Want to test your pharmacology knowledge before the PMHNP-BC exam? Below are free sample flashcards from the 140-card pharmacology section of our 1040-card PMHNP-BC (Psychiatric-Mental Health Nurse Practitioner) deck, which covers Viibryd, TGAs, SGAs, TCA and more.
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A patient on Nortriptyline is prescribed Fluoxetine for comorbid OCD. Why is this combination potentially hazardous regarding CYP450 metabolism?
Show answer →Fluoxetine is a potent inhibitor of CYP2D6. Nortriptyline is a substrate of CYP2D6. Inhibition leads to significantly elevated TCA levels, increasing the risk of cardiotoxicity (QTc prolongation) and anticholinergic toxicity. ANCC Tip: Fluoxetine and Paroxetine are the big two 2D6 inhibitors to remember; they can increase levels of secondary amines (Nortriptyline) and tertiary amines (Amitriptyline).
A patient is prescribed Vilazodone (Viibryd). Describe the dual pharmacodynamic mechanisms that characterize this SPARI.
Show answer →Vilazodone acts as a Serotonin Partial Agonist and Reuptake Inhibitor (SPARI). 1) It inhibits the Serotonin Transporter (SERT), increasing synaptic 5-HT. 2) It acts as a 5-HT1A receptor partial agonist. This dual action mimics the clinical effect of adding Buspirone to an SSRI, potentially leading to faster desensitization of presynaptic autoreceptors and a quicker antidepressant response with lower rates of sexual dysfunction.
Why are third-generation antipsychotics (TGAs) often preferred over second-generation antipsychotics (SGAs) for patients with comorbid metabolic syndrome?
Show answer →TGAs (Aripiprazole, Brexpiprazole, Cariprazine) generally have a more favorable metabolic profile, characterized by minimal weight gain and negligible effects on lipid levels or glucose metabolism. This is due to their partial agonism at D2 and 5-HT1A receptors and lower affinity for H1 (histamine) and 5-HT2C receptors, which are primary drivers of metabolic side effects. **ANCC Focus:** Monitoring parameters (BMI, waist circumference, HbA1c, lipids) remain necessary for all antipsychotics, but TGAs are the evidence-based preference for those at high cardiovascular risk. Always screen for metabolic syndrome using the ATP III criteria.
Which Tricyclic Antidepressant (TCA) is considered the gold standard for treating Obsessive-Compulsive Disorder (OCD) but carries a significantly higher risk of seizures?
Show answer →Clomipramine (Anafranil). Rationale: Clomipramine is unique among TCAs for its potent serotonin reuptake inhibition, making it effective for OCD. However, it is highly pro-convulsant, especially at doses exceeding 250mg/day. It is a tertiary amine, meaning it has more significant anticholinergic and sedative side effects than secondary amines. Exam Tip: Differentiate Clomipramine (OCD) from other TCAs like Desipramine (used for ADHD/depression) or Amitriptyline (used for chronic pain/migraine).
Which specific GABA-A receptor subunit is primarily responsible for the sedative effects of Z-drugs (e.g., Zolpidem) compared to the broader effects of traditional benzodiazepines?
Show answer →Alpha-1 subunit. Z-drugs (hypnotics) are selective for the alpha-1 subunit of the GABA-A receptor complex, which mediates sedation. Traditional BZDs are non-selective, binding to alpha-1, alpha-2, alpha-3, and alpha-5 subunits, leading to anxiolytic, anticonvulsant, and muscle relaxant effects. Exam Strategy: Distinguish selectivity to explain why Z-drugs are used for insomnia, not GAD.
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Try 30 free PMHNP-BC cards firstThe full PMHNP-BC deck contains 1040 flashcards, and 140 of them focus on pharmacology. This page shows 5 free samples.
Our PMHNP-BC deck dedicates 140 of 1040 cards (13%) to pharmacology — always cross-check the official ANCC exam outline for the current blueprint weighting.
Yes — the samples on this page are free, and the PMHNP-BC preview page has 30 more free cards. Full access to all 1040 cards is a one-time $7.
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