Week 3 Quiz
#1 is C.
The diffusion of neurotransmitter to nearby neurons.
The flow of neurotransmitter from postsynaptic neuron to presynaptic neuron
Clozapine levels would decrease, placing the patient at risk for re-emergence of psychotic symptoms.
Antagonist, in the presence of an agonist, can return a channel to resting state.
Concurrent use of some medications can slow absorption.
Classic synaptic neurotransmission
Protein binding of psychotropic drugs can impact their availability at receptor sites.
Environmental factors can alter a neuron’s gene expression.
Metabolism of the drug in the liver, prior to reaching systemic circulation
Pharmacodynamics- Action of drugs on the body
Pharmacokinetics- Action of the body on the drugs
Axon- The fiber-like part of the neuron that sends information to receiving neurons
Ionic filter- Regulates the flow of ions in ligand-gated channels
Excitation-secretion coupling- The conversion of an electrical signal to a chemical signal
Dendrite- The point of contact for receiving information from neurons in the classical neurotransmission
Haloperidol levels would increase, placing the patient at risk for antipsychotic side effects.
A Mediterranean diet.
Allosteric modulators can enhance or inhibit ion channels when in the presence of neurotransmitter.
Receptor binding site of the drug
Influence gene expression
Intracellular messengers activated by extracellular messengers.
Accumulation of psychotropic drugs occurs faster in the brain then adipose tissue.
Bind enzymes that synthesize second messengers.
Therapeutic blood monitoring of carbamazepine should not occur before 2 ½ days of starting the medication.
Steady-state refers to the point at which blood level fluctuations are mild and not clinically significant.
Gene expression and phosphoproteins.
Phase I metabolism refers to CYP450 enzyme activity whereas Phase II metabolism refers to conjugation of drug.
A means of preventing the degradation of neurotransmitters.
Week 4 Quiz
Atypical antipsychotics are not approved for the treatment of geriatric dementia-related psychosis and carry increased risk of mortality in this population.
They have the clinical profile of equal positive symptom antipsychotic actions but low extrapyramidal symptoms and less hyperprolactinemia compared to conventional antipsychotics.
Cognitive symptoms are the strongest correlate of real-world functioning in schizophrenia.
Muscarinic anticholinergic receptor blockade- Constipation, blurred vision, dry mouth, and drowsiness.
Histamine H1 receptor blockade- Weight gain and drowsiness
Alpha-1 adrenergic receptor blockade- Orthostatic hypotension and drowsiness.
Conventional antipsychotics are thought to block dopamine at the D2 receptor equally in dopamine neural circuits.
Elderly patients may develop tardive dyskinesia sooner in treatment than younger patients.
Patients taking atypical antipsychotics are at increased risk for diabetes and cardiovascular disease.
Chronic blockade of D2 receptors in the nigrostriatal dopamine pathway may result in tardive dyskinesia.
Tyrosine is a precursor to dopamine.
For antipsychotics with high anticholinergic, antihistaminergic and anti-alpha 1 adrenergic side effects, it is best to taper slowly to minimize withdrawal effects.
Stress from the environment can cause abnormal expression or abnormal silencing of normal genes which are associated with schizophrenia.
Patients with a history of neuroleptic malignant syndrome should not be initiated on LAI antipsychotics.
Diet and lifestyle education should be included as a strategy for reducing risk of metabolic syndrome.
Hyperactivity of the mesolimbic dopamine pathway may account for positive symptoms of schizophrenia.
EPS and Tardive dyskinesia are the result of dopamine blockade in the nigrostriatal pathway.
Hypoactivity of the mesocortical dopamine pathway is thought to be associated with negative and cognitive symptoms of schizophrenia.
Inhibition of dopaminergic neurons in the nigrostriatal dopamine pathway leads to increased prolactin levels.
These symptoms would best respond to a beta blocker.
Neuroleptic malignant syndrome could be mistaken for another side effect early in its progression.
FYI: Ingrezza (valbenazine) is now approved or the treatment of tardive dyskinesia (TD),
FYI: Dentrolene is for (NMS) Neuroleptic malignant Syndrome – s/s confusion/agitation/high temp/seizures, for patients who are placed on a 1st or generation aka typical antipsychotic.
FYI: For acute dysyonia use Benadryl / Akathisia use BB propanolol
Week 6 Quiz
Tyramine is metabolized by monoamine oxidase.
Escitalopram- Is considered to have fewest side effects and drug-drug interactions
Fluvoxamine- Is not FDA approved for depression in the US
Sertraline- Has dopamine transported inhibition
Paroxetine- Has the largest side effect profile and most drug-drug interactions of SSRIs
Fluoxetine- Is considered activating
Citalopram- Carries warnings about QTc prolongation in higher doses
Venlafaxine can cause hypertension at higher doses.
Standard rTMS treatments occur once a weekday for six weeks.
A bowl of ice cream.
The recommended length of treatment depends on the number of depressive episodes that a patient has had.
Trazodone is an effective hypnotic at low doses.
Neural circuits are hypothesized to account for variability in depression presentation.
Monoamine oxidase inhibitors- Can cause hypertensive crisis when combined with other antidepressants or foods containing tyramine, phenylalanine, tryptophan or tyrosine.
Tricyclic antidepressants (TCA’s)- Have overdose toxicity with as little as a 10 day supply.
Selective serotonin reuptake inhibitors- Are considered safe in overdose.
A patient has two adequate trials of antidepressants and fails to respond to treatment.
Bupropion may have a mild benefit in ADHD.
ECT has a rapid onset of action for depression.
Antidepressant use lowers the incidence of suicide in parents over 65.
STAR*D findings suggest the antidepressant non-responders should be switched to a different medication, whereas partial responders should be augmented.
Patients that achieve remission are less likely to relapse.
Symptoms of hyponatremia include lethargy, delirium, an nausea.
They have histaminergic side effects of weight gain and sedation.
Duloxetine carries risks for liver toxicity and should be avoided in patients with liver disease.
Misdiagnosis should be considered as a factor in non- or partial responders.
Can lead to increased risk of dental caries.
Concurrent use of antidepressants and NSAID’s can increase risk of bleeding.
SSRIs cause the indirect downregulation of 5HT1A autoreceptors, increasing neuronal impulse flow.
Discussing possible side effects before starting medication is associated with parents staying on medications longer.
Desvenlafaxine likely no more efficacious venlafaxine.
Psychotherapy can work synergistically with psychotropic medication.
BDNF is dysregulated in stress.
Risks of atypical antipsychotics (metabolic issues, EPS) should be considered before prescribing as an augmentation strategy.
The monoamine receptor hypothesis posits that dysregulation of monoamine receptors alters molecular events such as gene expression.
While both syndromes have muscular symptoms, only serotonin syndrome has hyperreflexia and myoclonus.
Mirtazapine has side effects of weight gain and sedation.
Week 8 Quiz
Generalized anxiety disorder.
Carbamazepine- CBC, LFT,
Valproic acid- LFT, CBC with platelet
Quetiapine- Glucose, lipid profile, BMI, blood pressure
Lithium- BUN/Cr, TSH/T4, electrolytes.
untreated insomnia often precedes depressive episodes
Topamax carries the problematic side effect of cognitive dulling.
Z-drugs can be taken mid-sleep cycle for mid sleep waking and early morning awakening.
Benzodiazepine binding to GABA receptors increases the frequency of opening of inhibitory chloride channels.
Correct answer: Lithium carbonate
Correct answer: it has twice daily dosing, therefore may be difficult for patients forgetful with medications.
Correct answer: Lamotrigine carries a black box warning for potentially life threatening rash.
Correct answer: Atypical antipsychotics are hypothesized to tune dysfunctional dopamine and serotonergic circuits in bipolar disorder.
Correct answer: Adjunctive use of benzodiazepines with mood stabilizers is useful for agitation and insomnia.
Correct answer: Overlapping symptoms of depression and anxiety suggest that both disorders can be targeted with the same first-line agents.
Kidney impairment after long term lithium treatment is a common adverse side effect.
Both short-acting and long-acting benzodiazepines have been associated with increased risk for the development of dementia.
Clonidine and propranolol target the physiologic symptoms associated with anxiety.
In some instances antidepressant use may lead to rapid cycling.
Seizure risk is high with abrupt cessation from long term benzodiazepine use.
New learning can modulate a conditioned fear response.
Dose nightly on an ongoing basis.
It is best begin a benzodiazepine taper with a long-acting benzodiazepine for increased tolerance to the taper.
Most anticonvulsants are believed to work through inhibitory effects on voltage sensitive ion channels.
Antidepressant use may increase cycling, including precipitating mania.
Memory recall can result in fear response via communication between the amygdala and the hippocampus.
Week Quiz 10
Rebound hypertension can occur when abruptly stopping guanfacine.
Dopamine and norepinephrine.
A patient requests to decrease the dose of his controlled substance.
Amphetamine salts appear to have a greater abuse potential than methylphenidate.
Buprenorphine should not be administered until a patient is in moderate opioid withdrawal.
Nicotine replacement is treatment of choice of nicotine withdrawal symptoms.
Dopamine pathways are implicated in all substances of abuse.
Chronic alcohol consumption results in an upregulation of NMDA receptors and increased excitability in acute abstinence.
Order of treatment should be individualized for the patient.
Anterior cingulate cortex.
Patients with active substance use should not be prescribed controlled substances.
Impulsivity and compulsion are modulate “top down” by the orbitoprefrontal cortex.
Agitation and psychosis may be present in early withdrawal states.
Dopaminergic neurons begin responding to environmental reminders of use through conditioned responses.
Buprenorphine is the preferred treatment for opioid maintenance therapy.
Over time, substance use shifts from seeking the pleasurable effects of intoxication to avoiding of dysphoria associated with withdrawal states.
Persons with a history of substance dependence are vulnerable to craving or relapse following exposure to any psychoactive substance.
Stress activates excessive phasic norepinephrine and dopamine firing, possible leading to the development of impulsivity and inattention.
A patient must provide the pharmacy with a hard copy of the prescription.
ADHD is believed to be a problem of dysfunctional tuning of dopamine and norepinephrine circuits.
The CIWA-Ar and COWS can guide treatment decisions for withdrawal states.
Atomoxetine is best targeted to patients who present with inattention as their primary difficulty.
Quiz Week 13
Norepinephrine levels increase with age.
Abnormal processing of amyloid precursor protein results in formation of amyloid plaques and the subsequent formation of tangles.
As a class, anticonvulsants carry the highest risk of major congenital malformations.
Increased body fat in girls impacts distribution and half-life considerations of psychotropics when compared with boys.
Antipsychotic use in dementia is associated with increased risk of CVA and of mortality.
The greatest risk of teratogenicity often occurs before a patient is aware that they are pregnant.
All medications cross the placenta and pose a potential risk to the fetus.
Atypical antipsychotic use in pregnancy does not appear to be associated with major congenital malformations.
Pharmacokinetic changes in pregnancy may result in need for higher dosages of medication to reach efficacy.
Haldol + lorazepam
It is important to address parent/caregiver’s perception of psychiatric medication.
The postpartum period is considered a vulnerable time for onset, relapse and recurrence of mental disorders.
For moderate to severe anxiety and depression, antidepressant benefit may outweigh risks.
Lifestyle changes such as eliminating caffeine and sugar, getting adequate sleep and regular exercise can mitigate symptoms of PMDD.
Substance use disorders.
GI side effects are common with cholinesterase inhibitors.
Persistent aggression in the presence of neurocognitive deficits.
SSRI discontinuation syndrome is time-limited and usually resolves within 2 weeks.
Memantine is a NMDA receptor antagonist and is hypothesized to reduce abnormal activation of glutamate.
Behavioral and psychological strategies should be included in all treatment plans.
Habilitation therapy, the practice of understanding problematic behaviors as communications of a need and then finding ways to meet that need, has been shown to reduce agitation.
Behavioral and psychotherapeutic interventions are first line treatment for all psychiatric disorders in preschool aged children.
Cholinesterase inhibitors prevent the inactivation of acetylcholine, slowing the decline in function on Alzheimer’s disease.
Escitalopram has been shown to be ineffective in the treatment of depression
Another way of looking at it
Substrate = Original drug (Haldol)
Inhibitor = Increases the substrate drug - More Haldol in blood
Inducer = decreases the substrate drug - Less Haldol in blood
Our motto is deliver assignment on Time. Our Expert writers deliver quality assignments to the students.
Get reliable and unique assignments by using our 100% plagiarism-free.
Get connected 24*7 with our Live Chat support executives to receive instant solutions for your assignment.
Get Help with all the subjects like: Programming, Accounting, Finance, Engineering, Law and Marketing.
Get premium service at a pocket-friendly rate at AssignmentHippo
I was struggling so hard to complete my marketing assignment on brand development when I decided to finally reach to the experts of this portal. They certainly deliver perfect consistency and the desired format. The content prepared by the experts of this platform was simply amazing. I definitely owe my grades to them.