Questions and Answers
Which class of medication found in the patient's prescription is responsible for constipation and urinary retention in a patient who takes nortriptyline for depression?
Which second-generation antidepressant medication interacts with non-steroidal anti-inflammatory drugs?
Serotonin and norepinephrine reuptake inhibitors (SNRIs)
What is the current indication for tricyclic antidepressants (TCAs)?
Insomnia, childhood enuresis, neuropathic pain syndrome
Which anxiolytic medication might be a better option for a patient with an anxiety disorder who is taking lorazepam but finds the side effect of drowsiness to be interfering with life?
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What instruction should the nurse include to educate a patient taking sertraline?
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Which mood stabilizing drug is used to treat bipolar disorder?
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Which type of medication is indicated to help the patient manage withdrawal symptoms while detoxifying from alcohol abuse?
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Which condition would the nurse suspect that a patient on lithium has been diagnosed with?
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Which anxiolytic drug promotes agonistic activity at both the serotonin and dopamine receptors?
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Which theory states that depression and mania are caused by alterations in the concentration of neurotransmitters in the brain?
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What does the nurse infer from a patient with increased blood glucose levels, increased blood pressure, and abnormal cholesterol levels?
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Which cue is indicative of benzodiazepine overdose?
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Which disorder is treated with mood stabilizers?
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Which drugs represent the largest class of conventional antipsychotic drugs?
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Which hypothesis postulates that depression results from a deficiency of neuronal and synaptic catecholamines?
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Which cue is a common symptom of serotonin syndrome?
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What activity should a patient be cautioned to avoid while taking a monoamine oxidase inhibitor (MAOIs)?
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Which atypical antipsychotic medication would the nurse anticipate a health care provider prescribing for treatment of refractory schizophrenia?
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What information should the nurse include in patient education to promote adherence to a therapeutic regimen of fluoxetine for anxiety?
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Which drug may cause serotonin syndrome if given together with an antidepressant medication?
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Which is the main receptor in the CNS that is blocked by conventional antipsychotic drugs?
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Which drug is responsible for an adverse effect of involuntary wavelike movements of the legs in a patient with bipolar disorder?
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What is the maximum oral dose of diazepam a patient with an anxiety disorder can receive in a day?
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What inquiry may the nurse make when reviewing a patient history for benzodiazepine use?
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Why is monitoring blood sodium levels necessary in a patient with bipolar disorder who takes lithium citrate?
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Which phenomenon is recognized as a positive symptom of schizophrenia?
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What time frame should the nurse include in patient teaching to explain how long it will take for escitalopram to be completely effective?
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Which adverse effects should the nurse monitor for in a patient prescribed alprazolam to treat panic disorder?
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What are the adverse effects from antipsychotic drugs acting on alpha-adrenergic receptors?
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What is a common symptom of serotonin syndrome?
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Which medication would the nurse expect to administer for a patient with a history of abusing opioid analgesics and needs an anti-anxiety agent?
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Which medication should be monitored continuously for hypertension due to a drug interaction with buspirone?
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Which condition does the nurse monitor for while administering flumazenil for an overdose of diazepam?
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What medication would a nurse suggest for a patient with psychosis who is experiencing extrapyramidal effects from conventional antipsychotic therapy?
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Which test will the nurse suggest to the health care provider before starting duloxetine for depression?
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Study Notes
Antipsychotic Drugs and Related Treatments
- Anticholinergics can cause constipation and urinary retention when used with nortriptyline, a tricyclic antidepressant (TCA).
- SNRIs (Serotonin and Norepinephrine Reuptake Inhibitors) may have interactions with non-steroidal anti-inflammatory drugs.
- Current indications for TCAs include insomnia, childhood enuresis, and neuropathic pain.
- Buspirone is an alternative anxiolytic that can reduce drowsiness compared to lorazepam.
Patient Education and Compliance
- Advise patients to take sertraline at the same time each day for consistency.
- Inform patients on fluoxetine that therapeutic effects may take an additional 2-4 weeks to manifest.
Mood Stabilizers and Their Uses
- Oxcarbazepine and lithium carbonate are commonly used mood stabilizers for bipolar disorder.
- Monitoring blood sodium levels in patients on lithium is essential to maintain therapeutic concentrations.
Treatment of Alcohol Abuse and Anxiety
- Benzodiazepines are indicated for managing withdrawal symptoms in alcohol detoxification.
- Maximum daily dosage of diazepam for anxiety disorder is 40mg, taken in divided doses of 2-10mg, 2-4 times a day.
Side Effects and Adverse Effects
- Patients taking benzodiazepines should be asked about oral contraceptive use, as it can reduce benzodiazepine elimination.
- Common adverse effects from antipsychotics include lightheadedness, reflex tachycardia, and postural hypotension related to alpha-adrenergic receptor activity.
- Monitor for signs of serotonin syndrome, including myoclonus and confusion.
Diagnosing with Medication
- A patient on lithium is likely diagnosed with bipolar disorder.
- Positive symptoms of schizophrenia manifest as delusions, hallucinations, and conceptual disorganization.
Drug Interactions and Monitoring
- Buspirone can lead to serotonin syndrome if combined with antidepressants.
- Continuous blood pressure monitoring is necessary when patients taking buspirone are also on MAOIs to prevent hypertension.
- Liver function tests should be conducted before initiating duloxetine due to risks of liver toxicity.
Extrapyramidal Effects
- Risperidone is recommended for patients experiencing extrapyramidal symptoms from conventional antipsychotic treatment.
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Test your knowledge on antipsychotic drugs and their effects with these flashcards. Each card includes a question and a detailed rationale to enhance your understanding of medications like nortriptyline and their interactions. Perfect for nursing and medical students preparing for exams.