25. Often, the bioavailability of trade name of brand form of a…

 

25. Often, the bioavailability of trade name of brand form of a psychotropic can differ significantly from its genetic form. If a patient with atypical depression is prescribed Bupropion rather than Wellbutrin, what statement may be true for this patient? (b, c incorrect)

 

1. Wellbutrin could have less bioavailability, contingent upon parenteral administration 
2. Bupropion bioavailability depends upon the percentage of administrated dose that inactivated in systemic circulation 
3. Bupropion’s bioavailability is contingent upon the percentage of prescribed dose circulating in the bloodstream 
4. None of the above 

 

26. Regarding kidney function and age-related variability, glomerular filtration rate (b. c incorrect)

 

1. Accelerates past the age of 45 
2. Decelerates in utero 
3. Accelerates from birth to 12 months 
4. None of above 

 

 

33. The PMHNP is seeing a 31 y/o male for follow-up after initiating Wellbutrin XL150 mg daily for depression, with the hope of addressing sexual side effects experienced on previous alternative antidepressant trials. However, the primary reason for initiating this antidepressant is to target smoking cessation. The patient reports decreased cravings for cigarettes, with heightened anxiety and irritability. Energy level has improved as well. The PMHNP attitudes increased irritability and anxiety to which of the following? (a, c are incorrect)

 

1. Wellbutrin has a higher affinity for the serotonin transporter and dopamine transporter, and simultaneous increase of serotonin and dopamine in the synaptic cleft results in the activating effects 
2. Wellbutrin has a lower affinity for the serotonin transporter and higher affinity for the norepinephrine transporter, resulting in a decrease in serotonin in the synaptic cleft and increase of norepinephrine in the presynaptic vesicle 
3. Wellbutrin has no affinity for the serotonin transporter and a high affinity for the dopamine transporter, increasing dopamine in the synaptic cleft, as well as norepinephrine transporter, rendering it ineffective in treating anxiety or ruminative worry 
4. Wellbutrin has no affinity for the serotonin transporter and no affinity for the norepinephrine transporter, rendering it ineffective in treating anxiety or ruminative worry 

 

37. The PMHNP is discussing with a new patient the necessity of tapering and discontinuing Xanax 2 mg three times daily, which the patient has been taking for fifteen years. The patient is concerned about the safety of discontinuing this medication. The PMHNP is also concerned about which of the following adverse risks associated with discontinuation (a. b are incorrect)

 

1. Gradual taper and discontinuation are correlated with impermanent memory loss 
2. Abrupt taper and discontinuation are correlated with increased anxiety 
3. Gradual taper and discontinuation are correlated with raising seizure threshold 
4. None of the above 

 

49. The psychiatric nurse practitioner is treating a 42y/o with history of MDD who started taking escitalopram 10 mg daily one week ago. The patient is calling expressing she has taken the medication daily but is still feeling “down.” The psychiatric nurse practitioner’s patient education includes (a and c are not correct)

 

1. Instruction that antidepressants should be taken for approximately 6 weeks before adequate assessment of therapeutic efficacy can be assessed 
2. Instruction that an alternative SSRI or SNRI trial is indicated at this time due to lack of efficacy 
3. Instruction that particular SSRI usually takes a full 4 weeks to achieve therapeutic serum levels and no dose increase is indicated prior to this time prior to this time period 
4. None of the above 

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