NURS 615 Exam II 2023 LATEST QUESTIONS WITH COMPLETE SOLUTIONS RATED (A+)

What blood values should be monitored with carbamazepine? - CORRECT ANS Plasma carbamazepine levels should be monitored on a regular basis. The therapeutic range is 4 to 12 mcg/L. Higher levels can lead to toxic symptoms consisting of initial adverse effects and also hypertension, tachycardia, ECG changes, stupor, agitation, nystagmus, urinary retention, respiratory depression, seizures, and coma. Children and elderly patient may develop toxicity levels below 12. CBC every 3 to 4 months Affects RBC, WBC, Platelets Agranulocytosis, Anemia What is the pharmacodynamics of carbamazepine? - CORRECT ANS Carbamazepine is metabolized in the liver and has the unique ability to induce its own metabolism (autoinduction). Due to autoinduction, initial concentrations within therapeutic range may later fall despite good compliance. It also induces the metabolism of many CYP450 enzymes and other substances. Slowly but well absorbed half life of about 30 hours, shortens to 15 hours when given repeatedly The exact mechanism of action of carbamazepine is not known, but they are thought to affect the sodium channels, slowing influx of sodium in the cortical neurons and slowing the spread of abnormal activity. Carbamazepine exerts its effect by depressing transmission in the nucleus ventralis anterior of the thalamus. This area is associated with the spread of seizure discharge. •Absorption and Distribution Carbamazepine is absorbed through the stomach, the suspension being absorbed more quickly than the tablet form. Absorption from the immediate-release tablets is slow and erratic because of its slow water solubility. The drug is highly lipophilic, resulting in high body tissue binding. •Metabolism and Excretion