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ANTI of CNS (Antiseizure (Contra's (Pregnancy, Worsening of depression…

- - - - Narrow therapeutic range
      - Adverse Effect
        
        gingival hyperplasia
      - Nursing considerations
        
        Needs consistent drug level to be therapeutic, protein can interfere with drug levels.
        
        slow drip w/ NS only
        
        Stay w/ brand or generic- don't switch
        
        Abrupt cessation can cause status epilepticus
    - - Use on status epilepticus
      - sit up slowly
- - - - Uses
        
        Depression
        
        enuresis
      - Adverse effects
        
        urinary retention
      - Nursing considerations
        
        Mimic panic attacks
        
        do not give concurrently with MAOIs, SSRIs
        
        Take in the evening
        
        Do not take with Hypericum
    - - Adverse Effects
        
        Wt. gain
        
        Edema
        
        Dairy, chocolate, beer, smoked meats
        
        Many drug interactions
    - - Drugs
        
        Fluoxetine (Prozac)
        
        paroxetine (Paxil)
        
        sertraline (Zoloft)
        
        bupropion (Wellbutrin)
        
        must not have history of seizures before going on this drug
        
        duloxetine (Cymbalta)
      - Interactions
        
        Caution with warfarin
      - Nursing Considerations
        
        children and adolescents
        
        counseling, support groups
  - - - amphetamine (Adderall)
      - methlphenidate (Ritalin)
      - atomoxetine (Strattera)
        
        non-dependent
- - - - Contra's
        
        Pregnancy
        
        Severe HTN
        
        CAD
    - - Effective against seizures
- - - - Adverse Effects
        
        pill rolling
        
        orthostatic hypotension
        
        anxiety
        
        depression
      - Contra's
        
        Glaucoma
        
        Heart disease
        
        GI issues
        
        melanoma
      - Nursing Considerations
        
        Fiber & H20 in diet
        
        Wearing off effect