Anticonvulsants Flashcards
CARBAMAZEPINE
(Carbatrol, Epitol, Equetro,
Tegretol, Tegretol XR)
◾ Avoid driving and other activities requiring alertness the first 3 days
◾ Monitor blood levels, CBC regularly, esp. during first 2 months; periodic
eye exams
◾ Take with food or milk to decrease GI upset; tablets (nonextendedrelease) may be crushed, extended-release capsules may be opened and
mixed with juice or soft food (no grapefruit products)
◾ Urine may turn pink to brown
◾ Avoid abrupt withdrawal; discontinue gradually
◾ Avoid use with alcohol, CNS depressants
◾ Inform physician before taking any new medication or herbal
medication
◾ Rx; Preg Cat D
Side Effects:
Myelosuppression
Dizziness, drowsiness, Ataxia
Diplopia, rash, Photosensitivity, Depression
N/V, Dyspepsia, Aplastic anemia, Stevens-Johnson
syndrome, Suicide attempts in
bipolar patients
DIVALPROEX SODIUM
Depakote, Depakote ER
◾ Management of seizures, manic episodes assoc. with bipolardisorder
(delayed-release only), migraine prophylaxis (delayed- and extendedreleaseonly)
◾ Take with or immediately after meals to lessen GI upset; swallow whole
◾ Avoid abrupt withdrawal after long-term use; discontinue gradually to
prevent convulsions
◾ Monitor blood levels, platelets, bleeding time, and liver function tests
◾ Delayed-release products: peak blood level 3–5 hours, duration 12–24 hours
◾ Extended-release products: onset 2–4 days, peak blood level 7–14 hours,
duration 24 hours
◾ Wear medical information tag
◾ Rx; Preg Cat D
Side Effects:
Sedation, drowsiness, dizziness, Mental status and
behavioral changes
Nausea, vomiting, constipation, diarrhea
Heartburn, Prolonged bleeding
time, Hepatotoxicity, Teratogenicity, Pancreatitis
Thrombocytopenia, Headache, Diplopia
Tremor, Alopecia, Multiorgan , hypersensitivity
GABAPENTIN
Gabarone, Neurontin
◾ Used for management of seizures and postherpetic neuralgia,
diabetic neuropathy
◾ Do not take within 2 hours of antacid use
◾ 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
orapplesauce
◾ Do not crush or chew capsules
◾ Use caution with hazardous activities
◾ Wear medical information tag
◾ Rx; Preg Cat C
Side Effects:
Drowsiness, Ataxia, Diplopia, Rhinitis, Constipation, Memory problems, Uncontrolled shaking, Back or joint pain, Edema, Flulike symptoms, Seizures
LAMOTRIGINE
Lamictal
◾ Used for management of seizures, abnormal mood disorders
◾ 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
adverseeffects
◾ Use caution with hazardous activities until stabilized
◾ Avoid abrupt withdrawal; stop gradually to prevent increase
infrequency of seizures
◾ Wear medical information tag
◾ Rx; Preg Cat C
Side Effects:
Ataxia, dizziness, Headache
Nausea, vomiting, anorexia, Diplopia, blurred vision
Abdominal pain, dysmenorrhea, Loss of coordination
Mood changes, Irritability, Insomnia, Depression
PHENOBARBITAL
Luminal
◾ 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,
cangive 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, abdomen/
muscle cramps, tremors, and possibly convulsions
◾ Vitamin D supplements are indicated for long-term use
◾ Rx C-IV; Preg Cat D
Side Effects:
Drowsiness, lethargy, rash, GI upset, contricts pupils, respiratory depression, ataxia, nightmares, unusual bleeding, dyspnea, dysphagia, excitement in children
PHENYTON
Dilantin
Management of seizures, migraines, Bell’s palsy
PO: Take divided, with or immediately after meals
May color urine and sweat a pink/ red/ brown
May cause an increase in blood sugar
IV admin may lead to cardiac arrest
Never mix with another IV or dextrose
Avoid abrupt withdrawal
Do not use antacids or anitdiarrheals within 2 hours of med
Folic acid supplements for long time use
Wear a medical tag
Preg Cat D
Side Effects:
Drowsiness, ataxia, nystagmus, blurred vision, hirsutism, lethargy, GI upset, suicidal behavior, skin rash
PREGABLIN
Lyrica
Treatment for neuropathic pain, diabetic pain, pain after shingles, fibromyalgia, and partial onset seizures in adults with epilepsy
Take around the same time ever day, 2-3 times a day, full effects take 4 weeks
Avoid abrupt withdrawal
Avoid alcohol
May increase suicidal thoughts and behaviors
Preg Cat C
Side Effects:
Dizziness, tiredness, weakness, HA, N/V, constipation, gas, bloating, mental status change, anxiety, lack of coordination, loss of balance, uncontrollable shaking and jerking, muscle twitching, weight gain, increased appetite, swelling of arms, hands, feet, ankles or lower legs, back pain infection, neuropathy
TOPIRAMATE
Topamax, Topiragen
Used for management of seizures, prohlyaxis or migrane headache, cluster headache and bulimia
Give without regard to meals, can put in juice or applesauce
Avoid abrupt withdrawal
Increase fluid intake
Stop immediately if eye problems occur
Use sunscreen and protectvie clothing to prevent photosensitivity
Wear medical tag
Preg Cat C
Side Effects:
Dizziness, drowsiness, fatigue, impaired concentration/ memory, nervousness, speech problems, nausea, weight loss, vision problems, ataxia, photosensitive, behavior problems, anorexia
VALPROATE
Depacon
Management of seizures, manic episodes of bipolar, prevent migraines
Avoid abrupt withdrawal
Give with food to decrease GI irritation
Monitor blood levels, plts, bleeding time, liver function
Preg Cat D
Side Effects:
Sedation, drowsiness, dizziness, mental status change, NV, constipation, diarrhea, heartburn, prolonged bleeding time, hepatotoxicity, teratogenicity, pancreatitis
VALPORIC ACID
Depakene Myproic Acid
Management of seizures, mania, prevent migraines
Take with or immediately adter meals
Swallow whole
Avoid abrupt withdrawal
Monitor blood levels, plts, bleeding time, liver fucntion
Wear medical tag
Preg Cat D
Side Effects:
Sedation, drowsiness, dizziness, mental status change, NV, constipation, diarrhea, heartburn, prolonged bleeding time, hepatotoxicity, teratogenicity, pancreatitis
