NURS 663 - Psychiatric Mental Health Diagnosis and Management II
Exam 1
Question:
Tricyclic mechanism of action
Answer:
Inhibit 5HT2, norepinephrine, dopamine and reuptake slows. Amino group interferes with ASP - 98 in HSERT. Causing down regulation of receptors.
Question:
Tricyclic side effects
Answer:
Anticholinergic effects (dry mouth, blurred vision, constipation, urine retention, impotence). Histamine effects (sedation, increased weight).Adrenergic alpha receptor (postural hypotension). Direct membrane effects (decrease seizure threshold and arrhythmias). 5HT2 receptor (increase weight and decrease anxiety).
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Question:
Amitriptyline dosing/Class
Answer:
Start at 25 to 50 mg per day, titrate 25 to 50 mg per day per week, Max dose is 300 mg per day/TCA
Question:
Names of tricyclics 10
Answer:
Amitriptyline, nortriptyline, clomipramine, imipramine, protriptyline, doxepin, amoxapine, desipramine, mapratiline, tripramine
Question:
Tricyclics are useful-2
Answer:
Pain, migraine
Question:
Tricyclics adverse effects-2
Answer:
Overdoses are cardiotoxic, high potency increases the risk of mania
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Question:
Nortriptyline mnemonic
Answer:
No-triptyline equals less sedation and hypotension
Question:
Tricyclics mnemonic-2
Answer:
Think car goes over tricycle to remember that an overdose is cardiotoxic. Do you remember mechanism think trans =serotonin and norepinephrine Chans= Na+ and Ca+ Ans= ACH and histamine
Question:
Clomipramine mnemonic/class
Answer:
TCA- think comipramine for obsessive compulsive disorder
Question:
Imipramine- pneumonic and class
Answer:
I'm peeingamine- nocturnal enuresis
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Question:
Unilateral electrode in ECT indications
Answer:
Typically first line because it has less cognitive side effects but has less efficacy
Question:
What is ECT?
Answer:
The use of electrical shock current delivered to the brain to induce a seizure that treats depression. Goal is to reverse atrophy.
Question:
ECT is FDA approved for what
Answer:
Bipolar disorder, schizophrenia, schizoaffective disorder, catatonia, neuroleptic malignant syndrome, treatment resistant refractory major depressive disorder
Question:
What is ECT schedule
Answer:
Typically Monday Wednesday Friday for 6 to 12 sessions
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