NRNP 6675 FINAL EXAM LAST EXAM EVERRRRR (minus boards) 8l 8l 8l 8l 8l 8l 8l 8l
Study online at https://quizlet.com/_d3fvek
8l 8l 8l
1. The 1/2 life of lithium is about?: 24 hours
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2. Fluoxetine is the SSRI with the WD risk?: lowest due to long half life 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
3. What antipsychotics are good for pts who miss doses of their meds?: Antipsy-
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chotics with long half-lives:
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1. Cariprazine(Vrylar): (2-4 days-active metabolites up to 3 weeks) 8l 8l 8l 8l 8l 8l 8l
2. Abilify(3 days) 8l 8l
3. Brexipiprazole (4 days) 8l 8l
4. Pimozide (4-5 days) 8l 8l
5. Pimavanserin (2 days, active metabolites 8 days) 8l 8l 8l 8l 8l 8l
4. Disulfiram's alcohol interactions persist for up to how long after the medica- 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l
tion is stopped?: LONG Half life--2-3 days
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persist up to 2 weeks following stopping
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5. What is the only TCA with a long half life?: Protriptyline (Vivactil)
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6. Most psychotropics have a medium range 1/2 life of approx?: 24 hours
8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8l
7. what does "steady state" mean in relation to 1/2 life?: steady state means thatyou are elimi
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
nating the drug at the same overall rate that you are ingesting it
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
8. Lithium reaches its 'steady state' when?: 5 half lives 8l 8l 8l 8l 8l 8l 8l 8l
example:
Day 1: Start pt on Lithium 600 mg daily
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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-
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
-therefore the pt has excreted 1/2 of the initial amount.
8l 8l 8l 8l 8l 8l 8l 8l 8l
THEN the pt takes his 2nd dose of 600 mg on DAY 2-
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resulting in a max dose of 900 (300 mg left in body + 600 mg of 2nd dose).
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
DAY 3: starts ott with 450 mg (1/2 of the 900 mg in pt's system) and after taking the day 3 600 mg dose, the pt now has a to
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
tal of 1050 mg.
8l 8l 8l
9. Due to the steady state of Lithium, when do we draw a blood level?: 5 half lives if you
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
check any earlier, the trough level will underestimate the actual level the pt is on after achieving steady state
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
18l/8l21
, NRNP 6675 FINAL EXAM LAST EXAM EVERRRRR (minus boards) 8l 8l 8l 8l 8l 8l 8l 8l
Study online at https://quizlet.com/_d3fvek
8l 8l 8l
10. Fluoxetine has a half life of about?: 2weeks1/2life 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
take 2.5 months to achieve steady state
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11. Most psychotropic medications operate in this fashion:: "whenyoudoublethedose, the
8l 8l 8l 8l 8l 8l 8l l8 l8 l8 l8 8l 8l
serum dose doubles." 8l 8l
*minus three SRIs and three anticonvulsants (Fluoxetine, fluvoxamine, paxil, gabapentin, valproate and carba- mazepine)
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
12. induces it's own metabolism, hastening excretion and shortening 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l
it's half life: A. Carbamazepine (Tegretol)
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*this ettect begins to "rev up" after 2-4 weeks--which is why a carbamazepine level is so important on obtaining 1-
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
2 months after starting Tegretol.
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13. Carbamazepine (Tegretol) level should be checked how soon after starting 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8l
to take this med?: 1-
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2 months due to Tegretol inducing it's own metabolism, hastening excretion and shortening it's half life.
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
14. has trouble getting a "serum" level because it binds to proteins that 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8l
render it therapeutically inactive?: A. Valproate Acid (Depakote)
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-
this is particularly true at the lower levels (eg. <50 mcg/mL), so you can expect dose changes to make a more dramatic dittere
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
nce when the pt's depakote level is in the higher range
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15. 's serum level is the opposite of Valproic Acid: it rises quickly at first a 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
nd then slows down?: Gabapentin
8l 8l 8l 8l
*gabapentin saturates the transporters that absorb it in the small intestine, causing its levels to rise at a snails pace when the
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
dosage goes above a certain saturation point (around 900 mg/day).
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
-from there, the saturation trickles down; @ 900 mg/day--60% is absorbed. @ 1200 mg/day--
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50 % is absorbed. @3000 mg/day--30% of the gabapentin is absorbed.
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
16. Due to Gabapentin's serum pattern for dosage: 8l 8l 8l 8l 8l 8l
@ 900 mg/day, how much is the patient absorbing?: @ 0900mg/day---60% is absorbed.
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
17. Due to Gabapentin's serum pattern for dosage: 8l 8l 8l 8l 8l 8l
@ 1200 mg/day, how much is the patient absorbing?: @1200mg/day--50%isabsorbed.
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
28l/8l21
, NRNP 6675 FINAL EXAM LAST EXAM EVERRRRR (minus boards)8l 8l 8l 8l 8l 8l 8l 8l
Study online at https://quizlet.com/_d3fvek
8l 8l 8l
18. Due to Gabapentin's serum pattern for dosage: 8l 8l 8l 8l 8l 8l
@ 3000 mg/day, how much is the patient absorbing?: @3000mg/day--
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30%ofthe gabapentin is absorbed.
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19. Carbamazepine (Tegretol's) serum level drops after how long after stopping 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
taking it?: 1-2months 8l 8l 8l
20. For Valproate (Depakote), 8l 8l 8l
dose changes can have big effects once the level is beyond 50 mcg/mL?: SMA
8l 8l 8l 8l 8l 8l 8l 8 l 8l 8l 8l 8l 8l
LL
21. potency refers to a drug's>: powerperunit 8l 8l 8l 8l 8l 8l 8l
-or the amount of pharmacological activity per milligram.
8l 8l 8l 8l 8l 8l 8l
22. Delayed release=: modified release 8l 8l 8l
"dont get absorbed until they have traveled to a specific site in the gut
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
23. Intermediate release (IR) medications:: dissolverapidlyintheGItractandareabsorbedinan hour 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
or two 8l
24. the serum concentrations of IR medications spike quickly and then fall bac
8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l
k down, leading to what?: leading to low trough levels before the next dose.
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*These ups and downs in serum levels can cause SE or eflcacy problems.
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
25. *the ups and downs in serum levels of IR medications can cause what?: can cau
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se SE or eflcacy problems.
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26. Bupropion can increase the risk of what?: Seizures 8l 8l 8l 8l 8l 8l 8l
*IF the serum level peaks too high
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27. IR stimulants can lose in the afternoon?: eflcacy due toIR ettect
8 l 8 l 8 l 8 l 8l 8l 8l 8l 8l 8l 8l
28. The rise and fall of Haldol levels increases what?: the likelihood of dystonic reactions
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
29. in MODERATE RELEASE/DELAYED RELEASE dissolvable solutions or "dissolv-
8l 8l 8l 8l 8l 8l 8l
able control", the medicine does what?: slowly dittuses out of a semi-permeable membrane
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
ex. Ettexor ER capsules, Wellbutrin XL and Focalin XR
8l 8l 8l 8l 8l 8l 8l 8l
30. in MODERATE RELEASE/DELAYED RELEASE
8l 8l 8l
is osmotic release pills, the medicine does what?: is pushed out by a tiny pump that is powered by
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
38l/8l21
Study online at https://quizlet.com/_d3fvek
8l 8l 8l
1. The 1/2 life of lithium is about?: 24 hours
8l 8l 8l 8l 8l 8l 8l 8l
2. Fluoxetine is the SSRI with the WD risk?: lowest due to long half life 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
3. What antipsychotics are good for pts who miss doses of their meds?: Antipsy-
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
chotics with long half-lives:
8l 8l 8l 8l
1. Cariprazine(Vrylar): (2-4 days-active metabolites up to 3 weeks) 8l 8l 8l 8l 8l 8l 8l
2. Abilify(3 days) 8l 8l
3. Brexipiprazole (4 days) 8l 8l
4. Pimozide (4-5 days) 8l 8l
5. Pimavanserin (2 days, active metabolites 8 days) 8l 8l 8l 8l 8l 8l
4. Disulfiram's alcohol interactions persist for up to how long after the medica- 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l
tion is stopped?: LONG Half life--2-3 days
8l 8l 8l 8l 8l 8l 8l
persist up to 2 weeks following stopping
8l 8l 8l 8l 8l 8l
5. What is the only TCA with a long half life?: Protriptyline (Vivactil)
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
6. Most psychotropics have a medium range 1/2 life of approx?: 24 hours
8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8l
7. what does "steady state" mean in relation to 1/2 life?: steady state means thatyou are elimi
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
nating the drug at the same overall rate that you are ingesting it
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
8. Lithium reaches its 'steady state' when?: 5 half lives 8l 8l 8l 8l 8l 8l 8l 8l
example:
Day 1: Start pt on Lithium 600 mg daily
8l 8l 8l 8l 8l 8l 8l 8l
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-
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
-therefore the pt has excreted 1/2 of the initial amount.
8l 8l 8l 8l 8l 8l 8l 8l 8l
THEN the pt takes his 2nd dose of 600 mg on DAY 2-
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
resulting in a max dose of 900 (300 mg left in body + 600 mg of 2nd dose).
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
DAY 3: starts ott with 450 mg (1/2 of the 900 mg in pt's system) and after taking the day 3 600 mg dose, the pt now has a to
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
tal of 1050 mg.
8l 8l 8l
9. Due to the steady state of Lithium, when do we draw a blood level?: 5 half lives if you
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
check any earlier, the trough level will underestimate the actual level the pt is on after achieving steady state
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
18l/8l21
, NRNP 6675 FINAL EXAM LAST EXAM EVERRRRR (minus boards) 8l 8l 8l 8l 8l 8l 8l 8l
Study online at https://quizlet.com/_d3fvek
8l 8l 8l
10. Fluoxetine has a half life of about?: 2weeks1/2life 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
take 2.5 months to achieve steady state
8l 8l 8l 8l 8l 8l
11. Most psychotropic medications operate in this fashion:: "whenyoudoublethedose, the
8l 8l 8l 8l 8l 8l 8l l8 l8 l8 l8 8l 8l
serum dose doubles." 8l 8l
*minus three SRIs and three anticonvulsants (Fluoxetine, fluvoxamine, paxil, gabapentin, valproate and carba- mazepine)
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
12. induces it's own metabolism, hastening excretion and shortening 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l
it's half life: A. Carbamazepine (Tegretol)
8l 8l 8l 8l 8l
*this ettect begins to "rev up" after 2-4 weeks--which is why a carbamazepine level is so important on obtaining 1-
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
2 months after starting Tegretol.
8l 8l 8l 8l
13. Carbamazepine (Tegretol) level should be checked how soon after starting 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8l
to take this med?: 1-
8l 8l 8l 8l
2 months due to Tegretol inducing it's own metabolism, hastening excretion and shortening it's half life.
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
14. has trouble getting a "serum" level because it binds to proteins that 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8l
render it therapeutically inactive?: A. Valproate Acid (Depakote)
8l 8l 8l 8l 8l 8l 8l
-
this is particularly true at the lower levels (eg. <50 mcg/mL), so you can expect dose changes to make a more dramatic dittere
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
nce when the pt's depakote level is in the higher range
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
15. 's serum level is the opposite of Valproic Acid: it rises quickly at first a 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
nd then slows down?: Gabapentin
8l 8l 8l 8l
*gabapentin saturates the transporters that absorb it in the small intestine, causing its levels to rise at a snails pace when the
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
dosage goes above a certain saturation point (around 900 mg/day).
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
-from there, the saturation trickles down; @ 900 mg/day--60% is absorbed. @ 1200 mg/day--
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
50 % is absorbed. @3000 mg/day--30% of the gabapentin is absorbed.
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
16. Due to Gabapentin's serum pattern for dosage: 8l 8l 8l 8l 8l 8l
@ 900 mg/day, how much is the patient absorbing?: @ 0900mg/day---60% is absorbed.
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
17. Due to Gabapentin's serum pattern for dosage: 8l 8l 8l 8l 8l 8l
@ 1200 mg/day, how much is the patient absorbing?: @1200mg/day--50%isabsorbed.
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
28l/8l21
, NRNP 6675 FINAL EXAM LAST EXAM EVERRRRR (minus boards)8l 8l 8l 8l 8l 8l 8l 8l
Study online at https://quizlet.com/_d3fvek
8l 8l 8l
18. Due to Gabapentin's serum pattern for dosage: 8l 8l 8l 8l 8l 8l
@ 3000 mg/day, how much is the patient absorbing?: @3000mg/day--
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
30%ofthe gabapentin is absorbed.
8l 8l 8l 8l 8l
19. Carbamazepine (Tegretol's) serum level drops after how long after stopping 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
taking it?: 1-2months 8l 8l 8l
20. For Valproate (Depakote), 8l 8l 8l
dose changes can have big effects once the level is beyond 50 mcg/mL?: SMA
8l 8l 8l 8l 8l 8l 8l 8 l 8l 8l 8l 8l 8l
LL
21. potency refers to a drug's>: powerperunit 8l 8l 8l 8l 8l 8l 8l
-or the amount of pharmacological activity per milligram.
8l 8l 8l 8l 8l 8l 8l
22. Delayed release=: modified release 8l 8l 8l
"dont get absorbed until they have traveled to a specific site in the gut
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
23. Intermediate release (IR) medications:: dissolverapidlyintheGItractandareabsorbedinan hour 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
or two 8l
24. the serum concentrations of IR medications spike quickly and then fall bac
8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l 8 l
k down, leading to what?: leading to low trough levels before the next dose.
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
*These ups and downs in serum levels can cause SE or eflcacy problems.
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
25. *the ups and downs in serum levels of IR medications can cause what?: can cau
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8 l
se SE or eflcacy problems.
8l 8l 8l 8l
26. Bupropion can increase the risk of what?: Seizures 8l 8l 8l 8l 8l 8l 8l
*IF the serum level peaks too high
8l 8l 8l 8l 8l 8l
27. IR stimulants can lose in the afternoon?: eflcacy due toIR ettect
8 l 8 l 8 l 8 l 8l 8l 8l 8l 8l 8l 8l
28. The rise and fall of Haldol levels increases what?: the likelihood of dystonic reactions
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
29. in MODERATE RELEASE/DELAYED RELEASE dissolvable solutions or "dissolv-
8l 8l 8l 8l 8l 8l 8l
able control", the medicine does what?: slowly dittuses out of a semi-permeable membrane
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
ex. Ettexor ER capsules, Wellbutrin XL and Focalin XR
8l 8l 8l 8l 8l 8l 8l 8l
30. in MODERATE RELEASE/DELAYED RELEASE
8l 8l 8l
is osmotic release pills, the medicine does what?: is pushed out by a tiny pump that is powered by
8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l 8l
38l/8l21
