Untitled Deck Flashcards
(25 cards)
what are the contraindications for phenytoin
category x, heart block, related seizures, hyperglycemia
adverse effects for phenytoin
Gingival hyperplasia (enlarged gums),
purple glove syndrome
nursing considerations for phenytoin oral, PIV and IV
PIV Administration
Give slowly
Dilute with normal saline
Use IV filter
Oral Administration
Do not switch between brands—can alter narrow therapeutic index
Monitor Phenytoin Level
Normal level is between 10-20 mcg/mL
Level too low—increased risk of seizure
Level too high—toxicity, adverse effect
Monitor good hygiene
Benzodiazepines
-epam is used for
active treatment of status epilepticus
-epam contraindications
pregnancy, older adults, liver, and kidney disease, and glaucoma
-epam adverse effects, think of “CHiBC”
CNS depression, hypotension, bradycardia, constipation
-epam nursing considerations (IV nd don’ts)
GIVEN IV TO STOP seizures immediately
IV SLOW PUSH
do not drive or use heavy machinery
don’t drink alcohol
What is carbamazepine used for?
Management of epilepsy
What are the contraindications for carbamazepine? (HELP acronym)
Hypersensitivity
Expecting (pregnancy)
Liver disease
Problems with kidneys or during lactation
What are the adverse effects of carbamazepine? (AASS acronym)
Anemia
Agranulocytosis
SJS (Stevens-Johnson Syndrome)
Signs of bleeding
What are the nursing considerations for carbamazepine?
Monitor for bleeding
Use reliable birth control
Monitor levels: 6–12 mcg/mL
Labs: AST/ALT, Cr, CBC w/ diff
What is valproic acid used for?
Status epilepticus, seizure management
What are the contraindications for valproic acid?
Pregnancy (Category X)
What are the adverse effects of valproic acid think of “please help today PHT”?
Pancreatitis, hepatotoxicity, thrombocytopenia
What are the nursing considerations for valproic acid?
Use reliable birth control
Sprinkle capsules in applesauce (peds)
Give with food (GI upset)
Monitor levels: 50–125 µg/mL
Labs: AST/ALT, Cr, CBC (platelets), Amylase/Lipase
What is donepezil’s action?
Increases ACh, slows neuron degradation (only delays disease)
What are the contraindications for donepezil?
Lung and heart disease
What are the adverse effects of donepezil? think of “AWAC”
Anorexia, worsens asthma/COPD
What are the nursing considerations for donepezil?
Administer at bedtime, monitor diet and therapeutic effect and drug does not cure
What is the pharmacokinetics of levodopa/carbidopa?
Levodopa: Converted to dopamine in the brain
Carbidopa: Prevents levodopa breakdown in gut/tissues, reduces CV side effects
What happens with long-term use of levodopa/carbidopa?
Medication eventually wears off
What are the contraindications for levodopa/carbidopa?
Hypersensitivity, glaucoma, hx of melanoma, severe liver/kidney disease
What are the adverse effects of levodopa/carbidopa? (T.O.P. H.A.T.)
Tachycardia
Orthostatic hypotension
Palpitations
Hyporexia (anorexia/weight loss)
Arrhythmias (monitor ECG)
Therapeutic monitoring needed
