Generic Name

levetiracetam
Peak
1-1.5 hr

Trade Name
Keppra
Onset
rapid

Classification
Dose
Route
Time/frequency
Anticonvulsants, pyrrolidines 500 mg PO
Q 12 hrs
Duration
Normal dosage range
12 hr
500mg twice daily initially; may be increased by 1000
mg/day at 2 wk intervals up to 3000 mg/day
Why is your patient getting this medication
For IV meds, compatibility with IV drips and/or solutions
Seizure disorder
N/A
Mechanism of action and indications
Nursing Implications
Hypersensitivity. Geriatric: renal elimination decreased;
The precise mechanism(s) by which levetiracetam
dose reduction may be necessary; Renal impairment (dose
exerts its antiepileptic effect is unknown. The
reduction recommended if CCr < or = 80mL/minr.)
antiepileptic activity of levetiracetam was assessed
Common side effects
in a number of animal models of epileptic seizures.
Dizziness, weakness

Interactions with other patient drugs, OTC or herbal

medicines
Reglan: 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.

Nursing Process- Assessment

(Pre-administration assessment)
Assess location, duration, and
characteristics of seizure activity. Assess
patient for CNS adverse effects
throughout therapy. These adverse effects
are categorized as somnolence and fatigue
(asthenia), coordination difficulties
(ataxia, abnormal gait, or incoordination),
and behavioral abnormalities

Lab value alterations caused by medicine

May cause decrease RBC and WBC and abnormal liver
function tests.
Be sure to teach the patient the following about this
medication
Instruct patient to take medication as directed. Take
missed doses as soon as possible unless almost time for
next dose. Do not double doses. Do not discontinue
abruptly; may cause increase in frequency of seizures.
May cause dizziness and somnolence. Caution patient to
avoid driving or activities requiring alertness until response
to medication is known. Do not resume driving until
physician gives clearance based on control of seizure
disorder. Instruct patient to notify health care professional
of medication regimen prior to 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
Check after giving
med?
Decrease in the frequency of
Abrupt discontinuation of this
or cessation of seizures.
medication may increase the
frequency of seizure activity.

Generic
Name
Folic acid
Peak
1 hour

Trade Name
Folate
Onset

Classification
Water soluable
vitamins
Duration
Unknown

Dose
1mg

Route
Po

Time/frequency
QD

Normal dosage range

0.4-1 mg per day

30-60 min
Why is your patient getting this medication
Anemia

For IV meds, compatibility with IV drips and/or solutions

N/A

Mechanism of action and indications

Required for protein syntheses and red blood cell
function, stimulates the production of RBCs.
Indicated for the prevention and treatment of
megaloblastic and macrocytic anemias.

Nursing Implications (what to focus on)

Contraindications/warnings/interactions
Uncorrected aplastic, or normocytic anemias.

Interactions with other patient drugs, OTC or

herbal medicines
No significant findings

Nursing Process- Assessment

(Pre-administration assessment)
Assess pt for signs of megoblastic
anemia (fatigue, weakness, dyspnea)
before and periodically throughout
therapy.

Common side effects

Rashes, irritability, difficulty sleeping, malaise, confusion,
fever

Lab value alterations caused by medicine

Monitor plasma folic acid levels, hemoglobin, hematocrit
and feticuloccyte count vefore and periodically during
therapy.
Be sure to teach the patient the following about this
medication
Encourage pt to comply with diet and exercise. Foods high in
folic acid include vegetables, fruits, and organ meats; heat
destroys folic acid in foods. Patients self-medicatinwith
vitamin supplements should be cautioned not to exceed
RDA. Folic acid may make urine more intensely yellow.
Notify health care provider if rash occurs.
Assessment
Evaluation
Why would you hold or not give this
Check after giving
med?
Resolution of symptoms of
if a rash occurs
megaloblastic anemia

Generic Name
pantoprazole

Trade Name
Protonix

Peak
Unknown

Onset
2.5 hrs

Classification
Dose
Route
Time/frequency
antiulcer agents,
40 mg
IVPB
daily
gastric acid pump
inhibitors
Duration
Normal dosage range
1 wk
40 mg once to twice daily, up to 120 mg twice daily.

Why is your patient getting this medication

Heartburn

For IV meds, compatibility with IV drips and/or solutions

Yes

Mechanism of action and indications

Nursing Implications (what to focus on)

Contraindications/warnings/interactions
Binds to an enzyme in the presence of acidic gastric Hypersensitivity, do not break chew or crush tablets.
pH, preventing the final transport of hydrogen ions
Common side effects
into the gastric lumen.
No common or life threatening side effects
Diminished accumulation of acid in the gastric
lumen, with lessened acid reflux, Healing of
duodenal ulcers and esophagitis, Decreased acid
secretion in hypersecretory conditions.
Interactions with other patient drugs, OTC or herbal Lab value alterations caused by medicine
medicines
May cause abnormal liver function tests, including AST,
None known for this patient.
ALT, alkaline phosphatase, and bilirubin.
Be sure to teach the patient the following about this
medication
Instruct patient to take medication as directed for the full
course of therapy, even if feeling better, Advise patient to
avoid alcohol, products containing aspirin or NSAIDs, and
foods that may cause an increase in GI irritation, Advise
patient to report onset of black, tarry stools; diarrhea; or
abdominal pain to health care professional promptly.
Nursing Process- Assessment
(Pre-administration assessment)
Assess patient routinely for epigastric or
abdominal pain and for frank or occult
blood in stool, emesis, or gastric aspirate.

Assessment
Why would you hold or not give this
med?
Hypersensitivity, signs of gastric
bleeding.

Evaluation
Check after giving
Healing in patients with
erosive esophagitis. Therapy
is continued for up to 8 wks.

Generic Name
Vitamin B1
Thiamine
Peak
Unknown

Trade Name
Onset
2.5 hrs

Classification
Dose
Route
Time/frequency
Water soluble
100 mg
PO
daily
vitamin
Duration
Normal dosage range
24 hours
100mg QD, 500mg-1000mg IM QW-QM

Why is your patient getting this medication

Alcohol abuse
Thiamine is required by our bodies to properly use
carbohydrates.

For IV meds, compatibility with IV drips and/or solutions

Yes

Mechanism of action and indications

Thiamine is released by the action of phosphatase
and pyrophosphatase in the upper small intestine.
At low concentrations, the process is carriermediated, and, at higher concentrations, absorption
occurs via passive diffusion. Active transport is
greatest in the jejunum and ileum

Nursing Implications (what to focus on)

Contraindications/warnings/interactions
Hypersensitivity
Common side effects
No common or life threatening side effects

Interactions with other patient drugs, OTC or herbal Lab value alterations caused by medicine
medicines
May cause variation liver function tests (improvement)
None known.
Increase in blood serum level
Be sure to teach the patient the following about this
medication
Instruct patient to take medication as directed
Nursing Process- Assessment
.

Assessment
Why would you hold or not give this
med?
Hypersensitivity

Evaluation