Final Exam: NR546/ NR 546 (NEW Update 2024/ 2025) Psychopharmacology for the PMHP Review |Weeks 5-8 | Questions and Verified Answers| 100% Correct-
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QUESTION
Tricyclic antidepressants (TCAs)
Answer:
Tricyclic antidepressants (TCAs) possess both SRI and NRI properties, but they also block other
receptors, including α1-adrenergic, histamine-1, and muscarinic cholinergic receptors. TCAs are
not used first-line because of the high incidence of adverse effects and the risk of potential
overdose and death due to overdose
QUESTION
Tricyclic antidepressants (TCAs)
Answer:
Drugs:
· amitriptyline (Elavil)
· desipramine (Norpramin)
· doxepin (Sinequan)
· imipramine (Tofranil)
· nortriptyline (Pamelor)
QUESTION
Tricyclic antidepressants (TCAs)
Answer:
Common adverse effects of TCAs
Alpha-1 adrenergic effects-Orthostatic hypotension
Histamine effects-Sedation
Histamine effects-Weight gain
Anticholinergic effects-Blurred vision
Anticholinergic effects-Urinary retention
Anticholinergic effects-Constipation
Anticholinergic effects-Dry mouth
QUESTION
MAOIs
Answer:
Last choice medication class for depression due to the many potential, serious side effects.
MAOIs have specific dietary restrictions that when ignored, may be very uncomfortable or very
serious for clients.
QUESTION
MAOIs
Answer:
Drugs:
· phenelzine (Nardil)
· selegiline (Emsam) - MAOI-B
· tranylcypromine (Parnate)
· isocarboxazid (Marplan)
QUESTION
MAOI's Key Points
Answer:
· Clients taking MAOIs are at high risk for hypertensive crisis if tyramine is ingested.
· Do not prescribe any serotonergic agents within 2 weeks of MAOI discontinuation due to an
increased risk of serotonin syndrome.
Wait at least 5 half-lives after discontinuing a serotonergic medication before initiating an
MAIO.
QUESTION
Foods to Avoid When Taking MAO-A Medications
Answer:
· Red wine (Avoid)
· Sauerkraut (Avoid)
· Cheese (Avoid)
· Soy (Avoid)
· Smoked meats (Avoid)
QUESTION
Foods to Avoid When Taking MAO-A Medications
Answer:
Rationale: Limiting the consumption of tyramine is necessary for orally available MAOIs due to
inhibition of MAO-A in the gut. Dietary restrictions are not required for the transdermal
formulation of selegiline.
Tyramine is present in many aged or preserved foods including aged cheeses, tap and nonpasteurized
beers,
aged
or
smoked
meat
or fish,
sauerkraut,
kimchee,
soy products,
and tofu.
Foods
to
be
avoided
when
taking MAO-A
medications
include
wine,
meats,
sauerkraut,
cheese,
and
soy.
QUESTION
Newer Treatments for Resistant Depression
Answer:
· The goal of antidepressant treatment is the remission of symptoms; however, the current
treatment response of clients with mood disorders varies widely and is often unsatisfactory.
· For example, in clients with MDD, the treatment efficacy of selective serotonin reuptake
inhibitors (SSRIs), the most used first-line pharmacological agent is between 48 and 64% with
reported remission rates as low as 23.5%.
· Treatment-resistant depression occurs when depression persists after the client has adequately
trialed at least two antidepressant therapies.
QUESTION
Newer Treatments for Resistant Depression
Answer:
Esketamine (Spravato)-N-methyl-D-aspartate (NMDA) receptor inhibito [Show Less]