NRNP 6675 FINAL EXAM LAST EXAM EVERRRRR (minus
boards) | UPDATED Questions with 100% Verified Answers
Walden University • NRNP 6675
Q1: The 1/2 life of lithium is about?
A: 24 hours
Q2: Fluoxetine is the SSRI with the ______ WD risk?
A: lowest due to long half life
Q3: What antipsychotics are good for pts who miss doses of their meds?
A: Antipsychotics with long half-lives: 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 metabolites 8 days)
Q4: Disulfiram's alcohol interactions persist for up to how long after the medication is stopped?
A: LONG Half life--2-3 days persist up to 2 weeks following stopping
Q5: What is the only TCA with a long half life?
A: Protriptyline (Vivactil)
Q6: Most psychotropics have a medium range 1/2 life of approx?
A: 24 hours
Q7: what does "steady state" mean in relation to 1/2 life?
A: steady state means that you are eliminating the drug at the same overall rate that you are ingesting it
Q8: Lithium reaches its 'steady state' when?
A: 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) because 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 off 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.
,Q9: Due to the steady state of Lithium, when do we draw a blood level?
A: 5 half lives if you check any earlier, the trough level will underestimate the actual level the pt is on after achieving
steady state
Q10: Fluoxetine has a half life of about?
A: 2 weeks 1/2 life take 2.5 months to achieve steady state
Q11: Most psychotropic medications operate in this fashion:
A: "when you double the dose, the serum dose doubles." *minus three SRIs and three anticonvulsants (Fluoxetine,
fluvoxamine, paxil, gabapentin, valproate and carbamazepine)
Q12: _________induces it's own metabolism, hastening excretion and shortening it's half life
A: A. Carbamazepine (Tegretol) *this effect begins to "rev up" after 2-4 weeks--which is why a carbamazepine level is so
important on obtaining 1-2 months after starting Tegretol. 3 multiple choice options
Q13: Carbamazepine (Tegretol) level should be checked how soon after starting to take this med?
A: 1-2 months due to Tegretol inducing it's own metabolism, hastening excretion and shortening it's half life.
Q14: _____ has trouble getting a "serum" level because it binds to proteins that render it therapeutically
inactive?
A: A. Valproate Acid (Depakote) -this is particularly true at the lower levels (eg. <50 mcg/mL), so you can expect dose
changes to make a more dramatic difference when the pt's depakote level is in the higher range 3 multiple choice
options
Q15: _______'s serum level is the opposite of Valproic Acid: it rises quickly at first and then slows down?
A: Gabapentin *gabapentin saturates the transporters that absorb it in the small intestine, causing its levels to rise at a
snails pace when the dosage goes above a certain saturation 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 absorbed.
Q16: Due to Gabapentin's serum pattern for dosage: @ 900 mg/day, how much is the patient absorbing?
A: @ 0900mg/day---60% is absorbed.
Q17: Due to Gabapentin's serum pattern for dosage: @ 1200 mg/day, how much is the patient absorbing?
A: @ 1200 mg/day--50 % is absorbed.
, Q18: Due to Gabapentin's serum pattern for dosage: @ 3000 mg/day, how much is the patient absorbing?
A: @3000 mg/day--30% of the gabapentin is absorbed.
Q19: Carbamazepine (Tegretol's) serum level drops after how long after stopping taking it?
A: 1-2 months
Q20: For Valproate (Depakote), ___ dose changes can have big effects once the level is beyond 50 mcg/mL?
A: SMALL
Q21: potency refers to a drug's>
A: power per unit -or the amount of pharmacological activity per milligram.
Q22: Delayed release=
A: modified release "dont get absorbed until they have traveled to a specific site in the gut
Q23: Intermediate release (IR) medications:
A: dissolve rapidly in the GI tract and are absorbed in an hour or two
Q24: the serum concentrations of IR medications spike quickly and then fall back down, leading to what?
A: leading to low trough levels before the next dose. *These ups and downs in serum levels can cause SE or efficacy
problems.
Q25: *the ups and downs in serum levels of IR medications can cause what?
A: can cause SE or efficacy problems.
Q26: Bupropion can increase the risk of what?
A: Seizures *IF the serum level peaks too high
Q27: IR stimulants can lose ____ in the afternoon?
A: efficacy due to IR effect
boards) | UPDATED Questions with 100% Verified Answers
Walden University • NRNP 6675
Q1: The 1/2 life of lithium is about?
A: 24 hours
Q2: Fluoxetine is the SSRI with the ______ WD risk?
A: lowest due to long half life
Q3: What antipsychotics are good for pts who miss doses of their meds?
A: Antipsychotics with long half-lives: 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 metabolites 8 days)
Q4: Disulfiram's alcohol interactions persist for up to how long after the medication is stopped?
A: LONG Half life--2-3 days persist up to 2 weeks following stopping
Q5: What is the only TCA with a long half life?
A: Protriptyline (Vivactil)
Q6: Most psychotropics have a medium range 1/2 life of approx?
A: 24 hours
Q7: what does "steady state" mean in relation to 1/2 life?
A: steady state means that you are eliminating the drug at the same overall rate that you are ingesting it
Q8: Lithium reaches its 'steady state' when?
A: 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) because 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 off 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.
,Q9: Due to the steady state of Lithium, when do we draw a blood level?
A: 5 half lives if you check any earlier, the trough level will underestimate the actual level the pt is on after achieving
steady state
Q10: Fluoxetine has a half life of about?
A: 2 weeks 1/2 life take 2.5 months to achieve steady state
Q11: Most psychotropic medications operate in this fashion:
A: "when you double the dose, the serum dose doubles." *minus three SRIs and three anticonvulsants (Fluoxetine,
fluvoxamine, paxil, gabapentin, valproate and carbamazepine)
Q12: _________induces it's own metabolism, hastening excretion and shortening it's half life
A: A. Carbamazepine (Tegretol) *this effect begins to "rev up" after 2-4 weeks--which is why a carbamazepine level is so
important on obtaining 1-2 months after starting Tegretol. 3 multiple choice options
Q13: Carbamazepine (Tegretol) level should be checked how soon after starting to take this med?
A: 1-2 months due to Tegretol inducing it's own metabolism, hastening excretion and shortening it's half life.
Q14: _____ has trouble getting a "serum" level because it binds to proteins that render it therapeutically
inactive?
A: A. Valproate Acid (Depakote) -this is particularly true at the lower levels (eg. <50 mcg/mL), so you can expect dose
changes to make a more dramatic difference when the pt's depakote level is in the higher range 3 multiple choice
options
Q15: _______'s serum level is the opposite of Valproic Acid: it rises quickly at first and then slows down?
A: Gabapentin *gabapentin saturates the transporters that absorb it in the small intestine, causing its levels to rise at a
snails pace when the dosage goes above a certain saturation 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 absorbed.
Q16: Due to Gabapentin's serum pattern for dosage: @ 900 mg/day, how much is the patient absorbing?
A: @ 0900mg/day---60% is absorbed.
Q17: Due to Gabapentin's serum pattern for dosage: @ 1200 mg/day, how much is the patient absorbing?
A: @ 1200 mg/day--50 % is absorbed.
, Q18: Due to Gabapentin's serum pattern for dosage: @ 3000 mg/day, how much is the patient absorbing?
A: @3000 mg/day--30% of the gabapentin is absorbed.
Q19: Carbamazepine (Tegretol's) serum level drops after how long after stopping taking it?
A: 1-2 months
Q20: For Valproate (Depakote), ___ dose changes can have big effects once the level is beyond 50 mcg/mL?
A: SMALL
Q21: potency refers to a drug's>
A: power per unit -or the amount of pharmacological activity per milligram.
Q22: Delayed release=
A: modified release "dont get absorbed until they have traveled to a specific site in the gut
Q23: Intermediate release (IR) medications:
A: dissolve rapidly in the GI tract and are absorbed in an hour or two
Q24: the serum concentrations of IR medications spike quickly and then fall back down, leading to what?
A: leading to low trough levels before the next dose. *These ups and downs in serum levels can cause SE or efficacy
problems.
Q25: *the ups and downs in serum levels of IR medications can cause what?
A: can cause SE or efficacy problems.
Q26: Bupropion can increase the risk of what?
A: Seizures *IF the serum level peaks too high
Q27: IR stimulants can lose ____ in the afternoon?
A: efficacy due to IR effect
