STUVIA 2024/2025
W3 Meds
⏺CNS effects
● Nystagmus, double vision, vertigo, staggering gait, and headache can occur, but cognitive function
is minimally affected.
NURSING ACTIONS
● Administer in low doses initially and then gradually increase dosage.
● Administer the largest portion of the daily dose at bedtime.
⏺Blood dyscrasias
● Leukopenia, anemia, thrombocytopenia
NURSING ACTIONS
● Obtain baseline CBC and platelets. Perform ongoing monitoring of CBC and platelets.
● Observe for manifestations of bruising and bleeding of gums, sore throat, fever, pallor, weakness,
and infection.
● Avoid administering to a client who has bone marrow suppression or bleeding disorders.
⏺Hypo-osmolarity
● Carbamazepine promotes secretion of ADH, which inhibits water excretion by the kidneys and
%
places clients who have heart failure at risk for fluid overload.
NURSING ACTIONS
● Monitor blood sodium periodically.
● Monitor for edema, decrease in urine output - ✔✔TRADITIONAL ANTIEPILEPTIC MEDICATIONS
NURSING ACTION
● Phenytoin
⏺GI effect
● Nausea, vomiting, indigestion
CLIENT EDUCATION: Take medication with food.
Enteric-coated formulation can decrease manifestations.
⏺Hepatotoxicity
● Anorexia, abdominal pain, jaundice
NURSING ACTIONS
◯ Assess baseline liver function and monitor liver function periodically.
◯ This medication should not be used for children younger than 2 years old.
◯ Medication should be prescribed in lowest effective dose.
◯ Avoid administering to a client who has liver disease.
stuvia
, STUVIA 2024/2025
CLIENT EDUCATION: Observe for manifestations of hepatotoxicity (anorexia, nausea, vomiting,
abdominal pain, and jaundice), and notify the provider if they occur.
⏺Pancreatitis
NURSING ACTIONS
● As evidenced by nausea, vomiting, and abdominal pain
● Monitor amylase levels.
● Medication should be discontinued if pancreatitis develops.
CLIENT EDUCATION: Observe for manifestations, and notify the provider immediately if these occur.
⏺Thrombocytop - ✔✔TRADITIONAL ANTIEPILEPTIC MEDICATIONS NURSING ACTION
● Valproic acid
⏺GI effects: Nausea, vomiting
NURSING ACTIONS: Administer with food.
⏺CNS effects: Sleepiness, lightheadedness, fatigue NURSING ACTIONS: Administer low initial
dosage. CLIENT EDUCATION: Avoid hazardous activities (driving).
%
Antiepileptics (AEDs) ATI CHAPTER 13 CHRONIC NEUROLOGIC DISORDERS -
✔✔TRADITIONAL ANTIEPILEPTIC MEDICATIONS NURSING ACTION
● Ethosuximide
● Catecholamine-O-methyltransferase (COMT) inhibitors enhance the effect of levodopa by blocking
its breakdown: entacapone, tolcapone
Anti-Parkinson's medications ATI CHAPTER 13 CHRONIC NEUROLOGIC DISORDERS -
✔✔Dopaminergic MEDICATIONS NURSING ACTION
●entacapone, tolcapone
● Dopamine agonists
activate dopamine receptors: pramipexole; bromocriptine; ropinirole, a first-line supplement to
levodopa. Apomorphine is a rescue medication for "off" times.
stuvia
, STUVIA 2024/2025
Anti-Parkinson's medications ATI CHAPTER 13 CHRONIC NEUROLOGIC DISORDERS -
✔✔Dopaminergic MEDICATIONS NURSING ACTION
● pramipexole; bromocriptine; ropinirole
● Dopamine releaser prevents dopamine reuptake
Anti-Parkinson's medications ATI CHAPTER 13 CHRONIC NEUROLOGIC DISORDERS -
✔✔Dopaminergic MEDICATIONS NURSING ACTION
●amantadine
● Dopamine synthesis medications (levodopa) are prepared in combination with a dopamine agonist
(carbidopa), or listed as levodopa/carbidopa.
◯ Levodopa crosses the blood-brain barrier, whereas
dopamine alone cannot cross this barrier and has a very short half-life. Levodopa is taken up by
dopaminergic nerve terminals and converted to dopamine (DA). This newly-synthesized DA is
released into the synaptic space and causes stimulation of DA receptors thus restoring a proper
balance between dopamine and acetylcholine.
%
◯ Carbidopa is used to augment levodopa by decreasing the amount of levodopa that is converted to
DA in the intestine and periphery. This results in larger amounts of levodopa reaching the CNS.
Anti-Parkinson's medications ATI CHAPTER 13 CHRONIC NEUROLOGIC DISORDERS -
✔✔Dopaminergic MEDICATIONS NURSING ACTION
● levodopa/carbidopa.
● Monoamine oxidase-B (MAO-B) inhibitors prevent dopamine breakdown:
Anti-Parkinson's medications ATI CHAPTER 13 CHRONIC NEUROLOGIC DISORDERS -
✔✔Dopaminergic MEDICATIONS NURSING ACTION
●selegiline, rasagiline
stuvia
, STUVIA 2024/2025
AEDs control seizure disorders by various mechanisms.
● Slowing the entrance of sodium and calcium back
into the neuron, thus extending the time it takes for the nerve to return to its active state and slows
the frequency of neuron firing.
● Suppressing neuronal firing, which decreases seizure activity and prevents propagation of seizure
activity into other areas of the brain
● Decreasing seizure activity by enhancing the inhibitory effects of gamma butyric acid (GABA)
Antiepileptics (AEDs) ATI CHAPTER 13 CHRONIC NEUROLOGIC DISORDERS - ✔✔EXPECTED
PHARMACOLOGICAL ACTION
ANTIEPILEPTIC MEDICATIONS
Hydantoins:
⏺CNS effects
● Nystagmus, sedation, ataxia, double vision, cognitive impairment
NURSING ACTIONS: Monitor for manifestations of CNS effects, and notify the provider if they occur.
⏺Gingival hyperplasia
%
● Softening and overgrowth of gum tissue, tenderness, and bleeding gums
NURSING ACTIONS: Advise clients to maintain good oral hygiene (dental flossing, massaging
gums). Folic acid supplements can decrease the occurrence.
⏺Skin rash
NURSING ACTIONS: Stop medication if rash develops.
⏺Cardiovascular effects: dysrhythmias, hypotension
NURSING ACTIONS
● Administer at slow IV rate (no faster than
50 mg/min) and in dilute solution to prevent adverse cardiovascular effects.
● Avoid administering to a client who has sinus bradycardia, sinoatrial block, or Stokes-Adams
syndrome.
⏺Endocrine and other effects
● Coarsening of facial features, hirsutism, and interference with vitamin D metabolism
CLIENT EDUCATION
◯ - ✔✔TRADITIONAL ANTIEPILEPTIC MEDICATIONS NURSING ACTION
stuvia
