10/28/24, 6:29 AM NURS 615 PHARM EXAM 2 LATEST 2024 REAL EXAM QUESTIONS AND CORRECT ANSWERS COMPLETE EXAM|AGRADE…
NURS 615 PHARM EXAM 2 LATEST 2024 REAL
EXAM QUESTIONS AND CORRECT ANSWERS
COMPLETE EXAM|AGRADE(MARYVILLE
UNIVERSITY)
Terms in this set (44)
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,
What blood values should
agitation, nystagmus, urinary retention, respiratory
be monitored with
depression, seizures, and coma. Children and elderly
carbamazepine?
patient may develop toxicity levels below 12.
CBC every 3 to 4 months
Affects RBC, WBC, Platelets
Agranulocytosis, Anemia
,10/28/24, 6:29 AM NURS 615 PHARM EXAM 2 LATEST 2024 REAL EXAM QUESTIONS AND CORRECT ANSWERS COMPLETE EXAM|AGRADE…
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.
What is the
pharmacodynamics of •Absorption and Distribution
carbamazepine? 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
, 10/28/24, 6:29 AM NURS 615 PHARM EXAM 2 LATEST 2024 REAL EXAM QUESTIONS AND CORRECT ANSWERS COMPLETE EXAM|AGRADE…
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 days.
Patients should be monitored for seizure activity,
What should families be severity, and duration. Patient should carry medical
taught regarding the identification for the seizure disorder. Patient should
monitoring of seizure report any mood changes or suicidal thoughts.
activity? Prevention of seizures. Do not abruptly end
medication increases risk of seizures
Patients taking topiramate may have decreased
concentrations of bicarbonate due to inhibition of
What electrolyte carbonic anhydrase and increased renal bicarbonate
imbalance is noted with loss, leading to hyperchloremic metabolic acidosis.
the administration of Severe metabolic acidosis has been reported in
topiramate? infants receiving a topiramate dose of 5mg/kg/day.
Serum bicarbonate levels should be monitored at
baseline and periodically throughout therapy.
What is the pregnancy Pregnancy Category X.
category for valproate?
Switch to another antiseizure medication such as
Keppra
What instructions will you
Use of these drugs during the first trimester of
provide to a woman who
pregnancy is associated with neural tube defects
wants to get pregnant and
including spina bifida. Their use should be restricted
has a seizure disorder
to cases in which a woman's life would be
controlled with valproate?
endangered without them and then only beyond the
first trimester. They should be used with caution
during lactation.
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