311 Questions
Where is the basal ganglia located in the brain?
Midbrain
Which neural network is responsible for cognition, executive function, and emotions?
Mesocortical
What symptoms are associated with overactivation of the mesolimbic neural network?
Positive symptoms (delusions, illogical changes in behavior/thoughts, & hyperactivity)
Which location in the brain is primarily responsible for emotional behaviors, reward, and pleasure?
VTA & mesolimbic pathway in the orbitalfrontal cortex
What are the symptoms of low dopamine levels in the brain?
Akathisia and dystonia (inability to sit still & involuntary contract of muscles)
Which network inhibits prolactin release leading to gynecomastia and galactorrhea?
Tuberoinfundibular
Which of the following is part of the basal ganglia neural network involved in voluntary motor movements?
Nigrostriatal
What is the main neurotransmitter imbalance associated with the symptoms of mania?
Excess of 5HT, NE, and DA
Which of the following factors is NOT mentioned as contributing to the causes of mood disorders?
Changes in posture
When initiating antidepressant therapy, what is the recommended initial approach?
Start with the lowest recommended dose and gradually increase as needed
Which of the following is NOT a key step in the process of adjusting antidepressant medication if the initial treatment is not effective?
Combine multiple antidepressant medications
Which of the following statements about the genetics of mood disorders is correct?
Mood disorders have complex causes with contributions from both genetic and environmental factors
Which brain structure is primarily involved in the regulation of posture and voluntary motor movements, motor learning, excutive funtions, behaviors, & emotions?
Basal ganglia
Which of the following neurotransmitters is primarily involved in the regulation of mood disorders?
Serotonin
Which brain structure is responsible for the integration of sensory information and coordination of voluntary movements, balance, language, & attention?
Cerebellum
Which of the following is a potential genetic risk factor for mood disorders?
Mutations in the serotonin transporter gene (5-HTT)
Which brain structure is primarily involved in the regulation of habit formation (motor learning)?
Basal ganglia
Which brain region is responsible for the integration of sensory information and the coordination of voluntary movements?
Cerebellum
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?
Cyclothymia
Which of the following symptoms is NOT commonly associated with mania?
Excessive guilt
What type of mood episode may NOT cause significant functional impairment, psychosis, or hospitalization?
Hypomanic
Why is bipolar disorder sometimes difficult to diagnose when the client presents in the depression phase?
Reluctance to report symptoms
What symptom mentioned in the text can be a sign of a manic episode?
Increased goal-directed activity
Which of the following is a characteristic of cyclothymia?
Does not meet criteria for manic/hypomanic episode or major depressive episode
What is a distinguishing feature of hypomanic episodes compared to manic episodes?
less than 7 days duration
Why might clients with bipolar disorder be reluctant to report their symptoms during certain phases?
Fear of stigmatization
Which neural network is located in the midbrain to basal ganglia responsible for posture and voluntary motor movements?
Nigrostriatal network
Which symptm can result from chronic blockage of dopamine receptors?
Akathisia, dystonia , & chorea (involuntary, irregular, unpredictable muscle movements)
Which neural network is responsible for cognition, executive function, and emotions?
Mesocortical network
In which location does dopamine inhibit prolactin release leading to symptoms like gynecomastia and galactorrhea?
Hypothalamus and anterior pituitary
Too little dopamine can lead to what disorder?
Parkinson's disease
What is the main function of the Tuberoinfundibular neural network?
Inhibiting prolactin release
Which SNRI is recommended to try a higher dose before switching to a different medication for treating both depression and anxiety disorders?
Venlafaxine (Effexor)
Which medication is effective for treating somatic symptoms of depression and atypical pain at higher doses?
Duloxetine (Cymbalta)
Which SNRI can be prescribed if the patient also suffers from perimenopausal vasomotor symptoms like sweating or flushing?
Desvenlafaxine (Pristiq)
What neurotransmitter systems are affected by NDRIs?
Dopamine and Norepinephrine
Which medication drug class is an NDRI that can be prescribed to improve alertness, energy, and motivation?
Bupropion (Wellbutrin)
Which medication drug class is an NDRI and is NOT a first-line treatment for anxiety?
Bupropion (Wellbutrin)
Which medication drug class is an NDRI that is contraindicated in clients with a history of seizure disorder?
Bupropion (Wellbutrin)
What are some potential side effects of NDRIs mentioned in the text?
Agitation, headache, dry mouth, constipation, weight loss, seizures
Which class of antidepressants should be restricted due to dietary restrictions?
Monoamine Oxidase Inhibitors (MAOIs)
Which antidepressant may worsen anxiety symptoms in clients with comorbid anxiety?
Fluoxetine (Prozac)
Which factor should be considered when choosing an antidepressant for a client who may forget to take their medication?
Half-life
Which antidepressant has the longest half-life?
Fluoxetine (Prozac)
Which factor should be considered when prescribing an antidepressant to ensure the client can afford and benefit from the treatment?
Cost and insurance benefits
Which antidepressant has the lowest risk of sexual side effects?
Bupropion (Wellbutrin)
Which class of antidepressants can help improve cognition and brain fog?
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
Which antidepressant medication is mentioned as having a mnemonic to help remember its class?
Venlafaxine (Effexor)
Which brain region is primarily responsible for the symptoms of decreased sleep, appetite, and arousal in depression?
Thalamus and Hypothalamus
Which neural network is primarily involved in the regulation of mood, guilt, and suicidality in depression?
Prefrontal Cortex and Amygdala
Which of the following is the recommended initial approach when starting antidepressant therapy for a patient with mood disorders?
Exhaust mood stabilizers before considering antidepressants
Which brain region is primarily responsible for the symptoms of physical fatigue and agitation in depression?
Striatum
Which of the following is NOT a common symptom associated with mood disorders?
Increased risk-taking and pressured speech
Which brain region is primarily responsible for the symptoms of pleasure interests and reward in depression?
Nucleus Accumbens
Which of the following is the most important step in differentiating between unipolar and bipolar depression?
Obtaining insight from a family member or caregiver
Which neurotransmitter imbalance is primarily associated with the symptoms of mania in bipolar disorder?
Dopamine
What is the primary reason for not using TCAs first-line in the treatment of depression?
High risk of overdose and potential fatality
Which neurotransmitter does Trazadone primarily act upon to treat depression?
Serotonin
What is the main reason for Trazadone being taken at bedtime?
To enhance its sedative effects
Which class of antidepressants possess both SRI and NRI properties along with blocking various receptors?
TCAs
What is a serious adverse effect associated with Trazadone that requires immediate medical attention?
Priapism
Why are MAOIs not considered a first-line treatment for depression?
High risk of dietary interactions and hypertensive crisis
How do SARIs like Trazadone primarily aid in the treatment of MDD?
By potently blocking serotonin receptors and enhancing sleep
When should a patient taking lithium return for monitoring after a dose adjustment?
5 days later
For a patient on valproic acid (Depakote), which condition can be caused by the medication?
Thrombocytopenia
Which medication should be avoided for clients with comorbid anxiety due to the potential of worsening symptoms?
Fluoxetine (Prozac)
What can Carbamazepine (Tegretol) lead to in patients who are taking it?
Hepatotoxicity
Which lab results should be monitored in patients on atypical antipsychotics due to the risk of blood dyscrasias?
Blood cell counts
Which class of antidepressants is not recommended for clients who may forget to take their medication on time?
MAOIs
In Bipolar Disorder type 1, what defines a diagnosis of a manic episode?
At least 1 episode of mania or hypomania for at least 1 week with a h/o one or more major depressive episodes
Which antipsychotic medication is likely to have the shortest half-life?
Risperidone (Risperdal)
Which antidepressant is known for its potential to improve cognition and help with brain fog?
Bupropion (Wellbutrin)
What differentiates Bipolar Disorder type 2 from type 1 in terms of diagnosis?
Chronic/ past hypomanic episode & current/past major depressive disorder
What is the characteristic feature of Bipolar Disorder diagnosis according to the text?
Fluctuations in mood and energy
If cost is a significant factor in medication choice, which antidepressant would be the least likely to be prescribed?
Venlafaxine (Effexor)
Which type of antidepressant may pose a higher risk of sexual side effects as compared to others?
Venlafaxine (Effexor)
For a patient who may forget to take their medication, which type of antidepressant should be considered based on half-life considerations?
SNRIs
What neurotransmitter reuptake inhibition mechanism makes SNRIs potentially beneficial for improving cognition?
Dopamine (DA)
Which statement about medication administration for substance abuse is correct?
Some medications can be started immediately, while others require mild withdrawal
Which of the following factors should be considered when prescribing medications for substance abuse?
Pregnancy risks and lifespan considerations
What is the difference between impulsivity and compulsivity in the context of substance abuse?
Impulsivity refers to unplanned actions, while compulsivity refers to repetitive behaviors
When prescribing stimulants for ADHD, which lifespan consideration should be taken into account?
Different stimulants may be recommended for different age groups, such as children, adults, and the elderly
What should be reviewed when prescribing stimulants for ADHD?
All of the above
Which of the following statements about prescribing stimulants for ADHD is correct?
The risks and benefits of prescribing stimulants should be reviewed
What is an essential step when prescribing medications for substance abuse or ADHD?
All of the above
What is the primary mechanism of action for controlled medications?
Modulating the release of neurotransmitters
What is the function of orexin in relation to sleep/wake cycles?
Orexin promotes wakefulness and arousal
Which class of medications is typically recommended as first-line treatment for Restless Leg Syndrome (RLS)?
Dopamine agonists
In the context of dementia, which stage is characterized by significant impairment in daily functioning?
Severe dementia
What biomarkers are being studied in Alzheimer's disease (AD) research to support diagnosis?
Increased levels of amyloid-beta and tau proteins
Which medications have a black box warning for use in dementia patients?
Antipsychotics
Which factor should be considered when selecting an appropriate medication for a client with potential medication adherence issues?
Medication half-life
Which neurotransmitter system is primarily affected by non-stimulant medications used to treat ADHD?
Norepinephrine
Which SSRI is recommended for a patient who takes multiple other medications for chronic conditions?
Fluoxetine (Prozac)
Which symptom is NOT listed as a common side effect of SSRIs?
Constipation
Which neurotransmitter is targeted by SSRIs?
Serotonin (5-HT)
Which SSRI is recommended for a patient who suffers from insomnia and social anxiety?
paroxetine (Paxil)
Which SSRI should be prescribed for a patient who suffers from hypersomnolence and social anxiety?
Sertraline (Zoloft)
Which SSRI has mild antihistamine effects?
Citalopram (Celexa)
Which SSRI is recommended for patients who may forget to take their medication due to its long half-life?
Escitalopram (Lexapro)
Which medication that treats anxiety and depression needs to be increased if the patient actively smokes?
Fluoxetine (Prozac)
Which of the following lab tests should be monitored for a patient taking lithium?
Serum lithium level, renal function, and thyroid function
When should lithium serum levels be monitored after a dose adjustment?
5 days after the adjustment
How often should lithium levels be monitored for patients on a stable dose?
Every 6 months
Which of the following lab tests should be monitored for a patient taking valproic acid (Depakote)?
Serum valproate level, liver function, and CBC
Which of the following lab tests should be monitored for a patient taking carbamazepine?
Serum carbamazepine levels, renal and liver function, and CBC
Which of the following lab tests should be monitored for a patient taking atypical antipsychotics?
CBC and HgB A1C
What is the primary distinguishing feature between Bipolar I and Bipolar II disorders?
Bipolar I involves at least one manic episode, while Bipolar II involves hypomanic episodes
Which of the following statements about the diagnosis of Bipolar I disorder is correct?
Requires at least one episode of mania for at least 1 week or any duration if hospitalization is required
Which medication would be the best choice for a patient who may forget to take their medication on time?
A medication with a longer half-life
Which medication is associated with a lower risk of sexual side effects?
Bupropion (Wellbutrin)
Which class of antidepressants is recommended for improving cognition and treating brain fog?
SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors)
Which SNRI is recommended for treating both depression and anxiety disorders, with a higher dose being tried before switching medications?
Duloxetine (Cymbalta)
Which medication should be avoided for patients with comorbid anxiety due to the potential of worsening symptoms?
Fluoxetine (Prozac)
Which class of antidepressants should be restricted due to dietary restrictions and potential interactions?
MAOIs (Monoamine Oxidase Inhibitors)
Which factor should be considered when prescribing antidepressants to patients who may have difficulty affording medication?
Cost and insurance benefits
Which antidepressant has the longest half-life?
Fluoxetine (Prozac)
Which medication would you NOT prescribe in clients with COPD or hepatic impairment?
Medications with potential for respiratory depression or impaired liver metabolism
Why do dementia medications cause GI distress?
They cause increased acetylcholine levels, leading to GI side effects
Will the GI side effects of dementia medications decrease over time?
It depends on the specific medication and the individual patient response
Which medication is made from a substance that is extracted from daffodils?
Galantamine (Razadyne)
Which medication should not be stopped abruptly?
Anticonvulsants
Which medication is the first-line treatment for dementia-related agitation?
Antipsychotics
Which medications involve the CYP450 enzymes, and which medication does not?
Antidepressants and antipsychotics involve CYP450, while memantine does not
Which medication is a mood stabilizer with a propensity to cause a rash as a side effect?
Lamotrigine (Lamictal)
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?
Cyclothymia
Which of the following is a characteristic symptom of mania?
Inflated self-esteem
Why might clients with bipolar disorder be reluctant to report their symptoms during certain phases?
They enjoy the elevation of mood during manic episodes and are reluctant to report these symptoms.
What symptom mentioned in the text can be a sign of a manic episode?
Decreased need for sleep
Which of the following is NOT a characteristic symptom of mania?
Decreased goal-directed activity
What is the primary reason why clients with bipolar disorder may be reluctant to report their symptoms?
They enjoy the elevation of mood during manic episodes and are reluctant to report these symptoms.
Which of the following is a characteristic of hypomania?
It is associated with anger and irritability as common symptoms.
What is the primary difference between mania and hypomania?
Mania is not of sufficient duration or severity to cause significant functional impairment, psychosis, or hospitalization, while hypomania is.
What is the main characteristic of Cyclothymia?
Chronic presentation of hypomanic and depressive symptoms
Which neurotransmitter is primarily associated with the loss of pleasure, interest, and alertness when levels are low?
Dopamine
What is the role of serotonin in the brain?
Promoting relaxation and comfort
Which neurotransmitter imbalance can lead to antsy, nervous feelings and impact the ability to focus?
Norepinephrine
What is the main effect of high dopamine levels in the brain?
Hallucinations
Which neurotransmitter dysfunction is associated with too little positive affect?
Dopamine and norepinephrine
What is the primary symptom of mania according to the text?
Excessive talkativeness
Which neurotransmitter plays a role in flight, fight, or fright responses in the brain?
(NE) Norepinephrine
What is the primary reason for combining an antidepressant with a mood stabilizer in bipolar disorder treatment?
To prevent onset of a hypomanic or manic episode
Which medication is specifically used for euphoric mania, rapid cycling, or maintenance therapy in bipolar disorder?
Lamotrigine (Lamictal)
In bipolar disorder, which medication is primarily used for acute mania, mixed mood, or comorbid substance use?
Valproic acid (Depakote)
Which class of medications is typically used in acute bipolar depression, manic episodes, or as a maintenance/adjunct therapy?
Antipsychotics
When might combination therapy be necessary in bipolar disorder treatment?
To target depression symptoms more effectively
What is one common symptom of Major Depressive Disorder (MDD) mentioned in the text?
Depressed mood
In which age group does Major Depressive Disorder (MDD) have a prevalence of around 13.1%?
Individuals aged 18-25
What should be a key consideration when prescribing medication to clients with bipolar disorder who have a lack of adherence to the regimen?
Considering alternative non-pharmacological treatments
Which lab tests should be routinely monitored for patients taking lithium?
All of the above
What is the recommended starting dose adjustment for lithium in patients with renal failure?
Reduce dose by at least 50%
Which medication should be taken with food for maximum absorption?
Lurasidone (Latuda)
Which of the following medications can increase lithium levels?
ACE inhibitors and diuretics
What is required by the FDA for all antidepressants?
Product labeling about potential mania risks
Which symptoms are associated with decreased positive affect due to dopamine and norepinephrine dysfunction?
Depressed mood, loss of joy, lack of interest
Which symptoms are associated with increased negative affect due to serotonin and norepinephrine dysfunction?
Depressed mood, guilt, fear, anxiety
Which neurotransmitter system regulates sleep, arousal, libido, aggression, and pain perception?
All of the above
What is the primary characteristic of a manic episode?
Persistent elevated, expansive, or irritable mood
Which of the following is NOT a common symptom associated with mania?
Excessive fatigue
What distinguishes hypomania from a manic episode?
Hypomania is less severe and does not cause significant functional impairment
What symptom is mentioned in the text that suggests the client may be experiencing a manic episode?
All of the above
What is cyclothymia?
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
Which of the following statements about anger and irritability in bipolar disorder is true?
Anger and irritability are common symptoms
Why may bipolar disorder be difficult to diagnose if the client presents in the depression phase?
Clients often enjoy the elevated mood and are reluctant to report symptoms of hypomania or mania
What is the significance of the client's presentation in the given scenario?
It suggests the client may be experiencing a manic episode
Which of the following statements about the causes of mood disorders is correct?
Dysfunctions in the brain, imbalance of neurotransmitters, life events, abuse/trauma, substance use, medications, menstruation, and seasonal changes can all contribute to mood disorders.
Which of the following statements accurately describes the role of neurotransmitters in mood disorders?
Mania occurs from an excess of serotonin, norepinephrine, and dopamine.
Which of the following factors contribute to the development of mood disorders?
Gene expression, environmental factors, and epigenetics
When initiating antidepressant therapy, what is the recommended initial approach?
Start the patient on a single drug at the lowest recommended dose to prevent side effects.
If the initial antidepressant therapy is ineffective, what is the recommended next step?
Switch to a different medication within the same drug class and titrate as necessary to achieve efficacy for a minimum of 8 weeks.
Which of the following statements about the monoamine neurotransmitter system is correct?
The monoamine neurotransmitter system consists of serotonin, norepinephrine, and dopamine.
Which of the following statements about the genetics of mood disorders is correct?
Major depressive disorder (MDD) and bipolar disorder (BD) are heritable disorders with contributions from genetic factors.
Which of the following statements accurately describes the role of pharmacological treatments in mood disorders?
Pharmacological treatments act on the monoamine neurotransmitter system, which includes serotonin, norepinephrine, and dopamine.
What can happen if major depressive disorder (MDD) is mistaken for bipolar depression and treated with antidepressant therapy?
It may precipitate a manic episode and induce a rapid-cycle bipolar depression
Which neurotransmitter is primarily targeted by selective serotonin reuptake inhibitors (SSRIs) to treat depression?
Serotonin (5-HT)
Which side effect mnemonic is commonly used to remember the common side effects of selective serotonin reuptake inhibitors (SSRIs)?
The 7 SE of SSRIs
Which selective serotonin reuptake inhibitor (SSRI) is recommended for patients who may forget to take their medication due to its long half-life?
Escitalopram (Lexapro)
Which selective serotonin reuptake inhibitor (SSRI) should be prescribed to a client who suffers from both insomnia and social anxiety?
paroxetine (Paxil)
Which selective serotonin reuptake inhibitor (SSRI) should be prescribed for a client who suffers from hypersomnolence (excessive sleepiness) and social anxiety?
Sertraline (Zoloft)
Which medication that treats both anxiety and depression needs to be increased if the client actively smokes?
Fluoxetine (Prozac)
Which selective serotonin reuptake inhibitor (SSRI) has mild antihistamine effects?
Citalopram (Celexa)
What is the primary characteristic of a manic episode?
Excessive energy and decreased need for sleep
Which of the following neurotransmitter systems are affected by Norepinephrine-Dopamine Reuptake Inhibitors (NDRIs)?
Norepinephrine and dopamine
What is the recommended next step if the initial antidepressant therapy is ineffective?
Switch to a medication in a different drug class
Which neurotransmitter dysfunction is associated with too little positive affect?
Deficiency in serotonin
Which medication is specifically used for euphoric mania, rapid cycling, or maintenance therapy in bipolar disorder?
Lithium (Priadel)
Which neural network is primarily involved in the regulation of mood, guilt, and suicidality in depression?
Mesolimbic
Which medication would be the best choice for a patient who may forget to take their medication on time?
Fluoxetine (Prozac)
What is the primary mechanism of action for controlled medications?
Antagonism of neurotransmitter receptors
What is the primary mechanism of action for mirtazapine?
Norepinephrine and specific serotonergic antidepressant (NaSSA)
What is the primary indication for prescribing duloxetine?
All of the above
Which statement about lithium is correct?
Lithium is well-established in helping prevent suicide in clients with mood disorders.
What is a common side effect associated with serotonin syndrome?
GI side effects
Which medication is known for its appetite-stimulating effects?
Mirtazapine (Rameron)
Which SSRI has a shorter half-life compared to others in its class?
Fluoxetine (Prozac)
What is a potential adverse effect of citalopram that requires ECG monitoring?
QT prolongation
Which medication is primarily used for insomnia in patients with mood disorders?
Trazodone (Desyrel)
Which medication would be appropriate for a patient who struggles with insomnia and anxiety?
Trazodone (Desyrel)
Which neurotransmitter imbalance is primarily associated with the symptoms of mania in bipolar disorder?
Increased dopamine
Which substance of abuse acts on the brain's reward and pleasure pathways?
All of the above
What is a potential side effect of antidepressants that may require monitoring?
Blood dyscrasias
Which class of antidepressants is known for improving cognition and reducing brain fog?
NDRIs
Which medication would be appropriate for a patient who may forget to take their medication due to its long half-life?
Fluoxetine (Prozac)
What is the primary distinguishing feature between Bipolar I and Bipolar II disorders?
Presence of mania or hypomania
Which medication may require monitoring of lithium levels due to potential interactions?
Fluoxetine (Prozac)
Which age group is most at risk for antidepressant-induced suicide?
Children and adolescents
What is the primary concern when prescribing serotonergic antidepressants with other serotonergic drugs?
Serotonin syndrome
When choosing an antidepressant medication, which of the following is NOT mentioned as a key consideration in the text?
Medication cost
What is the recommended initial approach when initiating antidepressant therapy?
Start with the lowest effective dose and titrate as necessary
What is the primary purpose of adding a second medication as an adjunct, according to the text?
To increase the efficacy of the initial antidepressant
Which of the following is NOT mentioned in the text as a potential risk factor for antidepressant-induced suicide?
Adults with a history of substance abuse
What is the primary reason for carefully reviewing a client's medication list prior to prescribing an antidepressant?
To identify potential drug-drug interactions
When prescribing antidepressants, which of the following factors is NOT mentioned in the text as a consideration?
Client's socioeconomic status
What should be considered when selecting a medication for a client who is at risk of forgetting to take their pills on time?
Medication with a longer half-life to avoid discontinuation syndrome
Which neurotransmitter's reuptake inhibition, found in SNRIs, is beneficial for improving cognition according to the text?
Dopamine (DA)
Why should MAOIs generally be reserved for clients who don't respond to other treatments?
They have many dietary restrictions which can be problematic
Which medication is specifically mentioned as having a mnemonic related to its usage?
Venlafaxine (Effexor)
For a client concerned about sexual side effects, which medication would be the most appropriate choice?
Bupropion (Wellbutrin)
Which antipsychotic is stated to have the longest half-life among the options?
Fluoxetine (Prozac)
The text suggests avoiding which type of medication for clients who cannot afford treatment?
$MAOIs due to dietary restrictions$
What is a symptom associated with decreased positive affect due to DA and NE dysfunction?
Loss of joy
Which neurotransmitters are related to symptoms of increased negative affect?
NE and 5HT
What is a common symptom of mood disorder linked to 5HT and NE dysfunction?
Hostility
Why should Lurasidone be taken with food?
To prevent gastrointestinal upset
What is the starting dose adjustment recommended for patients with renal failure prescribed lithium carbonate?
Reduce the dose by at least 50%
Which two medications can potentially increase lithium levels in the body?
NSAIDs and ACE Inhibitors
Why do clinicians monitor labs for patients on lithium treatment?
To monitor electrolyte balance
What is required by the FDA for antidepressants in their product labeling?
'Black box' warnings on potential risks of mania
What is the primary purpose of using antidepressant medications in clients with bipolar disorder?
To prevent the onset of a hypomanic or manic episode
Which medication is commonly used for the maintenance therapy of bipolar disorder?
Lamotrigine (Lamictal)
Which medication is primarily used for the acute treatment of mania in bipolar disorder?
Valproic acid (Depakote)
Which class of medications is typically used to treat acute bipolar depression?
Antipsychotics
What is a key consideration when prescribing medications to clients with bipolar disorder who have a lack of adherence to the medication regimen?
Prescribing a medication with a longer half-life
What is the primary distinguishing feature between Bipolar I and Bipolar II disorders?
The duration of manic episodes
What is the prevalence of Major Depressive Disorder (MDD) among adults in the United States?
Approximately 7.1%
Which medication is commonly used for the treatment of rapid cycling in bipolar disorder?
Lithium (Priadel)
What can happen if major depressive disorder (MDD) is mistaken for bipolar depression and treated with antidepressant therapy?
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.
Which neurotransmitter is targeted by SSRI medications to inhibit their reuptake?
Serotonin (5HT)
What is the most common side effect of SSRI medications?
Sexual dysfunction
Which SSRI medication has mild antihistamine effects?
Citalopram (Celexa)
Which SSRI medication should be prescribed to a client who suffers from hypersomnolence and social anxiety?
Sertraline (Zoloft)
Which medication that treats both anxiety and depression needs to be increased if the client actively smokes?
Fluoxetine (Prozac)
Which SSRI is recommended for a patient who suffers from insomnia and social anxiety?
Paroxetine (Paxil)
Which age group is most at risk for antidepressant-induced suicide?
Adults under 25
Which medication is recommended for patients who have difficulty falling and staying asleep?
Trazodone (Desyrel)
Which neural circuit is associated with reward and addiction?
Dopaminergic pathway
What is a potential requirement before initiating certain addiction medications?
Gradually tapering off the substance of abuse
Which substance of abuse primarily affects the dopaminergic pathway?
Stimulants
What is a potential sign or symptom of substance abuse that may be observed during a physical exam?
All of the above
Which medication class is FDA-approved for the treatment of addiction?
Opioid agonists/antagonists
What is the recommended time frame for initiating addiction medications?
After a period of detoxification and stabilization
What is an important aspect of client education for addiction medications?
All of the above
Which medication is most appropriate for a patient who has difficulty falling and staying asleep at night?
Trazodone (Desyrel)
Which brain region is primarily associated with the reward and addiction circuits?
Mesolimbic pathway
What is a potential requirement before initiating certain addiction medications?
Gradually tapering off the substance of abuse
Which substance of abuse primarily affects the dopaminergic system?
Stimulants
Which of the following is an important aspect of client education when prescribing addiction medications?
All of the above
Which class of medications is typically recommended as first-line treatment for restless leg syndrome (RLS)?
Dopamine agonists
What is the primary mechanism of action of the medication class used to treat Alzheimer's disease?
Inhibiting acetylcholinesterase
Which biomarker is commonly used in research to support the diagnosis of Alzheimer's disease?
Increased levels of amyloid-beta
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?
Orexin
Which medication class is contraindicated in patients with moderate to severe dementia due to an increased risk of adverse effects?
Antipsychotics
Which medication class is commonly used in combination with antidepressants for the treatment of bipolar depression?
Mood stabilizers
Which medication class is recommended for patients who may forget to take their medication on time?
Medications with a longer half-life
Which medication has the lowest risk of sexual side effects, according to the text?
Bupropion (Wellbutrin)
Which class of antidepressants is known for improving cognition and reducing brain fog?
Serotonin-norepinephrine reuptake inhibitors (SNRIs)
Which medication class should be avoided for clients with comorbid anxiety due to the potential of worsening symptoms?
Medications that target norepinephrine
If cost is a significant factor, which consideration should be made when prescribing medications?
Keep cost, insurance benefits, and pharmaceutical assistance programs in mind
Which medication class is mentioned in the text as having a mnemonic to help remember its members?
Serotonin-norepinephrine reuptake inhibitors (SNRIs)
Which symptom is most indicative of bipolar I disorder?
All of the above
What is the primary reason for directly asking about mania symptoms, according to the text?
To differentiate between major depressive disorder and bipolar I disorder
Which medication is extracted from a substance found in daffodils?
Galantamine (Razadyne)
Which dementia medication should not be stopped abruptly due to potential withdrawal effects?
Memantine (Nemdatine)
Which brain region is most likely affected when a patient experiences racing thoughts and grandiosity?
The text does not specify a brain region for these symptoms
What is a potential consequence of misdiagnosing bipolar depression as major depressive disorder?
Precipitating a manic episode or inducing rapid-cycling bipolar depression
Which medication is the first-line treatment for dementia-related agitation?
Quetiapine (Seroquel)
Which of the following statements about patients with bipolar disorder is true, according to the text?
They are reluctant to report mania or hypomania symptoms.
Which cytochrome P450 enzyme is not involved in the metabolism of certain dementia medications?
CYP1A2
What is a potential mechanism for the gastrointestinal side effects caused by certain dementia medications?
Increased acetylcholine levels in the gut
What is the primary risk associated with misdiagnosing bipolar depression as major depressive disorder, according to the text?
Increased incidence of death by suicide
Which action can help decrease gastrointestinal side effects from dementia medications?
All of the above
What action should the PMHNP take when a patient experiences diarrhea and an upset stomach after starting a newly prescribed SSRI?
Suggest that most adverse effects will subside after 4-5 days once the body adjusts to increased serotonin levels.
Why is Escitalopram considered the best-tolerated SSRI with the fewest CYP interactions?
It is metabolized by fewer liver enzymes, reducing drug interactions.
Which age group is most at risk when prescribed an SSRI, and why?
Elderly, due to an increased risk of serotonin syndrome.
Why is L-Methylfolate recommended as an adjunct in depression treatment?
To support neurotransmitter synthesis and enhance antidepressant effectiveness.
Which medication should be avoided in clients with anxiety, as it can exacerbate anxiety symptoms?
Fluvoxamine (Luvox)
What distinguishes SNRIs from other antidepressants like SSRIs in terms of mechanism of action?
SNRIs inhibit both 5HT and NE reuptake while increasing DA in the prefrontal cortex.
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?
Recommend taking the medication in the morning as it is not intended to be a sedative.
How does trazodone work to treat Major Depressive Disorder (MDD)?
Trazodone potently blocks serotonin, allowing more 5-HT to interact at postsynaptic sites.
Which of the following is a serious adverse effect of trazodone that is considered a medical emergency?
Priapism
Why are tricyclic antidepressants (TCAs) not used as first-line treatment for depression?
TCAs have a high incidence of adverse effects and risk of potential overdose and death.
Which neurotransmitter systems are affected by norepinephrine-dopamine reuptake inhibitors (NDRIs) like bupropion (Wellbutrin)?
Dopamine and norepinephrine
When should trazodone be taken for the treatment of insomnia in Major Depressive Disorder (MDD)?
Trazodone should be taken at bedtime due to its sedative effects.
Which medication is effective for treating the manic episodes of bipolar disorder?
Lithium (Priadel)
What is the primary reason for monitoring lithium levels in patients?
Lithium has a narrow therapeutic window and requires lab draws
Which class of medications can increase lithium levels?
NSAIDs and ACE inhibitors
What is the primary mechanism behind the gastrointestinal side effects of serotonin-related medications?
The presence of 90% of 5HT receptors in the GI tract
Which medication is mentioned in the text as having a mnemonic to help remember its members?
None of the above
Which medication is associated with a potential adverse effect that requires ECG monitoring?
Citalopram (Celexa)
Why would a clinician avoid prescribing certain medications to clients with COPD or hepatic impairment?
The medications are metabolized by the liver, leading to toxicity.
Why do dementia medications often cause gastrointestinal (GI) distress?
They alter cholinergic activity in the gut.
Which medication is generally made from a substance that is extracted from daffodils?
Galantamine (Razadyne)
Why should some medications not be stopped abruptly?
To prevent rebound symptoms
Which medication is considered the first-line treatment for dementia-related agitation?
Haloperidol (Haldol)
What action can help decrease gastrointestinal (GI) side effects caused by certain medications?
Dividing the medication into smaller doses throughout the day
Which class of medications are considered the last choice for treating depression due to potential serious side effects?
Monoamine Oxidase Inhibitors (MAOIs)
Which type of MAOI is used as an antidepressant and anxiolytic?
MAOI-A
Which foods should be avoided when taking an MAOI?
Foods high in tyramine, such as red wine, aged cheese, and smoked meats
Why do MAOIs increase the risk of a hypertensive crisis when ingesting foods high in tyramine?
MAOIs inhibit the breakdown of tyramine in the gut
What medications should be avoided when taking MAOIs, and why?
Serotonergic agents, because they increase the risk of serotonin syndrome
How many half-lives of a serotonergic medication should occur before starting an MAOI?
5 half-lives
This quiz challenges your ability to select the best medication for specific clinical situations, such as nicotine replacement and eating disorders. It also tests your knowledge on medications to avoid in clients with eating disorders or those that increase the risk for QTc prolongation.
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