REVIEW TEST SUBMISSION 4 VERIFIED AND UPDATED NURS-6630

Which drug below has an interaction with cigarette smoking and should be adjusted based on patient’s tobacco use/non-use?


Response Feedback:

“Clozapine blood levels are significantly lowered by cigarette smoking and by other hepatic enzyme-inducers.”



Which of the following medications is best to AVOID in maintenance treatment of bipolar disorder and why?


Response Feedback:

“As noted previously, antidepressants may contribute to an increase in mood episode frequency.”



Glia cells play a supportive role in the neuron. A few of the functions of the glial cells include providing nutrition, maintaining homeostasis, stabilizing synapses, and myelinating axons. The glial cells are categorized as microglia or macroglia. Of the macroglia cells, which one plays a role in myelinating axons, which may contribute to mood disorders if altered?


Which of the following are NOT primary target(s) symptom for antipsychotic agents in schizophrenia?

i. Depression, anxiety, demoralization, suicidality, excitability, and agitation
ii. Delusions, hallucinations, disorganized thoughts
iii. Affective flattening, alogia, avolition, anhedonia, social withdrawal
iv. Attention, memory, and executive functions

Response Feedback:

“For schizophrenia, the primary target symptoms for antipsychotic agents fall into three categories: psychotic symptoms (e.g., hallucinations, delusions, disorganization); agitation (e.g., distractibility, affective lability, tension, increased motor activity); and negative symptoms (e.g. apathy, diminished affect, social withdrawal, poverty of speech.” AND “Although cognitive deficits are an important contributor to disability in schizophrenia, cognitive deficits usually are not considered a target for antipsychotic agents because they are not very responsible to current agents.”



A 32-year-old males calls you complaining of decreased libido since starting Paroxetine 20 mg 2 weeks ago. He reported stopping the medication 1 day ago and is now experiencing extreme irritability and nervousness. He wishes to stop this medication due to side effects. What do you recommend?


Response Feedback:

under selective serotonin re-uptake inhibitors discontinuation syndrome subtitle: “The risk of such adverse events occurring seems to be

inversely related to the half-life of the SSRI, with fluoxetine reported as having a significantly lower risk than paroxetine in two studies. For more severe discontinuation-related adverse events, re-institution of the SSRI and slow taper may be necessary to alleviate these symptoms.”

With second-generation antipsychotics, what is the main side effect that requires frequent monitoring?


Response Feedback:

table 7-6 & page 80, table 7-7; Page 78: “However, attention over the past decade has focused on effect of second-generation antipsychotics on glucose metabolism and lipids and associated metabolic syndrome.”



A 23-year-old female was just diagnosed with major depressive disorder and is being started on escitalopram 10 mg daily. The patient should be counseled about which Black Box warning?


Response Feedback:

“In 2004, the FDA asked manufacturers of almost all the new antidepressant drugs to include in their labeling a warning statement that recommends close observation of adult and pediatric patients treated with these drugs for worsening depression or the emergence of suicidality."



Which anticonvulsant below induces its own metabolism over time?


In order for the NMDA receptor to fully open and allow an influx of calcium, both glutamate and glycine must bind to cause a depolarization of the cell that will ultimately displace which ion? Is the NMDA receptor an ionotropic or metabotropic receptor?


Which of the following medications are known as selective seroton