08 Oct Which of the following medications are FDA approved for Major Depressive Disorder?

Which of the following medications are FDA approved for Major Depressive Disorder? SELECT ALL THAT APPLY.

 

  Paxil (Paroxetine)

 

  Celexa (Citalpram)

 

  Lexapro (Escitalopram)

 

  Prozac (fluoxetine)

 

  Luvox (Fluvoxamine)

 

 Question 2The PMHNP has determined that Prozac (Fluoxetine) is not effective for the patient. The patient must be educated about how to stop this medication. Which of the following statements is correct?

 

  Because Prozac (Fluoxetine) has very low percentage of protein binding you may stop the medication immediately

 

  Because Prozac is not inhibitor, it must be tapered slowly over several weeks

 

  Due the short half life of the medication you take half the doss for one week, then one half of the dose for a second week

 

  Due to the long half life of Prozac (Fluoxetine), you may stop the medication without taper

 

 Question 3An inducing agent of the CYP450 system can increase the rate of another medication’s metabolism, resulting in decreased plasma level of that medication.  True or False?

 

  True

 

  False

 

 Question 4Which of the following Selective Serotonin Reuptake Inhibitor (SSRI) would be the best choice for treating someone with Major Depressive Disorder with Psychotic Features?

 

  Prozac (fluoxetine)

 

  Lexapro ( Escitalopram)

 

  Celexa (Citalopram)

 

  Zoloft ( Sertraline)

 

 Question 5The PMHNP has decided to start the patient on a Selective Serotonin Re-uptake Inhibitor. Which of the following should be included in patient education? SELECT ALL THAT APPLY

 

  There is a Black Box Warning for increased suicidal thoughts in children, adolescents, and young adults.

 

  If you experience side effects, they may go away in 2-4 weeks

 

  Side effects may include diaphoresis, sexual dysfunction, and sedation

 

  If you experience any side effect stop the medication immediately

 

  Therapeutic effect may take at least 4-8 weeks

 

 Question 6The PMHNP is assessing the patient who is being treated for Major Depressive Disorder. The patient is noted to be exhibiting the following symptoms:

 

-Tachycardia

 

-Fever of 101 degrees

 

-Diarrhea

 

-Diaphoresis, color is pink

 

Increased muscle tone

 

-Muscle spams/jerking

 

-Hyperreflexia

 

The PMHNP is concerned the client may be suffering from___________

 

  Serotonin Syndrome

 

  Hypertensive Crisis

 

  A drug interaction due to the CYP450 System

 

  Discontinuation Syndrome

 

 Question 7Which class of medications are considered first line treatment for first episode of Major Depressive Disorder?

 

  Monoamine oxidase inhibitors (MAOIs)

 

  Norepinephrine-Dopamine Reuptake Inhibitors (NDRI)

 

  Tricyclic antidepressants (TCA)

 

  Selective Serotonin Reuptake Inhibitors (SSRI)

 

 Question 8Which of the following test would the PMHNP consider ordering for a patient who is on Celexa?

 

  EKG

 

  Lab Values for therapeutic level

 

  Lipid panel

 

  MRI

 

 Question 9The PMHNP is assessing a patient who has been tapering off Paxil. The patient is noted to be exhibiting the following symptoms:

 

Dizziness

 

Vertigo

 

Paresthesia

 

“Electric Shock”

 

Fever, Sweating

 

Nausea

 

Vomiting

 

Muscle pain

 

Fatigue

 

Tremor

 

Headache

 

 The PMHNP is concerned the client may be suffering from___________

 

  A drug interaction due to the CYP450 System

 

  Discontinuation Syndrome

 

  Serotonin syndrome

 

  Hypertensive Crisis

 

 Question 10Which of the following receptors is associated with Anxiety?

 

  DA reuptake blockade

 

  NE reuptake blockade

 

  5HT2 Blockade

 

  5HT1A Blockade

 

 Question 11The PMHNP is seeing a 48 year old Female with Major Depressive Disorder. During the initial evaluation it is identified that the patient has is being treated for hypertension. Which of the following medications would the PMHNP want to avoid?

 

  Prozac (fluoxetine)

 

  Effexor ( Venlafaxine)

 

  Zoloft (Sertraline)

 

  Lexapro (Escitalopram)

 

 Question 12The only class of antidepressants that have a black box warning for suicidal thoughts for children, adolescents, and young adults is Selective Serotonin Re-uptake Inhibitors. True or False

 

  True

 

  False

 

 Question 13The PMHNP is care for a patient with Major Depressive Disorder, Alcohol Use Disorder, and Cirrhosis of the Liver. The PMHNP should avoid which of the following Serotonin and Norepinephrine Reuptake Inhibitors (SNRI).

 

  Cymbalta (Duloxetine)

 

  Pristiq (Desvenlafaxine)

 

  Savella (Milnacipran)

 

  Fetzima (Levomilnacipran)

 

 Question 14Which of the following conditions are contraindicated when prescribing Wellbutrin (Bupropion)? SELECT ALL THAT APPLY.

 

  Bulimia

 

  Hypertension

 

  Anorexia nervosa

 

  Concurrent Use of Cocaine

 

  History of Seizures

 

 Question 15The Tricyclic antidepressants are known to cause multiple side effects including  anticholinergic side effects. These include dry mouth, constipation, blurred vision, urinary hesitancy, esophageal reflux

 

This is due to the ________ of the ___________ receptor.

 

  Blockade of the M1 Ach ( Muscarinic Acetylcholine Receptors)

 

  Agonism of the 5HT1A (Sub type of the Serotonin Receptor

 

  Agonism of the M1 Ach ( Muscarinic Acetylcholine Receptors)

 

  Blockade of the 5HT1A (Sub type of the Serotonin Receptor)

 

 Question 16 A prescriber should avoid prescribing Tricylclic Antidepressants (TCA) in patients who are suicidal.

 

  True

 

  False

 

 Question 17The PMHNP has decided to change the patient’s MAOI medication to a SSRI. Which of the following must be done to ensure a safe transition? SELECT ALL THAT APPLY

 

  Monitor for signs of Serotonin Syndrome

 

  Allow for an appropriate wash out period

 

  Start the SSRI the day after stopping the MAO

 

  Weekly lab work

 

 Question 18The PMHNP is assessing the patient, who is taking Phenelzine for Major Depressive Disorder. The patient reports the following symptoms:

 

headache

 

Neck stiffness, soreness

 

Nausea, vomiting

 

Sweating

 

Fever, with cold, clammy skin

 

Photophobia

 

Racing Heart

 

 The PMHNP is concerned that the patient may be experiencing a ________________.

 

  Discontinuation Syndrome

 

  A drug interaction due to the CYP450 System

 

  Hypertensive Crisis

 

  Serotonin syndrome

 

 Question 19The PMHNP is doing education with a patient who is taking a Monoamine oxidase inhibitors (MAOIs).  Education should include which of the following. SELECT ALL THAT APPLY

 

  Report a headache or neck stiffness immediately

 

  Lab work must be drawn weekly for one month

 

  Consult your provider befor taking over the counter sleep aids or cold medication

 

  Avoid aged or smoked meats and cheeses

 

  Avoid Beer

 

 Question 20Dietary and drug restrictions must be maintained for 2 weeks after stopping Monoamine oxidase inhibitors (MAOIs). True or False

 

  True

 

  False

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