Psychopharma

Stephanie is a 36-year-old female who presents to the clinic with a history of anxiety. Social history is unremarkable. For the last 4 years, she has been well controlled on paroxetine, however she feels “it just doesn’t work anymore.” You have decided to change her medication regimen to vortioxetine 5mg, titrating up to a max dose of 20mg per day based on tolerability. The patient asks, “When can I expect this to start kicking in?” The best response is:
a. 3 or 4 days b. 1 or 2 weeks c. 3 or 4 weeks d. 10 weeks

3.75 points

Which of the following medications, when given intramuscularly, is most likely to cause severe postural hypotension?
a. haloperidol b. lorazepam c. benztropine d. chlorpromazine

3.75 points

Sam is a 48-year-old male who presents to the clinic with signs and symptoms consistent with GAD & MDD. Which of the following medications would be the LEAST appropriate choice when initiating pharmacotherapy?
a. duloxetine b. sertraline c. mirtazapine d. buproprion

3.75 points

Jason is a 6-year-old child whose mother presents to the clinic with him. The mother says that “he’s not himself lately.” After a thorough workup, you diagnose the patient as having GAD. Which of the following medications would be the LEAST appropriate to prescribe to this child?
a. Sertraline b. Paroxetine c. Venlafaxine d. Buspirone

3.75 points

Mirza is a 75-year-old patient with a long history of schizophrenia. During the past 5 years, she has shown significant cognitive decline consistent with dementia. The patient has been well controlled on a regimen of risperidone 1mg BID. As the PMHNP, the most appropriate course of action for this patient is:
a. Increase the risperidone to 1mg QAM, 2mg QPM b. Discontinue risperidone and prescribe a long-acting injectable such as Invega Sustenna. c. Discontinue risperidone and initiate therapy with clozapine. d. Augment the patient’s risperidone with brexpiprazole.

3.75 points