Maryville NURS 615 Exam 2
1. What blood values should be monitored with carbamazepine (Tegretol) <answer>
- CBC test every 3-4 months to monitor for decrease in WBCs, platelets, and trouble
with RBC production.
2. What are the pharmacodynamics of carbamazepine (Tegretol) <answer> - Auto-
me- tabolizes leading to lower serum levels despite compliance.
- Half-life 30 hours as single dose, 15 hours when given repeatedly.
3. What are the Black Box Warnings for carbamazepine (Tegretol) <answer>
- Stevens-Johnson Syndrome (SJS)
- Toxic Epidermal Necrolysis (TEN)
4. Carbamazepine (Tegretol) is what type of drug <answer> Anticonvulsant drug
5. What should families be taught regarding the monitoring of seizure activi- ty
<answer> - Prevention of seizures
- Patient Safety
- Quality of life issues
- Do not discontinue medication due to increased risk of seizures
6. What electrolyte imbalance is noted with the administration of topiramate
(Topamax) <answer> Decrease in sodium bicarbonate leading to hyperchloremic
metabolic acidosis.
7. What are adverse effects of topiramate (Topamax) <answer> - Weight loss,
especially in higher dose patients
- May affect ability to sweat
8. What are pregnancy precautions for valproate (Depakote) <answer> -
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,Pregnancy Category X
- Teratogen (an agent that causes malformation of an embryo)
9. What instructions will you provide to a woman who wants to get pregnant and has
a seizure disorder controlled with valproate (Depakote) <answer> - Pregnant women
should be advised to switch to another anticonvulsant during the first trimester, such
as levetiracetam (Keppra), then switch back to volproate (Depakote) in the second
trimester.
- All anticonvulsants for pregnant women should be monitored by a high-risk obste-
trician.
10. What are precautions and contraindications for tricyclic antidepressants?-
: - Caution cardiac disease patients (may act as an antiarrhythmic)
- HTN, tachycardia, and convulsions when used with MAOIs
11. What are adverse effects of tricyclic antidepressants <answer> - Anticholinergic
ef- fects (dry mouth, sedation, constipation, increased appetite, blurred vision, tinnitus,
euphoria, and mania)
12. Phenylzine (Nardil) is an MAOI.What are the precautions and contraindi- cations
<answer> - Avoid foods high in tyramine (fermented foods, wine, alcohol, aged
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, cheeses, yogurt, soy sauce, summer sausage, processed meats, etc.)
- Avoid St. John's Wort (Serotonin Syndrome)
-Many other drug-drug interactions
13. How long does it take to clear an MAOI from the body <answer> 2 full weeks, 5
weeks before using fluoxetine (Prozac)
14. What are the symptoms of hypertensive crisis <answer> Headache, heart
palpita- tions, stiff or sore neck, chest tightness, tachycardia, sweating, and dilated
pupils. Can be life threatening.
15. How long does it take for SSRIs to produce an effect for depression <answer> 2 -
6 weeks (most are full effect at 4 weeks)
16. When are buspirone (Buspar) and an SSRI combined <answer> Treatment of
anxious or agitated depression
17. What type of diet is recommended for lithium <answer> Consistent sodium intake
diet
18. Adverse effects of MAOIs: - CNS stimulation
- Orthostatic hypotension
- Hypertensive crisis
19. Adverse effects of SSRIs: - Anxiety
-Nervousness
- Insomnia
- Suicidal thoughts
- Sexual dysfunction
- Serotonin syndrome
20. What is the first line drug of choice for mild to moderate generalized
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17
1. What blood values should be monitored with carbamazepine (Tegretol) <answer>
- CBC test every 3-4 months to monitor for decrease in WBCs, platelets, and trouble
with RBC production.
2. What are the pharmacodynamics of carbamazepine (Tegretol) <answer> - Auto-
me- tabolizes leading to lower serum levels despite compliance.
- Half-life 30 hours as single dose, 15 hours when given repeatedly.
3. What are the Black Box Warnings for carbamazepine (Tegretol) <answer>
- Stevens-Johnson Syndrome (SJS)
- Toxic Epidermal Necrolysis (TEN)
4. Carbamazepine (Tegretol) is what type of drug <answer> Anticonvulsant drug
5. What should families be taught regarding the monitoring of seizure activi- ty
<answer> - Prevention of seizures
- Patient Safety
- Quality of life issues
- Do not discontinue medication due to increased risk of seizures
6. What electrolyte imbalance is noted with the administration of topiramate
(Topamax) <answer> Decrease in sodium bicarbonate leading to hyperchloremic
metabolic acidosis.
7. What are adverse effects of topiramate (Topamax) <answer> - Weight loss,
especially in higher dose patients
- May affect ability to sweat
8. What are pregnancy precautions for valproate (Depakote) <answer> -
1/
17
,Pregnancy Category X
- Teratogen (an agent that causes malformation of an embryo)
9. What instructions will you provide to a woman who wants to get pregnant and has
a seizure disorder controlled with valproate (Depakote) <answer> - Pregnant women
should be advised to switch to another anticonvulsant during the first trimester, such
as levetiracetam (Keppra), then switch back to volproate (Depakote) in the second
trimester.
- All anticonvulsants for pregnant women should be monitored by a high-risk obste-
trician.
10. What are precautions and contraindications for tricyclic antidepressants?-
: - Caution cardiac disease patients (may act as an antiarrhythmic)
- HTN, tachycardia, and convulsions when used with MAOIs
11. What are adverse effects of tricyclic antidepressants <answer> - Anticholinergic
ef- fects (dry mouth, sedation, constipation, increased appetite, blurred vision, tinnitus,
euphoria, and mania)
12. Phenylzine (Nardil) is an MAOI.What are the precautions and contraindi- cations
<answer> - Avoid foods high in tyramine (fermented foods, wine, alcohol, aged
2/
17
, cheeses, yogurt, soy sauce, summer sausage, processed meats, etc.)
- Avoid St. John's Wort (Serotonin Syndrome)
-Many other drug-drug interactions
13. How long does it take to clear an MAOI from the body <answer> 2 full weeks, 5
weeks before using fluoxetine (Prozac)
14. What are the symptoms of hypertensive crisis <answer> Headache, heart
palpita- tions, stiff or sore neck, chest tightness, tachycardia, sweating, and dilated
pupils. Can be life threatening.
15. How long does it take for SSRIs to produce an effect for depression <answer> 2 -
6 weeks (most are full effect at 4 weeks)
16. When are buspirone (Buspar) and an SSRI combined <answer> Treatment of
anxious or agitated depression
17. What type of diet is recommended for lithium <answer> Consistent sodium intake
diet
18. Adverse effects of MAOIs: - CNS stimulation
- Orthostatic hypotension
- Hypertensive crisis
19. Adverse effects of SSRIs: - Anxiety
-Nervousness
- Insomnia
- Suicidal thoughts
- Sexual dysfunction
- Serotonin syndrome
20. What is the first line drug of choice for mild to moderate generalized
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17
