NRNP 6675 FINAL EXAM 3 Day 2: (24 hours later) the amount left in
LATEST VERSIONS /NRNP 6675 his body is 300 mg (day 2 min) because
24 hours has passed--one 1/2 life--
WEEK 11 FINAL REAL EXAM therefore the pt has excreted 1/2 of the
QUESTIONS AND CORRECT initial amount.
ANSWERS|ALREADY GRADED A+ THEN the pt takes his 2nd dose of 600
(WALDEN 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.
Due to the steady state of Lithium, when
What antipsychotics are good for pts do we draw a blood level?
who miss doses of their meds? 5 half lives
Antipsychotics with long half-lives:
1. Cariprazine(Vrylar): (2-4 days-active if you check any earlier, the trough level
metabolites up to 3 weeks) will underestimate the actual level the pt
2. Abilify (3 days) is on after achieving steady state
3. Brexipiprazole (4 days) Fluoxetine has a half life of about?
4. Pimozide (4-5 days) 2 weeks 1/2 life
5. Pimavanserin (2 days, active
metabolites 8 days) take 2.5 months to achieve steady state
Disulfiram's alcohol interactions persist Most psychotropic medications operate
for up to how long after the medication is in this fashion:
stopped? "when you double the dose, the serum
LONG Half life--2-3 days dose doubles."
persist up to 2 weeks following stopping *minus three SRIs and three
What is the only TCA with a long half anticonvulsants (Fluoxetine,
life? fluvoxamine, paxil, gabapentin,
Protriptyline (Vivactil) valproate and carbamazepine)
Most psychotropics have a medium _________induces it's own metabolism,
range 1/2 life of approx? hastening excretion and shortening it's
24 hours half life
what does "steady state" mean in A. Carbamazepine (Tegretol)
relation to 1/2 life?
steady state means that you are *this effect begins to "rev up" after 2-4
eliminating the drug at the same overall weeks--which is why a carbamazepine
rate that you are ingesting it level is so important on obtaining 1-2
Lithium reaches its 'steady state' when? months after starting Tegretol.
5 half lives 3 multiple choice options
example: Carbamazepine (Tegretol) level should
Day 1: Start pt on Lithium 600 mg daily be checked how soon after starting to
take this med?
,1-2 months due to Tegretol inducing it's Carbamazepine (Tegretol's) serum level
own metabolism, hastening excretion drops after how long after stopping
and shortening it's half life. taking it?
_____ has trouble getting a "serum" 1-2 months
level because it binds to proteins that For Valproate (Depakote), ___ dose
render it therapeutically inactive? changes can have big effects once the
A. Valproate Acid (Depakote) level is beyond 50 mcg/mL?
SMALL
-this is particularly true at the lower potency refers to a drug's>
levels (eg. <50 mcg/mL), so you can power per unit
expect dose changes to make a more
dramatic difference when the pt's -or the amount of pharmacological
depakote level is in the higher range activity per milligram.
3 multiple choice options Delayed release=
_______'s serum level is the opposite of modified release
Valproic Acid: it rises quickly at first and
then slows down? "dont get absorbed until they have
Gabapentin traveled to a specific site in the gut
Intermediate release (IR) medications:
*gabapentin saturates the transporters dissolve rapidly in the GI tract and are
that absorb it in the small intestine, absorbed in an hour or two
causing its levels to rise at a snails pace the serum concentrations of IR
when the dosage goes above a certain medications spike quickly and then fall
saturation point (around 900 mg/day). back down, leading to what?
leading to low trough levels before the
-from there, the saturation trickles down; next dose.
@ 900 mg/day--60% is absorbed. @
1200 mg/day--50 % is absorbed. @3000 *These ups and downs in serum levels
mg/day--30% of the gabapentin is can cause SE or efficacy problems.
absorbed. *the ups and downs in serum levels of
Due to Gabapentin's serum pattern for IR medications can cause what?
dosage: can cause SE or efficacy problems.
@ 900 mg/day, how much is the patient Bupropion can increase the risk of
absorbing? what?
@ 0900mg/day---60% is absorbed. Seizures
Due to Gabapentin's serum pattern for
dosage: *IF the serum level peaks too high
@ 1200 mg/day, how much is the IR stimulants can lose ____ in the
patient absorbing? afternoon?
@ 1200 mg/day--50 % is absorbed. efficacy due to IR effect
Due to Gabapentin's serum pattern for The rise and fall of Haldol levels
dosage: increases what?
@ 3000 mg/day, how much is the the likelihood of dystonic reactions
patient absorbing? in MODERATE RELEASE/DELAYED
@3000 mg/day--30% of the gabapentin RELEASE dissolvable solutions or
is absorbed.
, "dissolvable control", the medicine does their lives, lack self-confidence, and may
what? experience intense discomfort when
slowly diffuses out of a semi-permeable alone for more than a brief period of
membrane time are demonstrating characteristics of
ex. Effexor ER capsules, Wellbutrin XL which of the following PD?
and Focalin XR C. Dependent PD
in MODERATE RELEASE/DELAYED 3 multiple choice options
RELEASE According to Sullivan, which of the
is osmotic release pills, the medicine following are consistent with a
does what? mentor/mentee relationship?
is pushed out by a tiny pump that is C. Goals for the mentoring are set
powered by a osmotic flow of water mutually
across a semipermeable membrane 3 multiple choice options
ex. Concerta, Invega, and Effexor ER The need for NPs to practice to the full
tablets extent of their education and training is
Pros of Modified Release/Delayed necessary for which of the following
Release meds? reasons?
D. All of the above B, C & D
3 multiple choice options 3 multiple choice options
Cons of Modified Release/Delayed The ARNP assessing lifestyle as a
Release meds? social determinant of health would ask
D. All of the above about which of the following?
3 multiple choice options A. Diet
Medicines that are preferred in IR? 3 multiple choice options
Benzos and stimulants Trifluphenazine is also known as?
Most ______ medications cannot be Stelazine
split or crushed without disrupting the
integrity of the time-release mechanism? first generation antipsychotic
MR/delayed release Lillipucin hallucinations are what?
Concerns when treating geriatric "little people or kids" hallucinations
patients with psychotherapeutic drugs What is a red flag that indicates Lewy
include all of the following EXCEPT? Body?
C. Elderly persons may metabolize Lillipucin hallucinations
psychotherapeutic drugs more rapidly
3 multiple choice options hallucinations of little people or kids
The treatment of others equitably and What is a key question to ask someone
distribution of benefits/burdens fairly is with dementia when performing an
known as which of the following? evaluation of mental status to show
B. Justice confabulation?
"You look familiar, didn't we meet
a fair an equitable distribution of health before?"
resources
3 multiple choice options will show confabulation
Persons who subordinate their own How to test for lewy body dementia?
needs to those of others, get others to (question to ask?)
assume responsibility for major areas of
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller perfectdoctor. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $17.99. You're not tied to anything after your purchase.
