Maryville University Pharm Exam 2 UPDATED ACTUAL
Questions and CORRECT Answers
1. What blood values should CBC for agranulosytosis (leukopenia/ neutropenia), BMP, and
be monitored with car- liver function tests, monitored at baseline prior to administration
bamazepine (Tegretol)? P. and followed throughout treatment
236-237
2. What is the pharmacodynam- Carbamazepine depresses transmission in the nucleus ventralis
ics of carbamazepine (Tegre- anterior of the thalamus. This area is associated with the spread
tol)? P. 235 of seizure discharge. Exact mechanism of action not known but
may work by slowing sodium influx to the cortical neurons thus
slowing the spread of abnormal neuron activity.
3. What should families be Seizure triggers, when to contact the physician, how to take
taught regarding the moni- medications properly and that medication needs may change
toring of seizure activity? with patient growth (kids), need for monitoring blood levels,
signs of adverse drug reactions
4. What electrolyte imbalance Topiramate is a carbonic anhydrase inhibitor used for seizures
is noted with the adminis- and migraines. This can increase bicarb loss (via the kid-
tration of topiramate (Topa- neys) which decreases serum bicarb levels. The result is hyper-
max)? P. 239 chloremic metabolic acidosis.
5. What is the pregnancy cate- Pregnancy category D (FDA dropped Pregnancy category desig-
gory for valproate? nations June 2015)
6. What instructions will you She should be advised to speak with her neurologist before
provide to a woman who trying to get pregnant. Valproate is a known teratogen (it can lead
wants to get pregnant and to neural tube defects), but may be taken after the first trimester
has a seizure disorder con- if needed.
trolled with valproate? P.
278-279
7. What are the precautions Contraindicated with cardiovascular disorders (Direct alpha
and contraindications for the adrenergic blocking effect and quinidine like effect on the my-
1/9
, Maryville University Pharm Exam 2 UPDATED ACTUAL
Questions and CORRECT Answers
tricyclic antidepressants? P. ocardium). Use with caution in those with glaucoma, prostatic
245-246 hypertrophy, or urinary incontinence. Do not use in combination
with MAOIs. Two week washout period. Use with extreme caution
in pregnancy. Most significant risk is cardiac conduction disorder
mostly in peds and elderly. May develop sinus tachycardia due
to slowing of depolarization of the cardiac muscle contributing
to prolongation of the QRS complex and PR/QT interval. Can
lower seizure threshold in those with seizure disorder. Use with
extreme caution in the elderly (norepinephrine effects in the
elderly can result in confusion, orthostatic hypotension, and falls.
May develop tardive dyskinesia
8. Phenelzine (Nardil) is an MAO Most commonly used for refractory unipolar depression. Irre-
inhibitor. What are the cau- versibly inactivate the enzymes that metabolize norepinephrine,
tions and contraindications? serotonin, and dopamine which increases the bioavailability of
How is it used to treat recalci- these neurotransmitters. Contraindicated in liver and kidney dis-
trant depression? P. 248-249 ease, HF, or CAD and in those over the age of 60. Prevents the
breakdown of tyramine Do not use in patient who cannot follow
appropriate dietary restrictions (tyramine-containing foods). Use
with extreme caution in pregnancy.
9. What are the symptoms of Severe headache, heart palpitations, blurred vision, stiff or sore
hypertensive crisis? neck, chest pain or tightness, nausea and vomiting, tachycardia,
sweating, shortness of breath, dilated pupils
10. How long does it take for se- Patients should be counseled that it may take as long as 3 to 4
lective serotonin reuptake in- weeks for maximum therapeutic benefits.
hibitors to produce an effect
in patients with depression?
P. 251
11. When are buspirone (Buspar)
and an SSRI combined? P. 217
2/9
Questions and CORRECT Answers
1. What blood values should CBC for agranulosytosis (leukopenia/ neutropenia), BMP, and
be monitored with car- liver function tests, monitored at baseline prior to administration
bamazepine (Tegretol)? P. and followed throughout treatment
236-237
2. What is the pharmacodynam- Carbamazepine depresses transmission in the nucleus ventralis
ics of carbamazepine (Tegre- anterior of the thalamus. This area is associated with the spread
tol)? P. 235 of seizure discharge. Exact mechanism of action not known but
may work by slowing sodium influx to the cortical neurons thus
slowing the spread of abnormal neuron activity.
3. What should families be Seizure triggers, when to contact the physician, how to take
taught regarding the moni- medications properly and that medication needs may change
toring of seizure activity? with patient growth (kids), need for monitoring blood levels,
signs of adverse drug reactions
4. What electrolyte imbalance Topiramate is a carbonic anhydrase inhibitor used for seizures
is noted with the adminis- and migraines. This can increase bicarb loss (via the kid-
tration of topiramate (Topa- neys) which decreases serum bicarb levels. The result is hyper-
max)? P. 239 chloremic metabolic acidosis.
5. What is the pregnancy cate- Pregnancy category D (FDA dropped Pregnancy category desig-
gory for valproate? nations June 2015)
6. What instructions will you She should be advised to speak with her neurologist before
provide to a woman who trying to get pregnant. Valproate is a known teratogen (it can lead
wants to get pregnant and to neural tube defects), but may be taken after the first trimester
has a seizure disorder con- if needed.
trolled with valproate? P.
278-279
7. What are the precautions Contraindicated with cardiovascular disorders (Direct alpha
and contraindications for the adrenergic blocking effect and quinidine like effect on the my-
1/9
, Maryville University Pharm Exam 2 UPDATED ACTUAL
Questions and CORRECT Answers
tricyclic antidepressants? P. ocardium). Use with caution in those with glaucoma, prostatic
245-246 hypertrophy, or urinary incontinence. Do not use in combination
with MAOIs. Two week washout period. Use with extreme caution
in pregnancy. Most significant risk is cardiac conduction disorder
mostly in peds and elderly. May develop sinus tachycardia due
to slowing of depolarization of the cardiac muscle contributing
to prolongation of the QRS complex and PR/QT interval. Can
lower seizure threshold in those with seizure disorder. Use with
extreme caution in the elderly (norepinephrine effects in the
elderly can result in confusion, orthostatic hypotension, and falls.
May develop tardive dyskinesia
8. Phenelzine (Nardil) is an MAO Most commonly used for refractory unipolar depression. Irre-
inhibitor. What are the cau- versibly inactivate the enzymes that metabolize norepinephrine,
tions and contraindications? serotonin, and dopamine which increases the bioavailability of
How is it used to treat recalci- these neurotransmitters. Contraindicated in liver and kidney dis-
trant depression? P. 248-249 ease, HF, or CAD and in those over the age of 60. Prevents the
breakdown of tyramine Do not use in patient who cannot follow
appropriate dietary restrictions (tyramine-containing foods). Use
with extreme caution in pregnancy.
9. What are the symptoms of Severe headache, heart palpitations, blurred vision, stiff or sore
hypertensive crisis? neck, chest pain or tightness, nausea and vomiting, tachycardia,
sweating, shortness of breath, dilated pupils
10. How long does it take for se- Patients should be counseled that it may take as long as 3 to 4
lective serotonin reuptake in- weeks for maximum therapeutic benefits.
hibitors to produce an effect
in patients with depression?
P. 251
11. When are buspirone (Buspar)
and an SSRI combined? P. 217
2/9
