QUESTIONS AND ANSWERS
What lab values should be monitored with Carbamazepine (Tegretol)? - ANSWER-CBC every 3-4
months
What can Carbamazepine (Tegretol) cause in labs findings? - ANSWER-Leukopenia,
thrombocytopenia, aplastic anemia, and agranulocytosis due to bone marrow depression
What are the pharamacodynamics of Carbamazepine (Tegretol)? - ANSWER-Thought to effect
sodium channels, slowing the influx of sodium in the cortical neurons and slowing the spread of
abnormal activity. It exerts its effects by depression transmission in the nuclus ventralis anterior
to the thalamus. causes autoinduced metabolism.
What is the peak and half life of Carbamazepine (Tegretol)? - ANSWER-Peak: 6 hours
Half Life: 65 hours initially, 12-17 hours with continued administration
What should families be taught regarding the monitoring of seizure activity? - ANSWER-Safety
and prevention. Do not stop medications abruptly.
What electrolyte imbalance is found with Topiramate (Topimax)? - ANSWER-Decrease in
bicarbonate
What are the pregnancy precautions for Valproate (Depakote)? - ANSWER-Should only be used
when a womans life would be endangered without it.
What can Valproate (Depakote) cause in the first trimester? - ANSWER-Neural tube defects
including spina bifida
What instructions will you provide to a woman who wants to get pregnant and has a seizure
disorder controlled by Valproate (Depakote)? - ANSWER-This medication can not be taken
during the first trimester or during lactation. Switch to another medication such as keppra.
What are the precautions and contraindications for tricyclic antidepressants? - ANSWER-
Patients with cardiovascular disorders. Can act as antiarrythmics. May be used with caution in
glaucoma, prostatic hypertrophy, or urinary incontinence
Should not be prescribed in combination with MAOI's or with demonstrated hypersensitivity to
this drug class. Can cause dry mouth, sedation, euphoria, and constipation, and tinnitus.
, What is Phenalzine (Nardil)? - ANSWER-MAOI
What are the cautions and contraindications of Phenelzine (Nardil)? - ANSWER-
Contraindications include liver disease, kidney disease, hypersensitivity, CHF, atherosclerotic
disease, and >60 years of age
Should be avoided in patients who are impulsive, cognitively impaired, or cannot follow dietary
restrictions. These medications inhibit the MAO. Treat a-typical depression. Often used as a last
line of treatment. Patients should avoid tyrmaine rich foods.
What are symptoms of a hypertensive crisis? - ANSWER-Headache, heart palpitations, stiff/sore
neck, chest tightness, tachycardia, sweating, and dilated pupils
How long does it take for selective serotonin reuptake inhibitors to produce an effect in patients
with depression? - ANSWER-2-6 weeks
When is Buspirone (Buspar) and an SSRI combined? - ANSWER-For treatment-resistant
depression due to combined serotogenic mechanisms. This medication can compliment SSRIs.
What type of diet is recommended with administration of Lithium? - ANSWER-Salt consistent
diet
What are side effects of tricyclics? - ANSWER-Anticholinergic effects - dry mouth, constipation,
urinary retention/retention, blurred vision, sedation, orthostatic hypotension, weight gain,
nausea, vomiting, gynecomastia, and changes in libido
What are the side effects of MAOI's? - ANSWER-Insomnia, anxiety, agitation, dry mouth, blurred
vision, urinary retention, and constipation.
What are the side effects of SSRIs? - ANSWER-Nausea, vomiting, dizziness, dry mouth, increased
sweating, weight gain/loss, exacerbation of anxiety, and agitation. Patients may also experience
sexual dysfunction
What receptors do benzodiazepines work on? - ANSWER-Gaba receptors
How do benzodiazepines work? - ANSWER-Exert their effect anxiolytic and sedative effect by
increasing their action of GABA (an inhibitory neurotransmitter) resulting in a decrease effect of
neuronal excitation.
What factors place a patient at risk for antibiotic resistance? - ANSWER-Recent antibiotic use,
being younger than 2 or over 65 years of age, day care center attendance, exposure to young
children, multiple medical comorbidities, recent hospitalization, and immunosuppression.
Excessive and inappropriate use of antibiotics (viruses, inadequate dosing, increased empirical
coverage)