VERIFIED ANSWERS.
1. The 1/2 life of lithium is about? 24 hours
2. Fluoxetine is the SSRI with the WD lowest due to long half life
risk?
3. What antipsychotics are good for pts who Antipsychotics with long half-lives:
miss doses of their meds? 1. Cariprazine(Vrylar): (2-4 days-active
metabolites up to 3 weeks)
2. Abilify (3 days)
3. Brexipiprazole (4 days)
4. Pimozide (4-5 days)
5. Pimavanserin (2 days, active metabo-
lites 8 days)
4. Disulfiram's alcohol interactions persist for LONG Half life--2-3 days
up to how long after the medication is
stopped? persist up to 2 weeks following stopping
5. What is the only TCA with a long half life? Protriptyline (Vivactil)
6. Most psychotropics have a medium range 24 hours
1/2 life of approx?
7. what does "steady state" mean in relation to steady state means that you are eliminat-
1/2 life? ing the drug at the same overall rate that
you are ingesting it
8. Lithium reaches its 'steady state' when? 5 half lives
example:
Day 1: Start pt on Lithium 600 mg daily
Day 2: (24 hours later) the amount left
in his body is 300 mg (day 2 min) be-
, NRNP 6675 FINAL EXAM 2026/2027 ACTUAL QUESTIONS WITH
VERIFIED ANSWERS.
cause 24 hours has passed--one 1/2
life--therefore the pt has excreted 1/2 of
the initial amount.
THEN the pt takes his 2nd dose of 600
mg on DAY 2-resulting in a max dose of
900 (300 mg left in body + 600 mg of
2nd dose).
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, the pt now has a
total of 1050 mg.
9. Due to the steady state of Lithium, when do 5 half lives
we draw a blood level?
if you check any earlier, the trough level
will underestimate the actual level the pt
is on after achieving steady state
10. Fluoxetine has a half life of about? 2 weeks 1/2 life
take 2.5 months to achieve steady state
11. Most psychotropic medications operate in "when you double the dose, the serum
this fashion: dose doubles."
*minus three SRIs and three anticon-
vulsants (Fluoxetine, fluvoxamine, pax-
il, gabapentin, valproate and carba-
mazepine)
12. induces it's own metabolism, has- A. Carbamazepine (Tegretol)
tening excretion and shortening it's half life
*this ettect begins to "rev up" after 2-4
, NRNP 6675 FINAL EXAM 2026/2027 ACTUAL QUESTIONS WITH
VERIFIED ANSWERS.
weeks--which is why a carbamazepine
level is so important on obtaining 1-2
months after starting Tegretol.
13. Carbamazepine (Tegretol) level should be 1-2 months due to Tegretol inducing
checked how soon after starting to take this it's own metabolism, hastening excretion
med? and shortening it's half life.
14. has trouble getting a "serum" level be- A. Valproate Acid (Depakote)
cause it binds to proteins that render it ther-
apeutically inactive? -this is particularly true at the lower levels
(eg. <50 mcg/mL), so you can expect
dose changes to make a more dramatic
ditterence when the pt's depakote level
is in the higher range
15. 's serum level is the opposite of Val- Gabapentin
proic Acid: it rises quickly at first and then
slows down? *gabapentin saturates the transporters
that absorb it in the small intestine, caus-
ing its levels to rise at a snails pace when
the dosage goes above a certain satura-
tion point (around 900 mg/day).
-from there, the saturation trickles down;
@ 900 mg/day--60% is absorbed. @
1200 mg/day--50 % is absorbed. @3000
mg/day--30% of the gabapentin is ab-
sorbed.
16. Due to Gabapentin's serum pattern for @ 0900mg/day---60% is absorbed.
dosage: