Ramelteon promotes sleep by stimulating receptors for melatonin, the hormone the pineal gland releases in darkness.
Missing Word
melatonin
Melatonin is the pineal hormone that signals night and helps regulate the sleep-wake cycle. Ramelteon is a melatonin receptor agonist that shortens the time it takes to fall asleep.
Category: Anxiolytics and Hypnotics
Question 2
A long-acting intramuscular antipsychotic such as haloperidol decanoate is called a depot injection, a name taken from the French word for a storehouse, because the drug is stored in muscle and released slowly.
Missing Word
depot
A depot injection leaves a reservoir of drug in muscle tissue that is released slowly, so doses are spaced far apart. It helps clients who have trouble taking daily oral doses, and clients are still monitored for extrapyramidal effects, which can be more troublesome with depot forms because the drug cannot be quickly withdrawn.
Category: Antipsychotics
Question 3
Antipsychotics can raise blood levels of the pituitary hormone prolactin, causing breast enlargement, milk discharge and changes in libido.
Missing Word
prolactin
Dopamine normally inhibits prolactin release from the pituitary, so dopamine blockade raises prolactin. Hyperprolactinemia can cause gynecomastia, galactorrhea and libido changes, which nurses explain to reduce distress.
Category: Antipsychotics
Question 4
The extrapyramidal effect called akathisia is an inner sense of restlessness that makes it hard for the client to sit still.
Missing Word
akathisia
Akathisia is a drug-induced motor restlessness in which the client feels compelled to keep moving, pace or shift position. It is one of the extrapyramidal symptoms seen mainly with first-generation antipsychotics.
Category: Antipsychotics
Question 5
The naturally occurring metallic salt lithium has long been the standard drug for treating and preventing mania.
Missing Word
lithium
Lithium is a mood stabilizer used to treat and prevent the manic phase of bipolar disorder. It has a narrow margin of safety, so serum levels and signs of toxicity are monitored.
Category: Mood Stabilizers
Question 6
In narcolepsy, sudden muscle weakness triggered by strong emotion such as laughter is called cataplexy.
Missing Word
cataplexy
Cataplexy is a brief loss of muscle tone brought on by strong emotion, and it is a feature of some forms of narcolepsy. Drugs such as sodium oxybate and pitolisant treat it.
Category: Stimulants and Nonstimulants
Question 7
The MAOI selegiline is the only antidepressant available as a transdermal patch.
Missing Word
selegiline
Selegiline is an MAOI that, as a skin patch, is used for major depression. At lower doses it selectively inhibits MAO-B, and at higher doses it becomes nonselective, so MAOI precautions still apply.
Category: Antidepressants
Question 8
In children, diazepam can cause a paradoxical reaction, producing excitement and agitation instead of calm.
Missing Word
paradoxical
A paradoxical reaction is the opposite of the expected drug effect. Children given benzodiazepines such as diazepam may become excited or agitated instead of sedated, so nurses watch for this response.
Category: Anxiolytics and Hypnotics
Question 9
The short-acting benzodiazepine midazolam is given IV for procedural sedation and as an oral syrup before pediatric anesthesia.
Missing Word
midazolam
Midazolam is a short-acting benzodiazepine used for sedation before and during procedures. IV midazolam carries a boxed warning for respiratory depression, so breathing is monitored and resuscitation equipment kept ready.
Category: Anxiolytics and Hypnotics
Question 10
The antidepressant mirtazapine blocks presynaptic alpha-2 receptors and histamine-1 receptors, so it causes sedation, increased appetite and weight gain.
Missing Word
mirtazapine
Mirtazapine blocks presynaptic alpha-2 receptors, which increases the release of norepinephrine and serotonin, and its histamine-1 blockade explains its sedation and weight gain. Weight, glucose and lipids are checked during therapy.
Category: Antidepressants
Question 11
First-generation antipsychotics such as haloperidol work mainly by blocking receptors for the neurotransmitter dopamine.
Missing Word
dopamine
Dopamine is the neurotransmitter whose excess activity is linked to positive psychotic symptoms. First-generation drugs block dopamine-2 receptors, which also explains their extrapyramidal and prolactin effects.
Category: Antipsychotics
Question 12
The ADHD drug lisdexamfetamine is an inactive prodrug that the body converts to dextroamphetamine.
Missing Word
lisdexamfetamine
Lisdexamfetamine is a prodrug: it has no stimulant effect until it is converted to dextroamphetamine in the body. It is used for ADHD and binge-eating disorder and carries a boxed warning for misuse.
Category: Stimulants and Nonstimulants
Question 13
Clozapine slows gut motility so strongly that severe constipation can progress to bowel obstruction, so bowel function is monitored closely.
Missing Word
constipation
Constipation is infrequent or difficult passage of stool. Clozapine's strong anticholinergic effect makes it a serious risk, so bowel sounds and habits are monitored and fluids, fiber and activity are encouraged.
Category: Antipsychotics
Question 14
The SSRI fluoxetine is the only antidepressant approved by the FDA to treat bulimia nervosa.
Missing Word
fluoxetine
Fluoxetine is an SSRI approved for major depression, obsessive-compulsive disorder, panic disorder and bulimia nervosa. It and its active metabolite are cleared very slowly, which matters when switching to or from other serotonergic drugs.
Category: Antidepressants
Question 15
Before starting an antidepressant, the nurse screens for bipolar disorder because an antidepressant alone can trigger a manic episode.
Missing Word
bipolar
Bipolar disorder involves alternating depression and mania. Treating its depressive phase with an antidepressant alone can switch a client into mania, so screening comes first and a mood stabilizer may be added.
Category: Antidepressants