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A 9-year-old child will be receiving carbamazepine suspension, 200 mg twice daily. The medication is available in a strength of 100 mg/5 mL. Identify how many milliliters the nurse will give to the patient for each dose.
Correct Answer: 10 mL
Rationale: 100 mg : 5 mL :: 200 mg : x mL; (100 * x) = (5 * 200); 100x = 1000; x = 10 mL/dose.
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The nurse is reviewing the dosage schedule for several different antiepileptic drugs (AEDs). Which antiepileptic drug allows for once-a-day dosing?
- A. Levetiracetam
- B. Phenobarbital
- C. Valproic acid
- D. Gabapentin
Correct Answer: B
Rationale: Phenobarbital has the longest half-life of all standard AEDs, including those listed in the other options; therefore, it allows for once-a-day dosing.
A patient is taking gabapentin, and the nurse notes that there is no history of seizures on his medical record. What is the best possible rationale for this medication order?
- A. The medication is used for the treatment of neuropathic pain.
- B. The medication is helpful for the treatment of multiple sclerosis.
- C. The medication is used to reduce the symptoms of Parkinson's disease.
- D. The medical record is missing the correct information about the patient's history of seizures.
Correct Answer: A
Rationale: Gabapentin is commonly used to treat neuropathic pain. The other options are incorrect.
The U.S. Food and Drug Administration has issued a warning for users of antiepileptic drugs. Based on this report, the nurse will monitor for which potential problems with this class of drugs?
- A. Increased risk of suicidal thoughts and behaviors
- B. Signs of bone marrow depression
- C. Indications of drug addiction and dependency
- D. Increased risk of cardiovascular events, such as strokes
Correct Answer: A
Rationale: The U.S. Food and Drug Administration (FDA) has required black box warnings on all antiepileptic drugs regarding the risk of suicidal thoughts and behaviors. Patients being treated with antiepileptic drugs for any indication need to be monitored for the emergence or worsening of depression, suicidal thoughts or behavior, or any unusual changes in mood or behavior. The other options are incorrect.
A patient is experiencing status epilepticus. The nurse prepares to give which drug of choice for the treatment of this condition?
- A. Diazepam
- B. Midazolam
- C. Valproic acid
- D. Carbamazepine
Correct Answer: A
Rationale: Diazepam and lorazepam are considered by many to be the drugs of choice for status epilepticus. Other drugs that are used are listed in Table 14-3 and do not include the drugs listed in the other options.
The nurse is monitoring a patient who has been taking carbamazepine for 2 months. Which effects would indicate that autoinduction has started to occur?
- A. The drug levels for carbamazepine are higher than expected.
- B. The drug levels for carbamazepine are lower than expected.
- C. The patient is experiencing fewer seizures.
- D. The patient is experiencing toxic effects from the drug.
Correct Answer: B
Rationale: With carbamazepine, autoinduction occurs and leads to lower than expected drug concentrations. Therefore, the dosage may have to be adjusted with time. The other options are incorrect.