NRNP 6675 FINAL EXAM LAST EXAM EVERRRRR (minus boards) Exam Questions and Answers

NRNP 6675 FINAL EXAM LAST EXAM EVERRRRR (minus boar 7b 7b 7b 7b 7b 7b 7b 7b



ds)
1. The 1/2 life of lithium is about?: 24 hours 7b 7b 7b 7b 7b 7b 7b 7b




2. Fluoxetine is the SSRI with the 7b 7b 7b 7b 7b 7b



WD risk?: lowest due to long half life 7b 7b 7b 7b 7b 7b 7b




3. What antipsychotics are good for pts who miss doses of their meds?
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: Antipsy- chotics with long half-lives:
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1. Cariprazine(Vrylar): (2-4 days-active metabolites up to 3 weeks) 7b 7b 7b 7b 7b 7b 7b




2. Abilify (3 days) 7b 7b




3. Brexipiprazole (4 days) 7b 7b




4. Pimozide (4-5 days) 7b 7b




5. Pimavanserin (2 days, active metabolites 8 days) 7b 7b 7b 7b 7b 7b




4. Disulfiram's alcohol interactions persist for up to how long after 7 b 7 b 7 b 7 b 7 b 7 b 7 b 7 b 7 b 7




bthe medica- tion is stopped?: LONG Half life--2-3 days
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persist up to 2 weeks following stopping
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5. What is the only TCA with a long half life?: Protriptyline (Vivactil)
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6. Most psychotropics have a medium range 1/2 life of approx?: 24
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hours
7. what does "steady state" mean in relation to 1/2 life?: steady state mean
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s that you are eliminating the drug at the same overall rate that you are ingesting it
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8. Lithium reaches its 'steady state' when?: 5 half lives 7b 7b 7b 7b 7b 7b 7b 7b




example:
Day 1: Start pt on Lithium 600 mg daily
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Day 2: (24 hours later) the amount left in his body is 300 mg (day 2 min) because 24 hours has pa
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ssed--one 1/2 life--therefore the pt has excreted 1/2 of the initial amount.
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THEN the pt takes his 2nd dose of 600 mg on DAY 2-
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resulting in a max dose of 900 (300 mg left in body + 600 mg of 2nd dose).
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DAY 3: starts ott with 450 mg (1/2 of the 900 mg in pt's system) and after taking the day 3 600 mg dose
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, the pt now has a total of 1050 mg.
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9. Due to the steady state of Lithium, when do we draw a blood level?:
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7b 5 half lives if you check any earlier, the trough level will underestimate the actual level the pt is on
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, NRNP 6675 FINAL EXAM LAST EXAM EVERRRRR (minus boar
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ds)
after achieving steady state
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, NRNP 6675 FINAL EXAM LAST EXAM EVERRRRR (minus boar
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ds)
10. Fluoxetine has a half life of about?: 2 weeks 1/2 life 7b 7b 7b 7b 7b 7b 7b 7b 7b 7b




take 2.5 months to achieve steady state
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11. Most psychotropic medications operate in this fashion:: "when you 7b 7b 7b 7b 7b 7b 7b 7b 7b




double the dose, the serum dose doubles." 7b 7b 7b 7b 7b 7b




*minus three SRIs and three anticonvulsants (Fluoxetine, fluvoxamine, paxil, gabapentin, valproate and ca
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rba- mazepine) 7b




12.
induces it's own metabolism, hastening excretion and shortening i
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t's half life: A. Carbamazepine (Tegretol)
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*this ettect begins to "rev up" after 2-4 weeks--
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which is why a carbamazepine level is so important on obtaining 1-2 months after starting Tegretol.
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13. Carbamazepine (Tegretol) level should be checked how soo 7 b 7 b 7 b 7 b 7 b 7 b 7 b




n after starting to take this med?: 1-
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2 months due to Tegretol inducing it's own metabolism, hastening excretion and shortening it's
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half life. 7b




14.
has trouble getting a "serum" level because it binds to proteins
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that render it therapeutically inactive?: A. Valproate Acid (Depakote)
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-this is particularly true at the lower levels (eg. <50 mcg/
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mL), so you can expect dose changes to make a more dramatic ditterence when the pt's depakote level is i
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n the higher range
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15. 's serum level is the opposite of Valproic Acid: it rises qu 7b 7b 7b 7b 7b 7b 7b 7b 7b 7b 7b




ickly at first and then slows down?: Gabapentin
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*gabapentin saturates the transporters that absorb it in the small intestine, causing its levels to rise at a
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snails pace when the dosage goes above a certain saturation point (around 900 mg/day).
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-from there, the saturation trickles down; @ 900 mg/day--60% is absorbed. @ 1200 mg/day--50
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% is absorbed. @3000 mg/day--30% of the gabapentin is absorbed.
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, NRNP 6675 FINAL EXAM LAST EXAM EVERRRRR (minus boar
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ds)
16. Due to Gabapentin's serum pattern for dosage:
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@ 900 mg/day, how much is the patient absorbing?: @ 0900mg/day---
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60% is absorbed. 7b 7b




17. Due to Gabapentin's serum pattern for dosage:
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@ 1200 mg/day, how much is the patient absorbing?: @ 1200 mg/day--50
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% is absorbed.
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