Maryville NURS 615 Pharm Exam 2 ACTUAL LATEST EXAM RATED A+, Exams of Nursing

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1. Carbamazepine (Tegretol) can sometimes show subtherapeutic range due to what?: Carbamazepine auto-induces metabolism, leading to lower levels de- spite good compliance
2. What are the black box warnings for Carbamazepine?: Dermatologic reac- tions
3. Steven's Johnson
4. Toxic epidermal necrolysis
5. What lab test should be ordered for patients on Carbamazepine?: CBC every 3-4 months because it can cause decreased WBC, decreased platelets, andtrouble with RBC
6. What kind of teaching needs to be done with families of patients who have seizure disorders?: Prevention is important, patient safety is important, Do NOT abruptly stop taking medication. 5. Ethosuximide (Zarontin), an anti-seizure medication can cause what?: - Blood dyscrasias
7. Patients taking Topiramate need to be monitored for what electrolyte im- balance?: Decreased sodium bicarb leading to hyperchloremic metabolic acidosis
8. Topiramate treats seizures and what is one common side effect?: Normal side effect is weight loss, especially in higher dose patients 8. A child on Topiramate that wants to play sports should monitor what?: - Don't get overheated. Topiramate may affect his ability to sweat in the heat.
9. What should a pregnant patient be told about taking Valproate (De- pakote)?: It is a known teratogen and category X medication. It should not be usedin the first trimester, it may be restarted in second trimester.
10. What patient population should tricyclic antidepressants be used cau- tiously in?: Heart Disease patients
11. Phenelzine (Nardil) is a MAOI. What teaching needs to be done with this medication?: He should not use serotonergic drugs like Imitrex. Also, this classof medication interacts with yogurt, sour cream, soy sauce, etc.

12. Phenelzine (Nardil) may cause what if there is an interaction with known contraindicated foods?: Hypertensive crisis
13. What are the side effects of tricyclic antidepressants?: Anticholinergic type effects like dry mouth, sedation, constipation, increased appetite, blurred vision, tinnitus, euphoria, mania
14. How long does it take for SSRIs to take effect: 2-6 weeks

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30. What receptors do Benzos act on?: Enhances the neurotransmitter GABA (gamma-aminobutyric acid) receptors

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31. What result do Benzos have on the body?: sedative hypnotic

anxiolytic anticonvulsant muscle relaxer

32. What are long acting Benzos prescribed for?: Treatment of anxiety
33. What are short acting Benzos prescribed for?: Treatment of insomnia
34. What would be a good medication to prescribe for panic disorder?: Di- azepam (Valium)
35. What is a anorexiant medication to treat obesity?: Phentermine
36. What is a precaution with Phentermine?: Anorexiants may cause tolerance and should only be used for 6 months
37. What medications or herbals should be avoided with Phentermine? Why?: SSRIs and St. Johns Wort...the combination may cause serotonin syn-drome
38. Phentermine releases what two chemicals?: Epinephrine and norepineph- rine
39. Epi and norepi causes what to break down?: Fat cells to break down storedfat
40. What are Signs and symptoms of seratonin syndrome?: Headache, agita- tion, mental confusion, hallucinations, coma 41. What are autonomic effects that you can get from seratonin syndrome?- : Shivering, sweating, hyperthermia, vasoconstriction, tachycardia, nausea, diar- rhea
41. What factors place a patient at risk for developing antimicrobial resistant organisms?: Inappropriate use of antibiotics

Children less than 2 years of age Adults older than 65 yrs of age

Patients who do not finish their antibiotic regimen

43. What are appropriate antibiotics to prescribe to pregnant women and children?: PCN or Cephalosporins

(Amoxicillin, or Augmentin)

45. Why is clavulanate added to Amoxicillin?: Clavulanate is a Beta-lactam inhibitor. This increases the spectrum of action and is effective at preventing amoxicillin-resistant bacteria that produce Beta-lactamase
46. What type of antibiotics should be avoided in children and pregnant women?: Tetracycline, fluoroquinolones
47. What is a normal side effect of amoxicillin?: Diarrhea and it is recommend-ed to continue to take the medicine, drink lots of water, and take probiotics daily, eat yogurt
48. The American Heart Association recommedations for prophylaxis an- tibiotic use prior to dental care are...: 1. Prosthetic cardiac valve or prosthetic material used in valve repair
49. Previous Endocarditis
50. The following congenital diseases I. Unrepaired cyanotic congenital heart disease including palliative shunts and conduits II. Completely repaired congenital heart disease with prosthetic material device, whether placed surgically or with a catheter for 6 months following the procedure III. Repaired congenital heart disease with residual effects at the site or adjacent to the site of a prosthetic patch or prosthetic device which inhibit endothelialization IV. Cardiac transplantation recipients with cardiac valvular disease
51. What antibiotic is used for dental appointments?: Amoxicillin 2 gm for adults

50mg/kg in children

50. What should fluoroquinolones be reserved to treat?: Community acquired pneumonia in patients with comorbidities and Hospital acquired pneumonia
51. What is the black box warning for fluoroquinolones?: It may cause tendon ruptures. Specifically of the achilles tendon.
52. What medication can be affected with the use of fluoroquinolones?: War- farin because fluoroquinolones displace the flora of the gut and displaces warfarin from albumin and interferes with metabolism by the P450 system.
53. Why are tetracyclines not recommended in pregnancy and in children less than 8 yrs of age?: They can cause staining of teeth, and cause problemswith bone growth.

54. What population can tetracyclines like minocycline be used on? And pa- tients who use it might develop what?: Adolescents. It may cause psuedotumor cerebri, drug-induced lupus and hepatitis, skin photosensitivity, tinnitus, fatty liver

69. Which class of antibiotics block bacterial protein production?: Bacterio- static antibiotics: Tetracyclie, Sulfonamides, Macrolides, Clindamycin, Ethambutol, Nitrofuantoin, Novobiocin, tigecycline, oxazolidinone
70. What labs need to be monitored for long term antifungal therapy with ketoconazole?: AST, ALT, Phosphatase, bilirubin
71. What teaching should be done with Flagyl?: Do not consume alcohol in any form with this medication
72. Which antihelmintic is used to treat parasitic worms?: Mebendazole, and agromectin

and ivermectin to treat true parasites

73. What antifungal can be used topically?: Clotrimazole
74. What medication treats scabies and lice?: Ivermectin and permethrin cream
75. Rifampin is used to treat what?: TB
76. Side effects of rifampin?: Joint pain because it can precipitate gout and it is hepatotoxic.
77. IF patients are hypersensitive to Sulfa, what other medications will they be sensitive to?: Loop Diuretics, thiazide diuretics, and sulfonylureas
78. Sulfa antibiotics can cause what?: Stephen Johnsons Syndrome and toxic epidermal necrolysis