Pharmacology Anticonvulsants.txt

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Pharmacology Anticonvulsants.txt
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2011-01-07 04:32:31
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Pharmacology Anticonvulsants
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Pharmacology Anticonvulsants flash cards
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  1. CARBAMAZEPINE
    (kar-ba-maz-e-peen)
    (Tegretol, Tegretol XR)


    Anticonvulsant
    • SIDE EFFECTS:
    • Myelosuppression, Dizziness, drowsiness, ataxia, diplopia, rash, photosensitivity

    • NURSING CONSIDERATIONS:
    • Management of seizures, trigeminal neuropathy
    • Avoid driving and other activities requiring alertness the first 3 days
    • Monitor blood levels, CBC, regularity, esp. during first 2 months, periodic eye exams
    • Take with food or milk to decrease GI upset; tablets (nonextended release) may be crushed, extended release capsules may be opened, mixed with juice or soft food.
    • Urine may turn pink to brown
    • avoid abrupt withdrawal: discontinue use with alcohol, other CNS depressants
    • RX: Preg Cat C
  2. DIVALPROEX SODIUM
    (dye-val-proe-ex)
    (Depakote, Depokote ER)


    Anticonvulsant
    • SIDE EFFECTS:
    • Sedation, drowsiness, dizziness, mental status and behavioral changes, nausea, vomiting, constipation, diarrhea, heartburn, prolonged bleeding time.

    • NURSING CONSIDERATIONS:
    • Management of seizuers, manic episodes associated with bipolar disorder (delayed release only), migraine prophylaxis (delayed and extended release only) Take with or immediately after meals to lessen GI upset.
    • Swallow tablets or capsules whole (no crushing, chweing)
    • Avoid abrupt withdrawal after long term use; discontinue gradually to prevent convulsions.
    • Monitor blood levels, platelets, bleeding time, and liver function test.
    • Delayed release products peak blood level 3-5 hours, duration 12-24 hours
    • Extended release prducts: onset 2-4 days, peak blood level 7-14 hours, duration 24 hours
    • Wear medical information tag
    • RX: Preg Cat D
  3. GABAPENTIN
    (gab-ah-pen-tin)
    (Neurontin)


    Anticonvulsant
    • SIDE EFFECTS:
    • Drowsiness, Ataxia, diplopia, rhinitis, constipation

    • NURSING CONSIDERATIONS:
    • Used for management of seizures and postherpetic neuralgia.
    • Do not take within 2 hrs of antacid.
    • Avoid abrupt withdrawal after long term use.
    • discontinue gradually over a week to prevent convulsions.
    • Give without regard to meals; can open capsules and put in juice or apple sauce.
    • Do not crush or chew capsules.
    • Use caution with hazardous activities
    • Wear medical information tag
    • RX: Preg Cat C
  4. LAMOTRIGINE
    (lah-moe-tri-jeen)
    (Lamictal)


    Anticonvulsant
    • SIDE EFFECTS:
    • Ataxia, dizziness, headache, nausea, vomiting, anorexia, diplopia, blurred vision, abd. pain, dysmenorrhea

    • NURSING CONSIDERATIONS:
    • Used for management of seizures
    • In pediatric patients, stop at first sign of rash; all patients should notify clinician of rashes.
    • Take divided doses with meals or just after to decrease adverse effects.
    • Use caution with hazardous activities until stabilized.
    • Avoid abrupt withdrawal: stop gradually to prevent increase in frequency of seizures.
    • Wear medical information tag
    • RX: Preg Cat C
  5. PHENOBARBITAL
    (fee-noe-bar-bi-tal)
    (Luminal)


    Anticonvulsant
    • SIDE EFFECTS:
    • Drowsiness, lethargy, rash, GI upset, initially constricts pupils, respiratory depression, ataxia

    • NURSING CONSIDERATIONS:
    • Management of epilepsy, febrile seizures in children, sedation, insomnia.
    • IV: Slow rate-- resuscitation equipment should be available
    • IM: Inject deep into large muscle mass to prevent tissue sloughing; can give subQ, onset 10-30 minutes
    • PO: onset 20-60 minutes, peak 8-12 hours, duration 6-10 hours
    • Use caution with hazardous activities until stabilized drowsiness usually diminishes after initial weeks of therapy.
    • Nystagmus may indicate early toxicity
    • Long-term use withdrawal symptoms: vomiting, sweating, abdominal muscle cramps, tremors, and possibly convulsions.
    • Vitamin D supplements are indicated for long-term use
    • RX: Schedule C-IV; Preg Cat D
  6. PHENYTOIN
    (fen-i-toyn)
    (Dilantin)


    Anticonvulsant
    • SIDE EFFECTS:
    • Drowsiness, Ataxia, Nystagmus, blurred vision, hirsutism, lethargy, GI upset, Gingival hypertrophy

    • NURSING CONSIDERATIONS:
    • Management of seizures, migraines, trigeminal neurlgia, bell's palsy
    • PO: Take divided doses, with or immediately after meals, to decrease adverse effects.
    • May color urine and sweat pink/red/brown
    • IV: administration may lead to cardiac arrest-- have resuscitation equipment available: never mix in IV with any other drug or dextrose.
    • Avoid abrupt withdrawals to prevent convulsions.
    • Do not use antacids or antidiarrheals within 2 hours of med
    • Use caution with hazardous activities until stabilized
    • Folic acid supplements are indicated for long-term use
    • Wear medical information tag
    • RX: Preg Cat C
  7. PREGABALIN
    (pree-gab-ah-lin)
    (Lyrica)


    Anticonvulsant
    • SIDE EFFECTS:
    • Tiredness, dizziness, headache, dry mouth, nausea, vomiting, constipation, gas, bloating, elevated mood confusion, forgetfulness

    • NURSING CONSIDERATIONS:
    • Treatment of epileptic seizures, neuropathic pain for people with diabets, shingles, fibromyalgia
    • Avoid use of alcohol, may increase drowsiness.
    • May be habit forming.
    • Withdrawal symptoms such as insomnia or seizures, if sudden discontinuation.
    • Diabetics should pay attention to skin condition, and report sores, redness or other skin problems.
    • Contact prescriber if changes in eyesight, chest pain or wheezing.
    • RX: Preg Cat C
  8. TOPIRAMATE
    (toh-pire-ah-mate)
    (Topamax)


    Anticonvulsant
    • SIDE EFFECTS:
    • Dizziness, drowsiness, fatigue, inpaired concentration/memory, nervousness, speech problems, nausea, weight loss, vision problems, ataxia, photosensitivity

    • NURSING CONSIDERATIONS:
    • Used for mangement of seizures
    • Give without regard to meals; can open capsules and put in juice or apple sauce.
    • Avoid abrupt withdrawal after long-term use; discontinue gradually to prevent seizures and status epilepticus.
    • Use caution with hazardous activities until stabilized
    • Increased fluid intake to prevent formation of kidney stones.
    • Stop drug immediately if eye problems; could lead to permanet loss of vision.
    • Use sunscreen and protective clothing to prevent photosensitivity
    • Wear medical information tag.
    • RX: Preg Cat C
  9. VALPROATE, VALPROIC ACID
    (val-proe-ate, val-proe-ic as-id)
    (Depacon, Depakene)


    Anticonvulsant
    • SIDE EFFECTS:
    • Sedation, drowsiness, dizziness, Mental status and behavioral changes. Nausea, vomiting, constipation, diarrhea, heartburn, prolonged bleeding time.

    • NURSING CONSIDERATIONS:
    • Used for management of seizures.
    • Avoid abrupt withdrawal after long-term use; discontinue gradually to prevent convulsions.
    • Monitor blood levels, platelets, bleeding time, and liver function tests.
    • Duration of anticonvulsant effect: 6-24 hours (varies with age)
    • RX: Preg Cat D

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