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NSG 552 Psychopharmacology Exam 1 - Modules 1-3(2025) Actual Exam Questions and Answers A+, Exams of Nursing

Hampton University (HU)Nursing

NSG 552 Psychopharmacology Exam 1 - Modules 1-3(2025) Actual Exam Questions and Answers A+ Graded.pdf

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NSG 552 Psychopharmacology Exam 1 - Modules 1-
3(2025) Actual Exam Questions and Answers A+ Graded
1.
Pharmacokinetics: .Studies .how .the .body .acts .on .the .drug
2.
Pharmacodynamics: .Studies .how .the .drug .acts .on .the .body
3.
First-generation .antipsychotic: .- .first .developed .in .the .1950s, .first .available
.treatment .for .psychosis .- .aka .typical .antipsychotics
-
increased .risk .for .EPS, .Tardive .dyskinesia
-
d2 .blocker
-
Currently .11 .FDA-approved .and .commerically .available .FGAs
-
Most .common .differences .between .individual .FGAs .are .their .potency .and .side
.effects
-
examples .include .Thorazine .(chlorpromazine), .Haldol .(haloperidol), .Prolixin
.(fluphenazine), .perphenazine .(Trilafon
4.
Second-generation .antipsychotic: .- .examples .include .Abilify .(aripiprazole),
.Seroquel .(quetiapine), .Zyprexa .(olanzapine), .Risperdal .(risperidone), .Clozaril
.(clozapine)
-
lower .risk .of .EPS .symptoms .compared .to .1st .gen
-
higher .risk .of .metabolic .side .effects
-
serotonin-dopamine .receptor .antagonists
-
AKA .atypical .antipsychotics
5.
EPS: .Involuntary .movements .that .occur .as .a .side .effect .to .certina .medications.
.AKA .drug .induced .movement .disorder. .May .include .tardive .dyskinesia, .dystonic
.reactions, .parkinsons-like .symptoms, .akathesia, .NMD, .akinesia
-
Can .be .acute .or .chronic
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Download NSG 552 Psychopharmacology Exam 1 - Modules 1-3(2025) Actual Exam Questions and Answers A+ and more Exams Nursing in PDF only on Docsity!

NSG 552 Psychopharmacology Exam 1 - Modules 1 -

3 (2025) Actual Exam Questions and Answers A+ Graded

  1. Pharmacokinetics:. Studies .how .the .body .acts .on .the .drug
  2. Pharmacodynamics:. Studies .how .the .drug .acts .on .the .body
  3. First-generation .antipsychotic:. - .first .developed .in .the .1950s, .first .available .treatment .for .psychosis .- .aka .typical .antipsychotics
  • increased .risk .for .EPS, .Tardive .dyskinesia
  • d2 .blocker
  • Currently. 11 .FDA-approved .and .commerically .available .FGAs
  • Most .common .differences .between .individual .FGAs .are .their .potency .and .side .effects
  • examples .include .Thorazine .(chlorpromazine), .Haldol .(haloperidol), .Prolixin .(fluphenazine), .perphenazine .(Trilafon
  1. Second-generation .antipsychotic:. - .examples .include .Abilify .(aripiprazole), .Seroquel .(quetiapine), .Zyprexa .(olanzapine), .Risperdal .(risperidone), .Clozaril .(clozapine)
  • lower .risk .of .EPS .symptoms .compared .to .1st .gen
  • higher .risk .of .metabolic .side .effects
  • serotonin-dopamine .receptor .antagonists
  • AKA .atypical .antipsychotics
  1. EPS:. Involuntary .movements .that .occur .as .a .side .effect .to .certina .medications. .AKA .drug .induced .movement .disorder. .May .include .tardive .dyskinesia, .dystonic .reactions, .parkinsons-like .symptoms, .akathesia, .NMD, .akinesia
  • Can .be .acute .or .chronic

NSG. 552 .Psychopharmacology .Exam. 1 .- .Modules. 1 - 3

  1. Affinity:. The .property .of .a .drug .that .describes .its .ability .to .bind .to .a .receptor .Constant Unique .for .each .drug-receptor .pair .as .it .is .dependent .on .each .of .their .structures
  2. CYP450:. - .membrane-bound .hemoproteins .that .play .a .pivotal .role .in .the .detoxification .of .xenobiotics, .cellular .metabolism, .and .homeostatis -Inhibitition .or .induction .of .CYP .enzymes .is .a .major .mechanism .underlying .drug- .drug .interactions
  • A .CYP450 .inhibitor .prevents .or .reduces .work .by .CYP450 .enzymes .= .decreased .drug .metabolism .and .increased .risk .for .toxicity
  • A .CYP450 .inducer .increases .rate .of .hepatic .metabolism .= .decreased .serum .concentation .of .other .drugs .metabolized .by .the .same .hepatic .isoenzyme .Grapefruit .juice .is .an .inhibtior, .which .can .increase .serum .levels .of .certain .drugs
  1. Dopamine .Pathways:. - .mesolimbic .(positive .sx)
  • mesocortical .(negative .sx)
  • nigrostriatal .(EPS)
  • tuberoinfundibular .(prolactin)
  1. Metabolic .Syndrome:. cluster .of .conditions .that .incerase .risk .for .T2DM .and .cardiovascular .disease .(obesity, .HTN, .high .triglycerides, .low .HDL, .insulin .resistance) .-increased .risk .for .metabolic .syndrome .found .with .some .antipsychotic .medications, .primarily .SGA

NSG. 552 .Psychopharmacology .Exam. 1 .- .Modules. 1 - 3

  1. High .Potency .vs .Low .Potency:. High .potency: .higher .risk .for .EPS/hyperprolactinemia. .Effective .at .lower .doses. .Haldol, .risperdal, .prolixin, .olanzapine Low .potency: .more .sedating .with .more .anticholinergic .symptoms. .Thorazine, .seroquel, .clozaril, .geodon
  2. Neuroleptic .malignant .syndrome .(NMS):. - .Life .threatening
  • occur .with .use .of .dopamine .receptor .antagonists .or .when .dopaminergic .medidcation .are .suddenly .withdrawn
  • sx .usually .begin .within. 2 .wks .of .starting .a .new .med .or .changing .dose.
  • Characterized .by .fever, .AMS, .muscle .rigidity, .autonomic .dysfuncton
  • Dantrolene .sodium .is .FDA .approved .to .treat. .Muscle .relaxant .that .reduces .hyperthermia/muscle .stiffness
  1. QTC .interval:. -measurement .of .the .left .ventricle's .repolarization .efficiency .on .ECG.
  • .usually .350-450 .(men), .360-460 .(women) -associated .with .life-threatening .cardiac .arrhythmias -antipsychotic .and .antidepressant .drugs .can .prolong .QT .intervals, .some .more .than .others
  1. The .study .of .the .use .of .psychotropic .medications .in .the .treatment .of .psychiatric .disorders::. Psychopharmacology
  2. The .study .of .what .the .body .does .to .drugs::. Pharmacokinetics
  3. The .study .of .what .drugs .do .to .the .body::. Pharmacodynamics

NSG. 552 .Psychopharmacology .Exam. 1 .- .Modules. 1 - 3

  1. Decreased .dopamine .in .this .pathway .is .associated .with .negative .symptoms::. mesocortical
  2. Decreased .dopamine .in .this .pathway .produces .motor .symptoms:: nigrostriatal
  3. Main .inhibitory .neurotransmitter .that .induces .calmness .and .relaxation:: Gamma-aminobutyric .acid .(GABA)
  4. Main .excitatory .neurotransmitter::. glutamate
  5. Major .organ .that .breaks .down .drugs .in .the .body=:. liver
  6. Electrolyte .imbalance .commonly .associated .wtih .psychotropic .medication::. hyponatremia
  7. The .time .needed .to .clear .50% .of .drugs .from .the .plasma::. half-life

  1. The .process .of .becoming .desensitized .and .less .responsive .to .a .particular .medication .dose .overtime .necessitating .an .increase::. Drug .tolerance/desensitization

  2. A .ration .describing .toxic .dose .to .effective .dose::. Therapeutic .index

  3. A .chemical .that .binds .to .a .receptor .to .produce .a .biologic .response:: Agonist

  4. A .chemical .that .binds .to .a .receptor .but .does .not .fully .activate .the .receptor::. partial .agonist

  5. A .chemical .that .binds .to .a .receptor, .blocking .it .to .inhibit .a .biologic .response::. Antagonist

  6. An .agent .that .binds .to .the .same .receptor .as .an .agonist .but .induces .an .opposite .biological .response::. inverse .agonist

  7. A .usually .undesired .but .forseeable .effect .that .occurs .regardless .of .dose .and .often .resolves .after .continued .therapy::. side .effect

  8. S/S .opposite .of .what .it .was .meant .to .treat::. paradoxical .reaction

  9. CYP450 .interactions .are .part .of::. Metabolism

  10. Escitalopram .is .a .CYP450-3A4 .substrate. .If .the .PMHNP .adds .a .second .medication .that .is .a .3A4 .inducer, .what .happens .to .the .escitalopram .levels?:. They .decrease

  11. Binding:. A .protein, .macromolecule, .nucleic .acid, .or .small .molecule .to .which .a .given .drug .binds, .resulting .in .an .alteration .of .the .normal .function .of .the .bound .molecule .and .a .desirable .therapeutic .effect.

  12. Affinity:. the .extent .or .fraction .to .which .a .drug .binds .to .receptors .at .any .given .drug .concentration

  1. What .are .the .metabolic .side .effects .associated .Atypical .antipsychotics:: . Hyperglycemia, .glucose .disregulation, .lipid .disturbance. .Leading .to .HTN/DMII/metabolic .d/o
  2. Includes .medications .such .as .Haloperidol, .chlorpromazine, .fluphenazine, .perphenzine::. FGA
  3. Medications .for .acute .agitation .or .psychosis::
  4. Includes .medications .such .as .Olanzapine, .Quetiapine, .Risperidone, .Clozapine, .etc::. SGA
  5. FGA .reduce .dopamine .transmission .by .blocking. .receptors::. D
  6. SGA .block .both. and. receptors::. D .and .Serotonin .(usually .with .5-HT2A)
  7. High .incidence .of .QTC .prolongation, .Tardive .dyskinesia, .Neuroleptic .Malignant .Syndrome .(NMS), .orthostatic .hypotension::. Typical
  8. H1 .blockade .leads .to .symptoms .of. and. :: sedation .and .weight .gain
  9. Involuntary .teeth .grinding .associated .with .antipsychotics::. Bruxism
  10. Safest .and .best .tolerated .anticonvulsant .for .patients .taking .clozapine .who .experience .dose-related .seizures::. valproate
  11. Less .incidence .of .antiadrenegic, .anticholinergic .and .antihistamine .side .effects .but .greater .EPS::. Higher .potency .antipsychotics
  12. Greater .incidence .of .antiadrenergic .anticholinergic .and .antihistamine .side .effects .but .less .EPS::. Lower .potency .antipsycotics
  1. Characterized .by .bradykinesia, .mask-like .face, .cogwheel .rigidity, .pill .rolling, .tremor::. Parkinsonian .side .effects
  2. Characterized .by .torticollis, .oculogyric .crisis, .and .can .be .life .threatening .if .it .affects .the .airway::. Acute .dystonia
  3. Characterized .by .an .internal .and .external .restlessness, .constant .need .to .pace .or .walk::. akithesia
  4. Onset .of .symptoms .for .dystonia::. hours .to .days .after .starting .treatment . 80. Onset .of .symptoms .for .Parkinsonism/Akathisia::. days .to .weeks .after .starting .antipsychotic .treament
  5. Onset .of .symptoms .of .Tardive .Dyskinesia::. late .onset. .Usually .months .to .years .after .initiating .antipsychotic .treatment.
  6. T/F .Medications .for .EPS .such .as .Cogentin, .Benadryl, .and .benzos .should .not .be .co-prescribed .to .prevent .EPS. .Why .or .why .not?:. True .- .the .medicaitons .shouldn't .be .prescribed .prophylacticalyl .as .there .is .then .an .increased .risk .for .anticholinergic .side .effects
  7. First-line .treatment .for .dystonia:. Cogentin
  8. First .line .treatment .for .akathisia:. Propranolol
  9. Occurs .due .to .D2 .blockade .in .the .nigrostriatal .pathway .and .is .mostly .irreversible::. Tardive .dyskinesia
  10. Characteristics .of .Tardive .Dyskinesia::. blinking .eyes .rapidly, .smacking .lips, .puffing .out .cheeks, .grunting, .frowning/grimacing, .chewing .motions .sticking .tongue .out .or .poking .it .into .inside .of .the .cheek .etc
  11. Atypical .antipsychotic .less .likely .to .cause .Tardive .Dyskinesia::. Clozaril. .Can .be .used .to .treat .tardive .dyskinesia.
  1. T/F: .Patients .started .on .Clozapine .need .to .be .registered .in .the .Clozapine .REMS .system:. T
  2. A .patient .newly .started .on .Clozapine .will .require .ANC .Monitoring x. months:. Weekly .for. 6 .months
  3. Parameters .that .require .monitoring .at .baseline .and .ongoing .once .a .patient .is .started .on .an .SGA::. Weight, .BMI, .BP, .FBG/AIC, .FLP
  4. Symptoms .of .gynecomastia, .erectile .dysfunction, .galactorrhea, .absence .of .menses, .are .all .indicative .of .D2 .blockade .in .the pathway .and .suggestive .of. .: . Tuberoinfundibular, .hyper-prolactin .104.. When .should .a .provider .consider .a .long-acting .antipsychotic .injectables?: 105.. Blackbox .warning .assocaited .with .antipsychotic .use .in .dementia ?:. increased .risk .of .death .and .CVA .events .106. may .occur .when .stopping .or .reducing .an .antipsychotic .medication. .What .are .the .characteristics?:. WIthdrawal. .N/V/D
  5. Antipsychotic .is .helpful .and .improve .symptoms .of .Tardive .Dyskinesia:: clozaril
  6. The .primary .managment .of .patients .who .experience .tardive .dyskinesia::. Limiting .drug .exposure, .stopping .antipsychotic .(with .slow .taper), .or .switching .to .an .SGA .like .clozapril .or .quetiapine. .Tetrabenazine .or .other .VMAT .inhibitor. Amantadine, .benzos, .beta .blockers, .levitracitam,
  7. In .obese .patients .seeking .antipsychotic .medications, .the .clinician .should .avoid .medications .that .blocks::. HT2C .and .5-HT1A .receptors, .histamine

H1 .receptor .and .dopamine .D2 .receptor .among .others. .Antipsychotics .differ .in .their .ability .to .block .these .receptors .and .this .partly .explains .their .different .liability .to .cause .weight .gain. .Both .olanzapine .and .clozapine, .drugs .with .a .high .risk .of .weight .gain, .bind .strongly .to .the .histamine .H1 .and .serotonin .5-HT2C .receptors.

  1. Antipsychotics .must .occupy .more .than. % .of. .receptors .to .cause .EPS::. 75-80% .of .D2 .receptors
  2. Auto-induction::. occurs .when .a .drug .produces .enymes .that .are .responsible .for .its .own .metabolism
  3. anticonvulsant::. a .drug .used .to .treat .epileptic .fits .and .other .convulsant .disorders
  4. Monoamine::. a .class .of .chemicals .characterized .by .a .single .amine .group; .monoamine .neurotransmitters .include .dopamine, .norepinephrine, .and .serotonin
  5. Catecholamine:. a .monoamine .neurotransmitter. .Includes .dopamine, .norepinephrine, .epiniephrine ..
  6. Stevens-Johnson .Syndrome::. Stevens-Johnson .syndrome/toxic .epidermal .necrolysis .is .a .rare, .acute, .serious, .and .potentially .fatal .skin .reaction .in .which .there .are .sheet-like .skin .and .mucosal .loss .accompanied .by .systemic .symptoms. .Medications .are .causative .in .over .80% .of .cases. .Anticonvulsants .are .the .most .likely .causative .agent.
  7. 5-HT:. another .name .for .serotonin, .a .monoamine .neurotransmitter
  8. Monoamines .refer .to::. Molecule .containing .one .amino .group .connected .to .an .aromatic .ring .by .a .two-carbon .chain .that .can .act .as .a .neurotransmitter .or .neuromodulator. .Includes .catecholemines .dopamine .and .norepinephrine, .as .well .as .serotonin

gastrointestinal .(nausea, .diarrhea, .constipation) .excessive .sweating .sexual .dysfunction SSRI-induced .anxiety/agitation .during .intial .treatment/dose .titration

  1. SSRI .most .lethal .in .overdose .and .associated .with .dose .dependent .QTC .prolongation .in .doses. 40 .mg+:. Citalopram
  2. SSRI .with .the .most .GI .side .effects .and .should .be .given .with .food .to .increase .bioavailability:. Sertraline
  3. SSRI .considered .to .be .generally .favored .during .pregnancy .and .nursing: Sertraline
  4. Duloxetine, .venlafaxine .are .both .examples .of .which .class .of .antidepressants:. SNRIs
  5. Fluoxetine, .Paroxetine, .sertraline, .citalopram .are .all .examples .of .which .class .of .antidepressants?:. SSRI
  6. Buproprion .is .an .example .of .which .class .of .antidepressants?:. NDRI
  7. Imipramine, .Nortriptyline, .Clomipramine .are .examples .of .which .class .of .antidepressants?:. Tricyclics
  8. Isocarboxazid .(Marplan), .Selegiline .(Emsam), .and .Phenelzine .(Nardil) .are .examples .of .which .class .of .antidepressants?:. MAOIs
  9. MOA .of .Buproprion:. Weakly .inhibits .reuptake .of .NE .and .dopamine. .May .also .stimulate .the .presynaptic .release .of .NE/dopamine .138.. Target .symptom .of .Buproprion:. depression
  10. Contraindications .for .buproprion:. seizure .d/o .and .eating .d/o
  11. Antidepressant .with .less .GI .distress, .that .is .weight .neutral .and .lacks .sexual .side .effects::
  1. MOA .of .trazodone:. Blocks .serotonin .2A .(5ht2a) .and .5ht2C .receptors. .Serotonin .receptor .antagonist
  2. Associated .with .prolonged .erection .(priaprism):. Trazodone
  3. Great .antidepressant .especially .for .elderly .patients .who .exhibit .symptoms .of .weight .loss .and .insomnia:. mirtazapine
  4. Class .of .antidepressant .associated .with .the .most .anticholinergic, .antiadrenergic, .antihistamine, .EKG .and .cardiac .dysrhythmias:. tricyclics
  5. Common .side .effects .associated .with .TCAs:. Anticholinergic .(Blurred .vision, .dry .mouth, .constipation) .antihistaminic .(Sedation .and .weight .gain) .anti-a-adrenergic .effects .(orthostatic .hypotension .and .tachycardia)
  6. Class .of .antidepressants .that .has .the .most .lethality .in .overdose, .hence .patients .should .only .be .given .a .few .days .to .max .of. 1 .week .prescription .if .high .risk::. tricyclics
  7. TCA .commonly .used .for .enuresis::. imipramine .- .helps .to .relax .the .bladder .muscle .and .contract .the .smooth .muscles .at .the .bladder .neck
  8. TCA .commonly .used .for .the .managment .of .OCD::. Clomipramine .(Anafranil) .- .inhibits .presynaptic .reuptake .of .serotonin
  9. TCA .Commonly .used .for .chronic .pain, .migraines, .and .insomnia: amitriptyline
  10. TCA .considered .to .be .generally .safe .in .the .geriatric .population: Nortryptyline .- .due .to .no .sedative .effect .and .weaker .anticholinergic .effect
  11. T.C.A. .which .has .a .similar .side .effect .profile .to .typical .antipsychotics .and .may .cause .E.P.S::
  12. TCA .most .lethal .in .overdose::. desipramine
  1. Antidepressants .with .the .lowest .incidence .of .sexual .dysfunction:: Atypical .antidressants .like .Wellbutrin .and .Remeron
  2. Treatment .of .SSRI .induced .sexual .dysfunction::. Buproprion .and .PDE- .(sildenafil)
  3. Clinical .manifestation .of .antidepressant .discontinuation .syndrome:: The .mnemonic .FINISH .summarizes .the .symptoms .of .antidepressant .discontinuation .syndrome: = .Flu-like .symptoms .(lethargy, .fatigue, .headache, .achiness, .sweating),
  • Insomnia .(with .vivid .dreams .or .nightmares),
  • Nausea .(sometimes .vomiting),
  • Imbalance .(dizziness, .vertigo, .light-headedness),
  • Sensory .disturbances .("burning," ."tingling," ."electric-like" .or ."shock-like" .sensations) .and
  • Hyperarousal .(anxiety, .irritability, .agitation, .aggression, .mania, .jerkiness).
  1. Clincal .manifestation .of .serotonin .syndrome::. AMS .Autonomic .Nervous .System .Overactivity Neuromuscular .Hyperactivity
  2. Antidepressant .medication .options .approved .for .use .in .pediatrics::. FDA .approved .for .treatment .of .depression: -Prozac .(8 .and .up) -Lexapro .(12 .and .up)
  3. Black .box .warning .assocated .with .antidepressant .use .in .children .and .adolescents::. Increased .risk .of .suicidality/self-harm .thoughts
  1. Sedating .antidepressants::. Atypical .tricyclic .(trazodone, .doxepin, .mirtazepine, .amitriptyline)
  2. Activating .antidepressants::. Prozac .and .wellbutrin
  3. Gold .standard .treatment .for .Bipolar .1::. Lithium
  4. FDA .approved .medications .for .bipolar .maintenance .treatment:: Monotherapy: .Lithium, .Lamictal, .Olanzapine, .Aripiprazole, .Risperidone .LAI Combos: .Aripiprazole .+ .Lithium .or .Depakote .Quetiapine .+Lithium .or .Depakote .Ziprasidone .+ .Lithium .or .Depakote .Risperdal .LAI .+ .Lithium .or .Depakote
  5. Mood .stabilizer .with .antisuicidal .properties::. Lithium
  6. Normal .lithium .level::. 0.6-1.2 .mEq/L
  7. Labs .to .obtain .prior .to .starting .lithium::. T.S.H., .creatinine, .B.U.N., .U.P.T., .C.B.C., .C.M.P., .E.K.G .for .over. 50 .years
  8. Signs .of .early .lithium .toxicity::. Nausea, .vomiting, .diarrhea, .thirst, .polyuria, .slurred .speech, .muscle .weakness
  9. Signs .of .late .ltihium .toxicity::. Kidney .failure, .polydipsia, .changes .in .urinary .frequency, .memory .disorders, .movement .disorders .(ie .tremors, .twitching)
  10. Factors .that .can .increase .Lithium .levels::. Kidney .dysfunction, .thyroid .disease, .being .over .50, .diabetes .insipidus
  11. An .equilibrium .is .reached .after. days .of .regular .lithium .intake.:. 5-7 .days
  12. Gold .standard .for .rapid-cycling .mania::. mood .stabilizers