PHARM TEST 2 | GUARANTEED SUCCESS STARTS HERE!
LEARN, PRACTICE & EXCEL!
Diazepam T & P Answer: T: Antiepileptic drug, anti anxiety drug, skeletal Muscle Relaxant
P: Benzodiazepine, Gaba receptor agonist
Diazepam Indications Answer: Seizures & seizure prophylaxis
Anxiety disorders
Prior to procedures such as cardio version or endoscopy to provide relaxation or sedation
Muscle relaxation for patients with acute inflammation, trauma, tetanus, or spasticity
Diazepam adverse effects (6) Answer: Most serious is Cardiovascular collapse: Assess for
hypotension, tachycardia, and edema, which are all precursors to cardiovascular collapse
Urinary retention & menstrual irregularities
Major respiratory adverse effects: laryngeal spasm & cough
Benzodiazepines are schedule 4 drugs and possess a risk for substance abuse in
susceptible individuals
Diazepam contraindications (5) Answer: Depressed vital signs
Patient in shock
Patient with acute alcohol intoxication
Pregnant patients
During lactation
How to discontinue Diazepam Answer: After prolonged therapy, abrupt discontinuation of
diazepam may precipitate withdrawal symptoms, including seizures in patients with
epilepsy
Diazepam Drug interactions (4) Answer: Alcohol will intensify sedative effects
Cimetidine will increase plasma level of diazepam
Antiparkinson's
Not within 14 days of MAOI due to risk of hypertensive crisis
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
,Diazepam Herbal/ food Answer: Kava & Valerian will result in additive sedative effects
Echinacea may lower the serum levels of diazepam
Grapefruit juice increases peak serum concentrations of diazepam by as much as two
times
Diazepam treatment of overdose Answer: Flumazenil
Phenytoin T & P Answer: T: Antiepileptic drug
P: Hydantoin, neuronal sodium channel modulator
Phenytoin indication Answer: Prophylactic therapy of all types of seizures except absence
seizures
Phenytoin off label use (5) Answer: Treat ventricular tachycardia (especially those induced
by digoxin)
paroxysmal atrial tachycardia
migraine headaches
Diabetic neuropathy
neuropathic pain
Phenytoin Adverse effects Answer: CNS
Cardiovascular
GI
Hematologic
Rashes and serious dermatologic conditions occur in 5-10% of patients taking the drug
pg. 322
Phenytoin what can abrupt discontinuation cause Answer: status epilepticus
Phenytoin Black Box Warning Answer: When IV infusion rates exceed 50 mg/min in adults
the patient is at risk for hypotension and dysrhythmias. Careful cardiovascular monitoring
is necessary
Phenytoin contraindications (3) Answer: Patients who have experienced seizures caused
by hypoglycemia
Patients with blood dycrasias
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
, Pregnancy
Phenytoin drug interactions (4) Answer: Corticosteroids, warfarin, & oral contraceptives
will be less effective
Alcohol
Phenytoin herbal/food (4) Answer: The administration or consumption of foods that
contain folic acid, calcium, and vitamin D will decrease the absorption of phenytoin
Ginko may decrease the anti seizure effectiveness of phenytoin
Phenytoin overdose treatment Answer: Treated with activated charcoal with gastric lavage
Carbamazepine T & P Answer: T: Antiepileptic drug
P: Dibenzazepine, neuronal sodium channel modulator
Carbamazepine indications (5) Answer: Generalized tonic-clonic
Partial seizures with complex symptomatology, and for mixed seizure patterns
Ineffective against absence seizures
Acute mania associated with bipolar disorder
Pain associated with trigeminal neuralgia
Carbamazepine off label use (3) Answer: Neuropathic pain associated with diabetic
neuropathy and postherpetic pain
hiccups
Management of severe symptoms of dementia such as aggression and agitation
Carbamazepine Answer: Long term administration of carbamazepine will result in the
need to increase the dose because its half life becomes shortened
Several weeks of therapy may be required before the optimum dose is determined and the
effective plasma drug concentration is achieved
Carbamazepine adverse effects Answer: Drowsiness, dizziness, ataxia, nausea, vomiting
Transient sedation
Other CNS effects
A few rare cases of hepatic impairment have been documented
look on pg 324
APPHIA – Crafted with Care and Precision for Academic Excellence.
3
LEARN, PRACTICE & EXCEL!
Diazepam T & P Answer: T: Antiepileptic drug, anti anxiety drug, skeletal Muscle Relaxant
P: Benzodiazepine, Gaba receptor agonist
Diazepam Indications Answer: Seizures & seizure prophylaxis
Anxiety disorders
Prior to procedures such as cardio version or endoscopy to provide relaxation or sedation
Muscle relaxation for patients with acute inflammation, trauma, tetanus, or spasticity
Diazepam adverse effects (6) Answer: Most serious is Cardiovascular collapse: Assess for
hypotension, tachycardia, and edema, which are all precursors to cardiovascular collapse
Urinary retention & menstrual irregularities
Major respiratory adverse effects: laryngeal spasm & cough
Benzodiazepines are schedule 4 drugs and possess a risk for substance abuse in
susceptible individuals
Diazepam contraindications (5) Answer: Depressed vital signs
Patient in shock
Patient with acute alcohol intoxication
Pregnant patients
During lactation
How to discontinue Diazepam Answer: After prolonged therapy, abrupt discontinuation of
diazepam may precipitate withdrawal symptoms, including seizures in patients with
epilepsy
Diazepam Drug interactions (4) Answer: Alcohol will intensify sedative effects
Cimetidine will increase plasma level of diazepam
Antiparkinson's
Not within 14 days of MAOI due to risk of hypertensive crisis
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
,Diazepam Herbal/ food Answer: Kava & Valerian will result in additive sedative effects
Echinacea may lower the serum levels of diazepam
Grapefruit juice increases peak serum concentrations of diazepam by as much as two
times
Diazepam treatment of overdose Answer: Flumazenil
Phenytoin T & P Answer: T: Antiepileptic drug
P: Hydantoin, neuronal sodium channel modulator
Phenytoin indication Answer: Prophylactic therapy of all types of seizures except absence
seizures
Phenytoin off label use (5) Answer: Treat ventricular tachycardia (especially those induced
by digoxin)
paroxysmal atrial tachycardia
migraine headaches
Diabetic neuropathy
neuropathic pain
Phenytoin Adverse effects Answer: CNS
Cardiovascular
GI
Hematologic
Rashes and serious dermatologic conditions occur in 5-10% of patients taking the drug
pg. 322
Phenytoin what can abrupt discontinuation cause Answer: status epilepticus
Phenytoin Black Box Warning Answer: When IV infusion rates exceed 50 mg/min in adults
the patient is at risk for hypotension and dysrhythmias. Careful cardiovascular monitoring
is necessary
Phenytoin contraindications (3) Answer: Patients who have experienced seizures caused
by hypoglycemia
Patients with blood dycrasias
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
, Pregnancy
Phenytoin drug interactions (4) Answer: Corticosteroids, warfarin, & oral contraceptives
will be less effective
Alcohol
Phenytoin herbal/food (4) Answer: The administration or consumption of foods that
contain folic acid, calcium, and vitamin D will decrease the absorption of phenytoin
Ginko may decrease the anti seizure effectiveness of phenytoin
Phenytoin overdose treatment Answer: Treated with activated charcoal with gastric lavage
Carbamazepine T & P Answer: T: Antiepileptic drug
P: Dibenzazepine, neuronal sodium channel modulator
Carbamazepine indications (5) Answer: Generalized tonic-clonic
Partial seizures with complex symptomatology, and for mixed seizure patterns
Ineffective against absence seizures
Acute mania associated with bipolar disorder
Pain associated with trigeminal neuralgia
Carbamazepine off label use (3) Answer: Neuropathic pain associated with diabetic
neuropathy and postherpetic pain
hiccups
Management of severe symptoms of dementia such as aggression and agitation
Carbamazepine Answer: Long term administration of carbamazepine will result in the
need to increase the dose because its half life becomes shortened
Several weeks of therapy may be required before the optimum dose is determined and the
effective plasma drug concentration is achieved
Carbamazepine adverse effects Answer: Drowsiness, dizziness, ataxia, nausea, vomiting
Transient sedation
Other CNS effects
A few rare cases of hepatic impairment have been documented
look on pg 324
APPHIA – Crafted with Care and Precision for Academic Excellence.
3
