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NURS 663 Exam with Verified Q&A’S | Latest Update
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NURS 663 Exam with Verified Q&A’S | LatestUpdate
Carbamazepine (Tegretol) - ✔✔This drug is metabolized through da CYP 450 3A4 System it is
metabolized in the liver and excreted renally. Due to how the drug is metabolized there are
many drug interactions.
Carbamazepine (Tegretol) - ✔✔Thos drug decreases serum concentrations of numerous
drugs as a result of the prominent induction of hepatic CYP 3A4 system. Monitoring for a
decrease in clinical affects is frequently indicated it can decrease blood concentration of Oral
contraceptives which can result in breakthrough bleeding and uncertain prophylaxis against
pregnancy. It should not be administered with MAOI's. Which must be stopped at least two
weeks before initiating this treatment. With this drug and Depakote/valproate the dosage of
this drug should be decreased because valproate displaces the strong binding onto proteins,
the dosage of valproate may need to be increased.
Carbamazepine (Tegretol) - ✔✔Side effects of this Medication that are noticeable include
sedation, dizziness, confusion, unsteadiness, headache, nausea, vomiting, diarrhea, blurred
vision, benign leukopenia and up to 10% of patients, rash, (Purpura, Steven Johnson syndrome),
And syndrome of inappropriate antidiuretic hormone secretion with hypo natremia. Patient
should be monitored carefully for signs of unusual bleeding or bruising, mouse or, infections,
fever or sore throat as the wrist for a plastic anemia in agranulocytosis with this medication is 5
to 8 times greater than in the general population.
Escitalopram (Lexapro) - ✔✔this is an SSRI that is not generally recommended for use during
pregnancy, especially during the first trimester there may be more bleeding in the mother and
transient irritability or sedation in the newborn.
Escitalopram (Lexapro - ✔✔this medication is a substrate for the CYP 452C 19 and three A4 it
has no significant actions on CYP 450 enzymes. Food does not affect absorption. Steady state
plasma concentrations are achieved within one week. It has a half life of 27 to 32 hours.
Tapering this medication is not usually necessary. Many patients tolerate 50% dose reduction
for three days then another 50% reduction for three days then discontinuation. If withdrawal
symptoms emerge during discontinuation, phase dose to stop symptoms and then restart
withdraw much more slowly.
,Escitalopram (Lexapro - ✔✔tramadol increases the risk of seizures in patients taking an
antidepressant. Can cause a fatal serotonin syndrome when combined with MAOIs, so do you
not use with MAOIs wise for at least 14 days after MAOIs are stopped. Do not start an MAOI for
at least 5 half lives 5 to 7 days for most drugs after discontinuing this medication. Could
theoretically cause weakness hyperreflexia and incoordination when combined with
sumatriptan or possibly other triptans requiring careful monitoring of patient. Possible increase
risk of bleeding especially when combined with anticoagulants. NSAIDs may impair
effectiveness of SSRIs. This medication has a few known adverse drug reactions.
Escitalopram (Lexapro - ✔✔Notable side effects include sexual dysfunction Gastro intestinal
problems central nervous system problems such as insomnia sedation agitation tremors
headache dizziness autonomic sweating syndrome of inappropriate antidiuretic hormone.
Escitalopram (Lexapro - ✔✔This is a moderate inhibitor of CYP2D6 and has been shown to
raise desipramine in metoprolol concentration significantly.
SSRIs - ✔✔not generally recommended for use during pregnancy especially during first
trimester. Continuous treatment during pregnancy may be necessary and has not proven to be
harmful to the fetus. At delivery there may be more bleeding in the mother in transient
irritability or sedation in the newborn. Exposure to those in pregnancy may be associated with
increased rate of septal heart defects.
Fluoxetine (Prozac) - ✔✔A taper of this SSRI is rarely necessary since fluoxetine tapers itself
after immediate discontinuation, due to the long half-life of fluoxetine and it's active
metabolites. Add or initiate other antidepressant with caution for up to five weeks after
discontinuing.
Nor fluoxetine - ✔✔This is the active metabolite in fluoxetine that has a two week half-life it
inhibits CYP 450 2D6 and CYp450 3A4
Fluoxetine (Prozac) - ✔✔this can be administered with tricyclic drugs but the clinician should
use low dosages of the tricyclic drug. Because the hepatic enzyme CYP two D6 metabolize is it it
, may interfere with the metabolism of other drugs in the 7% of the population do have an
efficient iso form of this enzyme in so-called poor metabolizers it may slow down the
metabolism of Tegretol Valium and Dilantin interactions me a fact the plasma line levels of
benzodiazepines, antipsychotics and lithium it may interact with Coumadin increasing the risk
for bleeding and bruising like many other SSRIs.
this can be administered with tricyclic drugs but the clinician should use low dosages of the
tricyclic drug. Because the hepatic enzyme CYP two D6 metabolize is it it may interfere with the
metabolism of other drugs in the 7% of the population do have an efficient iso form of this
enzyme in so-called poor metabolizers it may slow down the metabolism of Tegretol Valium
and Dilantin interactions me a fact the plasma line levels of benzodiazepines, antipsychotics
and lithium it may interact with Coumadin increasing the risk for bleeding and bruising like
many other SSRIs. - ✔✔
Fluoxetine/Prozac - ✔✔Due to the drugs unique 5 HT to see antagonist properties it could
contribute to agitation, anxiety, and undesirable activation especially early and dosing.
Dangerous or life-threatening side effects include rare seizures, induction of mania, activation is
suicidal ideation's in individuals less than 24 years old.
Paroxetine (Paxil) - ✔✔Paroxetine's weak anti-muscarinic properties can cause constipation
dry mouth and sedation, sexual dysfunction, gastrointestinal upset CNS affects such as;
insomnia, sedation agitation, does dependent tremors, headache and dizziness.
Paroxetine (Paxil) - ✔✔with this SSRI it is necessary to taper to avoid withdrawal effects such
as dizziness nausea stomach cramps sweating tingling and Dye seizures. Many patients tolerate
50% dose reduction for three days then another 50% reduction for three days in
discontinuation. Withdrawal effects can be more common or more severe with this medication
than other SSRIs.
Paroxetine (Paxil) - ✔✔An active metabolites for this SSRI it has a half-life of approximately
24 hours. It inhibits CYP 450 2D6
Paroxetine (Paxil) - ✔✔in pregnancy using this SSRI has shown an increased rest for
cardiovascular mouthformations, primarily ventricular and atrial septo defects, an infants born
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