Pharmacology

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Author:
mmcgraw
ID:
173827
Filename:
Pharmacology
Updated:
2012-09-27 08:05:15
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Pharmacology Neuro Anticonvulsants
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Description:
Pharmacology, Neuro: Anticonvulsants
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  1. Diazepam (Valium) Uses
    Anxiety• Alcohol withdrawal• Muscle spasms• Preoperative and preprocedure sedation• Seizure disorders• Status epilepticus
  2. Diazepam (Valium) Action:
    acts on central nervous system depressant to:• Stop seizure activity• Reduce anxiety• Cause relaxation and sleep
  3. Diazepam (Valium) Side Effects:
    Drowsiness• Bradycardia• Cardiovascular collapse• Physical or psychological dependence
  4. Diazepam(valium) Nursing Interventions:
    Do not give subcutaneously. When giving IV, do not mix with other   drugs.• Instruct client to avoid alcohol, driving, or operating machinery.• Monitor for CNS depression.• Keep resuscitation equipment near bedside.• Monitor respirations and other vital signs.
  5. Phenobarbital (Solfoton) Uses:
    Controlling seizures in epilepsy and status epilepticus.• Sedation• Inducing sleep• Preoperative sedation
  6. Phenobarbital (Solfoton) action:
    Increasing seizure threshold and depressing CNS nerve activity.• Suppressing seizure activity and inducing sedation
  7. Phenobarbital (Solfoton) Side Effects:
    Respiratory depression• Apnea• Stevens-Johnson syndrome (fever, rash, necrotizing skin disorder)• Angioedema• Bradycardia
  8. Phenobarbital (Solfoton) Nursing Intervention:
    Give IV slowly, and only in emergency situations.• Keep resuscitation equipment near bedside.• Monitor respirations and other vital signs.• Monitor drug level. Therapeutic drug level is 15-40mcg/mL.• Teach client on hormonal contraceptives to use an alternative form    of birth control.
  9. Topiramate (Topamax) Uses:
    Control partial seizures• Prevent migraine headaches
  10. Topiramate (Topamax) Action:
    Control partial seizures• Prevent migraine headaches
  11. Topiramate (Topamax) Side Effects:
    Generalized seizures• Paresthesia• Visual disturbances, diplopia • Leukopenia• Tremor• Ataxia• Confusion• Metabolic acidosis
  12. Topiramate (Topamax) Nursing Intervention:
    Monitor for metabolic acidosis.• Reduce dose for renal disease.• Encourage fluids if appropriate.• Teach client on hormonal contraceptives to use an alternative form    of birth control.• Teach client to report any visual disturbances.
  13. Tiagabine (Gabitril) Uses:
    Controlling partial seizures
  14. Tiagabine (Gabitril) action:
    May increase GABA, which inhibits nerve transmission, stopping   partial seizures.
  15. Tiagabine (Gabitril)Side Effects:
    Dizziness• Nervousness• Confusion• Nausea
  16. Tiagabine (Gabitril) Nursing Interventions:
    Reduce dose in clients with liver disease.• Take with food.• Advise women to inform health care provider if she is pregnant or    breast feeding.
  17. Gabapentin (Neurontin)Uses:
    Controlling partial seizures• Relieving neuralgia post-herpes
  18. Gabapentin (Neurontin) Action:
    acts to prevent partial seizures and relievepost-herpatic neuralgia through unknown means.
  19. Gabapentin (Neurontin) Side Effects:
    Dizziness• Ataxia• Visual disturbances• Leukopenia
  20. Gabapentin (Neurontin) Nursing interventions:
    Monitor for adverse reactions.• Take only as directed. Do not stop abruptly
  21. Felbamate (Felbatol) Uses:
    Control of partial seizures
  22. Felbamate (Felbatol) Action:
    increase GABA, which inhibits nervetransmission, stopping partial seizures.
  23. Felbamate (Felbatol) Side Effects:
    Aplastic anemia• Hepatic failure• Fever• Visual disturbances• Ataxia• Tremors
  24. Felbamate (Felbatol) Nursing Interventions:
    Monitor CBC, platelets, reticulocyte count, and liver enzymes. Storeaway from heat or sunlight.
  25. Felbamate (Felbatol) NURSE ALERT
    Felbamate (Felbatol) has severe toxic effects of aplastic anemia andhepatic failure. Use only in rare cases where other anticonvulsantsare ineffective.
  26. Carbamazepine (Tegretol) Uses:
    Control of general and mixed seizures• Trigeminal neuralgia• Bipolar affective disorder• Restless leg syndrome
  27. Carbamazepine (Tegretol) action:
    alter the exchange of sodium ionsduring nerve transmission to reduce seizure activity.
  28. Carbamazepine (Tegretol) Side Effects:
    Increased seizures• Heart failure• Aplastic anemia• Thrombocytopenia• Stevens-Johnson syndrome (lesions of the oral, vaginal and    conjunctival mucous membranes)
  29. Carbamazepine (Tegretol)Nursing Interventions
    Monitor drug level; therapeutic drug level is 4-12 mcg/mL• Monitor liver functions, CBC, platelets, and reticulocyte counts• Give with food• Advise client to notify health care provider of fever, sore throat,    mouth sores, bruising, or bleeding
  30. Phenytoin (Dilantin) uses:
    Control of partial and grand mal seizures• Prophylactic prevention of seizures during and after neurosurgery• Status epilepticus• Severe preeclampsia• Arrhythmias caused by cardiac glycosides
  31. Phenytoin (Dilantin) Action:
    stop seizure activity by altering theexchange of sodium ions across cell membranes during nerveconduction.
  32. Phenytoin (Dilantin) Side Effects:
    Thrombocytopenia• Leukopenia• Toxic Hepatitis• Confusion• Stevens-Johnson syndrome• Hypotension
  33. Phenytoin (Dilantin) Nursing Intervention:
    Monitor drug level; therapeutic drug level is 10-20 mcg/mL• Monitor liver functions, CBC, platelets, and reticulocyte counts• Give IV medications slowly• Monitor pulse, ECG, blood pressure, and respirations during IV infusion• Monitor for adverse reactions
  34. Phenytoin (Dilantin)NURSE ALERT!
    Too rapid infusion of phenytoin (Dilantin) or fosphenytoin (Cerebyx)may cause severe hypotension and cardiac arrhythmias.
  35. Lamotrigine (Lamictal) Uses:
    Control of partial or full seizures• Treating bipolar disorder
  36. Lamotrigine (Lamictal) Action:
    acts to stop seizures and control mood byinhibiting certain neurotransmitters.
  37. Lamotrigine (Lamictal) Side Effects:
    Dizziness• Headache• Ataxia• Seizures• Stevens-Johnson syndrome
  38. Lamotrigine (Lamictal) Nursing Interventions:
    Lower dose if used with valproate (Depakene)• Discontinue drug if client develops a rash• Instruct client to avoid sun or cover skin with clothing and sunscreen• Monitor for adverse reactions
  39. Valproate (Depakene) Uses:
    Simple and complex absence seizures and complex partial seizures• Mania• Migraine headaches
  40. Valproate (Depakene) action:
    increase GABA, which inhibits nervetransmission, stopping seizures.
  41. Valproate (Depakene) Side Effects:
    Sedation• Nausea• Pancreatitis• Hemorrhage• Leukopenia• Thrombocytopenia• Hepatotoxicity• Stevens-Johnson syndrome
  42. Valproate (Depakene) Nursing Interventions:
    • Monitor drug level, therapeutic drug level is 50-100 mcg/mL• Monitor liver functions, platelets, and coagulation counts• Give IV medications slowly• Monitor for fatigue, fever, and lethargy that may be early signs to    hepatic toxicity• Do not give to clients with a history of hepatic disease• Monitor for adverse reactions
  43. Ethosuximide (Zarontin) Uses:
    Absence or petit mal seizures
  44. Ethosuximide (Zarontin) actions:
    stop seizure activity by altering theexchange of sodium and calcium ions across cell membranesduring nerve conduction.
  45. Ethosuximide (Zarontin) Side Effects:
    Leukopenia• Pancytopenia• Systemic lupus erythematosis• Stevens-Johnson syndrome• Nausea• Drowsiness
  46. Ethosuximide (Zarontin) Nursing Interventions:
    Monitor liver functions, platelets, and coagulation counts• Monitor for signs of infection• Give with food• Advise client to notify health care provider of any unusual bruising    or bleeding
  47. Anticonvulsants: Actions:
    • decrease neuron excitability
    • increase seizure threshold
    • block abnormal nerve stimulus
  48. anticonvulsants: side effects:
    • Drowsy
    • Nausea
    • Vomit
    • lethargy
    • steven johnson syndrome
    • lupus erythematosus
    • headache
    • dysrythmias
    • bone marrow supression
  49. anticonvulsants: Nursing interventions:
    • seizure precautions
    • avoid driving/ operating machines
    • take anticonvulsants at same time of day with meals
    •  no crushing or chewing of tabs
    • give IM in DEEP muscle!
    • give IV slow!
    • monitor pulse, BP, RR during infusion
    • monitor IV site!
  50. Anticonvulsants: NURSE ALERT!
    Too rapid infusion of phenytoin (Dilantin) or fosphenytoin (Cerebyx)may cause severe hypotension and cardiac arrhythmias.• Encourage client to wear medic alert bracelet for seizure disorder• Educate client to take anticonvulsants as directed and not to   abruptly stop medications• Advise client to avoid alcohol• Monitor for sore throat, fever (blood dyscrasias), vomiting, Stevens-   Johnson syndrome, or other signs of toxicity

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