decreased reaction time, muscle incoordination, ataxia, dysarthria, to respiratory failure and coma.
mild to moderate
Levels of alcohol intoxication that require no formal treatment.
severe alcohol intoxication
Treatment includes cardiopulmonary function maintenance, thiamine, and haloperidol PRN agitation.
thiamine
Given IM/IV for 3 days to prevent Wernicke’s encephalopathy, along with IV fluids and a banana bag.
benzodiazepines
Class of drugs to avoid for acute alcohol intoxication.
uncomplicated alcohol withdrawal
Treatment includes BZD in either symptom triggered or fixed dose; diazepam and chlordiazepoxide have a longer half life, and oxazepam and lorazepam are suitable for pat
diazepam and chlordiazepoxide
BZDs with a long half-life used to treat AUD.
oxazepam and lorazepam
BZDs with moderate half-life used in AUD patients with liver disease.
chlordaizepoxide
BZD for AUD that should be avoided in patients with severe liver disease.
alcohol withdrawal seizures
Treatment includes diazepam IV or lorazepam IV/IM, thiamine IV/IM, and addressing electrolyte imbalances.
AUD
For patients with mild symptoms and no history of seizures or delirium tremens, supervised withdrawal can be managed safely and effectively in the ambulatory setting.
DT
Treatment includes acute care management, parenteral diazepam or lorazepam, thiamine, and antipsychotics if necessary.
alcohol hallucinosis
Usually auditory, antipsychotic agents are used to treat.
disulfiram
MOA is via negative reinforcement, where drinking is avoided due to unpleasant effects.
acamprosate
NMDA receptor antagonist that is renally cleared, suitable for AUD patients with hepatic dysfunction.
naltrexone
Treatment suitable for AUD with comorbid OUD, reducing consumption by decreasing reinforcing properties.
gum, patch, inhaler, nasal spray, lozenge
5 types of nicotine replacement therapy.
compulsion, control, cutting down, consequences
4 C’s of smoking cessation
ask, advise, assess, assist, arrange
5 A’s – behavioral treatment for smoking cessation
cut down, annoyed, guilty eye opener
CAGE questionnaire
NRT
Only deals with physical dependence, does not address the psychological component of smoking.
varenicline, bupropion, clonidine
Oral stop-smoking aids, remember Very Bad Cancer
buproprion
Patients on what medication for smoking cessation treatment should be observed for neuropsychiatric symptoms including changes in behavior, hostility, agitation, depressed mood, and suicide-related events, including ideation, behavior, and attempted suicide.
IV BZD
How would you treat cocaine induced chest pain/myocardial infarction?
AUD, OUD, nicotine
What substance use disorders have FDA approved pharmacological treatment?
smoking
What substance abuse disorder remains the #1 cause of premature death in the United States?
psychotherapy
What type of psychosocial interventions would you consider for substance abuse disorders?
atypical antipsychotics
Treatment for agitation in patients with dementia.
BZD
Used only for short term and acute episodes of aggression, agitation, and psychosis in patients with dementia.
decreased protein levels
In the elderly, this leads to more free medication in the body, increasing the risk of toxicity.
delirium
TCAs, Anticholinergics, Benzos, Non-benzos, Corticosteroids, H2 blockers, opioids cause what medical emergency in elderly patients?
speed of onset
What is the most telling sign when trying to differentiate dementia from delirium?
Alzheimers
Most common type of dementia.
aphasia, apraxia, agnosia
3 A’s of Alzheimer’s
hypersexuality, hyperorality
Klüver-Bucy syndrome, a type of frontotemporal degeneration (FTD), results from bilateral lesions of the medial temporal lobe and manifests with what 2 common symptoms?
Donepezil, rivastigmine, galantamine
Cholinesterase inhibitors appropriate for mild to moderate dementia, remember Damn, Grandma’s Regressing
memantine
NMDA receptor antagonist that promotes synaptic plasticity and is used for moderate to severe dementia.
nortiptyline
TCA with fewest anticholinergic effects, making it the most appropriate TCA in the elderly SSRIs ARE PREFERRED
mirtazapine
Most appropriate medication for elderly patient with MDD, insomnia, and decreased appetite.
methylphenidate
In cases of severe depression or psychomotor retardation, this may be used in low doses as an adjunct to antidepressants.
trazodone
Best alternative to sedative-hypnotic use for insomnia in the elderly as it’s less likely to cause memory impairment, paradoxical excitement, or rebound insomnia.
delirium
A reversible condition that may be caused by drugs, electrolyte imbalance, low O2 sat, infection, reduced sensory input, intracranial events, urinary retention, or myocardial issues.
Ach, NE
What are the two major neurotransmitters whose decrease is associated with dementia?
methylphenidate, amphetamine salts, dexmethylphenidate, dextroamphetamine
The 4 stimulants for treating ADHD. Man, Adhd Does Damage
TCAs, clonidine, guanfacine, bupropion, atomoxetine
The 5 non-stimulants for treating ADHD. Calm Teens Give Better Answers
height, weight, BP, HR, EKG
What baseline measurements are needed prior to starting treatment for ADHD?
short acting
Type of stimulant used as initial treatment for children under 6.
atomoxetine
Second line treatment, non-stimulant, used in patients with history of SUD or when family prefers non-stimulant.
intermediate or long acting
Types of stimulants used when patient needs duration of action longer than 4 hours; also improves adherence and is less likely to be abused.
dizziness, poor growth, decreased appetite, insomnia, mood lability
Common adverse effects of stimulants Dizzy Patients Demand Immediate Monitoring
dizziness
Children exhibiting this symptom require BP and HR monitoring. If it occurs at peak, patient should be switched to a longer acting formula.
insomnia
Patients exhibiting this stimulant associated symptom should be switched to a shorter acting formula.
cardiovascular
Prior to starting a stimulant, patient history, family history, and exam should be conducted with what focus?
tics
This stimulant side effect may require discontinuation of medication or change to clonidine or guanfacine.
intellectual disability
Pharmacological treatment for what condition is only initiated after careful assessment and targets co-occurring disorders for which medication is first-line therapy?
SNRIs, mood stabilizers, MAOIs, antipsychotics, TCAs
Stimulants should not be combined with these 5 medication classes. Stimulants Make Me Act Tense
bupropion, TCA
Non-stimulant ADHD treatment most appropriate in a patient with co-occurring depression, and class considered a “reasonable choice” in a patient with co-occurring depression AND anxiety.
stimulants
Among medically healthy patients, what type of medication has been used to augment the treatment of MDD in adults and to treat depression in the elderly?
risperidone, ariprazole
Which 2 medications are approved by the FDA to treat severe behavioral issues in ASD, specifically tantrums, self-injury, and aggression?
clomipramine
On-demand treatment for premature ejaculation.
sildenafil
Combining this medication with some others, such as nitrates, can cause an unsafe drop in blood pressure as well as headaches, flushing, and dizziness.
sexual dysfunction
Causes of this condition may be physiological (meds), psychological (depression), or hormonal (abnormal levels).
bupropion
Most appropriate medication for a female with depression and hypoarousal.
paroxetine
SSRI most likely to cause sexual dysfunction that may also be used to treat premature ejaculation.
dose reduction
May be used to reduce sexual side effects caused by psychotropic medications when cost is an issue.
hypogonadism
A cause of hypoactive desire in males that indicates a life-long rather than acquired condition.
PDE 5 inhibitors
Class of drugs that are first-line treatment of ED, -fils
tadalafil
PDE-5 inhibitor that is the only oral ED medication approved for daily use, has the longest half-life, and can improve BPH symptoms.
antisocial
Cluster B personality disorder that begins as a conduct disorder in childhood.
DBT
Gold-standard treatment for borderline.
countertransference
The unconscious generation of thoughts and emotions about clients based on clinicians’ past experience with individuals or situations.
BPD
What disorder represents a major source of chronic “treatment-resistant” depression?
BZD
Class of medications strongly discouraged in treating BPD, due to risks of worsening impulsivity and suicidality.
pharmacological
Treatment modality recommended against when treating the primary traits of antisocial personality disorder.
guanfacine
Non-stimulant medication that is longer acting than clonidine, with greater benefit for inattention and less sedation.
dopamine
Neurotransmitter that enhances libido.
serotonin
Neurotransmitter that inhibits sexual function.
hormone replacement therapy
Treatment for male hypoactive sexual desire disorder and female sexual interest/arousal disorder.
guanfacine
Alpha 2 agonist, first line for tic disorder.
encopresis
Recurrent inappropriate defecation not due to laxatives or another medical condition.
desmopressin, imipramine
First line treatment options for enuresis.
behavioral therapy
Modality for the management of IDD deficits.
methylphenidate
Stimulant medication FDA approved for children 6+ that should not be used in patients with PRE-EXISTING CARDIAC CONDITIONS.
dextromethylphenidate
FDA stimulant approved for children 3+.
guanfacine
Non-stimulant approved for children 6-17.
stimulants
Class considered first line treatment for ADHD.