Psychopharmacology fundamentals for non-medical mental health therapists

Psychopharmacology

Non-medical psychotherapists, such as Marriage and Family Therapists, should learn about psychopharmacology in order to:

Collaborate with prescribers regarding a patient's medication

For a patient with a borderline or dependent personality, a therapist not recommending medication would likely be seen as:

Conservative

Jim is disturbed by his psychiatrist's prescription of psychotropic medication, believing that the psychiatrist is attempting to control him and remove his autonomy. This most likely reflects:

Paranoid personality traits

Short, branched structures projecting from a nerve cell body are known as:

Dendrites

Messenger molecules are secreted by neurons and affect the functioning of adjacent neurons. Messenger molecules are also called:

Neurotransmitters

The space between the terminal button and receptors is the:

Synapse

Which statement most accurately describes nerve cell receptors?

They increase in number until age 50, then slowly die off

8) The area of the brain most closely associated with emotion is the:

Limbic system

9) Higher cognitive function takes place in which area of the brain?

Cortex

10) Increased heart rate, dry mouth, and increased blood pressure are reactions associated with the:

Sympathetic nervous system

11) Pharmacodynamics can be thought of as ___, whereas Pharmacokinetics can be thought of as:

Drug's effect on the body; Body's effect on the drug

12) Another word for biotransformation is:

Absorption

13) The organ primarily responsible for excretion is the:

Kidney

14) Two drugs competing for the same enzyme system is an example of drug:

Interaction

15) When a molecule binds to a receptor, occupying it but not activating it, this is an example of a (n) ___ effect.

Antagonist

16) According to research, in what percent of cases would you expect non-psychiatric medical disorders to be the primary cause of psychiatric symptoms?

9%-17%

17) Which of the following findings would increase your suspicion that a patient's psychiatric symptoms have a non-psychiatric medical origin?

Acute onset with no identifiable psychosocial stressors

18) Fatigue, appetite disturbance, and decreased sex drive are commonly referred to as:

Vegetative symptoms of depression

19) Psychotic depression is most effectively treated with:

Combined antipsychotic/antidepressant medication

20) Residents of Alaska often suffer from "cabin fever," a form of depression that strikes during the winter when there is little daylight. The clinical name for this is:

Claustrophobia

21) The Monoamine Hypothesis of depression holds that depression is caused by:

Depleted serotonin, dopamine, and norepinephrine

22) Compared to Bipolar II disorder, Bipolar I tends to have:

Manic and depressive episodes which are more pronounced

23) Which of the following drugs is not likely to induce mania?

Aspirin

24) Kindling Theory, applied to Bipolar Disorder, helps to explain:

The impact of psychosocial factors

25) Benzodiazepines would be contraindicated for patients with a history of:

Sleep disorder

26) Effective treatments for OCD include:

Psychoanalysis, SSRIs

27) A prominent theory proposes that schizophrenia is caused by:

Insufficient dopamine

28) Flashbacks, nightmares, and exaggerated startle response are symptoms of:

PTSD

29) For a depressed patient with a history of sexual dysfunction, you would most likely recommend:

Bupropion

30) A patient taking an MAOI should avoid eating:

Sauerkraut

31) A patient has been on an antidepressant medication for one week and doesn't notice any effect. You would recommend that he:

Ask his doctor to discontinue the medication since his depression is probably not responsive to medication

32) St. John's Wort is an herb available over-the-counter. Research has found that it is:

Effective for mild-to-moderate depression

33) In addition to Lithium, other medications found effective for Bipolar Disorder are in the class of:

Antidepressants

34) Beta blockers impact which symptom of anxiety?

Increased heart rate

35) After several years of treatment with antipsychotic medication, a patient begins demonstrating involuntary movements. This is most likely:

Tardive dyskinesia

36) An advantage of the atypical antipsychotics over older generation antipsychotics, is that they better impact:

Negative psychotic symptoms

37) Which of the following is true of herbal products?

There are few interactions between herbal products and prescription medication

38) Medication doses for pre-pubertal children tend to be:

Based on the child's weight as a percentage of adult weight

39) ADHD is typically treated with:

Stimulants

40) The "inattentive" subtype of ADHD generally:

Responds to slow-release medication

41) A characteristic which differentiates childhood-onset bipolar disorder from ADHD is:

Impulsivity

42) When diagnosing Major Depression in children, as opposed to adults, one more commonly sees:

Irritability and anhedonic mood

43) A drug's therapeutic index compares:

Effective dose to toxic dose

44) EPS side effects are often managed by the addition of Serotonin blockers

45) A medication half-life is the:

Amount of time required for the serum concentration to be reduced by 50%

46) A medication has reached "steady state" when:

Symptoms go into remission

47) What statement best describes the current application of ECT?

It is used for severe, treatment-refractory depression

48) Prescribers routinely order and review lab tests prior to starting lithium. This is done primarily:

To see if a lithium deficiency is present

49) Current practice is to place a patient on lifelong maintenance antidepressants after:

Antidepressants should always be discontinued after 1-2 years

50) Which of the following statements best describes the ethical and effective use of psychotropic medication?

The most effective treatment applies medical and/or psychological interventions as needed for a particular client

51) The body's main inhibitory neurotransmitter/neuromodulator is:

GABA

52) Which of the following are found in the soma?

The axon and the dendrites

53) Which of these is the correct progression of events?

Action potential, exocytosis, re-uptake

54) The physical space between neurons is called:

The synapse

55) GABA is the body's main inhibitory neurotransmitter substance, and ___ is the excitatory substance.

Glutamate

56) A non-medical psychotherapist says that she has focused her training exclusively on psychotherapeutic intervention. She says that she has intentionally not learned about psychopharmacology so that she can avoid liability for medication issues. You would respond to her by suggesting:

That her stance is only reasonable if she discloses to her clients that she has no knowledge of psychopharmacology

57) Excessive amounts of ___ may be implicated in psychosis.

Stimulants

83) A patient comes to you, reporting that he started seeing "ghosts" a few days ago. He realizes the experience is abnormal, he has never had odd experiences like this before, and has not had any recent stresses that he can think of. You would:

Suspect a non-psychiatric medical problem and refer him for medical evaluation

84) All of the following are atypical antipsychotics except:

Navane

85) Which of the following is a vegetative depressive symptom?

Weight loss and anorexia

86) How can you distinguish Major Depression with Psychotic Features from Schizoaffective Disorder?

With Schizoaffective Disorder, psychosis occurs only during a depressive episode

87) Irregularities of which neurotransmitter(s) has been implicated in ADHD?

Serotonin

88) Which of the following is not a stimulant per se, but rather an antidepressant with stimulant qualities?

Ritalin

89) Monoamines are:

The neurotransmitters dopamine, noradrenaline and serotonin

90) To be diagnosed with Bipolar I disorder, a client needs to have had:

At least one manic or mixed episode

91) The anticholinergic side effects are more common with which type of antidepressants?

None of these

92) When ruling out non-psychiatric medical causes for mania, one would be most likely to review which lab findings?

Thyroid function tests

93) Bipolar illness often starts with specific stressful events, but later manic episodes are more likely to occur spontaneously. This is best predicted by:

Kindling theory

94) Which of the following drugs is thought to be the "gold standard" for treating Bipolar Illness?

Lithium

95) When prescribing benzodiazepines, one of the most important concerns is:

Addictive potential

96) S-adenosyl-methionine or SAM-e is available without a prescription. Research has shown it to be:

An effective antidepressant

97) Continuous writhing movements of the extremities and involuntary movements of the mouth and tongue are symptoms of:

Tardive dyskinesia

98) The two broad areas of dysfunction found in ADHD are:

Hyperactivity and inattention

99) Lithium has a narrow therapeutic index. This means that:

The therapeutic dose is close to the toxic dose

100) The serum concentration level of Drug Z is 100 mcg/ml at noon and 25 mcg/ml at 4 pm. The drug's half-life is:

Four hours