NURS 615 Exam II Questions with 100% Correct Answers

NURS 615 Exam II Questions with 100% Correct Answers What blood values should be monitored with carbamazepine? - Answer ️️ - Plasma carbamazepine levels should be monitored on a regular basis. The therapeutic range is 4 to 12 mcg/L. Higher levels can lead to toxic symptoms consisting of initial adverse effects and also hypertension, tachycardia, ECG changes, stupor, agitation, nystagmus, urinary retention, respiratory depression, seizures, and coma. Children and elderly patient may develop toxicity levels below 12. CBC every 3 to 4 months Affects RBC, WBC, Platelets Agranulocytosis, Anemia What is the pharmacodynamics of carbamazepine? - Answer ️️ -Carbamazepine is metabolized in the liver and has the unique ability to induce its own metabolism (autoinduction). Due to autoinduction, initial concentrations within therapeutic range may later fall despite good compliance. It also induces the metabolism of many CYP450 enzymes and other substances. Slowly but well absorbed half life of about 30 hours, shortens to 15 hours when given repeatedly The exact mechanism of action of carbamazepine is not known, but they are thought to affect the sodium channels, slowing influx of sodium in the cortical neurons and slowing the spread of abnormal activity. Carbamazepine exerts its effect by depressing transmission in the nucleus ventralis anterior of the thalamus. This area is associated with the spread of seizure discharge. •Absorption and Distribution Carbamazepine is absorbed through the stomach, the suspension being absorbed more quickly than the tablet form. Absorption from the immediate-release tablets is slow and erratic because of its slow water solubility. The drug is highly lipophilic, resulting in high body tissue binding. •Metabolism and Excretion Excretion is through feces and urine. Average blood levels of carbamazepine occur approximately 6 hours after administration. Half-life can be as long as 65 hours with initial dosing, but is typically 12 to 17 hours as administration continues. It is noteworthy that the half- life after a single dose is much longer than the half-life after long-term use. Steady state is attained in 2 to 4 da