NURS 615 Pharm Exam 2 Mega Review Study Guide Latest Update
best exam study guide GRADED A+
Law-Ham Pharm Exam 2 Review
**Know every drug that is on the PowerPoint – have a one-line mechanism of action on a table
for each drug and understand it, as well as how and where it works
Carbamazepine (Tegretol) – is an anticonvulsant = thought to affect Na+ channels
to slow spread of abnormal activity
• SE = decreases body’s production of blood cells, rare reports of aplastic anemia and
agranulocytosis, can cause Steven Johnson Syndrome and Toxic Epidermal Necrolysis
• Should get a CBC Q3-4 months (watch for WBC count in particular)
• Carbamazepine is a strong inducer of hepatic enzymes/metabolism and can lead to lower
levels
• Do NOT stop taking abruptly, has a shorter half-life w/repeated uses
Levetiracetam (Keppra) – antiepileptic, does NOT affect GABA, does inhibit burst
firing and spread of seizure activity
• Mostly cleared through renal system, is not extensively metabolized
• Absolute contraindication is sensitivity to the drug
• At increased risk for suicidal thoughts and depression, behavioral changes,
somnolence, fatigue, dizziness, muscle coordination difficulties
• Potential for withdrawal seizures if keppra is stopped abruptly
NURS 615 Pharm Exam 2 Mega Review Study Guide Latest Update
best exam study guide GRADED A+
,NURS 615 Pharm Exam 2 Mega Review Study Guide Latest Update
best exam study guide GRADED A+
• Safer med for seizures in children and pregnancy
Topiramate (Topamax) – is for tx of epilepsy, seizures, migraine prophylaxis
• Blocks sodium channels or potentiate GABA
• Peaks 2 hours after oral admin, mostly eliminated via urine
• Can cause ↓ Na bicarb levels which can lead to hyperchloremic metabolic acidosis
• Serum bicarbonate should be monitored at baseline and periodically
• Can cause ocular syndrome (acute myopia and glaucoma) – should inform provider
immediately if pt experiences eye pain or blurred vision
• Rare side effect is oligohidrosis (↓sweating) and hyperthermia
• Can increase the risk of suicidal behavior/ideation, cause weight reduction
• Should NOT be discontinued abruptly
• Is a pregnancy category D and can increase risk of cleft lip/palate in infants
Valproate (Depakote) – is an anticonvulsant, for tx of bipolar disorder and mania also
• Blocks GABA uptake into presynaptic neurons
• SE = GI distress, heartburn, CNS depressant
• Is a pregnancy category X, known teratogen, may only be taken after the 1st trimester
if necessary, bur should recommend switching to different anticonvulsant like Keppra
NURS 615 Pharm Exam 2 Mega Review Study Guide Latest Update
best exam study guide GRADED A+
,NURS 615 Pharm Exam 2 Mega Review Study Guide Latest Update
best exam study guide GRADED A+
Ethosuximide (Zarontin) – tx for seizures
NURS 615 Pharm Exam 2 Mega Review Study Guide Latest Update
best exam study guide GRADED A+
, NURS 615 Pharm Exam 2 Mega Review Study Guide Latest Update
best exam study guide GRADED A+
• Should be monitored for blood dyscrasia (an abnormal condition or dx of the blood)
Antiepileptics block transmission, raise the seizure threshold, so that the patient will not peak
over the seizure threshold and have a seizure.
Anticonvulsants in terms of monitoring (most common side effects, most serious side effects) –
know that they are all monitored with blood work for their levels so that is a similarity amongst
them
• Carbamazepine – CBC – Causes agranulocytosis so be watching the white count
in particular although there is other bone marrow suppression as well
• What do you monitor? – TSH because the med can affect the thyroid
• Never want anyone to d/c suddenly, must be weaned off
• Talk to patients about safety – driving limitations, may have to report patient to
DMV if they are having active seizures
• Oral health can be affected by anti-seizure meds and extra trips to the dentist may
be required
Neurotransmitters
• GABA – calming
• Acetylcholine – muscle action, thought and learning
***If a specific drug is listed on the PowerPoint, know all about it.
NURS 615 Pharm Exam 2 Mega Review Study Guide Latest Update
best exam study guide GRADED A+
best exam study guide GRADED A+
Law-Ham Pharm Exam 2 Review
**Know every drug that is on the PowerPoint – have a one-line mechanism of action on a table
for each drug and understand it, as well as how and where it works
Carbamazepine (Tegretol) – is an anticonvulsant = thought to affect Na+ channels
to slow spread of abnormal activity
• SE = decreases body’s production of blood cells, rare reports of aplastic anemia and
agranulocytosis, can cause Steven Johnson Syndrome and Toxic Epidermal Necrolysis
• Should get a CBC Q3-4 months (watch for WBC count in particular)
• Carbamazepine is a strong inducer of hepatic enzymes/metabolism and can lead to lower
levels
• Do NOT stop taking abruptly, has a shorter half-life w/repeated uses
Levetiracetam (Keppra) – antiepileptic, does NOT affect GABA, does inhibit burst
firing and spread of seizure activity
• Mostly cleared through renal system, is not extensively metabolized
• Absolute contraindication is sensitivity to the drug
• At increased risk for suicidal thoughts and depression, behavioral changes,
somnolence, fatigue, dizziness, muscle coordination difficulties
• Potential for withdrawal seizures if keppra is stopped abruptly
NURS 615 Pharm Exam 2 Mega Review Study Guide Latest Update
best exam study guide GRADED A+
,NURS 615 Pharm Exam 2 Mega Review Study Guide Latest Update
best exam study guide GRADED A+
• Safer med for seizures in children and pregnancy
Topiramate (Topamax) – is for tx of epilepsy, seizures, migraine prophylaxis
• Blocks sodium channels or potentiate GABA
• Peaks 2 hours after oral admin, mostly eliminated via urine
• Can cause ↓ Na bicarb levels which can lead to hyperchloremic metabolic acidosis
• Serum bicarbonate should be monitored at baseline and periodically
• Can cause ocular syndrome (acute myopia and glaucoma) – should inform provider
immediately if pt experiences eye pain or blurred vision
• Rare side effect is oligohidrosis (↓sweating) and hyperthermia
• Can increase the risk of suicidal behavior/ideation, cause weight reduction
• Should NOT be discontinued abruptly
• Is a pregnancy category D and can increase risk of cleft lip/palate in infants
Valproate (Depakote) – is an anticonvulsant, for tx of bipolar disorder and mania also
• Blocks GABA uptake into presynaptic neurons
• SE = GI distress, heartburn, CNS depressant
• Is a pregnancy category X, known teratogen, may only be taken after the 1st trimester
if necessary, bur should recommend switching to different anticonvulsant like Keppra
NURS 615 Pharm Exam 2 Mega Review Study Guide Latest Update
best exam study guide GRADED A+
,NURS 615 Pharm Exam 2 Mega Review Study Guide Latest Update
best exam study guide GRADED A+
Ethosuximide (Zarontin) – tx for seizures
NURS 615 Pharm Exam 2 Mega Review Study Guide Latest Update
best exam study guide GRADED A+
, NURS 615 Pharm Exam 2 Mega Review Study Guide Latest Update
best exam study guide GRADED A+
• Should be monitored for blood dyscrasia (an abnormal condition or dx of the blood)
Antiepileptics block transmission, raise the seizure threshold, so that the patient will not peak
over the seizure threshold and have a seizure.
Anticonvulsants in terms of monitoring (most common side effects, most serious side effects) –
know that they are all monitored with blood work for their levels so that is a similarity amongst
them
• Carbamazepine – CBC – Causes agranulocytosis so be watching the white count
in particular although there is other bone marrow suppression as well
• What do you monitor? – TSH because the med can affect the thyroid
• Never want anyone to d/c suddenly, must be weaned off
• Talk to patients about safety – driving limitations, may have to report patient to
DMV if they are having active seizures
• Oral health can be affected by anti-seizure meds and extra trips to the dentist may
be required
Neurotransmitters
• GABA – calming
• Acetylcholine – muscle action, thought and learning
***If a specific drug is listed on the PowerPoint, know all about it.
NURS 615 Pharm Exam 2 Mega Review Study Guide Latest Update
best exam study guide GRADED A+
