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NURS 2516 Clinical Medications Worksheets (You will need to make additional copies of these forms) Generic Name

Trade Name clonazepam Klonopin Peak Onset 1-2 hr 20-60 min Classification Dose Route Time/frequency anticonvulsants 1mg IV 0900, 2100; twice daily Duration For IV meds, compatibility with IV drips and /or solutions 6-12 hr N/A Nursing Implications (what to focus on) Contraindications/warnings/interactions Hypersensitivity to clonazepam or other benzodiazepines • Severe liver disease Use Cautiously in: • Narrow-angle glaucoma • Chronic respiratory disease • History of porphyria • Do not discontinue abruptly Common side effects Behavioral side effects, drowsiness, ataxia Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically) Alcohol, antidepressants , antihistamines , otherbenzodiazepines, and opioid analgesics --concurrent use results in ↑ CNS depression Lab value alterations caused by medicine Patients on prolonged therapy should have CBC and liver function test results evaluated periodically. May cause an ↑ in serum bilirubin, AST, and ALT ○ May cause ↓ thyroidal uptake of sodium iodide, 123I, and 131I Be sure to teach the patient the following about this medication Instruct patient to take medication exactly as directed. Take missed doses within 1 hr or omit; do not double doses. Abrupt withdrawal of clonazepam may cause status epilepticus, tremors, nausea, vomiting, and abdominal and muscle cramps • Medication may cause drowsiness or dizziness. Advise patient to avoid driving or other activities requiring alertness until response to drug is known • Caution patient to avoid taking alcohol or other CNS depressants concurrently with this medication • Advise patient to notify health care professional of medication regimen prior to treatment or surgery • Instruct patient and family to notify health care professional of unusual tiredness, bleeding, sore throat, fever, clay-colored stools, yellowing of skin, or

Mechanism of action and indications (Why med ordered) Anticonvulsant effects may be due to presynaptic inhibition Produces sedative effects in the CNS, probably by stimulating inhibitory GABA receptors. Muscle spasms, associated anxiety.

behavioral changes • Patient on anticonvulsant therapy should carry identification at all times describing disease process and medication regimen • Emphasize the importance of follow-up exams to determine effectiveness of the medication

Nursing Process- Assessment (Pre-administration assessment) • Assess degree and manifestations of anxiety and mental status prior to and periodically during therapy • Assess patient for drowsiness, unsteadiness, and clumsiness. These symptoms are dose related and most severe during initial therapy; may decrease in severity or disappear with continued or long-term therapy

Assessment Why would you hold or not give this med? Problematic side effects

Evaluation Check after giving Decrease in frequency and severity of panic attacks • Relief of leg movements during sleep • Decrease in pain from neuralgia