Bipolar, antiepileptic, muscle spasm drugs Flashcards
mood stabilizer: lithium (lithobid): MOA
unknown
may block serotonin receptor
alter glutamate reuptake/release
mood stabilizer: lithium (lithobid) indications
manic episodes
prophylaxis mania/depression
mood stabilizer: lithium (lithobid) AE
GI upset
muscle weakness
fine hand tremors
poluria
lethargy
slurred speech
mood stabilizer: lithium (lithobid) nursing considerations
therapeutic range: 0.8-1mEq/L
draw labs in AM, 12 hrs after evening dose
initiation= levels every 2-3 days
established dosing= levels every 3-6 months
hemodialysis levels > 2.5mEq/L
improvements seen in 5-7 days
!full benefits in 2-3 weeks!
!adequate hydration!
Antiepileptic Drugs: Phenytoin (Dilantin) MOA
decreases Na+ into cell
Antiepileptic Drugs: Phenytoin (Dilantin) indications
partial and tonic-clonic seizures, post-neuro sx
off label antiarrhythmic, severe preeclampsia
Antiepileptic Drugs: Phenytoin (Dilantin) AE
nystagmus
ataxia
dysarthria
slurred speech
mental confusion
tremor
headache
insomnia
hirsutism
gingival hyperplasia (20% of pt)
increase glucose level
teratogenic effects
purple glove syndrome
!Vesicant!
Antiepileptic Drugs: Phenytoin (Dilantin) nursing considerations
therapeutic range: 10-20mcg/ml
toxicity >20
dose adjustments: levels Q 5-7 days, taper off discontinuation
take with food
Antiepileptic Drugs: Oxcarbazapine MOA
decreased Na+ into cell
Antiepileptic Drugs: Oxcarbazapine indicaitions
partial seizures
Antiepileptic Drugs: Oxcarbazapine AE
dizziness
drowsiness
double vision
nystamus
headache
ataxia
hyponatremia
hypothyroidism
stevens-johnson syndrome
hypersensitivity
Antiepileptic Drugs: Oxcarbazapine nursing considerations
take without regard to food
XR tablets- swallow whole
decrease effectiveness of oral contraceptives
Baclofen (Lioresal) MOA
mimics GABA, no direct effect on muscle strength
Baclofen (Lioresal) indications
multiple sclerosis
spinal cord injuries
NOT used for cerebral palsy, stroke, parkinson disease, huntingtons chorea
Baclofen (Lioresal) AE
drowsiness
dissiness
weakness
fatigue
abrupt withdrawal= visual hallucinations, paranoid ideations, seizures
Baclofen (Lioresal) nursing considerations
monitor neuro especially if on other CNS depressants
monitor UOP especially if exiting BPH or on anticholinergics
taper off slowly
overdose= supportive care only
Dantrolene (dantrium) MOA
decreases Ca+ release to decrease muscle contraction
Dantrolene (dantrium) indications
MS
cerebral palst
spinal cord injuries
malignant hyperthermia associated with succinylcholine
Dantrolene (dantrium) nursing considerations
monitor liver funtion
Dantrolene (dantrium) AE
hepatotoxicity
Cyclobenzaprine (Flexeril/Amrix) MOA
structurally like TCAs
acts on brainstem to reduce tonic somatic muscle activity
Cyclobenzaprine (Flexeril/Amrix) indications
localized muscle spasms/pain
Cyclobenzaprine (Flexeril/Amrix) AE
drowsiness & dizziness: mostly during early tx
fatigue
dry mouth
blurred vision
photophobia
urinary retention
constipation
dysrhythmias
Cyclobenzaprine (Flexeril/Amrix) nursing considerations
caution against operating heavy machinery
