NURS 612 pharm 2022 6A

1. What are the precautions and contraindications when prescribing phentermine? Ans increases BP, palpitations, and dysrhythmias, not advisable in pts with HTN or cardiovascular failure 2. What is the length of time that anorexiants should be prescribed? Ans 6 months duration and d/c at any signs of tolerance Pg.234 3. What is rectal diazepam (Diastat) used to treat? Ans * adjunct tx Epocrates, Status epilepticus, seizure disorder. 4. What is phenytoin hypersensitivity syndrome and when does it occur? Ans fever, skin rash, lymphadenopathy 5. What is the auto metabolism of carbamazepine? Ans is metabolized by the liver and has a unique ability to induce its metabolism (autoinduction). 6. What is the Black Box Warning of carbamazepine? Ans Use cautiously with increased intraocular pressure. Potential blood dyscrasias. Transient decrease in WBC, depresses bone marrow, leading to leukopenia, thrombocytopenia, agranulocytosis & aplastic anemia. Steven-Johnson syndrome, risk of aplastic anemia, &agranulocytosis. 7. What blood values should be monitored with carbamazepine? Ans monitor blood count, urinalysis, and liver function b4 beginning tx & during the first few months. 8. What is the pharmacodynamics of carbamazepine? Ans Exerts its effects by depressing transmission in the nucleus ventralis anterior of the thalamus 9. What are the adverse effects of ethosuximide (Zarontin) and what blood values should be monitored? GI distress (administer with food), CNS depression, sedation ataxia, lethargy, headache, rash, pruritus, mood swings, monitor serum levels (normal range 40-100 mcg/ml). seizure activity, renal, liver, and hematological periodically 10. How will you monitor patients for suicidal ideations when prescribing central nervous system medications? Ans Monitor mood changes, interview patient regarding their thoughts and feelings 11. Topiramate will cause weight loss. What patient teaching will you provide? Ans Weight loss is in 6 % of cases. Instruct on increased caloric intake 12. What should families be taught regarding the monitoring of seizure activity? Ans Do not abruptly withdraw medications. Monitor serum levels. Maintain follow-up appts. Instruct that medication needs to change with growth. 13. What electrolyte imbalance is noted with the administration of topiramate? Ans Decrease serum bicarbonate due to inhibition of carbonic anhydrase and increase renal bicarbonate, leading to hyperchloremic metabolic acidosis. 14. What drugs interact with levetiracetam? Ans It is mostly unbound and does not use CYP450 enzymes for metabolism, thereby decreasing the likelihood of interactions 15. Multi-organ failure is a risk with the administration of lamotrigine(Lamictal). What signs and symptoms indicate the onset of multi-organ failure? Ans monitor renal and hepatic function due to this risk. Most commonly noted in the liver