Benzodiazepines and Anticonvulsants

what are some examples of benzodiazepines?

alprazolam (xanax), midazolam (versed), clonazepam (klonopin), and diazepam (valium)

how do benzodiazepines work?

thought to enhance GABA

reason for taking benzodiazepines?

anxiety, alcohol withdrawal, panic disorders, and sedation

adverse reactions to benzodiazepines?

drowsiness, loss of coordination, dry mouth, and constipation

contraindications of benzodiazepines?

pregnancy and narrow angle glaucoma

what to monitor before and after giving benzodiazepines?

vitals and conciousness

if a patient is lethargic with shallow respirations what are you administering and what is the caution with this medication?

ramazicon and seizure causing

what is different about midazolam (versed) from other benzodiazepines?

high- alert medication and a short half-life

what is another name for ambien?

zolpidem

how does zolpidem (ambien) work?

binds to neuroreceptors that slows brain activity

reasons for taking zolpidem (ambien)?

insomnia

adverse reactions to zolpidem (ambien)?

decreased consciousness, confusion, and short term memory loss

contraindications of zolpidem (ambien)?

kidney disease and other CNS depressants

what is different about zolpidem (ambien) CR?

longer acting form with two separate drug reservoirs

what should patients be told about zolpidem (ambien)?

possibility for somnambulation (sleepwalking)

what is another name for flexeril?

cyclobenzaprine

how does cyclobenzaprine (flexeril) work?

relaxes smooth muscle to help alleviate pain for muscle tension or spasms

why take cyclobenzaprine (flexeril)?

for skeletal muscle conditions like muscle spasms or severe chronic disorders (multiple sclerosis, cerebral palsy)

adverse reactions to cyclobenzaprine (flexeril)?

weakness, fatigue, dizziness/drowsiness

contraindications of cyclobenzaprine (flexeril)?

other CNS depressants

how do you avoid crystalluria?

increase fluids

what is another name for imitrex?

sumatriptan

how does sumatriptan (imitrex) work?

stimulates 5-HT1 receptors in cerebral arteries causing vasoconstriction and helps decrease the production of inflammatory neuropeptides

reason for taking sumatriptan (imitrex)?

migraine and hyperactive disorders

contraindication for sumatriptan (imitrex)?

pregnancy

adverse reactions to sumatriptan (imitrex)?

cardiovascular effects, nervousness, insomnia, convulsions

what do you teach the patient about sumatriptan (imitrex)?

take before headache worsens

what is another name for dilantin?

phenytoin

how does phenytoin (dilantin) work?

thought to work on GABA to decrease impulses along the neuro pathway

reason to take phenytoin (dilantin)?

seizure disorder

adverse reactions to phenytoin (dilantin)?

gingival hyperplasia, acne, and hirsutism

contraindications of phenytoin (dilantin)?

teratogenic and possible drug interactions

why push IV slowly with phenytoin (dilantin)?

to avoid cardiac arrest, push 50mg/min

what are correct serum values for phenytoin (dilantin)?

10-20 mcg per mL

another name for tegretol?

carbamazepine

how does carbamazepine (tegretol) work?

thought to work on GABA to decrease impulses along the neuro pathway

reason to take carbamazepine (tegretol)?

seizure disorder and pain for neuropathies

adverse reactions to carbamazepine (tegretol)?

blisters around mouth, aplastic anemia, and anaphalactic reaction

contraindications for carbamazepine (tegretol)?

valproic acid, acetaminophen, benzos

what to notify MD for when taking carbamazepine (tegretol)?

unusual bleeding, fever, or sore throat

what is a regular serum level with carbamazepine (tegretol)?

4 - 12 mcg per mL

another name for keppra?

levetiracetam

how does levetiracetam (keppra) work?

thought to work on GABA to decrease impulses along the neuro pathway

reason for taking levetiracetam (keppra)?

seizure disorder

adverse reactions to levetiracetam (keppra)?

suicidal thoughts and steven-johnson syndrome

contraindication for levetiracetam (keppra)?

CNS depressants

how do you get an effective dose of levetiracetam (keppra) and what is the max dose?

it must be titrated and 3000 mg/day

another name for neurontin?

gabapentin

how does gabapentin (neurontin) work?

inhibits over excitement of brain activity by synthesizing GABA

reason to take gabapentin (neurontin)?

seizure disorder and neuropathy (used mostly for this)

adverse reactions of gabapentin (neurontin)?

respiratory depression, dizziness/ drowsiness, and edema

contraindications of gabapentin (neurontin)?

alcohol or other CNS depressants

another name for depakote?

valproic acid

how does valproic acid (depakote) work?

inhibits over excitement of brain activity by synthesizing GABA

reason for taking valproic acid (depakote)?

seizure disorder and bipolar disorder

adverse reactions to valproic acid (depakote)?

drowsiness, hair loss, hepatoxicity, and pancreatitis

contraindications for valproic acid (depakote)?

liver disorder and pancreatitis

what is the correct amount of serum for valproic acid (depakote)?

50 - 100 mcg per mL