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ANTIEPILEPTICS, PART 2: DRUG NAME: vigabatrin (Sabril) gabapentin (Neurontin, Gralise) CLASS: GABA inhibitors: GABA analogues: MECHANISM OF ACTION: Prevent GABA reuptake into presynaptic neurons; ↑ GABA concentration in synapse; ↓ seizure activity Mechanism of action is not known. May affect transport of amino acids across and stabilize neuronal membranes. Therapeutic Effects: Decreased incidence of seizures. Decreased postherpetic pain. Pregnancy considerations: A cohort study utilizing the US Medicaid dataset investigated gabapentin exposure during pregnancy from January 2000 to December 2013. While no significant associations were observed with major malformations, multiple administration of gabapentin was correlated with an increase in the risk of cardiac defects. nursing considerations As needed, open gabapentin capsules and mx contents with water, fruit juice, apple sauce or pudding before administration. Give drug at least 2 hours after an antacid. Nursing Considerations Therapeutic Effects Side/Adverse Effects; Anticonvulsant: gabapentin: Administer first dose at bedtime to decrease dizziness and drowsiness Monitor for worsening depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior Taper dose; do not stop abruptly: Decreased neuropathic pain or seizures So let's take a look at a few nursing considerations. Gabapentin may cause suicidal thoughts, ataxia, or lack of muscle control and depression with these things in mind, monitor your patient for changes and behavior and depression while on Gabapentin, make sure you assess seizure activity and pain level in your patient, teach your patient to Antiseizure agents (also known as antiepileptic drugs or as anticonvulsants) are drugs used to manage epilepsy, the most prevalent neurological disorder. Antiseizure agents of choice depends on the type of epilepsy, age of the patient, patient tolerance, and specific patient characteristics. Table of Common Drugs and Generic Names Here is a table of commonly encountered antiseizure agents So let's take a look at a few nursing considerations. Gabapentin may cause suicidal thoughts, ataxia, or lack of muscle control and depression with these things in mind, monitor your patient for changes and behavior and depression while on Gabapentin, make sure you assess seizure activity and pain level in your patient, teach your patient to Gabapentin is an anticonvulsant used in the prevention of partial seizures. It is frequently used for neuropathic pain including diabetic neuropathy, radiculopathy, shingles, and trigeminal neuralgia. Advise patient not to take gabapentin within 2 hr of an antacid. Gabapentin may cause dizziness and drowsiness. Caution patient to avoid driving or activities requiring alertness until response to medication is known. Seizure patients should not resume driving until physician gives clearance based on control of seizure disorder. gabapentin (Neurontin) Disease Spotlight: Epilepsy. Nursing Considerations. Here are important nursing considerations when administering this drug: Nursing Nursing Considerations for Gabapentin. When administering or caring for patients taking gabapentin, nurses should consider several important factors. Nursing Assessment. 1. Assess the patient’s medical history, including any known allergies, previous adverse reactions to gabapentin or similar medications, and relevant medical conditions. Understanding proper nursing considerations is crucial for safe and effective patient care. Generic name: Gabapentin. Brand names: Neurontin, Gralise, Horizant, Gabarone. Pharmacologic class: Anticonvulsant, Antiepileptic. Therapeutic class: Anticonvulsant, Analgesic for neuropathic pain. Nursing Implications Monitor of therapeutic effectiveness; may not occur until several weeks following initiation of therapy, in those treated for seizure disorders , assess frequency of seizures: In rare cases, the drug has increased the frequency of partial seizures, Monitor dizziness and CNS depression, monitor for changes in behavior that Identify the appropriate indications for gabapentin therapy, including neuropathic pain, partial onset seizures, restless legs syndrome, and other relevant neurological and psychiatric conditions. However, gabapentin is often used off-label for a variety of conditions. In fact, one study revealed that 83% of gabapentin prescriptions were for off-label use. Some of the common reasons gabapentin is prescribed are: Neuropathic pain and diabetic neuropathy (this is very common) Bipolar disorder and anxiety; Migraine prevention In this article, you’ll learn about Gabapentin (Neurontin) nursing implications and patient teachings. Also, its dosage, indication, contraindications, interactions, side effects, nursing assessment, and nursing interventions. Epilepsy: Starting dose is 300 mg PO tid, then titrated up as needed. Maintenance: 900–1,800 mg/day PO in divided doses tid PO; maximum interval between doses should not exceed 12 hr. Up to 2,400–3,600 mg/day has been used. Postherpetic neuralgia: Initial dose of 300 mg/day PO; 300 mg bid PO on day 2; 300 mg tid PO on day 3. Gabapentin is used for partial seizures and neuropathic pain. Nursing Considerations Across the Lifespan. This drug can cause harm to the fetus of pregnant women. Gabapentin use in pediatric patients with epilepsy 3 to 12 years of age is associated with the occurrence of central nervous system related adverse events. Identify appropriate indications for use of gabapentin. Relate general characteristics of gabapentin to specific patient situations. Apply nursing process considerations for gabapentin to specific patient situations. Correctly calculate dosage for gabapentin.
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