Anticonvulsant Meds

Question 1

Clonazepam

Adverse Effects

Answer 1

Drowsiness, Dizziness, Confusion, Respiratory depression

Question 2

Clonazepam

Nursing Considerations

Answer 2

Benzodiazepine
DO NOT discontinue suddenly
Avoid activities that require alertness

Question 3

Diazepam

Adverse Effects

Answer 3

Drowsiness, ataxia. Hypotension. Tachycardia, Respiratory depression.

Question 4

Diazepam

Nursing Considerations

Answer 4

IV push doses shouldn’t exceed 2 mg/min Monitor vital signs-resuscitation equipment avail if given IV. Alcohol increases CNS depression. After long term use, withdrawal leads to symptoms such as vomiting, sweating, cramps, tremors, and possibly convulsions.

Question 5

Fosphenytoin

Adverse Effects

Answer 5

Drowsiness, dizziness, confusion, leukopenia, anemia

Question 6

Fosphenytoin

Nursing Considerations

Answer 6

Used for tonic-clonic seizures, status epilepticus.

Highly-protein bound. Contact healthcare provider if rash develops

Question 7

Levetiracetam

Adverse Effects

Answer 7

Dizziness, suicidal ideation

Question 8

Levetiracetam

Nursing Considerations

Answer 8

Avoid alcohol, Avoid driving and activities that require alertness

Question 9

Phenytoin sodium

Adverse Effects

Answer 9

Drowsiness, ataxia. Nystagmus, blurred vision, hirsutism, lethargy, GI upset, Gingival hypertrophy.

Question 10

Phenytoin sodium

Nursing Considerations

Answer 10

Give oral medications with at least 1/2 glass of water, or with meals to minimize GI irritation. Inform client that red-brown or pink discoloration of sweat and urine may occur.
ID admin may lead to cardiac arrest-have resuscitation equipment at hand.
Never mix with any other drug or dextrose IV. Instruct in oral hygiene. Increase vitamin D intake and exposure to sunlight may be necessary with long-term use. Alcohol increases serum levels. Increased risk toxicity older adults.

Question 11

Phenobarbital

Adverse Effects

Answer 11

Drowsiness, rash. GI upset. Initially constricts pupils. Respiratory depression, ataxia.

Question 12

Phenobarbital

Nursing Considerations

Answer 12

Monitor vital signs-resuscitation equipment should be available if given IV.
Drowsiness diminishes after initial weeks of therapy. Don’t take alcohol or perform hazardous activities. nystagmus may indicate early toxicity. Sudden discontinuation may lead to withdrawal. Tolerance and dependence result from long-term use. Folic acid supplements are indicated for long-term use. Decreased cognitive function older adults.

Question 13

Primidone

Adverse Effects

Answer 13

Drowsiness, ataxia, diplopia, nausea and vomiting.

Question 14

Primidone

Nursing Considerations

Answer 14

Don’t discontinue use abruptly. Full therapeutic response may take 2 weeks. Shake liquid suspension well. Take with food if experiencing GI distress. Decreased cognitive function older adults.

Question 15

Magnesium Sulfate

Adverse Effects

Answer 15

FLushing, Sweating, Extreme thirst, hypotension, sedation, confusion.

Question 16

Magnesium Sulfate

Nursing Considerations

Answer 16

Monitor I&O. Before each dose, knee jerks should be tested. Vital signs should be monitored often during parenteral administration. Used for pregnancy induced hypertension.

Question 17

Valproic acid

Adverse Effects

Answer 17

Sedation, tremor, ataxia, nausea, vomiting, prolonged bleeding time.

Question 18

Valproic acid

Nursing Considerations

Answer 18

Agent of choice in MANY SEIZURE disorders of young children.

Question 19

Carbamazepine

Adverse Effects

Answer 19

Myelosuppression, dizziness, drowsiness, ataxia, diplopia, rash.

Question 20

Carbamazepine

Nursing Considerations

Answer 20

Monitor I&O. Supervise ambulation, Monitor CBC. Take with meals, Wear protective clothing due to photosensitivity. Multiple drug interactions.

Question 21

Ethosuximide

Adverse Effects

Answer 21

GI symptoms. Drowsiness, Ataxia and dizziness.

Question 22

Ethosuximide

Nursing Considerations

Answer 22

Monitor for behavioral changes. Monitor weight weekly.

Question 23

Gabapentin

Adverse Effects

Answer 23

Increased appetite, ataxia, irritability, dizziness, fatigue.

Question 24

Gabapentin

Nursing Considerations

Answer 24

Monitor weight and behavioral changes. Can also be used to treat postherpetic neuralgia.

Question 25

Lamotrigine

Adverse Effects

Answer 25

Diplopia, headaches, dizziness, drowsiness, ataxia, Nausea, vomiting, life-threatening rash when given with valproic acid.

Question 26

Lamotrigine

Nursing Considerations

Answer 26

Take divided doses with meals or just afterward to decrease adverse effects.

Question 27

Topiramate

Adverse Effects

Answer 27

Ataxia, Confusion, Dizziness, Fatigue, Vision problems.

Question 28

Topiramate

Nursing Considerations

Answer 28

Adjunct therapy for intractable partial seizures. Increased risk for renal calculi. Stop drug IMMEDIATELY if eye problems-could lead to permanent damage.

Question 29

Anticonvulsant Meds

Action

Answer 29

Decreases flow of calcium and sodium across neuronal membranes.

Question 30

Anticonvulsant Meds

Indication

Answer 30

Partial seizures: phenobarbital, carbamazepine, gabapentin
Generalized tonic-clonic seizures: phenobarbital, carbamazepine.
Absence seizures: ethosuximide
Status epilepticus: diazepam, phenytoin.

Question 31

Anticonvulsant Meds

Adverse Effects

Answer 31

Cardiovascular depression, respiratory depression, Agranulocytosis, Aplastic anemia.

Question 32

Anticonvulsant Meds

Nursing Considerations

Answer 32

Tolerance develops with long-term use. Don’t discontinue abruptly, Caution with use of medications that lower seizure threshold ( MAO inhibitors).
Barbiturates and benzodiazepines also used as anticonvulsants. Increased risk adverse reactions older adults.