Medication Selection and Adverse Effects Quiz
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Questions and Answers

Where is the basal ganglia located in the brain?

  • Temporal lobe
  • Frontal lobe
  • Midbrain (correct)
  • Parietal lobe

Which neural network is responsible for cognition, executive function, and emotions?

  • Mesolimbic
  • Tuberoinfundibular
  • Mesocortical (correct)
  • Nigrostriatal

What symptoms are associated with overactivation of the mesolimbic neural network?

  • Positive symptoms (delusions, illogical changes in behavior/thoughts, & hyperactivity) (correct)
  • Tics, dyskinesias, chorea
  • Negative, cognitive, and affective symptoms (apathy, lethargy, asociality, avolition, & algoia)
  • Akathisia and dystonia

Which location in the brain is primarily responsible for emotional behaviors, reward, and pleasure?

<p>VTA &amp; mesolimbic pathway in the orbitalfrontal cortex (B)</p> Signup and view all the answers

What are the symptoms of low dopamine levels in the brain?

<p>Akathisia and dystonia (inability to sit still &amp; involuntary contract of muscles) (C)</p> Signup and view all the answers

Which network inhibits prolactin release leading to gynecomastia and galactorrhea?

<p>Tuberoinfundibular (A)</p> Signup and view all the answers

Which of the following is part of the basal ganglia neural network involved in voluntary motor movements?

<p>Nigrostriatal (D)</p> Signup and view all the answers

What is the main neurotransmitter imbalance associated with the symptoms of mania?

<p>Excess of 5HT, NE, and DA (C)</p> Signup and view all the answers

Which of the following factors is NOT mentioned as contributing to the causes of mood disorders?

<p>Changes in posture (A)</p> Signup and view all the answers

When initiating antidepressant therapy, what is the recommended initial approach?

<p>Start with the lowest recommended dose and gradually increase as needed (A)</p> Signup and view all the answers

Which of the following is NOT a key step in the process of adjusting antidepressant medication if the initial treatment is not effective?

<p>Combine multiple antidepressant medications (D)</p> Signup and view all the answers

Which of the following statements about the genetics of mood disorders is correct?

<p>Mood disorders have complex causes with contributions from both genetic and environmental factors (B)</p> Signup and view all the answers

Which brain structure is primarily involved in the regulation of posture and voluntary motor movements, motor learning, excutive funtions, behaviors, & emotions?

<p>Basal ganglia (A)</p> Signup and view all the answers

Which of the following neurotransmitters is primarily involved in the regulation of mood disorders?

<p>Serotonin (C)</p> Signup and view all the answers

Which brain structure is responsible for the integration of sensory information and coordination of voluntary movements, balance, language, & attention?

<p>Cerebellum (B)</p> Signup and view all the answers

Which of the following is a potential genetic risk factor for mood disorders?

<p>Mutations in the serotonin transporter gene (5-HTT) (D)</p> Signup and view all the answers

Which brain structure is primarily involved in the regulation of habit formation (motor learning)?

<p>Basal ganglia (D)</p> Signup and view all the answers

Which brain region is responsible for the integration of sensory information and the coordination of voluntary movements?

<p>Cerebellum (D)</p> Signup and view all the answers

What is the chronic presentation that involves hypomania and major depressive symptoms but does not meet the criteria for a major depressive or manic/hypomanic episode?

<p>Cyclothymia (B)</p> Signup and view all the answers

Which of the following symptoms is NOT commonly associated with mania?

<p>Excessive guilt (D)</p> Signup and view all the answers

What type of mood episode may NOT cause significant functional impairment, psychosis, or hospitalization?

<p>Hypomanic (D)</p> Signup and view all the answers

Why is bipolar disorder sometimes difficult to diagnose when the client presents in the depression phase?

<p>Reluctance to report symptoms (A)</p> Signup and view all the answers

What symptom mentioned in the text can be a sign of a manic episode?

<p>Increased goal-directed activity (D)</p> Signup and view all the answers

Which of the following is a characteristic of cyclothymia?

<p>Does not meet criteria for manic/hypomanic episode or major depressive episode (C)</p> Signup and view all the answers

What is a distinguishing feature of hypomanic episodes compared to manic episodes?

<p>less than 7 days duration (C)</p> Signup and view all the answers

Why might clients with bipolar disorder be reluctant to report their symptoms during certain phases?

<p>Fear of stigmatization (A)</p> Signup and view all the answers

Which neural network is located in the midbrain to basal ganglia responsible for posture and voluntary motor movements?

<p>Nigrostriatal network (C)</p> Signup and view all the answers

Which symptm can result from chronic blockage of dopamine receptors?

<p>Akathisia, dystonia , &amp; chorea (involuntary, irregular, unpredictable muscle movements) (D)</p> Signup and view all the answers

Which neural network is responsible for cognition, executive function, and emotions?

<p>Mesocortical network (A)</p> Signup and view all the answers

In which location does dopamine inhibit prolactin release leading to symptoms like gynecomastia and galactorrhea?

<p>Hypothalamus and anterior pituitary (A)</p> Signup and view all the answers

Too little dopamine can lead to what disorder?

<p>Parkinson's disease (A)</p> Signup and view all the answers

What is the main function of the Tuberoinfundibular neural network?

<p>Inhibiting prolactin release (A)</p> Signup and view all the answers

Which SNRI is recommended to try a higher dose before switching to a different medication for treating both depression and anxiety disorders?

<p>Venlafaxine (Effexor) (B)</p> Signup and view all the answers

Which medication is effective for treating somatic symptoms of depression and atypical pain at higher doses?

<p>Duloxetine (Cymbalta) (B)</p> Signup and view all the answers

Which SNRI can be prescribed if the patient also suffers from perimenopausal vasomotor symptoms like sweating or flushing?

<p>Desvenlafaxine (Pristiq) (B)</p> Signup and view all the answers

What neurotransmitter systems are affected by NDRIs?

<p>Dopamine and Norepinephrine (C)</p> Signup and view all the answers

Which medication drug class is an NDRI that can be prescribed to improve alertness, energy, and motivation?

<p>Bupropion (Wellbutrin) (D)</p> Signup and view all the answers

Which medication drug class is an NDRI and is NOT a first-line treatment for anxiety?

<p>Bupropion (Wellbutrin) (A)</p> Signup and view all the answers

Which medication drug class is an NDRI that is contraindicated in clients with a history of seizure disorder?

<p>Bupropion (Wellbutrin) (D)</p> Signup and view all the answers

What are some potential side effects of NDRIs mentioned in the text?

<p>Agitation, headache, dry mouth, constipation, weight loss, seizures (B)</p> Signup and view all the answers

Which class of antidepressants should be restricted due to dietary restrictions?

<p>Monoamine Oxidase Inhibitors (MAOIs) (A)</p> Signup and view all the answers

Which antidepressant may worsen anxiety symptoms in clients with comorbid anxiety?

<p>Fluoxetine (Prozac) (A)</p> Signup and view all the answers

Which factor should be considered when choosing an antidepressant for a client who may forget to take their medication?

<p>Half-life (A)</p> Signup and view all the answers

Which antidepressant has the longest half-life?

<p>Fluoxetine (Prozac) (C)</p> Signup and view all the answers

Which factor should be considered when prescribing an antidepressant to ensure the client can afford and benefit from the treatment?

<p>Cost and insurance benefits (C)</p> Signup and view all the answers

Which antidepressant has the lowest risk of sexual side effects?

<p>Bupropion (Wellbutrin) (A)</p> Signup and view all the answers

Which class of antidepressants can help improve cognition and brain fog?

<p>Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) (B)</p> Signup and view all the answers

Which antidepressant medication is mentioned as having a mnemonic to help remember its class?

<p>Venlafaxine (Effexor) (B)</p> Signup and view all the answers

Which brain region is primarily responsible for the symptoms of decreased sleep, appetite, and arousal in depression?

<p>Thalamus and Hypothalamus (C)</p> Signup and view all the answers

Which neural network is primarily involved in the regulation of mood, guilt, and suicidality in depression?

<p>Prefrontal Cortex and Amygdala (C)</p> Signup and view all the answers

Which of the following is the recommended initial approach when starting antidepressant therapy for a patient with mood disorders?

<p>Exhaust mood stabilizers before considering antidepressants (B)</p> Signup and view all the answers

Which brain region is primarily responsible for the symptoms of physical fatigue and agitation in depression?

<p>Striatum (C)</p> Signup and view all the answers

Which of the following is NOT a common symptom associated with mood disorders?

<p>Increased risk-taking and pressured speech (A)</p> Signup and view all the answers

Which brain region is primarily responsible for the symptoms of pleasure interests and reward in depression?

<p>Nucleus Accumbens (D)</p> Signup and view all the answers

Which of the following is the most important step in differentiating between unipolar and bipolar depression?

<p>Obtaining insight from a family member or caregiver (B)</p> Signup and view all the answers

Which neurotransmitter imbalance is primarily associated with the symptoms of mania in bipolar disorder?

<p>Dopamine (A)</p> Signup and view all the answers

What is the primary reason for not using TCAs first-line in the treatment of depression?

<p>High risk of overdose and potential fatality (B)</p> Signup and view all the answers

Which neurotransmitter does Trazadone primarily act upon to treat depression?

<p>Serotonin (D)</p> Signup and view all the answers

What is the main reason for Trazadone being taken at bedtime?

<p>To enhance its sedative effects (B)</p> Signup and view all the answers

Which class of antidepressants possess both SRI and NRI properties along with blocking various receptors?

<p>TCAs (C)</p> Signup and view all the answers

What is a serious adverse effect associated with Trazadone that requires immediate medical attention?

<p>Priapism (B)</p> Signup and view all the answers

Why are MAOIs not considered a first-line treatment for depression?

<p>High risk of dietary interactions and hypertensive crisis (B)</p> Signup and view all the answers

How do SARIs like Trazadone primarily aid in the treatment of MDD?

<p>By potently blocking serotonin receptors and enhancing sleep (B)</p> Signup and view all the answers

When should a patient taking lithium return for monitoring after a dose adjustment?

<p>5 days later (B)</p> Signup and view all the answers

For a patient on valproic acid (Depakote), which condition can be caused by the medication?

<p>Thrombocytopenia (C)</p> Signup and view all the answers

Which medication should be avoided for clients with comorbid anxiety due to the potential of worsening symptoms?

<p>Fluoxetine (Prozac) (B)</p> Signup and view all the answers

What can Carbamazepine (Tegretol) lead to in patients who are taking it?

<p>Hepatotoxicity (D)</p> Signup and view all the answers

Which lab results should be monitored in patients on atypical antipsychotics due to the risk of blood dyscrasias?

<p>Blood cell counts (A)</p> Signup and view all the answers

Which class of antidepressants is not recommended for clients who may forget to take their medication on time?

<p>MAOIs (C)</p> Signup and view all the answers

In Bipolar Disorder type 1, what defines a diagnosis of a manic episode?

<p>At least 1 episode of mania or hypomania for at least 1 week with a h/o one or more major depressive episodes (B)</p> Signup and view all the answers

Which antipsychotic medication is likely to have the shortest half-life?

<p>Risperidone (Risperdal) (B)</p> Signup and view all the answers

Which antidepressant is known for its potential to improve cognition and help with brain fog?

<p>Bupropion (Wellbutrin) (D)</p> Signup and view all the answers

What differentiates Bipolar Disorder type 2 from type 1 in terms of diagnosis?

<p>Chronic/ past hypomanic episode &amp; current/past major depressive disorder (B)</p> Signup and view all the answers

What is the characteristic feature of Bipolar Disorder diagnosis according to the text?

<p>Fluctuations in mood and energy (B)</p> Signup and view all the answers

If cost is a significant factor in medication choice, which antidepressant would be the least likely to be prescribed?

<p>Venlafaxine (Effexor) (D)</p> Signup and view all the answers

Which type of antidepressant may pose a higher risk of sexual side effects as compared to others?

<p>Venlafaxine (Effexor) (D)</p> Signup and view all the answers

For a patient who may forget to take their medication, which type of antidepressant should be considered based on half-life considerations?

<p>SNRIs (A)</p> Signup and view all the answers

What neurotransmitter reuptake inhibition mechanism makes SNRIs potentially beneficial for improving cognition?

<p>Dopamine (DA) (B)</p> Signup and view all the answers

Which statement about medication administration for substance abuse is correct?

<p>Some medications can be started immediately, while others require mild withdrawal (A)</p> Signup and view all the answers

Which of the following factors should be considered when prescribing medications for substance abuse?

<p>Pregnancy risks and lifespan considerations (C)</p> Signup and view all the answers

What is the difference between impulsivity and compulsivity in the context of substance abuse?

<p>Impulsivity refers to unplanned actions, while compulsivity refers to repetitive behaviors (C)</p> Signup and view all the answers

When prescribing stimulants for ADHD, which lifespan consideration should be taken into account?

<p>Different stimulants may be recommended for different age groups, such as children, adults, and the elderly (A)</p> Signup and view all the answers

What should be reviewed when prescribing stimulants for ADHD?

<p>All of the above (D)</p> Signup and view all the answers

Which of the following statements about prescribing stimulants for ADHD is correct?

<p>The risks and benefits of prescribing stimulants should be reviewed (A)</p> Signup and view all the answers

What is an essential step when prescribing medications for substance abuse or ADHD?

<p>All of the above (D)</p> Signup and view all the answers

What is the primary mechanism of action for controlled medications?

<p>Modulating the release of neurotransmitters (D)</p> Signup and view all the answers

What is the function of orexin in relation to sleep/wake cycles?

<p>Orexin promotes wakefulness and arousal (D)</p> Signup and view all the answers

Which class of medications is typically recommended as first-line treatment for Restless Leg Syndrome (RLS)?

<p>Dopamine agonists (D)</p> Signup and view all the answers

In the context of dementia, which stage is characterized by significant impairment in daily functioning?

<p>Severe dementia (A)</p> Signup and view all the answers

What biomarkers are being studied in Alzheimer's disease (AD) research to support diagnosis?

<p>Increased levels of amyloid-beta and tau proteins (C)</p> Signup and view all the answers

Which medications have a black box warning for use in dementia patients?

<p>Antipsychotics (B)</p> Signup and view all the answers

Which factor should be considered when selecting an appropriate medication for a client with potential medication adherence issues?

<p>Medication half-life (C)</p> Signup and view all the answers

Which neurotransmitter system is primarily affected by non-stimulant medications used to treat ADHD?

<p>Norepinephrine (A)</p> Signup and view all the answers

Which SSRI is recommended for a patient who takes multiple other medications for chronic conditions?

<p>Fluoxetine (Prozac) (C)</p> Signup and view all the answers

Which symptom is NOT listed as a common side effect of SSRIs?

<p>Constipation (B)</p> Signup and view all the answers

Which neurotransmitter is targeted by SSRIs?

<p>Serotonin (5-HT) (B)</p> Signup and view all the answers

Which SSRI is recommended for a patient who suffers from insomnia and social anxiety?

<p>paroxetine (Paxil) (D)</p> Signup and view all the answers

Which SSRI should be prescribed for a patient who suffers from hypersomnolence and social anxiety?

<p>Sertraline (Zoloft) (D)</p> Signup and view all the answers

Which SSRI has mild antihistamine effects?

<p>Citalopram (Celexa) (D)</p> Signup and view all the answers

Which SSRI is recommended for patients who may forget to take their medication due to its long half-life?

<p>Escitalopram (Lexapro) (A)</p> Signup and view all the answers

Which medication that treats anxiety and depression needs to be increased if the patient actively smokes?

<p>Fluoxetine (Prozac) (B)</p> Signup and view all the answers

Which of the following lab tests should be monitored for a patient taking lithium?

<p>Serum lithium level, renal function, and thyroid function (D)</p> Signup and view all the answers

When should lithium serum levels be monitored after a dose adjustment?

<p>5 days after the adjustment (D)</p> Signup and view all the answers

How often should lithium levels be monitored for patients on a stable dose?

<p>Every 6 months (D)</p> Signup and view all the answers

Which of the following lab tests should be monitored for a patient taking valproic acid (Depakote)?

<p>Serum valproate level, liver function, and CBC (B)</p> Signup and view all the answers

Which of the following lab tests should be monitored for a patient taking carbamazepine?

<p>Serum carbamazepine levels, renal and liver function, and CBC (B)</p> Signup and view all the answers

Which of the following lab tests should be monitored for a patient taking atypical antipsychotics?

<p>CBC and HgB A1C (B)</p> Signup and view all the answers

What is the primary distinguishing feature between Bipolar I and Bipolar II disorders?

<p>Bipolar I involves at least one manic episode, while Bipolar II involves hypomanic episodes (C)</p> Signup and view all the answers

Which of the following statements about the diagnosis of Bipolar I disorder is correct?

<p>Requires at least one episode of mania for at least 1 week or any duration if hospitalization is required (A)</p> Signup and view all the answers

Which medication would be the best choice for a patient who may forget to take their medication on time?

<p>A medication with a longer half-life (C)</p> Signup and view all the answers

Which medication is associated with a lower risk of sexual side effects?

<p>Bupropion (Wellbutrin) (C)</p> Signup and view all the answers

Which class of antidepressants is recommended for improving cognition and treating brain fog?

<p>SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors) (D)</p> Signup and view all the answers

Which SNRI is recommended for treating both depression and anxiety disorders, with a higher dose being tried before switching medications?

<p>Duloxetine (Cymbalta) (D)</p> Signup and view all the answers

Which medication should be avoided for patients with comorbid anxiety due to the potential of worsening symptoms?

<p>Fluoxetine (Prozac) (B)</p> Signup and view all the answers

Which class of antidepressants should be restricted due to dietary restrictions and potential interactions?

<p>MAOIs (Monoamine Oxidase Inhibitors) (C)</p> Signup and view all the answers

Which factor should be considered when prescribing antidepressants to patients who may have difficulty affording medication?

<p>Cost and insurance benefits (B)</p> Signup and view all the answers

Which antidepressant has the longest half-life?

<p>Fluoxetine (Prozac) (A)</p> Signup and view all the answers

Which medication would you NOT prescribe in clients with COPD or hepatic impairment?

<p>Medications with potential for respiratory depression or impaired liver metabolism (C)</p> Signup and view all the answers

Why do dementia medications cause GI distress?

<p>They cause increased acetylcholine levels, leading to GI side effects (B)</p> Signup and view all the answers

Will the GI side effects of dementia medications decrease over time?

<p>It depends on the specific medication and the individual patient response (A)</p> Signup and view all the answers

Which medication is made from a substance that is extracted from daffodils?

<p>Galantamine (Razadyne) (B)</p> Signup and view all the answers

Which medication should not be stopped abruptly?

<p>Anticonvulsants (B)</p> Signup and view all the answers

Which medication is the first-line treatment for dementia-related agitation?

<p>Antipsychotics (C)</p> Signup and view all the answers

Which medications involve the CYP450 enzymes, and which medication does not?

<p>Antidepressants and antipsychotics involve CYP450, while memantine does not (C)</p> Signup and view all the answers

Which medication is a mood stabilizer with a propensity to cause a rash as a side effect?

<p>Lamotrigine (Lamictal) (A)</p> Signup and view all the answers

What is the chronic presentation of hypomania and major depressive symptoms that does not meet the criteria for a major depressive or manic/hypomanic episode?

<p>Cyclothymia (C)</p> Signup and view all the answers

Which of the following is a characteristic symptom of mania?

<p>Inflated self-esteem (D)</p> Signup and view all the answers

Why might clients with bipolar disorder be reluctant to report their symptoms during certain phases?

<p>They enjoy the elevation of mood during manic episodes and are reluctant to report these symptoms. (C)</p> Signup and view all the answers

What symptom mentioned in the text can be a sign of a manic episode?

<p>Decreased need for sleep (D)</p> Signup and view all the answers

Which of the following is NOT a characteristic symptom of mania?

<p>Decreased goal-directed activity (B)</p> Signup and view all the answers

What is the primary reason why clients with bipolar disorder may be reluctant to report their symptoms?

<p>They enjoy the elevation of mood during manic episodes and are reluctant to report these symptoms. (C)</p> Signup and view all the answers

Which of the following is a characteristic of hypomania?

<p>It is associated with anger and irritability as common symptoms. (D)</p> Signup and view all the answers

What is the primary difference between mania and hypomania?

<p>Mania is not of sufficient duration or severity to cause significant functional impairment, psychosis, or hospitalization, while hypomania is. (B)</p> Signup and view all the answers

What is the main characteristic of Cyclothymia?

<p>Chronic presentation of hypomanic and depressive symptoms (B)</p> Signup and view all the answers

Which neurotransmitter is primarily associated with the loss of pleasure, interest, and alertness when levels are low?

<p>Dopamine (C)</p> Signup and view all the answers

What is the role of serotonin in the brain?

<p>Promoting relaxation and comfort (A)</p> Signup and view all the answers

Which neurotransmitter imbalance can lead to antsy, nervous feelings and impact the ability to focus?

<p>Norepinephrine (D)</p> Signup and view all the answers

What is the main effect of high dopamine levels in the brain?

<p>Hallucinations (B)</p> Signup and view all the answers

Which neurotransmitter dysfunction is associated with too little positive affect?

<p>Dopamine and norepinephrine (A)</p> Signup and view all the answers

What is the primary symptom of mania according to the text?

<p>Excessive talkativeness (B)</p> Signup and view all the answers

Which neurotransmitter plays a role in flight, fight, or fright responses in the brain?

<p>(NE) Norepinephrine (C)</p> Signup and view all the answers

What is the primary reason for combining an antidepressant with a mood stabilizer in bipolar disorder treatment?

<p>To prevent onset of a hypomanic or manic episode (B)</p> Signup and view all the answers

Which medication is specifically used for euphoric mania, rapid cycling, or maintenance therapy in bipolar disorder?

<p>Lamotrigine (Lamictal) (B)</p> Signup and view all the answers

In bipolar disorder, which medication is primarily used for acute mania, mixed mood, or comorbid substance use?

<p>Valproic acid (Depakote) (B)</p> Signup and view all the answers

Which class of medications is typically used in acute bipolar depression, manic episodes, or as a maintenance/adjunct therapy?

<p>Antipsychotics (D)</p> Signup and view all the answers

When might combination therapy be necessary in bipolar disorder treatment?

<p>To target depression symptoms more effectively (C)</p> Signup and view all the answers

What is one common symptom of Major Depressive Disorder (MDD) mentioned in the text?

<p>Depressed mood (B)</p> Signup and view all the answers

In which age group does Major Depressive Disorder (MDD) have a prevalence of around 13.1%?

<p>Individuals aged 18-25 (C)</p> Signup and view all the answers

What should be a key consideration when prescribing medication to clients with bipolar disorder who have a lack of adherence to the regimen?

<p>Considering alternative non-pharmacological treatments (C)</p> Signup and view all the answers

Which lab tests should be routinely monitored for patients taking lithium?

<p>All of the above (D)</p> Signup and view all the answers

What is the recommended starting dose adjustment for lithium in patients with renal failure?

<p>Reduce dose by at least 50% (D)</p> Signup and view all the answers

Which medication should be taken with food for maximum absorption?

<p>Lurasidone (Latuda) (A)</p> Signup and view all the answers

Which of the following medications can increase lithium levels?

<p>ACE inhibitors and diuretics (A)</p> Signup and view all the answers

What is required by the FDA for all antidepressants?

<p>Product labeling about potential mania risks (B)</p> Signup and view all the answers

Which symptoms are associated with decreased positive affect due to dopamine and norepinephrine dysfunction?

<p>Depressed mood, loss of joy, lack of interest (C)</p> Signup and view all the answers

Which symptoms are associated with increased negative affect due to serotonin and norepinephrine dysfunction?

<p>Depressed mood, guilt, fear, anxiety (D)</p> Signup and view all the answers

Which neurotransmitter system regulates sleep, arousal, libido, aggression, and pain perception?

<p>All of the above (D)</p> Signup and view all the answers

What is the primary characteristic of a manic episode?

<p>Persistent elevated, expansive, or irritable mood (B)</p> Signup and view all the answers

Which of the following is NOT a common symptom associated with mania?

<p>Excessive fatigue (D)</p> Signup and view all the answers

What distinguishes hypomania from a manic episode?

<p>Hypomania is less severe and does not cause significant functional impairment (B)</p> Signup and view all the answers

What symptom is mentioned in the text that suggests the client may be experiencing a manic episode?

<p>All of the above (D)</p> Signup and view all the answers

What is cyclothymia?

<p>A chronic condition involving alternating periods of hypomania and major depressive symptoms that do not meet the criteria for a major depressive or manic/hypomanic episode (B)</p> Signup and view all the answers

Which of the following statements about anger and irritability in bipolar disorder is true?

<p>Anger and irritability are common symptoms (D)</p> Signup and view all the answers

Why may bipolar disorder be difficult to diagnose if the client presents in the depression phase?

<p>Clients often enjoy the elevated mood and are reluctant to report symptoms of hypomania or mania (B)</p> Signup and view all the answers

What is the significance of the client's presentation in the given scenario?

<p>It suggests the client may be experiencing a manic episode (A)</p> Signup and view all the answers

Which of the following statements about the causes of mood disorders is correct?

<p>Dysfunctions in the brain, imbalance of neurotransmitters, life events, abuse/trauma, substance use, medications, menstruation, and seasonal changes can all contribute to mood disorders. (D)</p> Signup and view all the answers

Which of the following statements accurately describes the role of neurotransmitters in mood disorders?

<p>Mania occurs from an excess of serotonin, norepinephrine, and dopamine. (D)</p> Signup and view all the answers

Which of the following factors contribute to the development of mood disorders?

<p>Gene expression, environmental factors, and epigenetics (C)</p> Signup and view all the answers

When initiating antidepressant therapy, what is the recommended initial approach?

<p>Start the patient on a single drug at the lowest recommended dose to prevent side effects. (C)</p> Signup and view all the answers

If the initial antidepressant therapy is ineffective, what is the recommended next step?

<p>Switch to a different medication within the same drug class and titrate as necessary to achieve efficacy for a minimum of 8 weeks. (C)</p> Signup and view all the answers

Which of the following statements about the monoamine neurotransmitter system is correct?

<p>The monoamine neurotransmitter system consists of serotonin, norepinephrine, and dopamine. (C)</p> Signup and view all the answers

Which of the following statements about the genetics of mood disorders is correct?

<p>Major depressive disorder (MDD) and bipolar disorder (BD) are heritable disorders with contributions from genetic factors. (A)</p> Signup and view all the answers

Which of the following statements accurately describes the role of pharmacological treatments in mood disorders?

<p>Pharmacological treatments act on the monoamine neurotransmitter system, which includes serotonin, norepinephrine, and dopamine. (A)</p> Signup and view all the answers

What can happen if major depressive disorder (MDD) is mistaken for bipolar depression and treated with antidepressant therapy?

<p>It may precipitate a manic episode and induce a rapid-cycle bipolar depression (D)</p> Signup and view all the answers

Which neurotransmitter is primarily targeted by selective serotonin reuptake inhibitors (SSRIs) to treat depression?

<p>Serotonin (5-HT) (A)</p> Signup and view all the answers

Which side effect mnemonic is commonly used to remember the common side effects of selective serotonin reuptake inhibitors (SSRIs)?

<p>The 7 SE of SSRIs (D)</p> Signup and view all the answers

Which selective serotonin reuptake inhibitor (SSRI) is recommended for patients who may forget to take their medication due to its long half-life?

<p>Escitalopram (Lexapro) (B)</p> Signup and view all the answers

Which selective serotonin reuptake inhibitor (SSRI) should be prescribed to a client who suffers from both insomnia and social anxiety?

<p>paroxetine (Paxil) (C)</p> Signup and view all the answers

Which selective serotonin reuptake inhibitor (SSRI) should be prescribed for a client who suffers from hypersomnolence (excessive sleepiness) and social anxiety?

<p>Sertraline (Zoloft) (D)</p> Signup and view all the answers

Which medication that treats both anxiety and depression needs to be increased if the client actively smokes?

<p>Fluoxetine (Prozac) (B)</p> Signup and view all the answers

Which selective serotonin reuptake inhibitor (SSRI) has mild antihistamine effects?

<p>Citalopram (Celexa) (D)</p> Signup and view all the answers

What is the primary characteristic of a manic episode?

<p>Excessive energy and decreased need for sleep (B)</p> Signup and view all the answers

Which of the following neurotransmitter systems are affected by Norepinephrine-Dopamine Reuptake Inhibitors (NDRIs)?

<p>Norepinephrine and dopamine (B)</p> Signup and view all the answers

What is the recommended next step if the initial antidepressant therapy is ineffective?

<p>Switch to a medication in a different drug class (C)</p> Signup and view all the answers

Which neurotransmitter dysfunction is associated with too little positive affect?

<p>Deficiency in serotonin (A)</p> Signup and view all the answers

Which medication is specifically used for euphoric mania, rapid cycling, or maintenance therapy in bipolar disorder?

<p>Lithium (Priadel) (D)</p> Signup and view all the answers

Which neural network is primarily involved in the regulation of mood, guilt, and suicidality in depression?

<p>Mesolimbic (B)</p> Signup and view all the answers

Which medication would be the best choice for a patient who may forget to take their medication on time?

<p>Fluoxetine (Prozac) (D)</p> Signup and view all the answers

What is the primary mechanism of action for controlled medications?

<p>Antagonism of neurotransmitter receptors (D)</p> Signup and view all the answers

What is the primary mechanism of action for mirtazapine?

<p>Norepinephrine and specific serotonergic antidepressant (NaSSA) (A)</p> Signup and view all the answers

What is the primary indication for prescribing duloxetine?

<p>All of the above (D)</p> Signup and view all the answers

Which statement about lithium is correct?

<p>Lithium is well-established in helping prevent suicide in clients with mood disorders. (C)</p> Signup and view all the answers

What is a common side effect associated with serotonin syndrome?

<p>GI side effects (A)</p> Signup and view all the answers

Which medication is known for its appetite-stimulating effects?

<p>Mirtazapine (Rameron) (A)</p> Signup and view all the answers

Which SSRI has a shorter half-life compared to others in its class?

<p>Fluoxetine (Prozac) (C)</p> Signup and view all the answers

What is a potential adverse effect of citalopram that requires ECG monitoring?

<p>QT prolongation (B)</p> Signup and view all the answers

Which medication is primarily used for insomnia in patients with mood disorders?

<p>Trazodone (Desyrel) (D)</p> Signup and view all the answers

Which medication would be appropriate for a patient who struggles with insomnia and anxiety?

<p>Trazodone (Desyrel) (A)</p> Signup and view all the answers

Which neurotransmitter imbalance is primarily associated with the symptoms of mania in bipolar disorder?

<p>Increased dopamine (C)</p> Signup and view all the answers

Which substance of abuse acts on the brain's reward and pleasure pathways?

<p>All of the above (D)</p> Signup and view all the answers

What is a potential side effect of antidepressants that may require monitoring?

<p>Blood dyscrasias (B)</p> Signup and view all the answers

Which class of antidepressants is known for improving cognition and reducing brain fog?

<p>NDRIs (A)</p> Signup and view all the answers

Which medication would be appropriate for a patient who may forget to take their medication due to its long half-life?

<p>Fluoxetine (Prozac) (A)</p> Signup and view all the answers

What is the primary distinguishing feature between Bipolar I and Bipolar II disorders?

<p>Presence of mania or hypomania (A)</p> Signup and view all the answers

Which medication may require monitoring of lithium levels due to potential interactions?

<p>Fluoxetine (Prozac) (B)</p> Signup and view all the answers

Which age group is most at risk for antidepressant-induced suicide?

<p>Children and adolescents (C)</p> Signup and view all the answers

What is the primary concern when prescribing serotonergic antidepressants with other serotonergic drugs?

<p>Serotonin syndrome (D)</p> Signup and view all the answers

When choosing an antidepressant medication, which of the following is NOT mentioned as a key consideration in the text?

<p>Medication cost (C)</p> Signup and view all the answers

What is the recommended initial approach when initiating antidepressant therapy?

<p>Start with the lowest effective dose and titrate as necessary (B)</p> Signup and view all the answers

What is the primary purpose of adding a second medication as an adjunct, according to the text?

<p>To increase the efficacy of the initial antidepressant (C)</p> Signup and view all the answers

Which of the following is NOT mentioned in the text as a potential risk factor for antidepressant-induced suicide?

<p>Adults with a history of substance abuse (D)</p> Signup and view all the answers

What is the primary reason for carefully reviewing a client's medication list prior to prescribing an antidepressant?

<p>To identify potential drug-drug interactions (A)</p> Signup and view all the answers

When prescribing antidepressants, which of the following factors is NOT mentioned in the text as a consideration?

<p>Client's socioeconomic status (D)</p> Signup and view all the answers

What should be considered when selecting a medication for a client who is at risk of forgetting to take their pills on time?

<p>Medication with a longer half-life to avoid discontinuation syndrome (D)</p> Signup and view all the answers

Which neurotransmitter's reuptake inhibition, found in SNRIs, is beneficial for improving cognition according to the text?

<p>Dopamine (DA) (A)</p> Signup and view all the answers

Why should MAOIs generally be reserved for clients who don't respond to other treatments?

<p>They have many dietary restrictions which can be problematic (B)</p> Signup and view all the answers

Which medication is specifically mentioned as having a mnemonic related to its usage?

<p>Venlafaxine (Effexor) (C)</p> Signup and view all the answers

For a client concerned about sexual side effects, which medication would be the most appropriate choice?

<p>Bupropion (Wellbutrin) (A)</p> Signup and view all the answers

Which antipsychotic is stated to have the longest half-life among the options?

<p>Fluoxetine (Prozac) (C)</p> Signup and view all the answers

The text suggests avoiding which type of medication for clients who cannot afford treatment?

<p>$MAOIs due to dietary restrictions$ (D)</p> Signup and view all the answers

What is a symptom associated with decreased positive affect due to DA and NE dysfunction?

<p>Loss of joy (D)</p> Signup and view all the answers

Which neurotransmitters are related to symptoms of increased negative affect?

<p>NE and 5HT (A)</p> Signup and view all the answers

What is a common symptom of mood disorder linked to 5HT and NE dysfunction?

<p>Hostility (D)</p> Signup and view all the answers

Why should Lurasidone be taken with food?

<p>To prevent gastrointestinal upset (B)</p> Signup and view all the answers

What is the starting dose adjustment recommended for patients with renal failure prescribed lithium carbonate?

<p>Reduce the dose by at least 50% (A)</p> Signup and view all the answers

Which two medications can potentially increase lithium levels in the body?

<p>NSAIDs and ACE Inhibitors (C)</p> Signup and view all the answers

Why do clinicians monitor labs for patients on lithium treatment?

<p>To monitor electrolyte balance (B)</p> Signup and view all the answers

What is required by the FDA for antidepressants in their product labeling?

<p>'Black box' warnings on potential risks of mania (C)</p> Signup and view all the answers

What is the primary purpose of using antidepressant medications in clients with bipolar disorder?

<p>To prevent the onset of a hypomanic or manic episode (D)</p> Signup and view all the answers

Which medication is commonly used for the maintenance therapy of bipolar disorder?

<p>Lamotrigine (Lamictal) (B)</p> Signup and view all the answers

Which medication is primarily used for the acute treatment of mania in bipolar disorder?

<p>Valproic acid (Depakote) (C)</p> Signup and view all the answers

Which class of medications is typically used to treat acute bipolar depression?

<p>Antipsychotics (B)</p> Signup and view all the answers

What is a key consideration when prescribing medications to clients with bipolar disorder who have a lack of adherence to the medication regimen?

<p>Prescribing a medication with a longer half-life (D)</p> Signup and view all the answers

What is the primary distinguishing feature between Bipolar I and Bipolar II disorders?

<p>The duration of manic episodes (D)</p> Signup and view all the answers

What is the prevalence of Major Depressive Disorder (MDD) among adults in the United States?

<p>Approximately 7.1% (C)</p> Signup and view all the answers

Which medication is commonly used for the treatment of rapid cycling in bipolar disorder?

<p>Lithium (Priadel) (B)</p> Signup and view all the answers

What can happen if major depressive disorder (MDD) is mistaken for bipolar depression and treated with antidepressant therapy?

<p>It may precipitate a manic episode, induce a rapid-cycle bipolar depression, and contribute to the incidence of death by suicide in children and adults under 25 years of age. (A)</p> Signup and view all the answers

Which neurotransmitter is targeted by SSRI medications to inhibit their reuptake?

<p>Serotonin (5HT) (C)</p> Signup and view all the answers

What is the most common side effect of SSRI medications?

<p>Sexual dysfunction (C)</p> Signup and view all the answers

Which SSRI medication has mild antihistamine effects?

<p>Citalopram (Celexa) (D)</p> Signup and view all the answers

Which SSRI medication should be prescribed to a client who suffers from hypersomnolence and social anxiety?

<p>Sertraline (Zoloft) (C)</p> Signup and view all the answers

Which medication that treats both anxiety and depression needs to be increased if the client actively smokes?

<p>Fluoxetine (Prozac) (B)</p> Signup and view all the answers

Which SSRI is recommended for a patient who suffers from insomnia and social anxiety?

<p>Paroxetine (Paxil) (D)</p> Signup and view all the answers

Which age group is most at risk for antidepressant-induced suicide?

<p>Adults under 25 (D)</p> Signup and view all the answers

Which medication is recommended for patients who have difficulty falling and staying asleep?

<p>Trazodone (Desyrel) (C)</p> Signup and view all the answers

Which neural circuit is associated with reward and addiction?

<p>Dopaminergic pathway (B)</p> Signup and view all the answers

What is a potential requirement before initiating certain addiction medications?

<p>Gradually tapering off the substance of abuse (C)</p> Signup and view all the answers

Which substance of abuse primarily affects the dopaminergic pathway?

<p>Stimulants (D)</p> Signup and view all the answers

What is a potential sign or symptom of substance abuse that may be observed during a physical exam?

<p>All of the above (D)</p> Signup and view all the answers

Which medication class is FDA-approved for the treatment of addiction?

<p>Opioid agonists/antagonists (D)</p> Signup and view all the answers

What is the recommended time frame for initiating addiction medications?

<p>After a period of detoxification and stabilization (C)</p> Signup and view all the answers

What is an important aspect of client education for addiction medications?

<p>All of the above (D)</p> Signup and view all the answers

Which medication is most appropriate for a patient who has difficulty falling and staying asleep at night?

<p>Trazodone (Desyrel) (C)</p> Signup and view all the answers

Which brain region is primarily associated with the reward and addiction circuits?

<p>Mesolimbic pathway (D)</p> Signup and view all the answers

What is a potential requirement before initiating certain addiction medications?

<p>Gradually tapering off the substance of abuse (D)</p> Signup and view all the answers

Which substance of abuse primarily affects the dopaminergic system?

<p>Stimulants (C)</p> Signup and view all the answers

Which of the following is an important aspect of client education when prescribing addiction medications?

<p>All of the above (D)</p> Signup and view all the answers

Which class of medications is typically recommended as first-line treatment for restless leg syndrome (RLS)?

<p>Dopamine agonists (B)</p> Signup and view all the answers

What is the primary mechanism of action of the medication class used to treat Alzheimer's disease?

<p>Inhibiting acetylcholinesterase (B)</p> Signup and view all the answers

Which biomarker is commonly used in research to support the diagnosis of Alzheimer's disease?

<p>Increased levels of amyloid-beta (A)</p> Signup and view all the answers

Which neurotransmitter is primarily involved in the regulation of the sleep-wake cycle and is associated with the mechanism of action of medications used to treat narcolepsy?

<p>Orexin (A)</p> Signup and view all the answers

Which medication class is contraindicated in patients with moderate to severe dementia due to an increased risk of adverse effects?

<p>Antipsychotics (A)</p> Signup and view all the answers

Which medication class is commonly used in combination with antidepressants for the treatment of bipolar depression?

<p>Mood stabilizers (A)</p> Signup and view all the answers

Which medication class is recommended for patients who may forget to take their medication on time?

<p>Medications with a longer half-life (D)</p> Signup and view all the answers

Which medication has the lowest risk of sexual side effects, according to the text?

<p>Bupropion (Wellbutrin) (C)</p> Signup and view all the answers

Which class of antidepressants is known for improving cognition and reducing brain fog?

<p>Serotonin-norepinephrine reuptake inhibitors (SNRIs) (C)</p> Signup and view all the answers

Which medication class should be avoided for clients with comorbid anxiety due to the potential of worsening symptoms?

<p>Medications that target norepinephrine (A)</p> Signup and view all the answers

If cost is a significant factor, which consideration should be made when prescribing medications?

<p>Keep cost, insurance benefits, and pharmaceutical assistance programs in mind (B)</p> Signup and view all the answers

Which medication class is mentioned in the text as having a mnemonic to help remember its members?

<p>Serotonin-norepinephrine reuptake inhibitors (SNRIs) (D)</p> Signup and view all the answers

Which symptom is most indicative of bipolar I disorder?

<p>All of the above (D)</p> Signup and view all the answers

What is the primary reason for directly asking about mania symptoms, according to the text?

<p>To differentiate between major depressive disorder and bipolar I disorder (B)</p> Signup and view all the answers

Which medication is extracted from a substance found in daffodils?

<p>Galantamine (Razadyne) (D)</p> Signup and view all the answers

Which dementia medication should not be stopped abruptly due to potential withdrawal effects?

<p>Memantine (Nemdatine) (C)</p> Signup and view all the answers

Which brain region is most likely affected when a patient experiences racing thoughts and grandiosity?

<p>The text does not specify a brain region for these symptoms (B)</p> Signup and view all the answers

What is a potential consequence of misdiagnosing bipolar depression as major depressive disorder?

<p>Precipitating a manic episode or inducing rapid-cycling bipolar depression (A)</p> Signup and view all the answers

Which medication is the first-line treatment for dementia-related agitation?

<p>Quetiapine (Seroquel) (D)</p> Signup and view all the answers

Which of the following statements about patients with bipolar disorder is true, according to the text?

<p>They are reluctant to report mania or hypomania symptoms. (D)</p> Signup and view all the answers

Which cytochrome P450 enzyme is not involved in the metabolism of certain dementia medications?

<p>CYP1A2 (C)</p> Signup and view all the answers

What is a potential mechanism for the gastrointestinal side effects caused by certain dementia medications?

<p>Increased acetylcholine levels in the gut (D)</p> Signup and view all the answers

What is the primary risk associated with misdiagnosing bipolar depression as major depressive disorder, according to the text?

<p>Increased incidence of death by suicide (A)</p> Signup and view all the answers

Which action can help decrease gastrointestinal side effects from dementia medications?

<p>All of the above (D)</p> Signup and view all the answers

What action should the PMHNP take when a patient experiences diarrhea and an upset stomach after starting a newly prescribed SSRI?

<p>Suggest that most adverse effects will subside after 4-5 days once the body adjusts to increased serotonin levels. (C)</p> Signup and view all the answers

Why is Escitalopram considered the best-tolerated SSRI with the fewest CYP interactions?

<p>It is metabolized by fewer liver enzymes, reducing drug interactions. (A)</p> Signup and view all the answers

Which age group is most at risk when prescribed an SSRI, and why?

<p>Elderly, due to an increased risk of serotonin syndrome. (B)</p> Signup and view all the answers

Why is L-Methylfolate recommended as an adjunct in depression treatment?

<p>To support neurotransmitter synthesis and enhance antidepressant effectiveness. (A)</p> Signup and view all the answers

Which medication should be avoided in clients with anxiety, as it can exacerbate anxiety symptoms?

<p>Fluvoxamine (Luvox) (B)</p> Signup and view all the answers

What distinguishes SNRIs from other antidepressants like SSRIs in terms of mechanism of action?

<p>SNRIs inhibit both 5HT and NE reuptake while increasing DA in the prefrontal cortex. (D)</p> Signup and view all the answers

What is the PMHNP's best response when a patient states they have been taking their bupropion (Wellbutrin) medication at bedtime to help them sleep?

<p>Recommend taking the medication in the morning as it is not intended to be a sedative. (D)</p> Signup and view all the answers

How does trazodone work to treat Major Depressive Disorder (MDD)?

<p>Trazodone potently blocks serotonin, allowing more 5-HT to interact at postsynaptic sites. (B)</p> Signup and view all the answers

Which of the following is a serious adverse effect of trazodone that is considered a medical emergency?

<p>Priapism (B)</p> Signup and view all the answers

Why are tricyclic antidepressants (TCAs) not used as first-line treatment for depression?

<p>TCAs have a high incidence of adverse effects and risk of potential overdose and death. (D)</p> Signup and view all the answers

Which neurotransmitter systems are affected by norepinephrine-dopamine reuptake inhibitors (NDRIs) like bupropion (Wellbutrin)?

<p>Dopamine and norepinephrine (D)</p> Signup and view all the answers

When should trazodone be taken for the treatment of insomnia in Major Depressive Disorder (MDD)?

<p>Trazodone should be taken at bedtime due to its sedative effects. (C)</p> Signup and view all the answers

Which medication is effective for treating the manic episodes of bipolar disorder?

<p>Lithium (Priadel) (B)</p> Signup and view all the answers

What is the primary reason for monitoring lithium levels in patients?

<p>Lithium has a narrow therapeutic window and requires lab draws (D)</p> Signup and view all the answers

Which class of medications can increase lithium levels?

<p>NSAIDs and ACE inhibitors (B)</p> Signup and view all the answers

What is the primary mechanism behind the gastrointestinal side effects of serotonin-related medications?

<p>The presence of 90% of 5HT receptors in the GI tract (C)</p> Signup and view all the answers

Which medication is mentioned in the text as having a mnemonic to help remember its members?

<p>None of the above (D)</p> Signup and view all the answers

Which medication is associated with a potential adverse effect that requires ECG monitoring?

<p>Citalopram (Celexa) (D)</p> Signup and view all the answers

Why would a clinician avoid prescribing certain medications to clients with COPD or hepatic impairment?

<p>The medications are metabolized by the liver, leading to toxicity. (C)</p> Signup and view all the answers

Why do dementia medications often cause gastrointestinal (GI) distress?

<p>They alter cholinergic activity in the gut. (B)</p> Signup and view all the answers

Which medication is generally made from a substance that is extracted from daffodils?

<p>Galantamine (Razadyne) (C)</p> Signup and view all the answers

Why should some medications not be stopped abruptly?

<p>To prevent rebound symptoms (A)</p> Signup and view all the answers

Which medication is considered the first-line treatment for dementia-related agitation?

<p>Haloperidol (Haldol) (A)</p> Signup and view all the answers

What action can help decrease gastrointestinal (GI) side effects caused by certain medications?

<p>Dividing the medication into smaller doses throughout the day (C)</p> Signup and view all the answers

Which class of medications are considered the last choice for treating depression due to potential serious side effects?

<p>Monoamine Oxidase Inhibitors (MAOIs) (C)</p> Signup and view all the answers

Which type of MAOI is used as an antidepressant and anxiolytic?

<p>MAOI-A (C)</p> Signup and view all the answers

Which foods should be avoided when taking an MAOI?

<p>Foods high in tyramine, such as red wine, aged cheese, and smoked meats (C)</p> Signup and view all the answers

Why do MAOIs increase the risk of a hypertensive crisis when ingesting foods high in tyramine?

<p>MAOIs inhibit the breakdown of tyramine in the gut (A)</p> Signup and view all the answers

What medications should be avoided when taking MAOIs, and why?

<p>Serotonergic agents, because they increase the risk of serotonin syndrome (C)</p> Signup and view all the answers

How many half-lives of a serotonergic medication should occur before starting an MAOI?

<p>5 half-lives (A)</p> Signup and view all the answers

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