Medications Flashcards
7 cards from real Psychiatric-Mental Health Nurse Practitioner Exam practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Medications flashcards as text
A patient on carbamazepine for bipolar disorder develops diplopia, ataxia, and elevated carbamazepine levels despite no dose change. What is the most likely explanation?
Answer: A new drug inhibited CYP3A4, raising carbamazepine levels
Carbamazepine is metabolized by CYP3A4; adding a CYP3A4 inhibitor (e.g., erythromycin, fluconazole) raises carbamazepine levels and can precipitate toxicity.
Which statement about lamotrigine dosing in the context of valproate co-administration is correct?
Answer: Valproate inhibits lamotrigine glucuronidation, requiring slower titration and lower target doses
Valproate inhibits UGT enzymes responsible for lamotrigine glucuronidation, doubling lamotrigine half-life; the combination requires halved lamotrigine doses and slower titration to prevent Stevens-Johnson syndrome.
A 70-year-old patient with dementia-related psychosis is prescribed haloperidol. What critical warning must be communicated to the family?
Answer: Antipsychotics are associated with increased mortality in elderly patients with dementia-related psychosis
All antipsychotics carry a black box warning of increased mortality (primarily cardiovascular and infectious causes) when used in elderly patients with dementia-related psychosis.
Which of the following describes the appropriate use of flumazenil in benzodiazepine overdose?
Answer: It should be avoided in patients with chronic benzodiazepine use due to risk of precipitating seizures
Flumazenil can precipitate life-threatening withdrawal seizures in benzodiazepine-dependent patients and should be used cautiously; it is not routinely recommended in chronic users.
A patient stabilized on sertraline begins rifampin for tuberculosis treatment. Which clinical outcome should the PMHNP anticipate?
Answer: Reduced sertraline efficacy due to CYP3A4 and CYP2C19 induction
Rifampin is a potent inducer of multiple CYP enzymes including CYP3A4 and CYP2C19, significantly increasing sertraline metabolism and potentially causing recurrence of depression.
What is the primary rationale for prescribing propranolol as an adjunct in a patient with performance anxiety (situational social anxiety)?
Answer: Propranolol blocks peripheral beta-adrenergic receptors, reducing somatic symptoms like tremor and palpitations
Propranolol reduces the peripheral autonomic manifestations of anxiety (tremor, tachycardia, sweating) by blocking beta-1 and beta-2 adrenergic receptors without significant CNS sedation.
A patient on venlafaxine for 2 years abruptly stops the medication. Which symptom cluster is most characteristic of what will occur within 24-48 hours?
Answer: Dizziness, electric shock sensations ('brain zaps'), nausea, and irritability
Venlafaxine has a short half-life and discontinuation syndrome (FINISH mnemonic) is common, characterized by flu-like symptoms, insomnia, nausea, sensory disturbances, and hyperarousal.