Monitor thyroid function (TSH panel), CBC, liver function panel,
carbamazepine blood lvls, renal function tests or CMP. Blood lvls should
be checked before initializing treatment, during course, then q3-4 months.
Monitor patient for seizure activity, Anticholinergic effects (glaucoma,
constipation, etc), pregnancy category D, risk of arrhythmias
2. What are the pharmacodynamics of carbamazepine?
Is metabolized by the liver, can be used to treat seizures and can be used
to treat symptoms of trigeminal neuralgia. Slow influx of sodium channel
ions reducing high frequency repetitive action potential in seizure activity
as well as action on synaptic transmission.
3. What should families be taught regarding the monitoring of seizure activity?
STUDY GUIDE EXAM 2 - EXAM REVIEW NOTES |
, l NURS 615 ADVANCED PHARMACOTHERAPEUTICS
(MARYVILLE UNIVERSITY) STUDY GUIDE-EXAM
OMoARcPSD| 22896205
Monitor severity and duration of seizures, should carry medical identification
for seizure activity, keep obstacles out of the way during seizure activity, do
not abruptly stop seizure medications, may increase risk of seizure, report
changes in behaviors while on medication.
Help patient monitor for seizure activity, keep a log for triggers (certain
foods, lack of sleep etc.), encourage patient to stay on medication (take
regularly), watch for side effects of medications, patient should have
medical alert systems (bracelet), family should learn how to treat seizures,
how to keep patient safe, when to activate emergency medical system,
drug interactions, alcohol should be avoided.
4. What electrolyte imbalance is noted with the administration of topiramate?
Closely monitor bicarbonate levels, increased risk of metabolic acidosis.
**Hyperchloremic Acidosis**
5. What are the pregnancy precautions for valproate?
Category X
Risk for neural tube defects, Can be used in 2nd or 3rd trimester, but generally
avoided, pregnancy Category D
6. What instructions will you provide to a woman who wants to get pregnant
and has a seizure disorder controlled with valproate?
Lamictal or Keppra is safer to use during pregnancy. If going to use any one
of these medications, it is recommended to stick to monotherapy and be given
folic acid at the beginning of treatment. Will need urgent referral to specialist.
STUDY GUIDE EXAM 2 - EXAM REVIEW NOTES |
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