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Psych
| Question | Answer |
|---|---|
| Drugs that can induce seizures? | meperidine metabolite, tramadol, bupropion, imipenem, chlorpromazine, clozapine, TCA, lithium, lidocaine, theophylline, recreational drugs |
| what is carbamazepine(tegretol) used for? Inducer or inhibitor? Tx levels? SE? | bipolar, trigeminal neuralgia, DM neurogenic; Autoinducer; 4-12mg/L; Rash, wt. gain. hyponateriaemia, aplastic anemia, folate definicency |
| What two drugs are used for absence sz? What epilepsy drug causes gingival? cause Acidosis? causes stones? causes hyponaturenima? | valproic acid and ethosuximide; Phenytoin; Toprimate; topiramate and zonisamide; carbamazepine and oxcarbazepine; |
| What epilepsy drugs cause wt gain (3)? wt loss (2)? hirsutism? alopeica? Rash? aplestic anemia? URI? hepatoxicity? | valproic acid, carbamazepine, oxcarbazepine; topiramate and zonisamide; phenytoin; valproic acid; carbamazepine, oxcarbazepine, lamotrigine; carbamazepine and felbamate; levetiracetam; felbamate |
| What are the tx levels for phenobarbital? primidone? phenytoin? valproic acid? ethosuximide? carbamzepine? | phenobarb: 15-40mg/L; primidone: 6-12mg/L; phenytoin 10-20mg/L; VA: 50-100mg/L; ethosux: 40-100mg/L; carbam: 4-12mg/L |
| 3 drug classes that decrease aqueous humor formation? 3 drug classes that increase uveoscleral outflow? | beta blocker, carbonic anhydrase inhibitor, alpha 2 agonist; prostaglandin, adrenergic agonist, cholinergic agonists |
| How long can it take Phenobarbital to reach steady state? What are some AE? | may take up to 3 wks; folate deficiency, hepatic failure, SJS |
| What does Primidone metabolize to? What are it's AE? | phenobarbital and PEMA; sedation, ataxia, GI |
| Phenytoin has this type of MOA thus titrate dose slowly? what should be monitored? What is it's LD and rate of admin? It can be mix with NS or D5W? | Michaelis mentens; monitor renal fxn and albumin since highly protein bound; 15mg/kg and no greater than 50mg/min in NS |
| What is phenytoins dose related toxicity? | nystagumus, ataxia, lethargy, and cognitive impairment |
| What are some AEs of phenytoin? | gingival hyperplasia, Vit D and Folate deficiency, hirsutism, and lupus like syndrome |
| Thing that decrease Phenytoin levels? What dosage forms is phenytoin available in? | antacids, carbamzepine, entral feedings (2hr before and after); capsule (don't crush) tablet (chew), suspension(shake), intramuscular (painful), IV (NS @ max 50mg/min) |
| What is Fosphenytoin equalvent of phenytoin? rate of admin and mixed in? | 1.5mg = 1mg phenytoin; 150mg/min in D5W via IM |
| What does phenytoin contain that limits it's rate of admin? | propylene glycol which is cardiotoxic |
| Ethosuximide AE? What can change it's levels? | GI, HA, hiccups, drowsiness, hyperactivity; Valproate increases Ethosux while carbamazepine decrease it |
| Oxcarbamazepine AE? what AE is not there which carbamazepine does have? | more hypoNa, wt gain, SJS; Aplastic anemia |
| Valproic acid is a inhibitor or inducer? If a patient is taking this medication they could test false + for this? What is the difference between depakene and divalproex sodium (depakote)? | Inhibitor; false + for ketones; depakene is immediate release (tk w/food) and depakote is EC delayed relase |
| What two antieplieptic drugs are highly protein bound? | phenytoin and valproic acid |
| What are some common AEs of Valproic acid? | wt gain, alopecia, hepatotixicity , pancreatitis, thrombocytopenia, folic acid deficiency |
| Meds that may cause Valproic acid toxicity? | Salicylates |
| Gabapentin is elimanated via? DI? Why is pregabalin more potent? What are the uses for pregabaline? elimination? | 100% renal elimination; avoid Al or Mg antacids; more potent due to faster onset; used in neuropathic pain and fibromyalgia; Renal; |
| What class is Pregabalin and why? What are AEs of Pregabalin? | CV due to euphoria; edema, wt gain |
| How should Lamictal be dose with phenytoin, carbamazepine, valproic acid? What is the biggest AE of lamictal? | with phenytoin/carbamzepine 25mg bid; with valproic acid 25mg qod; SJS (thus start low and titrate up) |
| Topirmate and Zonisamide MOA? AEs? Which one should not be used with sulfa allgery? | weak carbonic anhydrase inhibitors; kidney stones, wt.loss, metabolic acidosis, oligohidrosis, congnitive impairment (topirmate); Zonisamide is sulfonamide |
| Who is Tiagabine taken? DI? AE? | take with food and no DI can cause drowsiness and temor |
| When should keppra be used? What are some AE? | pts who are unresponsive to other meds; irritability and behavior change, URI |
| Felbamate is used when? it's AE? | severe refractory seizures, lennox gastaut syndrome; aplastic anemia, hepatic failure |
| Define status epilepticus? What is tx? | Sz lasting longer than 5 mins or >2 Sz without recovery of consciousness; ABCs then Ativan or Valium followed by IV phenytoin, Also IV phenobarb (20mg/kg) or cont. infusion of midazolam and finally medically induced coma but pt must be vented |
| Define Open angle glaucoma and Narrow angle glaucoma? | open: anterior chamber remains open but filtration is diminished; Narrow: shallow anterior chamber thus filtration is compromished due to blocking by iris |
| What is the DOC for open angle glaucoma | prostaglandin analogs and beta blockers (can use mono or combo) |
| Which class of drugs for glaucoma should not be used with sulfa allgeries? | carbonic anhydrase inhibiots |
| What are some AEs of prostaglandin analogs for glucoma? how is latanoprost administer? How long should you wait to wear contacts when using brimonidine? | iris pgimentation, eylid darkening; admin 1 drop qhs; wait 15 mins |
| What 3 class of Antiglaucoma agents decrease production of fluid? 3 classes that increase the outflow of the fluid? | Betablocker, Alpha 2 adrenergic agonists, Carbonic anhydrase inhbitors; Prostaglandin, adrenergic agonists, cholinergic agonists |
| Atypical antipsychotics that cause EPS? increase prolactin? Wt. Gain? DO NOT cause sedation? | Risperidone; Risperidone; Clozapine/Olanzapine; Risperidone/Olanzapine |
| What Atypical Antipsychotics cause Orthostasis? Agranulocytosis? SZ? Cataract? Pronglonged QT? | clozapine, risperidone, quetiapine; clozapine; clozapine; quetiapine; ziprasidone/paliperidone |
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Created by:
bhumz
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