NRNP 6675 FINAL EXAM LAST EXAM EVERRRRR (minus boards)
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NRNP 6675
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NRNP 6675
NRNP 6675 FINAL EXAM LAST EXAM EVERRRRR (minus boards)
The 1/2 life of lithium is about?
Fluoxetine is the SSRI with the
WD risk?
What antipsychotics are good for pts
who miss doses of their meds?
Disulfiram's alcohol interactions persist
for up to how long after the medication
is stopped?
...
NRNP 6675 FINAL EXAM LAST EXAM EVERRRRR (minus boards)
The 1/2 life of lithium is about? 24 hours
Fluoxetine is the SSRI with the
lowest due to long half life
WD risk?
Antipsychotics with long half-lives:
1. Cariprazine(Vrylar): (2-4 days-active
metabolites up to 3 weeks)
What antipsychotics are good for pts 2. Abilify (3 days)
who miss doses of their meds? 3. Brexipiprazole (4 days)
4. Pimozide (4-5 days)
5. Pimavanserin (2 days, active metabo-
lites 8 days)
Disulfiram's alcohol interactions persist LONG Half life--2-3 days
for up to how long after the medication
is stopped? persist up to 2 weeks following stopping
What is the only TCA with a long half life? Protriptyline (Vivactil)
Most psychotropics have a medium
24 hours
range 1/2 life of approx?
steady state means that you are eliminat-
what does "steady state" mean in rela-
ing the drug at the same overall rate that
tion to 1/2 life?
you are ingesting it
5 half lives
example:
Day 1: Start pt on Lithium 600 mg daily
Day 2: (24 hours later) the amount left in
his body is 300 mg (day 2 min) because
24 hours has passed--one 1/2 life--there-
Lithium reaches its 'steady state' when? fore the pt has excreted 1/2 of the initial
amount.
THEN the pt takes his 2nd dose of 600
mg on DAY 2-resulting in a max dose of
900 (300 mg left in body + 600 mg of 2nd
dose).
DAY 3: starts off with 450 mg (1/2 of the
900 mg in pt's system) and after taking
, NRNP 6675 FINAL EXAM LAST EXAM EVERRRRR (minus boards)
the day 3 600 mg dose, the pt now has a
total of 1050 mg.
5 half lives
Due to the steady state of Lithium, when
if you check any earlier, the trough level
do we draw a blood level?
will underestimate the actual level the pt
is on after achieving steady state
2 weeks 1/2 life
Fluoxetine has a half life of about?
take 2.5 months to achieve steady state
"when you double the dose, the serum
dose doubles."
Most psychotropic medications operate
*minus three SRIs and three anticon-
in this fashion:
vulsants (Fluoxetine, fluvoxamine, pax-
il, gabapentin, valproate and carba-
mazepine)
A. Carbamazepine (Tegretol)
induces it's own metabolism,
*this effect begins to "rev up" after 2-4
hastening excretion and shortening it's
weeks--which is why a carbamazepine
half life
level is so important on obtaining 1-2
months after starting Tegretol.
Carbamazepine (Tegretol) level should 1-2 months due to Tegretol inducing
be checked how soon after starting to it's own metabolism, hastening excretion
take this med? and shortening it's half life.
A. Valproate Acid (Depakote)
has trouble getting a "serum" level -this is particularly true at the lower levels
because it binds to proteins that render (eg. <50 mcg/mL), so you can expect
it therapeutically inactive? dose changes to make a more dramatic
difference when the pt's depakote level is
in the higher range
, NRNP 6675 FINAL EXAM LAST EXAM EVERRRRR (minus boards)
Gabapentin
*gabapentin saturates the transporters
that absorb it in the small intestine, caus-
ing its levels to rise at a snails pace when
's serum level is the opposite of the dosage goes above a certain satura-
Valproic Acid: it rises quickly at first and tion point (around 900 mg/day).
then slows down?
-from there, the saturation trickles down;
@ 900 mg/day--60% is absorbed. @
1200 mg/day--50 % is absorbed. @3000
mg/day--30% of the gabapentin is ab-
sorbed.
Due to Gabapentin's serum pattern for
dosage:
@ 0900mg/day---60% is absorbed.
@ 900 mg/day, how much is the patient
absorbing?
Due to Gabapentin's serum pattern for
dosage:
@ 1200 mg/day--50 % is absorbed.
@ 1200 mg/day, how much is the patient
absorbing?
Due to Gabapentin's serum pattern for
dosage: @3000 mg/day--30% of the gabapentin
@ 3000 mg/day, how much is the patient is absorbed.
absorbing?
Carbamazepine (Tegretol's) serum level
drops after how long after stopping tak- 1-2 months
ing it?
For Valproate (Depakote), dose
changes can have big effects once the SMALL
level is beyond 50 mcg/mL?
power per unit
potency refers to a drug's>
-or the amount of pharmacological activ-
ity per milligram.
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