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Finall Exam:l NRl 546/l NR546l (Latestl
2026/l 2027l Update)l Advancedl
Pharmacology:l Psychopharmacologyl forl
thel Psychiatric-Mentall Healthl Nursel Practitionerl Guide|l Q/Al |l Gradel A|l 100%l Correctl (Verifiedl Answers)l - Chamberlain
Q:l Alpha-1l adrenergicl effects
Answer:
Orthostaticl hypotension
Q:l Anticholinergicl effects
Answer:
Dryl mouth Blurredl vision Urinaryl retention Constipation
Q:l Histaminel effects
Answer:
Weightl gain Sedation
Q:l MAOIs
Answer:
firstl developed,l LASTl CHOICEl medicationl classl forl depressionl duel tol thel manyl potential,l seriousl sidel effects -specificl dietaryl restrictions,l Foodsl thatl containl tyraminel shouldl bel avoidedl (Redl wine,l Sauerkraut,l Cheese,l Soy,l Smokedl meats) 1 / 4
-blockl enzymesl responsiblel forl thel breakdownl ofl 5-HT,l NE,l andl DA
•l twol primaryl formsl ofl thel MAOl enzyme:l MAO-Al andl MAO-Bl
•l bothl locatedl inl thel brain,l MAO-Al alsol inl gut
Drugs:
-phenelzinel (Nardil)l -l durationl 14l days -selegilinel (Emsam)l -l MAOI-Bl -l durationl 14l days -tranylcyprominel (Parnate)l -durationl 14-30l days -isocarboxazidl (Marplan)l -l durationl 14l days
Sidel effects:
-Confusion -Dizziness -Insomnia -Sedation -Vividl dreams
Pearls:
-highl riskl forl hypertensivel crisisl ifl tyraminel isl ingested -Dol notl prescribel anyl serotonergicl agentsl withinl 2l weeksl ofl MAOIl discontinuationl duel tol anl increasedl riskl ofl serotoninl syndrome -Waitl atl leastl 5l half-livesl afterl discontinuingl al serotonergicl medicationl beforel initiatingl anl MAIO
Q:l MAO-A
Answer:
breaksl downl 5-HT,l DA,l NE,l andl tyramine -usedl tol treatl depressionl andl anxiety "A"l isl forl antidepressantl orl anxiolytic
Q:l MAO-B
Answer:
responsiblel forl thel breakdownl ofl dopamine,l phenylethylamine,l andl tyramine -usedl tol treatl Parkinson'sl disease;l however,l high-dosel selegilinel (Emsam)l mayl bel usedl tol treatl anxietyl orl depression
Q:l Foodsl tol avoidl whenl takingl MAOIs
Answer: 2 / 4
Tyraminel isl presentl inl manyl agedl orl preservedl foodsl includingl agedl cheeses,l tapl andl nonpasteurizedl beers,l agedl orl smokedl meatl orl fish,l sauerkraut,l kimchee,l soyl products,l andl tofu.
Q:l Adjunctl treatmentl forl depression
Answer:
Antipsychoticl medicationsl arel sometimesl prescribedl atl lowl dosesl asl adjunctivel medicationsl forl severel depression
Q:l Newerl txl forl resistantl depression:l esketaminel (Spravato)
Answer:
nasall sprayl forl thel treatmentl ofl majorl depressivel disorderl (MDD)l withl acutel suicidall ideationl orl behavior -reachesl peakl onsetl inl thel bodyl inl betweenl 20-40l minutes -riskl ofl adversel outcomesl duel tol sedationl andl dissociation *mustl bel administeredl inl al supervisedl healthcarel setting
Q:l Newerl txl forl resistantl depression:l Ketaminel clinics
Answer:
Ketaminel isl anl N-methyl-D-aspartatel (NMDA)l receptorl inhibitor,l resultsl inl thel downstreaml releasel ofl glutamate -highl doses,l ketaminel mayl causel psychoticl symptoms,l inl lowl doses,l itl hasl al rapidl effectl onl depression -Ketaminel clinicsl havel providedl intravenousl ketaminel forl treatment-resistantl unipolarl andl bipolarl depression *requiredl frequentl dosing,l inconvenient,l expensive
Q:l Newerl txl forl resistantl depression:l dextromethorphan/quinidinel (Nuedexta)
Answer:
Researchersl arel investigating,l relatedl tol NMDA -currentlyl approvedl byl thel FDAl forl thel treatmentl ofl pseudobulbarl affect *combinesl dextromethorphanl andl quinidinel asl anl orall treatment
Q:l consideredl whenl selectingl anl antidepressantl medication
Answer:
Clientl preference Priorl treatmentl response Anticipatedl adversel effects 3 / 4
Comorbidities Half-lifel andl interactions Cost
Q:l Antidepressants:l Initiatingl Medication
Answer:
Startl clientsl onl al singlel drugl forl 4-8l weeksl tol assessl efficacy.l Startl withl thel lowestl recommendedl dosel tol reducel sidel effects.l Ifl al medicationl isl notl achievingl efficacy: -Increasel thel dosel graduallyl tol thel efficaciousl dosel range.-Switchl tol al differentl drugl withinl thel samel classl afterl anl adequatel triall whichl includesl higherl dosingl andl al minimuml ofl eightl weeksl ofl trial.-Switchl tol al drugl inl al differentl classl afterl anl adequatel triall whichl includesl higherl dosingl andl al minimuml ofl eightl weeksl ofl trial.-Addl al secondl medicationl asl anl adjunct.
Q:l Antidepressants:l Discontinuingl Medications
Answer:
Don'tl suddenlyl stopl orl omitl dosesl duel tol riskl ofl discontinuationl syndrome -Paroxetinel highestl riskl duel tol serotoninl transporterl inhibitionl andl anticholinergicl rebound -Ifl al treatmentl coursel hasl lastedl 8l weeks,l discontinuationl overl 1-2l weeksl isl safe.l Oncel symptomsl arel inl remission,l continuel treatmentl forl 4-9l monthsl tol reducel thel riskl ofl relapse
Q:l Antidepressantsl Importantl Prescribingl Considerations:l Blackl Boxl Warning
Answer:
Suicidel Riskl withl Antidepressantl Drugs -Clientsl withl depressionl mayl considerl orl attemptl suicide -riskl forl suicidel mayl increasel atl thel startl ofl treatment -Antidepressant-inducedl suicidel isl morel prevalentl inl children,l adolescents,l andl adultsl youngerl thanl 25l years.
Q:l Antidepressantsl Importantl Prescribingl Considerations:l Drug-Drugl Interactions
Answer:
Mostl antidepressantl medicationsl havel seriousl drug-drugl interactions.l Carefullyl reviewl thel client'sl historyl andl currentl prescriptionsl beforel selectingl al medication.
Q:l Antidepressantsl Importantl Prescribingl Considerations:l Serotoninl Syndrome
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