Drowsiness monitoring

This drug may cause dizziness or drowsiness Monitoring Parameters... 

AMANTADINE The nurse should monitor the patient for the occurrence of drowsiness, dizziness, light-headedness, or mood changes (irritability or mood change). 

Monitoring and Managing Adverse Reactions Drowsiness is a common adverse reaction of the anticonvulsant drug , especially early in therapy Therefore, the nurse should assist the patient with all ambulatory activities. The nurse helps tire patient to arise from the bed slowly and sit for a few minutes before standing. Drowsiness decreases with continued use ... 

The patient is monitored for adverse reactions. The sedation and drowsiness that sometimes occur with the use of an antianxiety drug may decrease as therapy continues. Prolonged tiierapy (> 3-4 months) may lead to dependence. 

The study will commence with the administration of low doses, as judged from the non-clinical data. As the study progresses - and provided that there are no indications that it is unsafe to do so - the dosage levels may be increased past the anticipated therapeutic range. Subjects are closely monitored for changes in vital signs (blood pressure, heart rate, body temperature, etc.) and the emergence of any adverse side effects (nausea, drowsiness, pain, headache, irritability, hair loss, etc.). 

In patients taking NSAIDs, monitor for increases in blood pressure, weight gain, edema, skin rash, and central nervous system adverse effects such as headaches and drowsiness. 

Patients should be asked if they are having adverse effects from their medications. They should also be monitored for any signs of drug-related effects, such as skin rash, headaches, drowsiness, weight gain, or hypertension from NSAIDs. 

The dose of gabapentin should be started at 600-900 mg/day in two or three doses per day. The usual effective dose is 900-4800 mg/day. Laboratory monitoring is not needed when prescribing gabapentin. It is well tolerated with the most common side effects being drowsiness and headache. 

Of the mood stabilizers, valproic acid (Depakene, Depakote) is the most widely used. Like the other mood stabilizers, its onset of action can be delayed by several days. Valproic acid is a reasonably well tolerated mood stabilizer. It does occasionally cause tremor, and it can on rare occasion lower platelet counts or cause liver problems. For this reason, blood monitoring is required when starting this medication. In addition, valproic acid can irritate the stomach lining, but this problem is largely overcome by using the buffered form sodium divalproex (Depakote or Depakote ER). Finally, valproic acid can also cause hair loss or drowsiness. 

EMS Monitor for i HR resp OD Drowsiness, confusion, coma, labored breathing, hypotension, bradycardia, slurred speech, impaired coordination support BP and resp until drug wears off (1/2-life about 12 h) flumazenil may be used to reverse resp depression... 

Buspirone (BuSpar) [Anxiolytic] WARNING Closely monitor for worsening depression or emergence of suicidality Uses Short-term relief of anxiety Action Antianxiety antagonizes CNS serotonin receptors Dose Initial 7.5 mg PO bid T by 5 mg q2-3d to effect usual 20-30 mg/d max 60 mg/d Contra w/ MAOI Caution [B, /-] Avoid w/ severe hepatic/renal insuff Disp Tabs SE Drowsiness, dizziness, HA, N, EPS, serotonin synd, hostility, depression Notes No abuse potential or physical/psychologic d endence Interactions T Effects W/ erythromycin, clarithromycin, itraconazole, ketoconazole, diltiazem, verapamil, grapefruit juice effects W/ carbamazepine, rifampin, phenytoin, dexamethasone, phenobarbital, fluoxetine EMS T Sedation w/ concurrent EtOH use grapefruit juice may T risk of adverse effects OD May cause dizziness, miosis, N/V symptomatic and supportive... 

Diphenoxylate + Atropine (Lomotil, Lonox) [C V] [Opioid Antidiarrheal] Uses D Action Constipating m CTidine congener, X GI motihty Dose Adults. Initial, 5 mg PO tid—qid until controlled, then 2.5-5 mg PO bid 20 mg/d max Peds >2 y. 0.3-0.4 mg/kg/24 h (of diphenoxylate) bid-qid, 10 mg/d max Caution [C, +] Contra Obstructive jaundice, D d/t bacterial Infxn children <2 y Disp Tabs, Liq SE Drowsiness, dizziness, xCTostomia, blurred vision, urinary retention, constipation Interactions T Effects W/ CNS depressants, opioids, EtOH, T risk HTN crisis W7 MAOIs EMS Monitor for Sxs of electrolyte disturbances and hypovolemia d/t D OD May cause Szs, hypotension, and anticholinergic effects (xerostomia [dry mouth], urine retention, flushed skin) activated charcoal may be effective for OD... 

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