Nurs 615 Exam II Broad Questions with Correct and
Confirmed Graded A+ Answers. Assured Pass.
Terms in this set (44)
Plasma carbamazepine levels should be monitored on a regular basis. The
therapeutic range is 4 to 12 mcg/L. Higher levels can lead to
toxic symptoms consisting of initial adverse effects and also
hypertension, tachycardia, ECG changes, stupor, agitation,
What blood values should be nystagmus, urinary retention, respiratory depression,
monitored with seizures, and coma. Children and elderly patient may develop
carbamazepine? toxicity levels below 12.
CBC every 3 to 4 months
Affects RBC, WBC,
Platelets
Agranulocytosis,
Anemia
, Carbamazepine is metabolized in the liver and has the unique ability
to induce its own metabolism (autoinduction). Due to autoinduction,
initial concentrations within therapeutic range may later fall
despite good compliance. It also induces the
metabolism of many CYP450 enzymes and other substances. Slowly but well
absorbed half life of about 30 hours, shortens to 15 hours when given
repeatedly
The exact mechanism of action of carbamazepine is not known, but
they are thought to affect the sodium channels, slowing influx of
sodium in the cortical neurons and
slowing the spread of abnormal activity. Carbamazepine exerts its effect by
depressing transmission in the nucleus ventralis anterior of the
thalamus. This area is associated with the spread of seizure
discharge.
What is the pharmacodynamics of
carbamazepine?
• Absorption and Distribution
Carbamazepine is absorbed through the stomach, the suspension
being absorbed more quickly than the tablet form. Absorption from
the immediate-release tablets is slow and erratic because of its
slow water solubility. The drug is highly lipophilic,
resulting in high body tissue binding.
• Metabolism and Excretion
Excretion is through feces and urine.
Average blood levels of carbamazepine occur approximately 6 hours after
administration. Half-life can be as long as 65 hours with initial
dosing, but is typically 12 to 17 hours as administration continues.
It is noteworthy that the half-life after a
single dose is much longer than the half-life after long-term use.
Steady state is attained in 2 to 4 days.
Patients should be monitored for seizure activity, severity, and duration. Patient
What should families be taught should carry medical identification for the seizure disorder. Patient
regarding the monitoring of should report any mood changes or suicidal thoughts. Prevention
, seizure activity? of seizures. Do not abruptly end
medication increases risk of seizures
Patients taking topiramate may have decreased concentrations of
bicarbonate due to inhibition of carbonic anhydrase and increased
What electrolyte imbalance is
renal bicarbonate loss, leading to hyperchloremic metabolic
noted with the administration of
acidosis. Severe metabolic acidosis has been reported in infants
topiramate?
receiving a topiramate dose of 5mg/kg/day. Serum bicarbonate
levels should be monitored at baseline and periodically
throughout therapy.
What is the pregnancy category for Pregnancy Category X.
valproate?
Switch to another antiseizure medication such as Keppra
What instructions will you
provide to a woman who wants Use of these drugs during the first trimester of pregnancy is
to get pregnant and has a seizure associated with neural tube defects including spina bifida. Their use
disorder controlled with should be restricted to cases in which a woman's life would be
valproate? endangered without them and then only beyond the first
trimester. They should be used with caution during lactation.
Confirmed Graded A+ Answers. Assured Pass.
Terms in this set (44)
Plasma carbamazepine levels should be monitored on a regular basis. The
therapeutic range is 4 to 12 mcg/L. Higher levels can lead to
toxic symptoms consisting of initial adverse effects and also
hypertension, tachycardia, ECG changes, stupor, agitation,
What blood values should be nystagmus, urinary retention, respiratory depression,
monitored with seizures, and coma. Children and elderly patient may develop
carbamazepine? toxicity levels below 12.
CBC every 3 to 4 months
Affects RBC, WBC,
Platelets
Agranulocytosis,
Anemia
, Carbamazepine is metabolized in the liver and has the unique ability
to induce its own metabolism (autoinduction). Due to autoinduction,
initial concentrations within therapeutic range may later fall
despite good compliance. It also induces the
metabolism of many CYP450 enzymes and other substances. Slowly but well
absorbed half life of about 30 hours, shortens to 15 hours when given
repeatedly
The exact mechanism of action of carbamazepine is not known, but
they are thought to affect the sodium channels, slowing influx of
sodium in the cortical neurons and
slowing the spread of abnormal activity. Carbamazepine exerts its effect by
depressing transmission in the nucleus ventralis anterior of the
thalamus. This area is associated with the spread of seizure
discharge.
What is the pharmacodynamics of
carbamazepine?
• Absorption and Distribution
Carbamazepine is absorbed through the stomach, the suspension
being absorbed more quickly than the tablet form. Absorption from
the immediate-release tablets is slow and erratic because of its
slow water solubility. The drug is highly lipophilic,
resulting in high body tissue binding.
• Metabolism and Excretion
Excretion is through feces and urine.
Average blood levels of carbamazepine occur approximately 6 hours after
administration. Half-life can be as long as 65 hours with initial
dosing, but is typically 12 to 17 hours as administration continues.
It is noteworthy that the half-life after a
single dose is much longer than the half-life after long-term use.
Steady state is attained in 2 to 4 days.
Patients should be monitored for seizure activity, severity, and duration. Patient
What should families be taught should carry medical identification for the seizure disorder. Patient
regarding the monitoring of should report any mood changes or suicidal thoughts. Prevention
, seizure activity? of seizures. Do not abruptly end
medication increases risk of seizures
Patients taking topiramate may have decreased concentrations of
bicarbonate due to inhibition of carbonic anhydrase and increased
What electrolyte imbalance is
renal bicarbonate loss, leading to hyperchloremic metabolic
noted with the administration of
acidosis. Severe metabolic acidosis has been reported in infants
topiramate?
receiving a topiramate dose of 5mg/kg/day. Serum bicarbonate
levels should be monitored at baseline and periodically
throughout therapy.
What is the pregnancy category for Pregnancy Category X.
valproate?
Switch to another antiseizure medication such as Keppra
What instructions will you
provide to a woman who wants Use of these drugs during the first trimester of pregnancy is
to get pregnant and has a seizure associated with neural tube defects including spina bifida. Their use
disorder controlled with should be restricted to cases in which a woman's life would be
valproate? endangered without them and then only beyond the first
trimester. They should be used with caution during lactation.
