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Pharmacology - NCLEX > Anticonvulsants (36) > Flashcards

Anticonvulsants (36) Flashcards

1
Q

SUMATRIPTAN: Nursing Considerations

A
  • PO: swallow tablets whole, take as soon as symptoms appear
  • Transdermal: apply to dry intact skin, discard after folding in half
  • Onset 10 minutes to 2 hours, peak 10–20 minutes
  • Ingestion of tyramine-containing foods (pickled products, beer, preservatives, chocolate) and caffeine may precipitate headaches
  • Not to be used for more than 3–4 migraines per month
  • Rx; Preg Cat D
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2
Q

SUMATRIPTAN: Side Effects

A
  • Burning, tingling
  • Dizziness, numbness
  • Flushing
  • MI
  • Hypo/hypertension
  • Throat and nasal discomfort
  • Vision changes
  • Abdominal discomfort
  • Weakness, myalgia
  • Chest tightness, pressure
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3
Q

SUMATRIPTAN: Purpose

A

Acute treatment of migraines

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4
Q

VALPROATE, VALPROIC ACID: Nursing Considerations

A
  • Avoid abrupt withdrawal after long-term use; discontinue gradually to prevent convulsions
  • May be given with food to decrease GI irritation
  • Monitor for suicidal thoughts or behavior
  • Rx; Preg Cat D
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5
Q

VALPROATE, VALPROIC ACID: Side Effects

A
  • Sedation, drowsiness, dizziness
  • Mental status and behavioral changes
  • Prolonged bleeding time
  • Nausea, vomiting, constipation, diarrhea, heartburn
  • Hepatotoxicity
  • Pancreatitis
  • Rash
  • Hypo/hypertension
  • Visual disturbances
  • SIADH
  • Dyspnea
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6
Q

VALPROATE, VALPROIC ACID: Purpose

A

Management of seizures, prophylaxis of bipolar disorder and migraine

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7
Q

TOPIRAMATE: Nursing Considerations

A
  • Give without regard to meals
  • Avoid abrupt withdrawal after long-term use; discontinue gradually to prevent seizures and status epilepticus
  • Do not crush or chew
  • Use caution with hazardous activities until stabilized
  • Increase fluid intake to prevent formation of kidney stones
  • Notify provider immediately if experiencing periorbital pain or blurred vision
  • Wear medical information tag
  • Rx; Preg Cat C
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8
Q

TOPIRAMATE: Side Effects

A
  • Dizziness, drowsiness, fatigue
  • Impaired concentration/memory
  • Nervousness, speech problems
  • Nausea, weight loss
  • Vision problems
  • Ataxia
  • Photosensitivity
  • Behavior problems, mood problems
  • Anorexia
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9
Q

TOPIRAMATE: Purpose

A

Management of seizures, prophylaxis and treatment of migraines

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10
Q

PREGABALIN: Nursing Considerations

A
  • Take around the same time every day, 2–3 times daily; full therapeutic effects may require 4 weeks
  • Do not crush or chew
  • Avoid abrupt withdrawal after long-term use; discontinue gradually
  • Avoid use with alcohol
  • Use caution in potentially hazardous activities
  • May increase the risk of suicidal thoughts or behavior
  • Rx; Preg Cat C
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11
Q

PREGABALIN: Side Effects

A
  • Dizziness, tiredness, weakness
  • Headache
  • Nausea, vomiting, constipation
  • Flatulence, bloating
  • Mental status and behavioral changes
  • Lack of coordination
  • Increased appetite, weight gain
  • Back pain
  • Angioedema
  • Blurred vision
  • Tremor, twitching
  • Hypoglycemia
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12
Q

PREGABALIN: Purpose

A

Treatment of neuropathic pain, postherpetic neuralgia, and fibromyalgia

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13
Q

PHENYTOIN: Nursing Considerations

A
  • PO: take divided doses, with or immediately after meals, to decrease adverse effects
  • IV administration may lead to cardiac arrest—have resuscitation equipment available; never mix in IV with any other drug or dextrose
  • Avoid abrupt withdrawal to prevent convulsions
  • Do not use antacids or antidiarrheals within 2 hours of med
  • Use caution with hazardous activities until stabilized
  • Wear medical information tag
  • Rx; Preg Cat D
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14
Q

PHENYTOIN: Side Effects

A
  • Drowsiness, ataxia
  • Nystagmus
  • Blurred vision
  • Rash
  • Hypotension
  • Lethargy
  • GI upset
  • Gingival hypertrophy
  • Depression
  • Urine discoloration
  • Thrombocytopenia
  • Hyperglycemia
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15
Q

PHENYTOIN: Purpose

A

Management of seizures

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16
Q

PHENOBARBITAL: Nursing Considerations

A
  • 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
  • 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
17
Q

PHENOBARBITAL: Side Effects

A
  • Drowsiness, lethargy, rash
  • GI upset
  • Initially constricts pupils
  • Respiratory depression
  • Ataxia
  • Nightmares
  • Excitement in children
  • Dizziness
  • Hypotension
  • Thrombocytopenia
18
Q

PHENOBARBITAL: Purpose

A

Long-term management of seizures, management of febrile seizures, therapeutic sedation

19
Q

MAGNESIUM SULFATE: Nursing Considerations

A
  • Given IM or IV
  • Antidote: calcium gluconate
  • Rx
20
Q

MAGNESIUM SULFATE: Side Effects

A
  • Muscle weakness
  • Flushing
  • Confusion, dizziness
  • Hypotension
  • Oliguria
  • Bradycardia
  • Decreased reflexes
  • Bradypnea
  • Hypophosphatemia
  • Hyperkalemia
  • Hypocalcemia
21
Q

MAGNESIUM SULFATE: Purpose

A

Prophylaxis of seizures that occur with preeclampsia; treatment of eclampsia, acute nephritis in children, and hypomagnesemia

22
Q

LAMOTRIGINE: Nursing Considerations

A
  • In pediatric patients, stop at first sign of rash; all patients should notify provider 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
23
Q

LAMOTRIGINE: Side Effects

A
  • Ataxia, dizziness
  • Headache
  • Nausea, vomiting, anorexia
  • Rhinitis
  • Diplopia, blurred vision
  • Abdominal pain, dysmenorrhea
  • Loss of coordination
  • Mood changes
  • Irritability
  • Insomnia
  • Depression
24
Q

LAMOTRIGINE: Purpose

A

Management of seizures and bipolar disorder

25
Q

GABAPENTIN: Nursing Considerations

A
  • 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 or applesauce
  • Do not crush or chew capsules
  • Use caution with hazardous activities
  • Wear medical information tag
  • Rx; Preg Cat C
26
Q

GABAPENTIN: Side Effects

A
  • Drowsiness
  • Ataxia
  • Diplopia
  • Rhinitis
  • Constipation
  • Memory problems
  • Back or joint pain
  • Edema
  • Diarrhea
27
Q

GABAPENTIN: Purpose

A

Management of seizures, postherpetic neuralgia, and primary restless leg syndrome

28
Q

DIVALPROEX SODIUM: Nursing Considerations

A
  • 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
29
Q

DIVALPROEX SODIUM: Side Effects

A
  • 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
30
Q

DIVALPROEX SODIUM: Purpose

A

Management of seizures, prophylaxis of migraine headache

31
Q

CLONAZEPAM: Nursing Considerations

A
  • Do not discontinue abruptly, seizures may increase
  • Avoid alcohol, CNS depressants
  • May take with food or milk to decrease GI symptoms
  • Report signs of toxicity: bone marrow suppression, nausea, vomiting, ataxia, diplopia, cardiovascular collapse
  • May increase risk of suicidal thoughts
  • Wear medication identification tag
  • Rx C-IV
32
Q

CLONAZEPAM: Side Effects

A
  • Drowsiness, dizziness
  • Behavioral changes
  • Poor coordination
  • Palpitations, tachycardia
  • Blurred vision
  • Increased salivation
  • Nausea, constipation
  • Dysuria
  • Libido changes
  • Thrombocytopenia
  • Respiratory depression
  • Rash
  • Muscle weakness
33
Q

CLONAZEPAM: Purpose

A

Management of seizures and panic disorder

34
Q

CARBAMAZEPINE: Nursing Considerations

A
  • 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
  • Do not mix with grapefruit juice
  • Urine may turn pink to brown
  • Avoid abrupt withdrawal; discontinue gradually
  • Avoid use with alcohol, CNS depressants
  • Inform provider before taking any new medication or herbal medication
  • Rx; Preg Cat D
35
Q

CARBAMAZEPINE: Side Effects

A
  • Myelosuppression
  • Dizziness, drowsiness
  • Ataxia
  • Diplopia, rash
  • Photosensitivity
  • Depression
  • Nausea
  • Vomiting
  • Dyspepsia
  • Aplastic anemia
  • Stevens-Johnson syndrome
  • Suicidal thoughts
36
Q

CARBAMAZEPINE: Purpose

A

Management of seizures, trigeminal neuralgia, and neuropathic pain

37
Q
  1. SUMATRIPTAN
  2. VALPROATE, VALPROIC ACID
  3. TOPIRAMATE
  4. PREGABALIN
  5. PHENYTOIN
  6. PHENOBARBITAL
  7. MAGNESIUM SULFATE
  8. LAMOTRIGINE
  9. GABAPENTIN
  10. DIVALPROEX SODIUM
  11. CLONAZEPAM
  12. CARBAMAZEPINE

Pharmacology - NCLEX (20 decks)

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