Description
NURS 6630 Midterm Exam Study Guide
*This study guide is meant to help guide you in preparing for the midterm. Please note that all material in the required reading is subject to examination. Most of the exam questions will come from the main textbook. Major concepts learned in the decision tree assignments, articles, and short answer assessments may also be used for examination material.
Camprodon, J. A., & Roffman, J. L. (2016). Psychiatric neuroscience: Incorporating pathophysiology into clinical case formulation. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 1–19). Elsevier
Chapter 1: Psychiatric Neuroscience
· Pathophysiology theories regarding mental illness
· Methods in studying psychiatric neuroscience
· Role of genetics in mental health
· Neuroplasticity and neurodevelopment
· Central nervous system structure
o Human brain structure and function
o Neurons and Glia
o Neuronal projections
· Synapse structure and process for transmission
· Enzymes as targets of psychotropic drugs
· Cytochrome P450 drug metabolizing enzymes as targets of psychotropic drugs
· Neurotransmitters
o Type
o Biosynthesis
o Storage
o Release
o Reuptake
o Action
o Pathways
o Innervation
· Receptor/Channel mechanism
o G-protein coupled receptors
o Ion Channels
§ Voltage-sensitive ion channels as targets of psychopharmacological drug action
§ Ion channels and neurotransmission
§ Ligand-gated ion channels
o Speed
· Gene expression
· Epigenetics
· Role of the environment
· Medication classifications (full agonist, partial agonist, inverse agonist, antagonists, etc.…)
· Approaches to treatment
Chapter 2: Treatment Adherence
· Epidemiology of adherence
· Implication of non-adherence
· Risk factors for non-adherence
· Clinical factors for non-adherence
· Integrating adherence into treatment
· Treatment planning
· Ongoing assessments
· Problem solving barriers + Logistics
· Motivational interviewing
· Problem solving skills as a strategy to improve adherence
Chapter 3: Antidepressants
· How to identify improvement in a patient following administration of medication
· System-based approaches to treatment
· Indications for treatments
· Mechanism of action of all classes of antidepressants (SSRI, SNRI, NDRI, TCA, MAOIs, etc…)
· Major adverse effects
o Class effects/side effect profile
o Medication specific effects
· Clinical use of medication
· Continuation and monitoring
· Suicidal risk
· Choosing an appropriate treatment pathway
· How to successfully use antidepressants
· Treating special populations
· Drug interactions
· Drug-food interactions/dietary restrictions
· Overdose
Chapter 4: Treatment-Resistant Depression
· Definition
· Staging models
· Clinical features
· Clinical approach
· Strategies for treatment
o Switching
o Combinations
o Augmentation
· How to identify improvement in a patient following administration of medication
· MAO inhibitors
· System-based approaches to treatment
· Non-pharmacological treatment
Chapter 5: Bipolar Disorder
· How to identify improvement in a patient following administration of medication
· System-based approaches to treatment
· Epidemiology
· Risk factors
· Clinical features/phenomenology
· Manic episode criteria
· Diagnostic features
· Bipolar I versus II
· Psychosis
· Suicidal ideations
· Cognitive symptoms
· Case presentation
· Mood episodes/chronicity
· Rapid cycling
· Medication-induced mania/hypomania
· Role of seasonality + climate
· Pathophysiology
· Studies
· Evaluation + diagnosis + types
· Personality disorder
· Secondary mania
· Spectrum
· Screening
· Symptom monitoring
· Mood state determination and symptom severity
· Treatment strategies
o General
o Mania
o Mixed states
o Depression
o Medical co-morbidity
· Mechanism of action of all treatment options
· Major adverse effects
o Class effects/side effect profile
o Medication specific effects
· Clinical use of medication
· Choosing an appropriate treatment pathway
· Drug interactions
· Psychosocial interventions
· Prognosis
· Special populations
Chapter 6: Anxiety Disorders
· Differences in types of anxiety disorder
o General anxiety disorder
o Social anxiety disorder
o Posttraumatic stress disorder
o Obsessive-compulsive disorder
o Panic disorder
o Agoraphobia
· How to identify improvement in a patient following administration of medication
· System-based approaches to treatment
· Role of antidepressants
· Mechanism of action regarding treatment options
· Class effects
· Medication specific side effects
· Limitations in treatment
· Role of benzodiazepines
· Caution when using benzodiazepines
· Additional treatment options
· Role of anticonvulsants
· Role of antipsychotics
· Role of beta-blockers
Chapter 8: Lithium and its role in Psychiatry
· Mechanism of action
· Pharmacokinetic and pharmacodynamics
· Efficacy
· Use in mania
· Use in bipolar depression
· Role in treatment and relapse prevention
· Rapid-cycling
· Suicide prevention
· Use in children and adolescents
· Other uses of lithium
o Augmentation
o Relapse prevention in MDD
o Psychotic disorders
o Alcohol dependence
· Principles of treatment
· Monitoring therapy
· Dosing
· Adverse effects
· Adverse effect management
· Signs of toxicity
· Pregnancy and breast-feeding
· Adherence
Chapter 9: The Use of Antiepileptic Drugs in Psychiatry
· How to identify improvement in a patient following administration of medication
· System-based approaches to treatment
· Valproic acid
· Lamotrigine
· Carbamazepine
· Oxcarbazepine
· Gabapentin
· Levetiracetam
· Pregabalin
· Tiagabine
· Topiramate
· Zonisamide
· Mechanism of action of the above agents
· Pharmacokinetic principles
· Pharmacodynamic principles
· Monitoring therapy
· Role in therapy
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