NURS 615 Exam II Practice Questions and
Answers (100% Pass)
What blood values should be monitored with carbamazepine? -
Answer️️ -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 ...
NURS 615 Exam II Practice Questions and
Answers (100% Pass)
What blood values should be monitored with carbamazepine? -
Answer✔️✔️-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, nystagmus,
urinary retention, respiratory depression, seizures, and coma. Children and
elderly patient may develop toxicity levels below 12.
CBC every 3 to 4 months
Affects RBC, WBC, Platelets
Agranulocytosis, Anemia
What is the pharmacodynamics of carbamazepine? - Answer✔️✔️-
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.
•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.
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.
What should families be taught regarding the monitoring of seizure
activity? - Answer✔️✔️-Patients should be monitored for seizure activity,
severity, and duration. Patient should carry medical identification for the
seizure disorder. Patient should report any mood changes or suicidal
thoughts. Prevention of seizures. Do not abruptly end medication increases
risk of seizures
What electrolyte imbalance is noted with the administration of topiramate?
- Answer✔️✔️-Patients taking topiramate may have decreased
concentrations of bicarbonate due to inhibition of carbonic anhydrase and
increased renal bicarbonate loss, leading to hyperchloremic metabolic
acidosis. Severe metabolic acidosis has been reported in infants receiving a
3
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