NRNP 6675 FINAL EXAM LAST EXAM
1. The 1/2 life of lithium is about? 24 hours
2. Fluoxetine is the SSRI with the ______ WD lowest due to long half life
risk?
3. What antipsychotics are good for pts who Antipsychotics with long half-lives:
miss doses of their meds? 1. Cariprazine(Vrylar): (2-4 days-active
metabolites up to 3 weeks)
2. Abilify (3 days)
3. Brexipiprazole (4 days)
4. Pimozide (4-5 days)
5. Pimavanserin (2 days, active metabo-
lites 8 days)
4. Disulfiram's alcohol interactions persist for LONG Half life--2-3 days
up to how long after the medication is
stopped? persist up to 2 weeks following stopping
5. What is the only TCA with a long half life? Protriptyline (Vivactil)
6. Most psychotropics have a medium range 24 hours
1/2 life of approx?
7. what does "steady state" mean in relation to steady state means that you are eliminat-
1/2 life? ing the drug at the same overall rate that
you are ingesting it
8. Lithium reaches its 'steady state' when? 5 half lives
example:
Day 1: Start pt on Lithium 600 mg daily
Day 2: (24 hours later) the amount left
in his body is 300 mg (day 2 min) be-
, NRNP 6675 FINAL EXAM LAST EXAM
cause 24 hours has passed--one 1/2
life--therefore the pt has excreted 1/2 of
the initial amount.
THEN the pt takes his 2nd dose of 600
mg on DAY 2-resulting in a max dose of
900 (300 mg left in body + 600 mg of
2nd dose).
DAY 3: starts off with 450 mg (1/2 of the
900 mg in pt's system) and after taking
the day 3 600 mg dose, the pt now has a
total of 1050 mg.
9. Due to the steady state of Lithium, when do 5 half lives
we draw a blood level?
if you check any earlier, the trough level
will underestimate the actual level the pt
is on after achieving steady state
10. Fluoxetine has a half life of about? 2 weeks 1/2 life
take 2.5 months to achieve steady state
11. Most psychotropic medications operate in "when you double the dose, the serum
this fashion: dose doubles."
*minus three SRIs and three anticon-
vulsants (Fluoxetine, fluvoxamine, pax-
il, gabapentin, valproate and carba-
mazepine)
12. _________induces it's own metabolism, has- A. Carbamazepine (Tegretol)
tening excretion and shortening it's half life
*this effect begins to "rev up" after 2-4
, NRNP 6675 FINAL EXAM LAST EXAM
weeks--which is why a carbamazepine
level is so important on obtaining 1-2
months after starting Tegretol.
13. Carbamazepine (Tegretol) level should be 1-2 months due to Tegretol inducing
checked how soon after starting to take this it's own metabolism, hastening excretion
med? and shortening it's half life.
14. _____ has trouble getting a "serum" level be- A. Valproate Acid (Depakote)
cause it binds to proteins that render it ther-
apeutically inactive? -this is particularly true at the lower levels
(eg. <50 mcg/mL), so you can expect
dose changes to make a more dramatic
difference when the pt's depakote level
is in the higher range
15. _______'s serum level is the opposite of Val- Gabapentin
proic Acid: it rises quickly at first and then
slows down? *gabapentin saturates the transporters
that absorb it in the small intestine, caus-
ing its levels to rise at a snails pace when
the dosage goes above a certain satura-
tion point (around 900 mg/day).
-from there, the saturation trickles down;
@ 900 mg/day--60% is absorbed. @
1200 mg/day--50 % is absorbed. @3000
mg/day--30% of the gabapentin is ab-
sorbed.
16. Due to Gabapentin's serum pattern for @ 0900mg/day---60% is absorbed.
dosage:
1. The 1/2 life of lithium is about? 24 hours
2. Fluoxetine is the SSRI with the ______ WD lowest due to long half life
risk?
3. What antipsychotics are good for pts who Antipsychotics with long half-lives:
miss doses of their meds? 1. Cariprazine(Vrylar): (2-4 days-active
metabolites up to 3 weeks)
2. Abilify (3 days)
3. Brexipiprazole (4 days)
4. Pimozide (4-5 days)
5. Pimavanserin (2 days, active metabo-
lites 8 days)
4. Disulfiram's alcohol interactions persist for LONG Half life--2-3 days
up to how long after the medication is
stopped? persist up to 2 weeks following stopping
5. What is the only TCA with a long half life? Protriptyline (Vivactil)
6. Most psychotropics have a medium range 24 hours
1/2 life of approx?
7. what does "steady state" mean in relation to steady state means that you are eliminat-
1/2 life? ing the drug at the same overall rate that
you are ingesting it
8. Lithium reaches its 'steady state' when? 5 half lives
example:
Day 1: Start pt on Lithium 600 mg daily
Day 2: (24 hours later) the amount left
in his body is 300 mg (day 2 min) be-
, NRNP 6675 FINAL EXAM LAST EXAM
cause 24 hours has passed--one 1/2
life--therefore the pt has excreted 1/2 of
the initial amount.
THEN the pt takes his 2nd dose of 600
mg on DAY 2-resulting in a max dose of
900 (300 mg left in body + 600 mg of
2nd dose).
DAY 3: starts off with 450 mg (1/2 of the
900 mg in pt's system) and after taking
the day 3 600 mg dose, the pt now has a
total of 1050 mg.
9. Due to the steady state of Lithium, when do 5 half lives
we draw a blood level?
if you check any earlier, the trough level
will underestimate the actual level the pt
is on after achieving steady state
10. Fluoxetine has a half life of about? 2 weeks 1/2 life
take 2.5 months to achieve steady state
11. Most psychotropic medications operate in "when you double the dose, the serum
this fashion: dose doubles."
*minus three SRIs and three anticon-
vulsants (Fluoxetine, fluvoxamine, pax-
il, gabapentin, valproate and carba-
mazepine)
12. _________induces it's own metabolism, has- A. Carbamazepine (Tegretol)
tening excretion and shortening it's half life
*this effect begins to "rev up" after 2-4
, NRNP 6675 FINAL EXAM LAST EXAM
weeks--which is why a carbamazepine
level is so important on obtaining 1-2
months after starting Tegretol.
13. Carbamazepine (Tegretol) level should be 1-2 months due to Tegretol inducing
checked how soon after starting to take this it's own metabolism, hastening excretion
med? and shortening it's half life.
14. _____ has trouble getting a "serum" level be- A. Valproate Acid (Depakote)
cause it binds to proteins that render it ther-
apeutically inactive? -this is particularly true at the lower levels
(eg. <50 mcg/mL), so you can expect
dose changes to make a more dramatic
difference when the pt's depakote level
is in the higher range
15. _______'s serum level is the opposite of Val- Gabapentin
proic Acid: it rises quickly at first and then
slows down? *gabapentin saturates the transporters
that absorb it in the small intestine, caus-
ing its levels to rise at a snails pace when
the dosage goes above a certain satura-
tion point (around 900 mg/day).
-from there, the saturation trickles down;
@ 900 mg/day--60% is absorbed. @
1200 mg/day--50 % is absorbed. @3000
mg/day--30% of the gabapentin is ab-
sorbed.
16. Due to Gabapentin's serum pattern for @ 0900mg/day---60% is absorbed.
dosage:
