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</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)</p> Signup and view all the answers

    Which network inhibits prolactin release leading to gynecomastia and galactorrhea?

    <p>Tuberoinfundibular</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</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</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</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</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</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</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</p> Signup and view all the answers

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

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

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

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

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

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

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

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

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

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

    Too little dopamine can lead to what disorder?

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

    What is the main function of the Tuberoinfundibular neural network?

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

    What neurotransmitter systems are affected by NDRIs?

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

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

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

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

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

    Which antidepressant has the longest half-life?

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

    Which antidepressant has the lowest risk of sexual side effects?

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

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

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

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

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

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

    <p>Dopamine</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</p> Signup and view all the answers

    Which neurotransmitter does Trazadone primarily act upon to treat depression?

    <p>Serotonin</p> Signup and view all the answers

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

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

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

    <p>TCAs</p> Signup and view all the answers

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

    <p>Priapism</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</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</p> Signup and view all the answers

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

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

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

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

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

    <p>Hepatotoxicity</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</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</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</p> Signup and view all the answers

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

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

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

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

    What should be reviewed when prescribing stimulants for ADHD?

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

    What is the primary mechanism of action for controlled medications?

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

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

    <p>Antipsychotics</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</p> Signup and view all the answers

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

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

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

    <p>Constipation</p> Signup and view all the answers

    Which neurotransmitter is targeted by SSRIs?

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

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

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

    Which SSRI has mild antihistamine effects?

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

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

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

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

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

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

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

    Which antidepressant has the longest half-life?

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

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

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

    Which medication should not be stopped abruptly?

    <p>Anticonvulsants</p> Signup and view all the answers

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

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

    Which of the following is a characteristic symptom of mania?

    <p>Inflated self-esteem</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.</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</p> Signup and view all the answers

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

    <p>Decreased goal-directed activity</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.</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.</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.</p> Signup and view all the answers

    What is the main characteristic of Cyclothymia?

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

    What is the role of serotonin in the brain?

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

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

    <p>Norepinephrine</p> Signup and view all the answers

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

    <p>Hallucinations</p> Signup and view all the answers

    Which neurotransmitter dysfunction is associated with too little positive affect?

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

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

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

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

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

    When might combination therapy be necessary in bipolar disorder treatment?

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

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

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

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

    <p>All of the above</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%</p> Signup and view all the answers

    Which medication should be taken with food for maximum absorption?

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

    Which of the following medications can increase lithium levels?

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

    What is required by the FDA for all antidepressants?

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

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

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

    What is the primary characteristic of a manic episode?

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

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

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

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

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

    What is the primary characteristic of a manic episode?

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

    Which neurotransmitter dysfunction is associated with too little positive affect?

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

    What is the primary mechanism of action for controlled medications?

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

    What is the primary mechanism of action for mirtazapine?

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

    What is the primary indication for prescribing duloxetine?

    <p>All of the above</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.</p> Signup and view all the answers

    What is a common side effect associated with serotonin syndrome?

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

    Which medication is known for its appetite-stimulating effects?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

    Which neurotransmitters are related to symptoms of increased negative affect?

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

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

    <p>Hostility</p> Signup and view all the answers

    Why should Lurasidone be taken with food?

    <p>To prevent gastrointestinal upset</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%</p> Signup and view all the answers

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

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

    Why do clinicians monitor labs for patients on lithium treatment?

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

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

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

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

    <p>Antipsychotics</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</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</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%</p> Signup and view all the answers

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

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

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

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

    What is the most common side effect of SSRI medications?

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

    Which SSRI medication has mild antihistamine effects?

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

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

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

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

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

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

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

    Which neural circuit is associated with reward and addiction?

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

    Which substance of abuse primarily affects the dopaminergic pathway?

    <p>Stimulants</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</p> Signup and view all the answers

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

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

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

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

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

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

    Which substance of abuse primarily affects the dopaminergic system?

    <p>Stimulants</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</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</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</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</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</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</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</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</p> Signup and view all the answers

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

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

    Which symptom is most indicative of bipolar I disorder?

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

    Which medication is extracted from a substance found in daffodils?

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

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

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

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

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

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

    <p>CYP1A2</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</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</p> Signup and view all the answers

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

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

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

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

    Which class of medications can increase lithium levels?

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

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

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

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

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

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

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

    Why should some medications not be stopped abruptly?

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

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

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

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

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

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