Pharm II Exam 3

Question 1

Mannitol

Answer 1

osmotic diuretic

i: inc ICP
ta: high glucose content cause osmotic effect to dec swelling in brain - dec ICP
ci: severe renal failure, active IC bleeding
c: x
ae: CHF, pulmonary edema, f/e loss, hypoT, tachycardia,
di: x
ni: inline filter required b/c of high glucose content

Question 2

pentobarbital

Answer 2

barbiturate sedative

i: uncontrollable inc ICP
ta: barbiturate induced coma dec blood requirement - dec ICP
ci: x
c: x
ae: x
di: x
ni: taper dose, monitor ICP, EEG to titrate dose, HOB elevated

Question 3

dexamethasone

Answer 3

glucocorticoid steroid

i: tumor or abscess
ta: anti-inflam to counter tumor induced inflam. - dec ICP
ci: x
c: DM
ae: inc BS, dec immunity, GI bleeding d/t inc gastric acid, anxiety/irritability/mania
di: titrate insulin
ni: taper dose, only short-term big dose

Question 4

phenytoin

Answer 4

hydantoin

i: antiseizure
ta: dec sodium influx
ci: HB, bradycardia / BBW - IVP 50 mg/min with normal saline and large vein only
c: liver impair, elderly, preg D
ae: CNS depressant, gingival hyperplasia, liver toxicity, derm (SJS)
di: BC phenytoin syndrome, ETOH, dec acetaminophen, dig inc, ibuprofen inc effect, amiodarone inc effect
ni: taper dose, 10-20 therapeutic, dental care, s/s liver impair, nutrition

Question 5

phenobarbital

Answer 5

barbiturate

i: abortive/preventive seizure
ta: inhibit RAS conduction, stabilize nerve membrane
ci: liver impair, preg / BBW - SI
c: x
ae: sedation, CNS, dep, SJS
di: CNS dep, ETOH, dec estrogen, steroid dec
ni: monitor CNS and dep, no driving

Question 6

diazepam

Answer 6

benzodiazepam

i: status epilepticus, clautonic
ta: potentiate GABA
ci: acute glaucoma, preg
c: x
ae: CNS dep, paradoxical effect
di: CNS dep, ETOH
ni: withdrawal, d/c if paradoxical effect, flumazenil antidote