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Drugs Affecting the Central Nervous System
Sarah, a 42-year-old female, requests a prescription for an anorexiant to treat her obesity. A trial of phentermine is prescribed. Prescribing precautions include: A. Understanding that obesity is a contraindication to prescribing phentermine B. Anorexiants may cause tolerance and should only be prescribed for 6 months C. Patients should be monitored for postural hypotension D. Renal function should be monitored closely while on anorexiants ANS: B PTS: 1 2. Before prescribing phentermine to Sarah, a thorough drug history should be taken including assessing for the use of serotonergic agents such as SSRIs and St John’s Wort due to: A. Additive respiratory depression risk B. Additive effects affecting liver function C. The risk of serotonin syndrome D. The risk of altered cognitive functioning ANS: C PTS: 1 3. Antonia is a 3 year old who has a history of status epilepticus. Along with her routine antiseizure medication, she should also have a home prescription for____ to be used for an episode of status epilepticus. A. IV phenobarbital B. Rectal diazepam (Diastat) C. IV phenytoin (Dilantin) D. Oral carbamazepine (Tegretol) ANS: B PTS: 1 4. Rabi is being prescribed phenytoin for seizures. Monitoring includes: A. Assessing for phenytoin hypersensitivity syndrome 3 to 8 weeks after starting treatment B. Assessing for pedal edema throughout therapy
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C. Assessing heart rate at each visit and consider altering therapy if heart rate is less than 60 bpm D. Assessing for vision changes, such as red- green blindness, at least annually ANS: A PTS: 1 5. Dwayne has recently started on carbamazepine to treat seizures. He comes to see you and you note that while his carbamazepine levels had been in the therapeutic range, they are now low. The possible cause for the low carbamazepine levels include: A. Dwayne hasn’t been taking his carbamazepine because it causes insomnia B. Carbamazepine auto-induces metabolism, leading to lower levels in spite of good compliance C. Dwayne was not originally prescribed the correct amount of carbamazepine D. Carbamazepine is probably not the right antiseizure medication for Dwayne ANS: B PTS: 1 6. Carbamazepine has a Black Box warning due to life-threatening: A. Renal toxicity, leading to renal failure B. Hepatotoxicity, leading to liver failure C. Dermatologic reaction, including Steven’s Johnson and toxic epidermal necrolysis D. Cardiac effects, including supraventricular tachycardia ANS: C PTS: 1 7. Long-term monitoring of patients who are taking carbamazepine includes: A. Routine troponin levels to assess for cardiac damage B. Annual eye examinations to assess for cataract development C. Monthly pregnancy tests for all women of childbearing age D. Complete bl
