Pharmacology of Anticonvulsants

Study Notes

Drug Classification

Anticonvulsant and mood stabilizer used for various neurological and psychiatric conditions

Dose Range

Typical oral dosage is 400 mg daily, divided into multiple doses
Common dosage range falls between 400-800 mg

Pharmacological Action

Reduces synaptic transmission in the central nervous system
Primarily affects sodium channels in neurons

Therapeutic Uses

Effective in managing bipolar disorder
Used to control various seizure types
Treats trigeminal neuralgia and diabetic neuropathy

Side Effects/Adverse Effects

Potential for suicidal thoughts and behaviors
May cause ataxia, drowsiness, psychosis, and blurred vision
Can lead to increased liver enzymes and severe skin reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis)
Risk of blood disorders such as aplastic anemia and agranulocytosis
Other effects include dizziness, hypotension, sedation, and leukopenia

Medication/Food Interactions

Corticosteroids and contraceptives may reduce Tegretol's effectiveness
Benzodiazepines and haloperidol can also lower the drug's efficacy
MAOIs require caution due to potential interactions
SSRIs and antidepressants might increase Tegretol levels and toxicity risk
Grapefruit juice can elevate drug levels, necessitating caution

Nursing Interventions/Client Education

Emphasize adherence to prescribed dosing schedule
Advise against concurrent use of other CNS depressants
Recommend sun protection due to potential skin sensitivity
Suggest non-hormonal contraceptive methods
Educate on monitoring for skin changes and mental status shifts
Stress the importance of reporting missed doses, suicidal ideation, or worsening mood changes
Pregnancy status should always be communicated to the healthcare provider
Assist patients in rising from sitting positions to prevent dizziness
Regular CBC monitoring for platelets, iron, and white blood cells is essential
Monitor laboratory results to ensure therapeutic range (4-12 µg/mL)

Nursing Administration Concerns

Vigilantly monitor for changes in platelets, iron, and white blood cell counts
Contraindicated in patients with bone marrow depression
Necessary to check labs for increased blood urea nitrogen (BUN), urine protein, glucose, and calcium levels

Evaluation of Medication Effectiveness

Monitor for reduction in mania and depressive symptoms in individuals with bipolar I disorder
Assess for decrease in pain levels
Ensure absence or reduction in seizure frequency and severity

Description

This quiz covers the classification, dosage, pharmacological actions, therapeutic uses, side effects, and interactions of anticonvulsant medications. Test your knowledge on how these drugs function, their applications in treating psychiatric and neurological conditions, and the potential risks associated with their use.