Clinical Medications Worksheets

Generic Name gabapentin Peak 2-4 hr Trade Name Neurontin Onset rapid Classification analgesic adjuncts, anticonvulsants Duration 8 hr Dose 900 mg Route PO Time/frequency tid Normal dosage range 300 mg 3 times daily initially. Titration may be continued until desired (range is 900-1800 mg/day in 3 divided doses; doses should not be more than 12 hr apart). Doses up to 2400-3600 mg/day have been well tolerated. For IV meds, compatibility with IV drips and/or solutions N/A Nursing Implications (what to focus on) Contraindications/warnings/interactions Hypersensitivity. Geriatric patients (because of age-related ↓ in renal function). Common side effects Confusion, depression, drowsiness, ataxia.

Why is your patient getting this medication. Partial seizures with and without secondary generalization (adjunct treatment). Neuropathy. Mechanism of action and indications (Why med ordered) Gabapentin interacts with cortical neurons at auxillary subunits of voltage-sensitive calcium channels. Gabapentin increases the synaptic concentration of GABA, enhances GABA responses at non-synaptic sites in neuronal tissues, and reduces the release of mono-amine neurotransmitters. One of the mechanisms implicated in this effect of gabapentin is the reduction of the axon excitability measured as an amplitude change of the presynaptic fibre volley (FV) in the CA1 area of the hippocampus. This is mediated through its binding to presynaptic NMDA receptors. Other studies have shown that the antihyperalgesic and antiallodynic effects of gabapentin are mediated by the descending noradrenergic system, resulting in the activation of spinal alpha2-adrenergic receptors. Gabapentin has also been shown to bind and activate the adenosine A1 receptor. Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically) Seroquel: Central nervous system- and/or respiratorydepressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients. Reglan: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.

Nursing Process- Assessment (Pre-administration assessment) Assess location, duration, and characteristics of seizure activity. Assess location, characteristics, and intensity of pain periodically during therapy.

Lab value alterations caused by medicine May cause false-positive readings when testing for urinary protein with Ames N-Multistix SG dipstick test; use sulfosalicylic acid precipitation procedure. May cause leucopenia. Be sure to teach the patient the following about this medication Instruct patient to take medication exactly as directed. Take missed doses as soon as possible; if less than 2 hr until next dose, take dose immediately and take next dose 1-2 hr later, then resume regular dosing schedule. Do not double doses. Advise patient not to take gabapentin within 2 hr of an antacid. Gabapentin may cause dizziness and drowsiness. Caution patient to avoid driving or activities requiring alertness until response to medication is known. Instruct patient to notify health care professional of medication regimen before treatment or surgery. Advise patient to carry identification describing disease process and medication regimen at all times. Assessment Evaluation Why would you hold or not give this med? Check after giving Before surgery. Symptoms of overdose Decreased incidence of seizures. include ataxia, labored breathing, ptosis, sedation, hypoactivity, and excitation.

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