Name of Drug
Generic Name:
Classification
Anti-convulsant
Dosage, Route, & Frequency
250mg/10 mL
Magnesium sulfate ACTION: Brand Name: Elin Magnesium Sulfate
Name of Drug
Generic Name:
To prevent or control seizures in preeclampsia or eclampsia
May decrease acetylcholine released by nerve impulses, but its anticonvulsant mechanism is unknown
Classification
Anti-convulsant
Contraindication
>Parenteral administration contraindicated in patients with heart block or myocardial damage >Use cautiously in patients with impaired renal function
Dosage, Route, & Frequency
100 mg tid, po
Phenytoin
Brand Name:
Indication
Indication
Contraindication
Adverse Reaction
CNS: drowsiness, hypothermia CV: flushing, bradycardia, circulatory collapse EENT: diplopia Metabolic: hypocalcemia
Adverse Reaction
Nursing Responsibilities
>If used with seizures, take appropriate seizure precaution >Watch for respiratory depression and s/sx of heart block
Nursing Responsibilities
Tonic-clonic &
History of
GI disturbances;
>full effectiveness of
complex partial
hypersensitivity to
ataxia, slurred
PO administered hydantoins is delayed
ACTION:
> 6 yr 30 yr 30 mg
(psychomotor,
phenytoin or other
speech; diplopia,
Acts in the motor
bid, may be
temporal lobe),
hydantoins.
nystagmus &
and may take 6-9
Dilantin
cortex of the brain
increased to 30
prevention &
mental confusion
days to be fully
to reduce the
mg tid or qid.
treatment of seizures
w/ headache,
established
spread of electrical
Pedia 5
occurring during or
dizziness, gingival
> when hydantoins
discharges from the
mg/kg/day
following
hyperplasia,
are substituted for or
rapidly firing
Initially in 2-3
neurosurgery.
hirsutism,
added to another
epileptic foci in
equally divided doses
hyperglycemia,
antivconvulsant
osteomalacia.
medication, their
this area. This is accomplished by
dosage is gradually
stabilizing
increased, while
hyperexcitable
dosage of the other
cells possibly
drug isdecreased
affecting sodium
> avoid IM, SC or
efflux. Also,
pervascular
phenytoin
injections
decreases activity
> list reasons for
of centers in the
theray, onset,
brain stem
characteristics of
responsible for the
signs and symptoms
tonic phase of
>note history and
grand mal seizures.
nature of seizures,
Has few sedative
addressing location, frequency and
effects.
duration
Name of Drug
Generic Name:
Classification
Anti-convulsant
Divalproex Sodium ACTION: Brand Name: Depakote ER
Increases level of gamma/aminobutyric in brain, which decreases seizure activity.
Dosage, Route, & Frequency
15 mg/kg daily increased at 1wk intervals by 5-10 mg/kg daily, po
Indication
Contraindication
Treatment of primary Hepatic dysfunction, generalized seizures, urea cycle disorder and notably absence and myoclonic seizures, and also for partial seizures. Also used to treat acute manic phase of bipolar disorders and for the prophylaxis of migraine.
Adverse Reaction
The most frequent adverse effects are GI disturbances, particularly in initiation of therapy.
Nursing Responsibilities
>Assess for GI complaints. >Assess for pain. >Assess for changes in bowel. >Assess for EPS. >Instruct the patient to inform physician of transient intestinal cramps, increased plasma prolactin levels and EPS occur.
Name of Drug
Generic Name:
Classification
Anti-convulsant
Oxcarbazepine ACTION: Brand Name: Trileptal
Oxcarbazepine and its active metabolite, monohydroxy derivative (MHD), have effects on sodium channels and possibly potassium and calcium channels. Neither oxcarbazepine nor MHD has an effect at binding sites for GABA or other neurotransmitter receptors.
Dosage, Route, & Frequency
600 600 mg/ mg/da day y tid tid,, po
Indication
Mono Monoth ther erap apy y or or adjunct in the treatment of partial seizures w/ or w/o secondary generalised tonicclonic seizures.
Trileptal® (oxcarbazepine) is indicated for use as monotherapy or adjunctive therapy in the treatment of partial seizures in adults and as monotherapy in the treatment of partial seizures in children aged 4 years and above with epilepsy, epilepsy, and as adjunctive therapy in children aged 2 years and above with epilepsy.
Contraindication
Hypersensitivity. Lactation.
Adverse Reaction
Nursing Responsibilities
Dizziness, somnolence, headache, ataxia, fatigue, vertigo, nervousness, amnesia, abnormal thinking, insomnia, speech disorder, agitation, confusion; vomiting, nausea, abdominal pain, diarrhoea, dyspepsia, constipation, gastritis, wt gain; abnormal gait, tremor, weakness, back pain, abnormal coordination, dysmetria, sprains/strains, muscle weakness; diplopia, nystagmus, abnormal vision and accommodation; hypotension, leg
Nurse should have to know if the patient have any of these conditions: • an alcohol abuse problem • depression • kidney disease • suicidal thoughts, plans, or attempt; a previous suicide attempt by you or a family member • any unusual or allergic reaction to oxcarbazepine, carbamazepine, other medicines, foods, dyes, or preservatives • pregnant or trying to get pregnant • breast-feeding
Rarely, serious skin
oedema; rash, acne; hyponatraemia; rhinitis, chest infection, epistaxis, sinusitis.
allergic reactions may occur with this medicine. If you develop a skin rash, redness, itching, peeling skin inside your mouth, swollen glands, or a fever while taking this medicine,
Oxcarbazepine should be taken at the same times each day to maintain even levels of the drug in your blood.
Name of Drug
Generic Name: levetiracetam
Classification
Anti-convulsant
Dosage, Route, & Frequency
PO/IV Ad Adjunct in in partial seizures Intial: 500 mg twice daily on the 1st day,
Indication
Contraindication
It is currently hypersensitivity. indicated as adjunctive treatment to for partial seizures in drug/class/components
Adverse Re Reaction
Cough, dizziness, dizziness, and muscle weakness are the most frequently reported side effects
Nursing Responsibilities
You should not use Keppra if you are allergic to
ACTION: Brand Name: Keppra
The mechanism for the anticonvulsant effect of levetiracetam is not well understood. It is not chemically related to other anticonvulsants and does not appear to act through the traditional mechanisms of neurotransmitter modulation. In animal studies, levetiracetam does not prevent acute seizures induced by electroshock or pentylenetetrazol; however, it does appear to attenuate fully kindled seizures and the development of kindling. This suggests that levetiracetam may act by preventing
may increase gradually. Max: 3 g/day. Monotherapy for partial seizures w/ or w/o secondary generalisation Inital: 500 mg/day,
patients 16 years of age and older.[5,6] Although not as well studied, preliminary reports suggest that levetiracetam may also be useful in some patients with generalized, absence, or myoclonic seizures, and in patients with Lennox-Gastaut syndrome
.
of levetiracetam. Other possible side effects that do not usually require avoid abrupt withdrawal medical attention include: >dryness or soreness of throat caution if pregnancy >fever caution if renal impairment
>hoarseness or voice changes >sleepiness or unusual drowsiness
caution if psychiatric disorder
caution in elderly pts
>tender, swollen glands in neck >numbness, prickling, "pins and needles," or tingling or tingling feelings >loss of appetite of appetite or weight loss
levetiracetam.
should also be alert to changes in pt mood or symptoms
Do not crush, chew, or break a Keppra XR tablet. Swallow the pill whole. Keppra can be taken with or without food.
hypersynchronization of epileptiform burst firing, producing an inhibition of the spread of seizure activity.
Name of Drug
Generic Name: Ipratropium Br, Salbutamol/ albuterol sulfate
Brand Name:
Classification
Antasthmatic & COPD Preparations
ACTION: In low doses, acts relatively selectively at beta 2
Dosage, Route, & Frequency
Neb q 4 hours
Indication
Contraindication
Adverse Reaction
>Relief and prevention of
>Patients who is allergic to the Drugs.
brochospasm in patients
>Patients with Hypertropic obstructive cardiomyopathy
Fine tremor of Skeletal Muscle; Palpitations; Headache, dizziness, nervousness; Dryness of the mouth, throat irritation; urinary retention.
with reversible obstructive airway
>Patients having tachyarrythmia
Nursing Responsibilities
>Use Cautiously to patients with known sensitivity to atropine, soybeans, soya lecithin, and peanuts. >Assess Vital Signs Before drug
Combivent, Ventolin
–
disease.
administration
adrenergic receptors to
>Inhalation: treatment of
cause bronchodilation and
acute attacks of
>Observe for paradoxical bronchospasm (Wheezing). If Condition occurs, withhold Medication and notify physician or other health care professional immediately.
vasodilation; at higher
brochospasm. >Prevention of exerciseinduced
doses, beta 2 selectivity is
brochospasm.
lost, and the drug acts at
>Unlabeled use: adjunct in
beta 2 receptors to cause
treating serious
typical sympathomimetic cardiac effect.
hyperkalemia in dialysis patients; seems to lower potassium concentration when inhaled by patients on hemodialysis.
>Instruct patient to contact health care professional immediately if shortness of breath is not relieved by medication or is accompanied by diaphoresis, dizziness, palpitations, or chest pain. >Advise the patient to rinse mouth with water after using the nebulizer to minimize
dry mouth.
Name of Drug
Generic Name: Clarithromycin
Classification
Anti-biotic, Macrolide ACTION:
Brand Name: Biaxin
Macrolide antibiotic that acts by binding to the 50S ribosomal subunit of susceptible organisms, thus interfering with or inhibiting microbial protein synthesis.
Dosage, Route, & Frequency
500mg per tab 1 tab PO OD
Indication
Contraindication
Adverse Reaction
Nursing Responsibilities
>Treatment of upper respiratory infections caused by S. pyogenes, S. pneumoniae >Treatment of lower respiratory infections caused by Mycoplasma pneumoniae, S. pneumoniae, H. influenzae, M. catarrhalis >Treatment of skin and skin-structure infections caused by S. aureus, S. pyogenes >Treatment of disseminated mycobacterial infections due to M. avium and M. intracellular >Treatment of active duodenal ulcer
Hypersen-sitivity to clarithro-mycin, other macrolide antibiotics, or erythro-mycin. Clients taking pimozide. Use with ranitidine bismuth citrate in those with history of acute porphyria.
GI: diarrhea, nausea, vomiting, abdominal pain
Before: -Note sensitivity to erythromycin or any macrolide antibiotics. -List drugs currently prescribed to prevent any interactions. -Document onset, severity and characteristics of S&S.
CNS: headache, dizziness, hallucination, insomnia,
Allergic: urticaria, mild skin eruption, anaphylactic
During: -May administer with or without food. -Explain effects of the drug and its side effects. -Administer as prescribed.
Miscella-neous: hearing loss, rash, After: alteration in sense of -Report adverse smell, hepatic failure effects or lack of improvement after 48-72 hr.
with H. pylori in pylori in combination with proton pump inhibitor >Treatment of acute otitis media, acute maxillary sinusitis due to H. influenzae, M. cararrhalis, S. pneumoniae >ER tablets: Treatment of mild to moderate communityacquired pneumonia in adults
Name of Drug
Classification
Dosage, Route, & Frequency
Indication
-Report any persistent diarrhea. -Document administration of medication.
Contraindication
Adverse Reaction
Nursing Responsibilities
Generic Name: Cefuroxime
Anti-infective, antibiotic, second generation cephalosporin
Brand Name: Ceftin
ACTION: Cefuroxime is bactericidal and has a similar spectrum of antimicrobial action and pattern of resistance to those of cefamandole. It is more resistant to hydrolysis by betalactamases than cefamandole, and therefore may be more active against beta-lactamaseproducing strains of, for example, haemophilus influenzae and neisseria gonorrhoeae.
IV 50mg q6
It is effective for the treatment of penicillinaseproducing Neisseria gonorrhoea (PPNG). Effectively treats bone and joint infections, bronchitis, meningitis, gonorrhea, otitis media, pharyngitis/tonsillitis, sinusitis, lower respiratory tract infections, skin and soft tissue infections, urinary tract infections, and is used for surgical prophylaxis, reducing or eliminating infection.
Hypersensitivity to cephalosporins and related antibiotics; pregnancy (category B), lactation.
Body as a Whole: Thrombophlebitis (IV site); pain, burning, cellulitis (IM site); superinfections, positive Coombs' test. GI: Diarrhea, nausea, antibioticassociated colitis. Skin: Rash, pruritus, urticaria. Urogenital: Increased serum creatinine and BUN, decreased creatinine clearance.
>Determine history of hypersensitivity reactions to cephalosporins, penicillins, and history of allergies, particularly to drugs, before therapy is initiated.
>Inspect IM and IV injection sites frequently for signs of phlebitis. >Report onset of loose stools or diarrhea. Although pseudomembranous colitis. >Monitor I&O rates and pattern: Especially important in severely ill patients receiving high doses. Report any significant changes.
