Question

Chapter 18: What are the therapeutic outcomes for antiepileptic medications? What is patient teaching for someone on Dilantin? Chapter 19: When is it appropriate to administer opiate agonist such as morphine? What are serious side effects of opioid agonists and what are appropriate nursing actions?

Answer 1

What are the therapeutic outcomes for antiepileptic medications?

Definition of epilepsy: Epilepsy is a condition where there is abnormal electrical impulse which hinders the active messaging system between brain cells.

Symptoms:

• Convulsions with no temperature
• Person becomes stiff
• Person suddenly falls down
• Sudden bouts of chewing without any apparent reason
• Repetitive movements that seam in-appropriate

Causes:

• Exact cause is unknown
• Head trauma due to accidents
• Brain conditions including strokes and tumours
• Brain injury that occurs at birth
• Developmental disorders like autism

Treatment:

• There is no cure for epilepsy.
• Surgeries can help to some extent.
• Vagus nerve stimulation and special diet also can help control epilepsy.
• Common medications used are
  • Sodium valproate
  • Carbamazepine
  • Iamotigine
  • Levetiracetam

Outcome of antiepileptic medications:

• Increased understanding of the disease by patients, caregivers, relatives and society.
• Certain medication is associated with certain type of epilepsy.So the right diagnosis is required.
• New antiepileptic drugs increase the possibility of effective treatment who had failed theraphy initially.
• Anti-epileptic drugs decreases the frequency and severity of seizures in people with epilepsy.
• It maximizes the quality of life by diminishing seizure frequencies while reducing adverse drug effects.

What is patient teaching for someone on Dilatin?

Brand Name: Dilatin

Generic Name: Phenytoin

Dilatins is an anti-epileptic drug. It works by slowing impulse in the brain that causes seizures.

Indications: All sort of epilepsy except abscence seizure.

Patient Teaching:

• Advice patient to seek immediate medical attention in case of serious drug reaction that can affect many body parts. Symptoms may include: Skin rashes, fever, muscle aches, yellowing of the skin etc.
• Take the medication after food or along with food.
• Advice patient and care takers to recognize signs of blood and skin disorders.
• Avoid sudden withdrawal of medicine.
• Do not change from one form of Dilatin to another form without consulting your doctor.
• If a dose is missed, advice the patient to take the missed dose as soon as possible.But remember that in a day more than 2 doses should not be taken.
• Avoid alcohol consumption during intake of this medication.

When is it appropriate to administer opiate agonist such as morphine?

Morphine is given to a patient as a treatment for moderate to severe pain.It has a strong analgesic effect. It can also be used as a pre-operative medication and as a analgesic adjunct to general anesthesia.

What are serious side effects of opioid agonists and what are appropriate nursing actions?

Side effects:

• Respiratory Depression
• Stupor
• Renal Failure
• Absent or hypoactive bowel sounds
• Hypothermia
• Blurred vision
• Adrenal insufficiency
• Constipation
• Dizziness
• Confusion

Nursing Action:

• Instruct patient on how and when to ask for pain medications
• Advise patient to change position slowly in case of orthostatic hypotension
• Avoid alcohol during intake of opiod drug
• Encourage patient who are immobilized for long time to change thier position.
• Teach the importance of prevention of constipation when taking opiods.