NURS 615 Pharm Exam 2 Mega
Review Study Guide latest
NURS 615 Pharm Exam 2 Mega Review Study Guide
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
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
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
• Safer med for seizures in children and pregnancy
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
Ethosuximide (Zarontin) – tx for seizures
NURS 615 Pharm Exam 2 Mega Review Study Guide
• 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.
• All these drugs are listed on the PowerPoint
• Seizure
o Topiramate – topamax
o Carbamazepine – Tegretol
o Valproate – Depakote
o Levetiracetam – Keppra
• MAOI
o Phenelzine – Nardil
• Anxiolytics
Phentermine (Adipex-P) – used for obesity, stimulating satiety centers
• Should only be used short-term (6 months or less)
• DO NOT mix w/ SSRIs or St. John’s Wart (Serotonin Syndrome), or w/ MAOIs (HTN crisis)
Lithium— tx of choice for manic-depressive (bipolar) illness, ↓ severity/frequency of mania
▪ Replaces Na+ during depolarization in neurons = stops transmission of electrical impulses
▪ Inversely proportional to Na+ --- ↓Na+ = ↑Lithium ↑Na+ = ↓Lithium
▪ Lithium Toxicity can occur = drowsiness, nausea, course tremors, diarrhea, confusion, stupor
▪ NOT to be used in renal pts, children under 12, or pregnant women
▪ Pt education = avoid dehydration, eat a diet with consistent Na+ levels
Review Study Guide latest
NURS 615 Pharm Exam 2 Mega Review Study Guide
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
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
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
• Safer med for seizures in children and pregnancy
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
Ethosuximide (Zarontin) – tx for seizures
NURS 615 Pharm Exam 2 Mega Review Study Guide
• 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.
• All these drugs are listed on the PowerPoint
• Seizure
o Topiramate – topamax
o Carbamazepine – Tegretol
o Valproate – Depakote
o Levetiracetam – Keppra
• MAOI
o Phenelzine – Nardil
• Anxiolytics
Phentermine (Adipex-P) – used for obesity, stimulating satiety centers
• Should only be used short-term (6 months or less)
• DO NOT mix w/ SSRIs or St. John’s Wart (Serotonin Syndrome), or w/ MAOIs (HTN crisis)
Lithium— tx of choice for manic-depressive (bipolar) illness, ↓ severity/frequency of mania
▪ Replaces Na+ during depolarization in neurons = stops transmission of electrical impulses
▪ Inversely proportional to Na+ --- ↓Na+ = ↑Lithium ↑Na+ = ↓Lithium
▪ Lithium Toxicity can occur = drowsiness, nausea, course tremors, diarrhea, confusion, stupor
▪ NOT to be used in renal pts, children under 12, or pregnant women
▪ Pt education = avoid dehydration, eat a diet with consistent Na+ levels
