A client has been taking antidepressants for 2 years. He tells ...

[armygirl]

A client has been taking antidepressants for 2 years. He tells the nurse that his medication no longer seems to be working despite the fact that he ensures that he never misses a dose. What phenomenon could account this client's claim?
 
  A) Refractoriness
  B) Efficacy
  C) Affinity
  D) Noncompliance

Question 2

A client has been severely depressed for several months and has failed to respond appreciably to treatment with selective serotonin reuptake inhibitors (SSRIs).
 
  As a result, his psychiatrist has begun a course of monoamine oxidase inhibitors (MAOIs). The care team has been careful to monitor for what adverse effect related to excess tyramine?
  A) Increased agitation
  B) Hypertensive crises
  C) Serotonin syndrome
  D) Tardive dyskinesia

[makaylafy]

Answer to Question 1

Ans: A
Feedback:
Refractoriness means the desensitization of cells to a drug over time. Also called downregulation, refractoriness generally occurs when agonists continually stimulate cells. The resultant repeated exposure of cells to the same concentration of the drug causes the drug to have diminished effectiveness.

Answer to Question 2

Ans: B
Feedback:
Normally, MAO breaks down tyramine; however, because MAOIs inhibit MAO, tyramine can accumulate in the bodies of clients taking these drugs and eating tyramine-containing foods at the same time. Tyramine also releases norepinephrine from nerve endings. These metabolic actions can precipitate a hypertensive crisis.