DRUG DATA CLASSIFICATION MECHANISM OF INDICATIONS CONTRAINDICATIONS SIDE EFFECT/ NURSING RESPONSIBILITIES

ACTION ADVERSE
REACTIONS
GENERIC NAME: PHARMACOLOGIC: Increases level of gamma- GENERAL CONTRAINDICA- BEFORE:
Valproic Acid Carboxylic acid aminobutyric acid in brain, INDICATIONS: TIONS: CNS: confusion, 1. Take vital signs prior to
derivative reducing seizure activity - Complex partial - Hypersensitivity to dizziness, administration.
seizures drug or tartazine (some headache, 2. Confirm medication on medication
TRADE NAME: - Simple or products) sedation, ataxia, ticket, medication sheet, and doctor’s
Aleptiz, Depacon, THERAPEUTIC: PHARMACOKINETICS: complex absence - Hepatic impairment paresthesia, orders.
Depakene, Epival, Anticonvulsant, mood A: Rapid absorption from seizures - Urea cycle disorders asthenia, tremor, 3. Physical: Weight; skin color,
Depkote, Depakote ER stabilizer, antimigraine gastrointestinal tract. - Mania associated - Pregnanacy drowsiness, lesions; orientation, affect, reflexes;
agent M: metabolized almost with bipolar emotional bowel sounds, normal output; CBC
entirely by the liver disorder PRECAUTIONS: liability, and differential, bleeding time tests,
PATIENT’S DOSE: E: Less than 3% of an - To prevent Use cautiously in: abnormal LFTs, serum ammonia level, exocrine
PREGNANCY administered dose is migraine - bleeding disorders, thinking, pancreatic function tests, EEG
CATEGORY: excreted unchanged in urine organic brain disease, amnesia 4. History: Hypersensitivity to
D Half-life: 9-16 hours bone marrow EENT: valproic acid; hepatic impairment;
MINIMUM DOSE: Protein binding: 90% depression, renal amblyopia, pregnancy, lactation
250 mg/day protein bound PATIENT’S impairment blurred vision, 5. Perform handwashing prior to
ACTUAL - posttraumatic seizures nystagmus, administration.
ROUTE: PO (capsules) INDICATIONS: caused by head injury tinnitus,
MAXIMUM DOSE: ONSET: Rapid (use not recommended) pharyngitis DURING:
1 g/day PEAK: 1-4 hours - history of hepatic GI: Nausea, 1. Give drug with food if GI upset
DURATION: 6-24 hours disease vomiting, occurs
- breastfeeding patients diarrhea, 2. Greet pt. and SO, verify client
CONTENTS: ROUTE: PO (syrup) - children abdominal pain, identity (verbal, pt. tags, bed
dipropylacetic acid, ONSET: Rapid dyspepsia, number). Assess baseline v/s
corn oil, FD&C PEAK: 15-120 hours DRUG anorexia, 3. Don’t give syrup in carbonated
Yellow No. 6, gelatin, DURATION: 6-24 hours INTERACTIONS: pancreatitis beverages (may cause mouth and
glycerin, iron oxide, Hematologic: throat irritation)
methylparaben, ROUTE: PO (delayed, DRUG TO DRUG leucopenia, 4. Give IV only when oral therapy
propylparaben, and extended) - Activated charcoal, thrombocytopen isn’t feasible.
titanium dioxide. ONSET: Unknown cholestyramine: ia 5. For IV use, dilute valproate sodium
PEAK: Unknown decreased valproate Hepatic: in at least 50 ml of dextrose 5% in
AVAILABILITY & DURATION: Unknown absorption hepatotoxicity water, lactated Ringer’s solution, or
COLOR: - Antiplatelet agents Musculoskeletal normal saline solution. Infuse over 1
Capsules (liquid- ROUTE: I.V. (including abciximab, : back pain hour at a rate slower than 20
filled): 250 mg ONSET: Rapid aspirin and other Respiratory: mg/minute.
Injection: 100 mg/ml PEAK: End of 1 hour nonsteroidal anti- dyspnea
in 5-ml vial infusion inflammatory drugs, Skin: rash, AFTER:
Syrup: 25o mg/5 ml DURATION: Unknown eptifibatide, tirofiban), alopecia, 1. Closely monitor neurologic status.
Capsules (containing cefamandole, brusing Watch for seizures.
coated particles or cefoperazone, cefotetan, Other: abnormal 2. Evaluate GI status. Stay alert for
sprinkles): 125 mg heparin, thrombolytics, taste, increased signs and symptoms of pancreatitis.
Tablets (enteric- THERAPEUTIC warfarin: increased risk appetite, weoght 3. Advise patient to immediately
coated, delayed- LEVELS: of bleeding gain, flulike report malaise, weakness, lethargy,
release): 125 mg, 250 50 – 200 mcg/ml - Barbiturates, symptoms, appetite loss, vomiting or yellowing
mg, 500 mg primidone: decreased infection, of skin or eyes
Tablets (extended- metabolism and greater infusion site 4. DOCUMENT hour, amount,
release): 250 mg, 500 risk of toxicity of these pain and medication and drug reaction (if any)
mg drugs, decreased reaction 5. Caution patient not to stop therapy
valproate efficacy abruptly.
ROUTE/S OF - Carbamazepine:
ADMINISTRATION increased
: P. O., I.V. carbamazepine blood
level, decreased
valproate blood level,
poor seizure control
- Chlorpromazine:
decreased valproate
clearance and increased
trough level
- Cimetidine: decreased
valproate clearance
- Clonazepam: absence
seizures in patients with
history of these seizures
- CNS depressants
(such as antihistamines
and antidepressants,
MAO inhibitors, opioid
analgesics, sedative-
hypnotics): additive
CNS depression
- Diazepam:
displacement of
diazepam from binding
site, inhibited diazepam
metabolism
- Erythromycin,
felbamate: increased
valproate blood level,
greater risk of toxicity
- Ethosuximide:
inhibited ethosuximide
metabolism
- Lamotrigine:
decreased valproate
blood level, increased
lamotrigine blood level
- Phenytoin: increased
phenytoin effects and
risk of toxicity,
decreased valproate
effects
- Salicylates (large
doses in children):
increased valproate
effects
- Tricyclic
antidepressants:
increased blood levels
of these drugs, greater
risk of adverse reactions
- Zidovudine: decreased
zidovudine clearance in
patients with human
immunodeficiency virus

FOOD TO DRUG
- None
Source: Schull, P. D. Source: Schull, P. D. Source: Schull, P. D. (2010). Source: Schull, P. Source: Schull, P. D. Source: Source: Schull, P. D. (2010).
(2010). Nursing (2010). Nursing Nursing Spectrum Drug D. (2010). Nursing (2010). Nursing Schull, P. Nursing Spectrum Drug Handbook.
Spectrum Drug Spectrum Drug Handbook. New York, NY: Spectrum Drug Spectrum Drug D. (2010). New York, NY: McGraw Hill. (pp
Handbook. New Handbook. New York, McGraw Hill. (pp 1216- Handbook. New Handbook. New York, Nursing 1216-1219)
York, NY: McGraw NY: McGraw Hill. (pp 1219) York, NY: McGraw NY: McGraw Hill. (pp Spectrum
Hill. (pp 1216-1219) 1216-1219) Hill. (pp 1216- 1216-1219) Drug
http://www.drugbank.ca/dru 1219) Handbook.
gs/DB00313 New York,
NY:
McGraw
Hill. (pp
1216-1219)