Clinical Medications Worksheets
Generic Name Trade Name Classification Dose Route Time/frequency
levetiracetam Keppra Anticonvulsants, pyrrolidines 500 mg PO Q 12 hrs
Peak Onset Duration Normal dosage range
1-1.5 hr rapid 12 hr 500mg twice daily initially; may be increased by 1000 mg/day at 2 wk
intervals up to 3000 mg/day
Why is your patient getting this medication For IV meds, compatibility with IV drips and/or solutions
Seizure disorder N/A
Mechanism of action and indications Nursing Implications (what to focus on)
(Why med ordered) Contraindications/warnings/interactions
The precise mechanism(s) by which levetiracetam exerts its Hypersensitivity. Geriatric: renal elimination decreased; dose
antiepileptic effect is unknown. The antiepileptic activity of reduction may be necessary; Renal impairment (dose reduction
levetiracetam was assessed in a number of animal models of recommended if CCr < or = 80mL/minr.)
epileptic seizures. Levetiracetam did not inhibit single seizures Common side effects
induced by maximal stimulation with electrical current or Dizziness, weakness
different chemoconvulsants and showed only minimal activity
in submaximal stimulation and in threshold tests. Protection
was observed, however, against secondarily generalized
activity from focal seizures induced by pilocarpine and kainic
acid, two chemoconvulsants that induce seizures that mimic
some features of human complex partial seizures with
secondary generalization. Levetiracetam also displayed
inhibitory properties in the kindling model in rats, another
model of human complex partial seizures, both during kindling
development and in the fully kindled state. The predictive
value of these animal models for specific types of human
epilepsy is uncertain.
Interactions with other patient drugs, OTC or herbal Lab value alterations caused by medicine
medicines (ask patient specifically) May cause decrease RBC and WBC and abnormal liver function tests.
Reglan: Central nervous system- and/or respiratory-depressant
effects may be additively or synergistically increased in Be sure to teach the patient the following about this medication
patients taking multiple drugs that cause these effects, Instruct patient to take medication as directed. Take missed doses as
especially in elderly or debilitated patients. soon as possible unless almost time for next dose. Do not double
doses. Do not discontinue abruptly; may cause increase in frequency
of seizures. May cause dizziness and somnolence. Caution patient to
avoid driving or activities requiring alertness until response to
medication is known. Do not resume driving until physician gives
clearance based on control of seizure disorder. Instruct patient to
notify health care professional of medication regimen prior to
treatment or surgery. Advise patient to carry identification describing
disease process and medication regimen at all times.
Nursing Process- Assessment Assessment Evaluation
(Pre-administration assessment) Why would you hold or not give this med? Check after giving
Assess location, duration, and characteristics of Abrupt discontinuation of this medication may Decrease in the frequency of or
seizure activity. Assess patient for CNS adverse increase the frequency of seizure activity. cessation of seizures.
effects throughout therapy. These adverse effects
are categorized as somnolence and fatigue
(asthenia), coordination difficulties (ataxia,
abnormal gait, or incoordination), and behavioral
abnormalities (agitation, hostility, anxiety, apathy,
emotional lability, depersonalization, depression)
and usually occur during the first 4 weeks of
therapy.
