NURS 615 ADVANCED
PHARMACOTHERAPEUTICS
PROFESSIONAL CLINICAL PREP
QUESTIONS AND ACCURATE ANSWERS
GRADED A+
●● What are the pharmacodynamics of carbamazepine (Tegretol)?
Answer: - Auto-metabolizes leading to lower serum levels despite
compliance.
- Half-life 30 hours as single dose, 15 hours when given repeatedly.
●● What are the Black Box Warnings for carbamazepine (Tegretol)?
Answer: - Stevens-Johnson Syndrome (SJS)
- Toxic Epidermal Necrolysis (TEN)
●● Carbamazepine (Tegretol) is what type of drug?
Answer: Anticonvulsant drug
●● What should families be taught regarding the monitoring of seizure
activity?
Answer: - Prevention of seizures
- Patient Safety
,- Quality of life issues
- Do not discontinue medication due to increased risk of seizures
●● What electrolyte imbalance is noted with the administration of
topiramate (Topamax)?
Answer: Decrease in sodium bicarbonate leading to hyperchloremic
metabolic acidosis.
●● What are adverse effects of topiramate (Topamax)?
Answer: - Weight loss, especially in higher dose patients
- May affect ability to sweat
●● What are pregnancy precautions for valproate (Depakote)?
Answer: - Pregnancy Category X
- Teratogen (an agent that causes malformation of an embryo)
●● 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 obstetrician.
, ●● What are precautions and contraindications for tricyclic
antidepressants?
Answer: - Caution cardiac disease patients (may act as an
antiarrhythmic)
- HTN, tachycardia, and convulsions when used with MAOIs
●● What are adverse effects of tricyclic antidepressants?
Answer: - Anticholinergic effects (dry mouth, sedation, constipation,
increased appetite, blurred vision, tinnitus, euphoria, and mania)
●● Phenylzine (Nardil) is an MAOI. What are the precautions and
contraindications?
Answer: - Avoid foods high in tyramine (fermented foods, wine, alcohol,
aged cheeses, yogurt, soy sauce, summer sausage, processed meats, etc.)
- Avoid St. John's Wort (Serotonin Syndrome)
-Many other drug-drug interactions
●● How long does it take to clear an MAOI from the body?
Answer: 2 full weeks, 5 weeks before using fluoxetine (Prozac)
●● What are the symptoms of hypertensive crisis?
Answer: Headache, heart palpitations, stiff or sore neck, chest tightness,
tachycardia, sweating, and dilated pupils. Can be life threatening.
PHARMACOTHERAPEUTICS
PROFESSIONAL CLINICAL PREP
QUESTIONS AND ACCURATE ANSWERS
GRADED A+
●● What are the pharmacodynamics of carbamazepine (Tegretol)?
Answer: - Auto-metabolizes leading to lower serum levels despite
compliance.
- Half-life 30 hours as single dose, 15 hours when given repeatedly.
●● What are the Black Box Warnings for carbamazepine (Tegretol)?
Answer: - Stevens-Johnson Syndrome (SJS)
- Toxic Epidermal Necrolysis (TEN)
●● Carbamazepine (Tegretol) is what type of drug?
Answer: Anticonvulsant drug
●● What should families be taught regarding the monitoring of seizure
activity?
Answer: - Prevention of seizures
- Patient Safety
,- Quality of life issues
- Do not discontinue medication due to increased risk of seizures
●● What electrolyte imbalance is noted with the administration of
topiramate (Topamax)?
Answer: Decrease in sodium bicarbonate leading to hyperchloremic
metabolic acidosis.
●● What are adverse effects of topiramate (Topamax)?
Answer: - Weight loss, especially in higher dose patients
- May affect ability to sweat
●● What are pregnancy precautions for valproate (Depakote)?
Answer: - Pregnancy Category X
- Teratogen (an agent that causes malformation of an embryo)
●● 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 obstetrician.
, ●● What are precautions and contraindications for tricyclic
antidepressants?
Answer: - Caution cardiac disease patients (may act as an
antiarrhythmic)
- HTN, tachycardia, and convulsions when used with MAOIs
●● What are adverse effects of tricyclic antidepressants?
Answer: - Anticholinergic effects (dry mouth, sedation, constipation,
increased appetite, blurred vision, tinnitus, euphoria, and mania)
●● Phenylzine (Nardil) is an MAOI. What are the precautions and
contraindications?
Answer: - Avoid foods high in tyramine (fermented foods, wine, alcohol,
aged cheeses, yogurt, soy sauce, summer sausage, processed meats, etc.)
- Avoid St. John's Wort (Serotonin Syndrome)
-Many other drug-drug interactions
●● How long does it take to clear an MAOI from the body?
Answer: 2 full weeks, 5 weeks before using fluoxetine (Prozac)
●● What are the symptoms of hypertensive crisis?
Answer: Headache, heart palpitations, stiff or sore neck, chest tightness,
tachycardia, sweating, and dilated pupils. Can be life threatening.
