Maryville NURS 615 Exam 2
What blood values should be monitored with carbamazepine (Tegretol)? - Answer-CBC test every 3-4
months to monitor for decrease in WBCs, platelets, and trouble with RBC production.
What are the pharmacodynamics of carbamazepine (Tegretol)? - Answer-- Auto-metabolizes leading to
lower serum levels despite compliance.
- Half-life 30 hours as single dose, 15 hours when given repeatedly.
What are the Black Box Warnings for carbamazepine (Tegretol)? - Answer-- Stevens-Johnson Syndrome
(SJS)
- Toxic Epidermal Necrolysis (TEN)
Carbamazepine (Tegretol) is what type of drug? - Answer-Anticonvulsant drug
What should families be taught regarding the monitoring of seizure activity? - Answer-- Prevention of
seizures
- Patient Safety
- Quality of life issues
- Do not discontinue medication due to increased risk of seizures
, What electrolyte imbalance is noted with the administration of topiramate (Topamax)? - Answer-
Decrease in sodium bicarbonate leading to hyperchloremic metabolic acidosis.
What are adverse effects of topiramate (Topamax)? - Answer-- Weight loss, especially in higher dose
patients
- May affect ability to sweat
What are pregnancy precautions for valproate (Depakote)? - Answer-- Pregnancy Category X
- Teratogen (an agent that causes malformation of an embryo)
What instructions will you provide to a woman who wants to get pregnant and has a seizure disorder
controlled with valproate (Depakote)? - Answer-- Pregnant women should be advised to switch to
another anticonvulsant during the first trimester, such as levetiracetam (Keppra), then switch back to
volproate (Depakote) in the second trimester.
- All anticonvulsants for pregnant women should be monitored by a high-risk obstetrician.
What are precautions and contraindications for tricyclic antidepressants? - Answer-- Caution cardiac
disease patients (may act as an antiarrhythmic)
- HTN, tachycardia, and convulsions when used with MAOIs
What are adverse effects of tricyclic antidepressants? - Answer-- Anticholinergic effects (dry mouth,
sedation, constipation, increased appetite, blurred vision, tinnitus, euphoria, and mania)
Phenylzine (Nardil) is an MAOI. What are the precautions and contraindications? - Answer-- Avoid foods
high in tyramine (fermented foods, wine, alcohol, aged cheeses, yogurt, soy sauce, summer sausage,
processed meats, etc.)
- Avoid St. John's Wort (Serotonin Syndrome)
-Many other drug-drug interactions
What blood values should be monitored with carbamazepine (Tegretol)? - Answer-CBC test every 3-4
months to monitor for decrease in WBCs, platelets, and trouble with RBC production.
What are the pharmacodynamics of carbamazepine (Tegretol)? - Answer-- Auto-metabolizes leading to
lower serum levels despite compliance.
- Half-life 30 hours as single dose, 15 hours when given repeatedly.
What are the Black Box Warnings for carbamazepine (Tegretol)? - Answer-- Stevens-Johnson Syndrome
(SJS)
- Toxic Epidermal Necrolysis (TEN)
Carbamazepine (Tegretol) is what type of drug? - Answer-Anticonvulsant drug
What should families be taught regarding the monitoring of seizure activity? - Answer-- Prevention of
seizures
- Patient Safety
- Quality of life issues
- Do not discontinue medication due to increased risk of seizures
, What electrolyte imbalance is noted with the administration of topiramate (Topamax)? - Answer-
Decrease in sodium bicarbonate leading to hyperchloremic metabolic acidosis.
What are adverse effects of topiramate (Topamax)? - Answer-- Weight loss, especially in higher dose
patients
- May affect ability to sweat
What are pregnancy precautions for valproate (Depakote)? - Answer-- Pregnancy Category X
- Teratogen (an agent that causes malformation of an embryo)
What instructions will you provide to a woman who wants to get pregnant and has a seizure disorder
controlled with valproate (Depakote)? - Answer-- Pregnant women should be advised to switch to
another anticonvulsant during the first trimester, such as levetiracetam (Keppra), then switch back to
volproate (Depakote) in the second trimester.
- All anticonvulsants for pregnant women should be monitored by a high-risk obstetrician.
What are precautions and contraindications for tricyclic antidepressants? - Answer-- Caution cardiac
disease patients (may act as an antiarrhythmic)
- HTN, tachycardia, and convulsions when used with MAOIs
What are adverse effects of tricyclic antidepressants? - Answer-- Anticholinergic effects (dry mouth,
sedation, constipation, increased appetite, blurred vision, tinnitus, euphoria, and mania)
Phenylzine (Nardil) is an MAOI. What are the precautions and contraindications? - Answer-- Avoid foods
high in tyramine (fermented foods, wine, alcohol, aged cheeses, yogurt, soy sauce, summer sausage,
processed meats, etc.)
- Avoid St. John's Wort (Serotonin Syndrome)
-Many other drug-drug interactions
