NUR 600: ADVANCED CLINICAL PHARMACOLOGY: FINAL EXAM
STUDY GUIDE QUESTIONS WITH COMPLETE SOLUTIONS
1) Phenobarbital -- Answer ✔✔ Anticonvulsant
2) mechanism of action phenobarbital -- Answer ✔✔ Phenobarbital increases the
amount of time chloride channels are open, consequently depressing the central
nervous system. This action occurs by acting on GABA-A receptor subunits.
3) indications for phenobarbital in children -- Answer ✔✔ Phenobarbital is used to
treat infants (ages 0-1 year) with any type of seizure disorder, and other children
with generalized, partial or febrile seizures. It is also used for treatment of status
epilepticus (seizures lasting greater than 15 minutes).
4) Dosage of Phenobarbital pediatric -- Answer ✔✔ 15-20 mg/kg loading dose no
faster than 1 mg/kg/min max 30mg/min for kids - 60 for adults
Adult dosage of phenobarbital is 2-3 mg/kg/d - kids 1-5 mg/kg/d
The blood level of phenobarbital that is found to prevent seizures in most people
is between 15- 40µg/ml.
5) side/adverse effects of phenobarb -- Answer ✔✔ Nervous System: Agitation,
somnolence, confusion, CNS depression, hyperkinesia, ataxia, nervousness,
, nightmares, psychiatric disturbance, thinking abnormality, insomnia, anxiety,
hallucinations, dizziness.
Respiratory System: Apnea, hypoventilation.
Cardiovascular System: Hypotension, bradycardia, syncope.
6) contraindications of phenobarb -- Answer ✔✔ Phenobarbital is contraindicated
in patients with severe liver disease known barbiturate sensitivity. Barbiturates,
including phenobarbital, are contraindicated in a patient with a history/manifest or
latent porphyria, liver impairment, and large doses in patients with nephritic
syndrome.
7) Dilantin (PHENYTOIN) -- Answer ✔✔ Phenytoin
Anticonvulsant
8) mechanism of action Dilantin -- Answer ✔✔ Phenytoin is an antiepileptic drug
which can be useful in the treatment of epilepsy. The primary site of action
appears to be the motor cortex where spread of seizure activity is inhibited.
9) indications for Dilantin -- Answer ✔✔ Dilantin is indicated for the control of
generalized tonic-clonic (grand mal) and complex partial (psychomotor, temporal
lobe) seizures and prevention and treatment of seizures occurring during or
following neurosurgery.
10) dosage for Dilantin -- Answer ✔✔ Status epilepticus
Load 15-20 mg/kg at 25-50 mg/min, THEN
Maintenance: 4-6 mg/kg/hour (adults and children)
Administer IV slowly; not to exceed 50 mg/min
Anticonvulsant
Tablet
100 mg PO TID
Maintenance: 300-400 mg/day; increase to 600 mg/day if necessary
May adjust dose no sooner than 7-10 day intervals when indicated
STUDY GUIDE QUESTIONS WITH COMPLETE SOLUTIONS
1) Phenobarbital -- Answer ✔✔ Anticonvulsant
2) mechanism of action phenobarbital -- Answer ✔✔ Phenobarbital increases the
amount of time chloride channels are open, consequently depressing the central
nervous system. This action occurs by acting on GABA-A receptor subunits.
3) indications for phenobarbital in children -- Answer ✔✔ Phenobarbital is used to
treat infants (ages 0-1 year) with any type of seizure disorder, and other children
with generalized, partial or febrile seizures. It is also used for treatment of status
epilepticus (seizures lasting greater than 15 minutes).
4) Dosage of Phenobarbital pediatric -- Answer ✔✔ 15-20 mg/kg loading dose no
faster than 1 mg/kg/min max 30mg/min for kids - 60 for adults
Adult dosage of phenobarbital is 2-3 mg/kg/d - kids 1-5 mg/kg/d
The blood level of phenobarbital that is found to prevent seizures in most people
is between 15- 40µg/ml.
5) side/adverse effects of phenobarb -- Answer ✔✔ Nervous System: Agitation,
somnolence, confusion, CNS depression, hyperkinesia, ataxia, nervousness,
, nightmares, psychiatric disturbance, thinking abnormality, insomnia, anxiety,
hallucinations, dizziness.
Respiratory System: Apnea, hypoventilation.
Cardiovascular System: Hypotension, bradycardia, syncope.
6) contraindications of phenobarb -- Answer ✔✔ Phenobarbital is contraindicated
in patients with severe liver disease known barbiturate sensitivity. Barbiturates,
including phenobarbital, are contraindicated in a patient with a history/manifest or
latent porphyria, liver impairment, and large doses in patients with nephritic
syndrome.
7) Dilantin (PHENYTOIN) -- Answer ✔✔ Phenytoin
Anticonvulsant
8) mechanism of action Dilantin -- Answer ✔✔ Phenytoin is an antiepileptic drug
which can be useful in the treatment of epilepsy. The primary site of action
appears to be the motor cortex where spread of seizure activity is inhibited.
9) indications for Dilantin -- Answer ✔✔ Dilantin is indicated for the control of
generalized tonic-clonic (grand mal) and complex partial (psychomotor, temporal
lobe) seizures and prevention and treatment of seizures occurring during or
following neurosurgery.
10) dosage for Dilantin -- Answer ✔✔ Status epilepticus
Load 15-20 mg/kg at 25-50 mg/min, THEN
Maintenance: 4-6 mg/kg/hour (adults and children)
Administer IV slowly; not to exceed 50 mg/min
Anticonvulsant
Tablet
100 mg PO TID
Maintenance: 300-400 mg/day; increase to 600 mg/day if necessary
May adjust dose no sooner than 7-10 day intervals when indicated
