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Psychiatry NP
Info & Q: NP EXAM
Question | Answer |
---|---|
What controls mood? | Monoamine System 1. norepinephrine 2. serotonin 3. dopamine |
Which neurotransmitter allows you to go ahhhhh yes (feeling of joy after turning in all the papers) at the end of the semester? | serotonin |
Which neurotransmitter makes it possible for you to sleep at night? | serotonin |
Which neurotransmitter makes you excitable, motivated? | 1. norepinephrine 2. dopamine |
When you put dopamine into a bag and infuse it into your pt what happens to his HR, BP and renal perfusion? | They all go UP |
Serotonin decreases impulsivity, so a pt with obsessive compulsive disorder we should load them up on which drugs? | SSRIs (antidepressants) 1. celexa 2. lexapro 3. paxil 4. prozac 5. zoloft |
What is the biggest complaint with giving an SSRI? | decrease libido |
What is a SE from SSRI in pt that is compliant with their meds? | weight gain because it constantly knocks on the appetite center in your brain saying GO AHEAD and eat another brownie |
Which neurotransmitter increases concentration, motivation and vigilance? | norepinephrine and dopamine |
Commercial for Stratera to tx ADD shows how it allows more of this to hang around instead of being reuptaken thereby increasing concentration. | norepinephrine because it is an SNRI |
Stressful situations bring on depression which we might understand as a decreased level of these neurotransmitters? | 1. serotonin 2. norepinephrine 3. dopamine |
Stressful situations cause your pts to eat up neurotransmitters faster than they can produce them, True or False? | True |
A positive correlation with depression is when a pt states that they have felt depressed or disinterested over how long of time? | 2 weeks |
The first drug of choice to treat depression includes any AD EXCEPT? | MAOI |
SSRI cause increase availability of serotonin and then in 6 to 8 weeks there is more of these available? | 1. norepinephrine 2. dopamine |
SSRIs are commonly used to treat depression and other disorders; Name the DO and some SSRIs? | A. Dysthymia-OCD-Anxiety 1. celexa 2. lexapro 3. paxil 4. prozac 5. zoloft |
For a pt with increased anxiety wouldn't it be nice to give them something that will allow them to go ahhhhhh? | SSRI |
A common complaint of pt that starts on SSRI is? | I can't sleep |
What is the action of TCAs? | Cause more serotonin and norepinephrine hang around. |
What is a common problem with TCAs? | Cause pt to be sleepy |
What is a common TCA that is used to help pt sleep at night? | Trazodone |
TCA have several SE: | 1. dry mouth 2. heavy tongue 3. urinary retention |
We should avoid TCA in this population? | Elderly men with enlarged prostate because of the SE urinary retention |
A pt c/o Wt gain and decrease sex so doesn't want to take SSRI what do you do? | Dopamine antagonist like Wellbutrin |
Before Rx a TCA we should obtain an EKG for what reason? | R/O any Bradyarrhythmias like 2ndary heart blocks |
How much supply of TCA should we give to pt? | Smallest amount possible b/c OD will kill them |
Name some TCAs: | 1. Elavil 2. Sinequan 3. Tofranil 4. Trazodone |
Pt with anxiety have what problem with sleep? | Trouble falling asleep |
Pt with depression has what problem with sleep? | Trouble staying asleep |
If you suspect pt of heavy alcohol what should the NP do? | 1. Cutdown 2. Agitated if asked 3. Guilty feeling for drinking 4. Eyeopener |
A pt with bulemia is going to be at what wt? below avg, avg, above avg | avg weight |