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Divalproex (Depakote) Nursing Considerations

Divalproex (Depakote) Nursing Considerations

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Outline

Generic Name

Divalproex

Trade Name

Depakote

Indication

Seizures, manic episodes, prevention of headache

Action

Increases the level of GABA (inhibitory neurotransmitter) in CNS

Therapeutic Class

Anticonvulsant, vascular headache suppressants

Pharmacologic Class

None

Nursing Considerations

• May cause suicidal thoughts, agitation, dizziness, insomnia, hepatotoxicity,
pancreatitis
• Increases risk for bleeding with Warfarin
• Use caution with MAOIs
• Monitor liver function tests

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Transcript

Okay, let’s talk about Divalproex, also known as Depakote. This is an oral medication, as you can see here from the packaging, but it also comes in an IV form. So remember when we talk about the therapeutic class, we are talking about how the drug works in the body while the pharmacologic class is the chemical effect. In this case, Divalproex does not have a pharmacologic class while the therapeutic class of Divalproex is an anticonvulsant and vascular headache suppressant. So Divalproex works by increasing the level of GABA in the central nervous system and is indicated for the treatment of seizures, manic episodes, and the prevention of headaches as low levels of GABA are said to be linked to epilepsy, anxiety, chronic pain and mood disorders. So this all makes sense.
Some of the side effects that we see with Divalproex are agitation, dizziness, and insomnia. Some nursing considerations with Divalproex. Monitor liver function tests in your patients, be aware that this medication can cause suicidal thoughts, hepatotoxicity, and pancreatitis. There is an increased risk of bleeding if the patient is also on warfarin. Use caution if your patient is also on MAOIs. Teach the patient to report immediately any thoughts and feelings of suicide to the provider. And guys serum drug level monitoring of seizure medications. Like this one is super important. There are often wide ranges stated in literature, but some patients may require less than that while other patients require more. So do not be surprised if there is a variation in the amount of medication needed for seizure control in your patient. That’s it for Divalproex or Depakote. Now go out and be your best self today. And as always happy nursing.

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My Study Plan

Concepts Covered:

Study Plan Lessons

Pharmacology Course Introduction

12 Points to Answering Pharmacology Questions

54 Common Medication Prefixes and Suffixes

Therapeutic Drug Levels (Digoxin, Lithium, Theophylline, Phenytoin)

Essential NCLEX Meds by Class

6 Rights of Medication Administration

Pharmacodynamics

Pharmacokinetics

The SOCK Method – Overview

The SOCK Method – S

The SOCK Method – O

The SOCK Method – C

The SOCK Method – K

Basics of Calculations

Dimensional Analysis Nursing (Dosage Calculations/Med Math)

Oral Medications

Injectable Medications

IV Infusions (Solutions)

Complex Calculations (Dosage Calculations/Med Math)

Disease Specific Medications

Antianxiety Meds

Benzodiazepines

Alprazolam (Xanax) Nursing Considerations

Lorazepam (Ativan) Nursing Considerations

Midazolam (Versed) Nursing Considerations

Diazepam (Valium) Nursing Considerations

Buspirone (Buspar) Nursing Considerations

Amiodarone (Pacerone) Nursing Considerations

Adenosine (Adenocard) Nursing Considerations

Procainamide (Pronestyl) Nursing Considerations

Clopidogrel (Plavix) Nursing Considerations

Warfarin (Coumadin) Nursing Considerations

Enoxaparin (Lovenox) Nursing Considerations

Heparin (Hep-Lock) Nursing Considerations

Alteplase (tPA, Activase) Nursing Considerations

Streptokinase (Streptase) Nursing Considerations

Carbamazepine (Tegretol) Nursing Considerations

Divalproex (Depakote) Nursing Considerations

Gabapentin (Neurontin) Nursing Considerations

Lamotrigine (Lamictal) Nursing Considerations

Levetiracetam (Keppra) Nursing Considerations

Phenytoin (Dilantin) Nursing Considerations

Antidepressants

Bupropion (Wellbutrin) Nursing Considerations

Selegiline (Eldepyrl) Nursing Considerations

Escitalopram (Lexapro) Nursing Considerations

Fluoxetine (Prozac) Nursing Considerations

Paroxetine (Paxil) Nursing Considerations

Sertraline (Zoloft) Nursing Considerations

Glipizide (Glucotrol) Nursing Considerations

Metformin (Glucophage) Nursing Considerations

Insulin – Rapid Acting (Novolog, Humalog) Nursing Considerations

Insulin – Short Acting (Regular) Nursing Considerations

Insulin – Intermediate Acting (NPH) Nursing Considerations

Insulin – Mixtures (70/30)

Insulin – Long Acting (Lantus) Nursing Considerations

Histamine 1 Receptor Blockers

Diphenhydramine (Benadryl) Nursing Considerations

Promethazine (Phenergan) Nursing Considerations

Histamine 2 Receptor Blockers

Cimetidine (Tagamet) Nursing Considerations

Famotidine (Pepcid) Nursing Considerations

Ranitidine (Zantac) Nursing Considerations

Renin Angiotensin Aldosterone System

Atenolol (Tenormin) Nursing Considerations

Metoprolol (Toprol XL) Nursing Considerations

Propranolol (Inderal) Nursing Considerations

ACE (angiotensin-converting enzyme) Inhibitors

Captopril (Capoten) Nursing Considerations

Enalapril (Vasotec) Nursing Considerations

Lisinopril (Prinivil) Nursing Considerations

Angiotensin Receptor Blockers

Losartan (Cozaar) Nursing Considerations

Calcium Channel Blockers

Amlodipine (Norvasc) Nursing Considerations

Diltiazem (Cardizem) Nursing Considerations

Nifedipine (Procardia) Nursing Considerations

Verapamil (Calan) Nursing Considerations

Cardiac Glycosides

Digoxin (Lanoxin) Nursing Considerations

Gentamicin (Garamycin) Nursing Considerations

Metronidazole (Flagyl) Nursing Considerations

Nystatin (Mycostatin) Nursing Considerations

Isoniazid (Niazid) Nursing Considerations

Rifampin (Rifadin) Nursing Considerations

Acyclovir (Zovirax) Nursing Considerations

Meropenem (Merrem) Nursing Considerations

Ciprofloxacin (Cipro) Nursing Considerations

Levofloxacin (Levaquin) Nursing Considerations

Vancomycin (Vancocin) Nursing Considerations

Clindamycin (Cleocin) Nursing Considerations

Erythromycin (Erythrocin) Nursing Considerations

Azithromycin (Zithromax) Nursing Considerations

Anti-Infective – Penicillins and Cephalosporins

Amoxicillin (Amoxil) Nursing Considerations

Ampicillin (Omnipen) Nursing Considerations

Cefaclor (Ceclor) Nursing Considerations

Cefdinir (Omnicef) Nursing Considerations

Cephalexin (Keflex) Nursing Considerations

Trimethoprim-Sulfamethoxazole (Bactrim) Nursing Considerations

Tetracycline (Panmycin) Nursing Considerations

Atypical Antipsychotics

Chlorpromazine (Thorazine) Nursing Considerations

Haloperidol (Haldol) Nursing Considerations

Quetiapine (Seroquel) Nursing Considerations

Olanzapine (Zyprexa) Nursing Considerations

Autonomic Nervous System (ANS)

Methylphenidate (Concerta) Nursing Considerations

Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)

Dobutamine (Dobutrex) Nursing Considerations

Dopamine (Inotropin) Nursing Considerations

Carbidopa-Levodopa (Sinemet) Nursing Considerations

Parasympathomimetics (Cholinergics) Nursing Considerations

Neostigmine (Prostigmin) Nursing Considerations

Parasympatholytics (Anticholinergics) Nursing Considerations

Atropine (Atropen) Nursing Considerations

Benztropine (Cogentin) Nursing Considerations

Diphenoxylate-Atropine (Lomotil) Nursing Considerations

Guaifenesin (Mucinex) Nursing Considerations

Albuterol (Ventolin) Nursing Considerations

Montelukast (Singulair) Nursing Considerations

Salmeterol (Serevent) Nursing Considerations

Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)

Furosemide (Lasix) Nursing Considerations

Hydrochlorothiazide (Hydrodiuril) Nursing Considerations

Spironolactone (Aldactone) Nursing Considerations

Mannitol (Osmitrol) Nursing Considerations

Bisacodyl (Dulcolax) Nursing Considerations

Bismuth Subsalicylate (Pepto-Bismol) Nursing Considerations

Lactulose (Generlac) Nursing Considerations

Loperamide (Imodium) Nursing Considerations

Metoclopramide (Reglan) Nursing Considerations

Ondansetron (Zofran) Nursing Considerations

Pancrelipase (Pancreaze) Nursing Considerations

Sucralfate (Carafate) Nursing Considerations

Proton Pump Inhibitors

Omeprazole (Prilosec) Nursing Considerations

Pantoprazole (Protonix) Nursing Considerations

Epoetin (Epogen) Nursing Considerations

Glucagon (GlucaGen) Nursing Considerations

Iodine Nursing Considerations

Levothyroxine (Synthroid)

Propylthiouracil (PTU) Nursing Considerations

Cyclosporine (Sandimmune) Nursing Considerations

HMG-CoA Reductase Inhibitors (Statins)

Atorvastatin (Lipitor) Nursing Considerations

Magnesium Sulfate

Magnesium Sulfate in Pregnancy

Magnesium Sulfate (MgSO4) Nursing Considerations

Calcium Acetate (PhosLo) Nursing Considerations

Calcium Carbonate (Tums) Nursing Considerations

Ferrous Sulfate (Iron) Nursing Considerations

Alendronate (Fosamax) Nursing Considerations

Mood Stabilizers

Lithium (Lithonate) Nursing Considerations

Acetaminophen (Tylenol) Nursing Considerations

Phenazopyridine (Pyridium) Nursing Considerations

ASA (Aspirin) Nursing Considerations

Celecoxib (Celebrex) Nursing Considerations

Ibuprofen (Motrin) Nursing Considerations

Indomethacin (Indocin) Nursing Considerations

Ketorolac (Toradol) Nursing Considerations

Naproxen (Aleve) Nursing Considerations

Terbutaline (Brethine) Nursing Considerations

Uterine Stimulants (Oxytocin, Pitocin) Nursing Considerations

Meds for Postpartum Hemorrhage (PPH)

Methylergonovine (Methergine) Nursing Considerations

Oxytocin (Pitocin) Nursing Considerations

Prostaglandins in Pregnancy

Rh Immune Globulin in Pregnancy

Lung Surfactant for Newborns

Eye Prophylaxis for Newborn

Phytonadione (Vitamin K) for Newborn

Hepatitis B Vaccine for Newborns

Opioid Analgesics in Pregnancy

Butorphanol (Stadol) Nursing Considerations

Codeine (Paveral) Nursing Considerations

Fentanyl (Duragesic) Nursing Considerations

Hydrocodone-Acetaminophen (Vicodin, Lortab) Nursing Considerations

Hydromorphone (Dilaudid) Nursing Considerations

Meperidine (Demerol) Nursing Considerations

Methadone (Methadose) Nursing Considerations

Morphine (MS Contin) Nursing Considerations

Nalbuphine (Nubain) Nursing Considerations

Oxycodone (OxyContin) Nursing Considerations

Sedatives-Hypnotics

Phenobarbital (Luminal) Nursing Considerations

Pentobarbital (Nembutal) Nursing Considerations

Propofol (Diprivan) Nursing Considerations

Lidocaine (Xylocaine) Nursing Considerations

Corticosteroids

Betamethasone and Dexamethasone in Pregnancy

Cortisone (Cortone) Nursing Considerations

Dexamethasone (Decadron) Nursing Considerations

Fluticasone (Flonase) Nursing Considerations

Methylprednisolone (Solu-Medrol) Nursing Considerations

Hydralazine (Apresoline) Nursing Considerations

Nitro Compounds

Nitroglycerin (Nitrostat) Nursing Considerations

Nitroprusside (Nitropress) Nursing Considerations

Epinephrine (EpiPen) Nursing Considerations

Norepinephrine (Levophed) Nursing Considerations

Vasopressin (Pitressin) Nursing Considerations