Ch 19: Antiseizure Drugs

phenytoin class & use

anticonvulsant

seizures

phenytoin moa

suppress sodium influx to dec neural firing

phenytoin se

gingival hyperplasia: swollen gums d/t bad oral hygiene

PURPLE GLOVE SYNDROME: purple discoloration of limb d/t IV complication → necrosis or amputation

ventricular fibrillation

suicidal ideation

hyperglycemia

thrombocytopenia (blood in vomit, pee, and poop)

phenytoin nsg con

therapeutic serum phenytoin level: 10-20 mcg/mL

frequent labs

assess gums/oral hygiene

check IV to avoid purple glove syndrome

fall, bleeding, and seizure precautions

NO FOR PREGNANT WOMEN → pt ed additional contraceptives

no driving

urine may turn reddish-brown

why can’t pregnant women take antiseizure/anticonvulsant meds

antiseizure meds inhibit vitamin K

contributes to infant hemorrhage after birth

bleeding precautions

soft toothbrush

electric razor

no IM injections

mon black tarry stool, blood emesis, petechia

check pt nose, mouth, skin, and urine for bleeding

no aspirin and NSAIDs

fall risk precautions

low HOB

non-slip socks

adequate lighting

call light within reach

clutter-free floor

assist with ambulation

grab bats

often used items are within reach

seizure precautions

pad side rails

low HOB

no restraints

don’t put stuff in pt mouth

O2 and suction available

mon neuro status

loosen tight clothes

admin PRN meds (esp antiseizure meds) as ordered

medical ID

neutropenic precautions for immunosuppressed pt

frequent hand hygiene

wear masks in public

no fresh flowers, plants, fruits, veggies

mon temp closely

no crowded places, live vaccines, and invasive procedures

put in private room, limit visitations, and close doors