Maryville NURS 615 Pharm Exam 2
Carbamazepine (Tegretol) can sometimes show subtherapeutic range due to what? -
ANS-Carbamazepine auto-induces metabolism, leading to lower levels despite good
compliance
What are the black box warnings for Carbamazepine? - ANS-Dermatologic reactions
1. Steven's Johnson
2. Toxic epidermal necrolysis
What lab test should be ordered for patients on Carbamazepine? - ANS-CBC every 3-4
months because it can cause decreased WBC, decreased platelets, and trouble with
RBC
What kind of teaching needs to be done with families of patients who have seizure
disorders? - ANS-Prevention is important, patient safety is important, Do NOT abruptly
stop taking medication.
Ethosuximide (Zarontin), an anti-seizure medication can cause what? - ANS-Blood
dyscrasias
Patients taking Topiramate need to be monitored for what electrolyte imbalance? -
ANS-Decreased sodium bicarb leading to hyperchloremic metabolic acidosis
Topiramate treats seizures and what is one common side effect? - ANS-Normal side
effect is weight loss, especially in higher dose patients
A child on Topiramate that wants to play sports should monitor what? - ANS-Don't get
overheated. Topiramate may affect his ability to sweat in the heat.
What should a pregnant patient be told about taking Valproate (Depakote)? - ANS-It is a
known teratogen and category X medication. It should not be used in the first trimester,
it may be restarted in second trimester.
What patient population should tricyclic antidepressants be used cautiously in? -
ANS-Heart Disease patients
, Phenelzine (Nardil) is a MAOI. What teaching needs to be done with this medication? -
ANS-He should not use serotonergic drugs like Imitrex. Also, this class of medication
interacts with yogurt, sour cream, soy sauce, etc.
Phenelzine (Nardil) may cause what if there is an interaction with known contraindicated
foods? - ANS-Hypertensive crisis
What are the side effects of tricyclic antidepressants? - ANS-Anticholinergic type effects
like dry mouth, sedation, constipation, increased appetite, blurred vision, tinnitus,
euphoria, mania
How long does it take for SSRIs to take effect - ANS-2-6 weeks
SSRIs may cause what onset of action symptoms? - ANS-Nausea, but this will usually
resolve in a week.
What is one thing you should not do with SSRIs? - ANS-Drink alcohol
What should happen when going off an SSRI? - ANS-Wean slowly, do not stop abruptly
What medications would a patient with depression and anxiety respond well to? -
ANS-Buspar and an SSRI combined
Celexa (Citalopram)
Lexapro (Escitalopram)
Why should you combine an SSRI with Buspar? - ANS-Buspar augments the SSRI and
is a good combo for anxiety and depression
What is a first line drug for mild to moderate generalized anxiety disorder? -
ANS-Buspirone
How fast does Celexa start to demonstrate effects? - ANS-Improved appetitie and
concentration in 1-2 weeks.
What is a major drug to treat bipolar disease? - ANS-Lithium
Blood levels need to be monitored with Lithium because why? - ANS-Lithium has a
narrow therapeutic range so it is important to recognize toxicity
What are symptoms of lithium toxicity? - ANS-Drowsiness and Nausea
Carbamazepine (Tegretol) can sometimes show subtherapeutic range due to what? -
ANS-Carbamazepine auto-induces metabolism, leading to lower levels despite good
compliance
What are the black box warnings for Carbamazepine? - ANS-Dermatologic reactions
1. Steven's Johnson
2. Toxic epidermal necrolysis
What lab test should be ordered for patients on Carbamazepine? - ANS-CBC every 3-4
months because it can cause decreased WBC, decreased platelets, and trouble with
RBC
What kind of teaching needs to be done with families of patients who have seizure
disorders? - ANS-Prevention is important, patient safety is important, Do NOT abruptly
stop taking medication.
Ethosuximide (Zarontin), an anti-seizure medication can cause what? - ANS-Blood
dyscrasias
Patients taking Topiramate need to be monitored for what electrolyte imbalance? -
ANS-Decreased sodium bicarb leading to hyperchloremic metabolic acidosis
Topiramate treats seizures and what is one common side effect? - ANS-Normal side
effect is weight loss, especially in higher dose patients
A child on Topiramate that wants to play sports should monitor what? - ANS-Don't get
overheated. Topiramate may affect his ability to sweat in the heat.
What should a pregnant patient be told about taking Valproate (Depakote)? - ANS-It is a
known teratogen and category X medication. It should not be used in the first trimester,
it may be restarted in second trimester.
What patient population should tricyclic antidepressants be used cautiously in? -
ANS-Heart Disease patients
, Phenelzine (Nardil) is a MAOI. What teaching needs to be done with this medication? -
ANS-He should not use serotonergic drugs like Imitrex. Also, this class of medication
interacts with yogurt, sour cream, soy sauce, etc.
Phenelzine (Nardil) may cause what if there is an interaction with known contraindicated
foods? - ANS-Hypertensive crisis
What are the side effects of tricyclic antidepressants? - ANS-Anticholinergic type effects
like dry mouth, sedation, constipation, increased appetite, blurred vision, tinnitus,
euphoria, mania
How long does it take for SSRIs to take effect - ANS-2-6 weeks
SSRIs may cause what onset of action symptoms? - ANS-Nausea, but this will usually
resolve in a week.
What is one thing you should not do with SSRIs? - ANS-Drink alcohol
What should happen when going off an SSRI? - ANS-Wean slowly, do not stop abruptly
What medications would a patient with depression and anxiety respond well to? -
ANS-Buspar and an SSRI combined
Celexa (Citalopram)
Lexapro (Escitalopram)
Why should you combine an SSRI with Buspar? - ANS-Buspar augments the SSRI and
is a good combo for anxiety and depression
What is a first line drug for mild to moderate generalized anxiety disorder? -
ANS-Buspirone
How fast does Celexa start to demonstrate effects? - ANS-Improved appetitie and
concentration in 1-2 weeks.
What is a major drug to treat bipolar disease? - ANS-Lithium
Blood levels need to be monitored with Lithium because why? - ANS-Lithium has a
narrow therapeutic range so it is important to recognize toxicity
What are symptoms of lithium toxicity? - ANS-Drowsiness and Nausea
