Question

Answer the following question about the Drug Depakote,
classification, FDA-approved uses, and off-label uses (if any). If your medication is controlled, please list the federal, regulations, your state's regulations, and best practices regarding dispensing.
Explain how the drug works and the mechanism of action.
List the most common side effects and any black box warnings.
State the starting dose and how you would taper up and taper off the medication.
State what should be included for patient education.
Call two pharmacies in your area and find out what a 30-day supply would cost without insurance. List the pharmacy and the cost.
List any labs you would need prior to starting this medication and any labs you would need throughout the medication regimen.
List any contraindications.
List pregnancy and breastfeeding precautions.
List any age limitations (such as “not approved in children under 12”).

Answer 1

Depakote or Divalproex sodium

1)a.classification :Antiepileptics or anticonvulsant.its a derivative of valporate sodium which is used for seizures .

b.FDA approved uses: Migraine headache,as a single or adjunctive therapy in case of complex or partial seizures.In treatment of bipolar disorders like mania )

C.off label use:there are some off label use of depakote like treatment of schizophrenia,bipolar depression,alcohol dependence, aggression

d.Depakote is not a controlled drug but it needs a prescription from a medical practitioner for procuring the medicine also the drug falls into the category of X which means it's highly teratogenic which can cause birth defects in fetus .

2.action of drug Divalproex sodium:It is converted to valporic acid once the patient consumes it .valporic acid affects the GABA gamma Amino butyric acid which is a neurotransmitter in the brain.valporic acid increases the concentration of GABA in the brain this causing a coordinated communication between the nerves and thus reducing seizures.

3.common side effects are abdominal pain,low appetite,blurred vision,sudden headache,nausea, thrombocytopenia, vomiting,weight loss or weight gain

Black box warning are : it's highly hepatotoxic.which can be fatal if consumed liver enzymes can be deranged very quickly ,high risk for children below 2 years,pregnancy risk includes neural tube defects and other birth defects in fetus, Pancreatitis

4.Dosage

In mania : recommended is 750 mg daily maximum it can be increased upto 60mg/kg/day

Seizures:15 mg/kg/ day till seizures are settled it can increased ata. Rate of 5mg/kg/day at an interval of one week .maximum dose is 69mg/kg/day

Migraine headache:250 mg BD twice a day

Depakote should not be stopped immediately.ut should be tapered off slowly which will help the brain to cope with less amount of drug .ideally drug dose should be reduced by 20%of the present dose every two weeks to slowly taper off

5)Patient education:while on depakote drug the patient should be educated on the following aspects .

Depakote is highly hepato toxic so a regular lab workup of liver enzymes should be done

It's highly teratogenic so patient should be educated to avoid this drug in case of pregnancy and to take strict birth control measures while on this drug

Drug should not be taken in case of lactation as well

Advise the patient to take plenty of fluid along with the medicine

The medicine should not be crushed or chewed it should be swallowed because it has a extended release capsule which will maintain a therapeutic level in blood

Advise the patient not to stop medication abruptly .

Store in cool and safe place out of reach of children