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Summary WGU D345 Comprehensive Study Guide: Dr Cole Remediation for OA 2026 update, Exams of Advanced Education

Widener University - DelawareAdvanced Education

• 1. Neurotransmitters: know all the neurotransmitters, the role of various neurotransmitters in various diagnosis and symptoms. Recommendation: Make a chart with various diagnosis and the role various neurotransmitters play in that diagnosis/symptom. • The study of the magnitude and variation of drug response is the definition of pharmacodynamics. Psychodynamics is the study of what the body does to a drug and helps explain the relationship between the dose and response. o Dopamine produced in substantia nigra and ventral tegmental area ▪ D: Drive/Drugs ▪ O: psychOsis ▪ P: Prolactin Inhibition ▪ A: Attention ▪ M: Motivation ▪ I: Involuntary Movements ▪ N: Nausea ▪ E: Energy

Typology: Exams

2025/2026

Available from 07/02/2026

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Comprehensive Study Guide D345
1
Summary WGU D345 Comprehensive Study Guide:
Dr Cole Remediation for OA
2026 update
Section 1 Highlight Guide
•
1. Neurotransmitters: know all the neurotransmitters, the role of
various neurotransmitters in various diagnosis and symptoms.
Recommendation: Make a chart with various diagnosis and the role
various neurotransmitters play in that diagnosis/symptom.
•
The study of the magnitude and variation of drug response is the
definition of
pharmacodynamics
.
Psychodynamics
is the study of
what the body does to a drug and helps explain the relationship
between the dose and response.
o
Dopamine produced in substantia nigra and ventral tegmental
area
▪
D: Drive/Drugs
▪
O: psychOsis
▪
P: Prolactin Inhibition
▪
A: Attention
▪
M: Motivation
▪
I: Involuntary Movements
▪
N: Nausea
▪
E: Energy
o
Serotonin is produced mostly in Raphe nucleus
▪
DOMAINS: Depression, Obsession, Migraines, Anxiety,
Intestines, Nausea, and Sexual.
▪
Serotonin Syndrome:
Shits and SHIVERS.
Shits(diarrhea), Shivering, Hyperreflexia, Increased
temperature, Vital sign instability, Encephalopathy,
Restlessness, and Sweating.
o
Norepinephrine is produced in locus ceruleus of the pons
▪
Receptors A1, A2, B1, B2, and B3. More blood vessels.
▪
Fight or flight. Sympathetic nervous system.
▪
Concentrating, focusing, burst of energy, increased
BP/HR, mobilizing glucose
o
Epinephrine produced by the adrenal glands
▪
More heart
▪
Fight or flight. Sympathetic nervous system.
o
Acetylcholine synthesized by the Basal Nucleus of Meynart
▪
Parasympathetic Nervous system. Rest and Digest. Feed
and breed.
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Download Summary WGU D345 Comprehensive Study Guide: Dr Cole Remediation for OA 2026 update and more Exams Advanced Education in PDF only on Docsity!

Summary WGU D345 Comprehensive Study Guide:

Dr Cole Remediation for OA 2026 update

Section 1 Highlight Guide

    1. Neurotransmitters: know all the neurotransmitters, the role of various neurotransmitters in various diagnosis and symptoms. Recommendation: Make a chart with various diagnosis and the role various neurotransmitters play in that diagnosis/symptom.
  • The study of the magnitude and variation of drug response is the definition of pharmacodynamics. Psychodynamics is the study of what the body does to a drug and helps explain the relationship between the dose and response. o Dopamine produced in substantia nigra and ventral tegmental area ▪ D: Drive/Drugs ▪ O: psychOsis ▪ P: Prolactin Inhibition ▪ A: Attention ▪ M: Motivation ▪ I: Involuntary Movements ▪ N: Nausea ▪ E: Energy o Serotonin is produced mostly in Raphe nucleus ▪ DOMAINS: Depression, Obsession, Migraines, Anxiety, Intestines, Nausea, and Sexual. ▪ Serotonin Syndrome: Shits and SHIVERS. Shits(diarrhea), Shivering, Hyperreflexia, Increased temperature, Vital sign instability, Encephalopathy, Restlessness, and Sweating. o Norepinephrine is produced in locus ceruleus of the pons ▪ Receptors A1, A2, B1, B2, and B3. More blood vessels. ▪ Fight or flight. Sympathetic nervous system. ▪ Concentrating, focusing, burst of energy, increased BP/HR, mobilizing glucose o Epinephrine produced by the adrenal glands ▪ More heart ▪ Fight or flight. Sympathetic nervous system. o Acetylcholine synthesized by the Basal Nucleus of Meynart ▪ Parasympathetic Nervous system. Rest and Digest. Feed and breed.

o Muscarinic Receptors

    1. Pharmacokinetics and Pharmacodynamics are factors that affect both. o Pharmacokinetics- What the BODY does to the drug or how it is processed by the body. o Pharmacodynamics- What the Drug does to the body and how it produces the therapeutic effect. The MOA. o Pharmacokinetics processes vary between patients because they are affected by body factors such as gender, age, weight, genetics, and also drug-drug interactions. The process is affected by a pregnancy and a patient's pathophysiology. o Pharmacodynamics is another process involving the relationship between drug concentration at the site of action and its effects. Medication binding determines drug impact at the site of movement with a receptor. Understanding each medication's full range of receptor interactions is critical
    1. Agonist, antagonist, partial agonist, inverse agonist, depolarization, repolarization o Agonist- Substance which initiates a physiological response when combined with a receptor. o Antagonist- Substance that interferes/inhibits the physiological action of another. o Partial Agonist- Binds to a receptor and activates it, but to a lesser extent than a full agonist.

ii. A2 and A3 subtype receptors are linked to anti-anxiety, muscle relaxant, and alcohol-potentiating actions. iii. A5 is mostly in the hippocampus and may be linked to cognition. c. Dual Orexin Receptor Antagonists(DORAS): Block wake stabilizing orexin 1&2 receptors. Reversible so when the orexin levels rise in the morning, it goes back to normal. Lemborexant has a faster reversal due to dissociation kinetics at receptor 2(orexin). i. Suvorexant and Lemborexant. Promote sleep without side effects of Benzo or Z-drug(hypnotic). d. Serotonergic Hypnotics: 5HT2A/A1/H1 antagonist. TRAZADONE. Reduces the arousal in insomnia. REDUCES AROUSAL vs enhancing sleep drive. Blockade of arousal neurotransmitters(serotonin, norepinephrine, and histamine). Used for depression but insomnia is a non-intended treatment effect. e. Histamine 1 Antagonists: Diphenhydramine/Benadryl(allergy meds) or doxylamine. Doxepin(depression med/other tricyclic antidepressants too), and psychosis meds(chlorpromazine and quetiapine). Low doses for them function as hypnotics. f. Anticonvulsants: Gabapentin and pregabalin. i. Gabapentin

  1. Short half life 5 - 7 hours. Can experience withdrawal.
  2. For partial seizures, post herpetic neuralgia, RLS. a. Off Label anxiety, withdrawal of alcohol or benzo, alcohol dependence. b. Dizzy, somnolence, ataxia, weight gain. c. Blocks voltage dependent CA channels. d. Not metabolized, excreted unchanged by kidneys. g. Oxcarbazepine(Trileptal): i. Seizure disorder in children and adults.
  3. Off label Bipolar. ii. Dizzy, somnolence, headache, ataxia, N, S. iii. Serious Stevens Johnson. Angioedema. Monitor serum sodium(especially first 3 months). iv. NA channel blocker. POTENT INDUCE CYP3A4.

v. Asian descent screen for HLA-B. Increased risk of steven johnson syndrome. vi. Can be used as mood stabilizer. Trileptal reduces effectiveness of birth control.

  1. Benzodiazepines: Flurazepam (long lasting agent), Temazepam (intermediate acting agent), Triazolam (short acting agent)
  2. P450 system-inducers, inhibitors. See supplemental learning materials under course tips. a. Pharmacokinetic actions via hepatic and gastrointestinal drug- metabolizing systems. P450(CYP450 2D6 enzyme to help break down).

g. Y subunit tend to be synaptic to mediate phasic neurotransmission and be sensitive to Benzodiazepines. h. GABA-a with δ subunit are extrasynaptic and mediate tonic(low level release of neurotransmitters) neurotransmission. Insensitive to benzos. i.

j. k. Flumazenil kicks GABA receptor out and returns the GABA-a receptor back. Benzo receptor antagonist.

  1. Methadone: indications, contraindications, side effects. a. Methadone is full agonist at μ-opioid receptors and can suppress withdrawal symptoms completely given orally and usually administered daily at a clinic. b. For severe pain and opioid dependence. c. Accumulates with repeated doses, may need reduction after 3- 5 days to prevent CNS depression. d. Avoid with other CNS depressant medications. e. Constipation, dizziness, sedation, nausea, sweating. i. May prolong QT. Torsades de point.
  2. Withdrawal management (pharmacological and nonpharmacological) for various substances. a. Nicotine: Options are gums, lozenges, nasal sprays, inhalers, and transdermal patches. i. Can help to reduce craving due to a steady amount of nicotine that is delivered and presumably desensitizes an important number of resensitizing and craving nicotinic receptors.
  1. Diarrhea, weakness, peripheral edema, insomnia, anxiety.
  2. Acute Renal failure, SI,.
  3. Pt. Education: Does not tx or prevent withdrawal symptoms. Monitor for SI or depression. Do not drink alcohol and do not operate heavy machinery. iii. Disulfiram: Irreversible inhibitor of the liver enzyme aldehyde dehydrogenase. This normally metabolizes alcohol. This causes a build-up of toxic levels of acetaldehyde. Flushing, nausea, vomiting, and hypotension results.
  4. For Alcohol dependence.
  5. Monitor LFTs.
  6. Skin eruptions, drowsiness, fatigue, impotence, headache, and metallic tastes.
  7. Serious is hepatic failure.
  8. Pt. Ed. Do not drink while on. CV collqapse and death, liver failure, carry identification card. iv. Unapproved: topiramate and ondansetron. v. Naltrexone: Shortens the withdrawal time of an A2 agonist administered with methadone or buprenorphine.
  9. Monthly injections and assist in adherence. Chooses once to take every 30 vs choosing to take a pill daily.
  10. For Alcohol dependence and opioid addiction(prevents relapse following detox).
  11. LFT.
  12. Headache, nausea, somnolence, vomiting.
  13. CYP450. Opioid antagonist. HTN, bracelet.
  14. Signs of withdrawal from various substances a. Stimulants: Sleepiness/Anhedonia. b. Inhalants: Depression, weight loss, brain damage.
  15. FDA approved medications for alcohol use disorder-Campral, Disulfiram, Naltrexone-what are the contraindications, indications, side effects, patient education for each one of these. a. See above. b. Naltrexone: Shortens the withdrawal time of an A2 agonist administered with methadone or buprenorphine.
  16. Monthly injections and assist in adherence. Chooses once to take every 30 vs choosing to take a pill daily. c. Vivitrol: indications, formulations, contraindications, side effects
  17. Pharmacological agents useful in treating cravings and maintaining abstinence. Use Stahl’s book.

a. See Above

  1. ADHD Medication Times.

Section 3 Highlight Guide

  1. Bupropion: indications, side effects, contraindications, off-label uses. a. Serotonin 1A partial agonist. Generalized anxiety disorder. Can augment drugs for depression. SSSRI, SPARI(partial agonist reuptake), psychosis drugs. Anxiolytic actions. i. Least likely sexual s/e. Helps smoking quit. ii.
  2. Agents used for Anxiety symptom treatment including SSRIs, SNRIs, benzodiazepines, buspirone, propranolol, atenolol. Non benzodiazepines used for anxiety in adults (page 205 in review and resource manual). a. GAD i. SSRI, SNRI, Benzo, buspirone, alpha 2 delta ligands(pregabalin/gabapentin). Avoid benzo with those using substances. Off-label mirtazapine, trazodone, vilazodone, an, sedating antihistamines(hydroxyzine). b. Panic Disorder i. SSRI, SNRI, Benzo, alpha 2 delta ligands(pregabalin/gabapentin). Off label is mirtazapine and trazodone. MAOIs but can help with panic when others fail. c. Social Anxiety Disorder i. SSRI, SNRI, alpha 2 delta ligands(pregabalin/gabapentin). Benzo is not usually done. Beta blockers. d. PTSD i. SSRI. No benzo due to comorbid substance use. EMDR
  3. Wake Promoting Agents. a. Caffeine, stimulants, modafinil/armodafinil, NDRI (norepinephrine–dopamine reuptake inhibitor) and an H antagonist. i. Caffeine is antagonist of adenosine. Enhances dopaminergic effects by not allowing adenosine to reduce the D2 receptor sensitivity. ii. Amphetamine and Methylphenidate: Wake promoting and fatigue-reducing effects. Norepinephrine-dopamine reuptake inhibitors. Amphetamine is also a dopamine releaser. Good for narcolepsy but not OSA(Obstructive sleep apnea) or SWD(shift work disorder).
  4. Enhance the synaptic availability of wake-promoting neurotransmitters dopamine/norepinephrine.

iii. Modafinil/Armodafinil:

  1. Only approved for narcolepsy. Adjunctive tx for OSA and SWD.
  2. MOA: Thought to inhibit the dopamine transporter(DAT) or dopamine reuptake pump. a. Modafinil is weak DAT, the concentrations after oral dose is high to affect DAT. Slow rise in plasma and sustained plasma level. b. Armodafinil: Later time to peak levels, longer half-life, higher plasma drug levels after 6- 14 hours.
  3. Obstructive Sleep Apnea a. CPAP first line. Bad adherence rate. BPAP. Exercise. b. Modafinil and Armodafinil as adjuncts.
  4. Shift Work Disorder a. Modafinil, armodafinil, with Circadian rhythm adjunctive therapy.
  5. Solriamfetol NDRI a. Wake promotion for daytime sleepiness. Narcolepsy and adjunct for OSA. b. Norepinephrine and dopamine reuptake. More potent than bupropion but less potent/more tolerable than stimulants(amphetamine/methylphenidate). Short half life.
  6. Pitolisant H3 presynaptic antagonist. a. Narcolepsy by blocking H3 autoreceptors. No abuse potential. Adjunct. Can overly activate and cause anxiety or insomnia.
  7. Sodium Oxybate and Narcolepsy/Cataplexy a. Y-hydroxybutyrate(GHB) is full agonist at GHB receptors and GABA B partial agonist. i. Cataplexy and excessive sleepiness. Enhance slow wave sleep and reduce hypnagogic hallucinations and sleep paralysis.
  8. Meds for Anxiety a. SSRI i. Fluoxetine(Prozac)
  9. Serotonergic transmission increases, noradrenergic and dopaminergic effects. Metabolized via CYP2D