Clinical Medications Worksheets

Generic Name Trade Name Classification Dose Route Time/frequency

gabapentin Neurontin analgesic adjuncts, anticonvulsants 900 mg PO tid
Peak Onset Duration Normal dosage range
2-4 hr rapid 8 hr 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.
Why is your patient getting this medication. For IV meds, compatibility with IV drips and/or solutions
Partial seizures with and without secondary generalization N/A
(adjunct treatment). Neuropathy.
Mechanism of action and indications Nursing Implications (what to focus on)
(Why med ordered) Contraindications/warnings/interactions
Gabapentin interacts with cortical neurons at auxillary subunits Hypersensitivity. Geriatric patients (because of age-related ↓ in renal
of voltage-sensitive calcium channels. Gabapentin increases function).
the synaptic concentration of GABA, enhances GABA
Common side effects
responses at non-synaptic sites in neuronal tissues, and reduces
Confusion, depression, drowsiness, ataxia.
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 Lab value alterations caused by medicine
medicines (ask patient specifically) May cause false-positive readings when testing for urinary protein with
Seroquel: Central nervous system- and/or respiratory- Ames N-Multistix SG dipstick test; use sulfosalicylic acid precipitation
depressant effects may be additively or synergistically procedure. May cause leucopenia.
increased in patients taking multiple drugs that cause these Be sure to teach the patient the following about this medication
effects, especially in elderly or debilitated patients. Instruct patient to take medication exactly as directed. Take missed
Reglan: Central nervous system- and/or respiratory-depressant doses as soon as possible; if less than 2 hr until next dose, take dose
effects may be additively or synergistically increased in immediately and take next dose 1-2 hr later, then resume regular
patients taking multiple drugs that cause these effects, dosing schedule. Do not double doses. Advise patient not to take
especially in elderly or debilitated patients. 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.
Nursing Process- Assessment Assessment Evaluation
(Pre-administration assessment) Why would you hold or not give this med? Check after giving
Assess location, duration, and characteristics of Before surgery. Symptoms of overdose Decreased incidence of seizures.
seizure activity. Assess location, characteristics, include ataxia, labored breathing, ptosis,
and intensity of pain periodically during therapy. sedation, hypoactivity, and excitation.