Question

Search for Depakote information: Generic Name, Brand Name, Type of drug, Pregnancy Category, Therapeutic action, . Indications, Contraindications,. Dose / Adult and Pediatric, Adverse effects, Interactions, Nursing considerations in implementation and Patient Education

Answer 1

DEPAKOTE

1.GENERIC NAME - divalproex sodium

2.BRAND NAME - depakote, depakote ER

3.TYPE OF DRUG - antiepileptic drug

4.PREGNANCY CATEGORY- category D

5.THERAPEUTIC ACTION -
✓depakote dissociates into valproate ions in gastrointestinal system.
✓ valproate ions increase the concentration of GABA ( gama aminobutyric acid ) in the brain, leading to its clinical effects.

6.INDICATIONS -
✓ mania
✓epilepsy ( solo or adjunctive therapy)
✓migraine ( as a prophylactic)
✓ seizures

7.CONTRA INDICATIONS -
✓ patients with hepatic dysfunction
✓hypersensitive reaction to the drug
✓patients suffering from urea cycle disorders
✓ in women of reproductive age group , since it causes neural tube defects in fetus.

8.DOSES -
ADULT -
✓ oral administration
✓mania - maximum recommended dose is 60mg/kg/day
✓ epilepsy - initially 10-15mg/kg/day. Increased to 5-10 mg/kg/week till clinical response is optimum.
✓ migraine - 250 mg twice daily
  
PAEDIATRIC-
✓ must be used as a sole therapy.
✓20-40 mg/kg/day initially. Maximum 60 mg/kg/day.
  
9.ADVERSE EFFECTS- adverse effects on various body systems are
✓ gastrointestinal - nausea,vomiting, indigestion, abdominal cramps
✓nervous system - headache, hallucination, tremor, sedation, confusion, vertigo.
✓skin related - pruritus , rash, hair loss
✓ psychological - depression, mood swings
✓blood - thrombocytopenia, leucopenia , eosinophilia, aplastic anaemia,etc
✓hepatic - abnormal live function tests
✓ generalised muscle weakness
✓ acute pancreatitis
✓other symptoms - bradycardia , hypothermia, edema, anaphylaxis,etc.

10.INTERACTIONS -
✓ aspirin - decreases protein binding if co administered.
✓ felbamate - increase peak concentration of depakote.
✓rifampin - depakote's oral clearance is increased.
✓ diazepam - depakote inhibits it's metabolism.
✓phenobarbital - depakote inhibits it's metabolism
✓ no clinically significant drug interaction - acetaminophen, lithium , lorazepam,etc.

11.NURSING CONSIDERATIONS FOR -

•IMPLEMENTATION-
✓monitor dosing carefully . Overdosing may cause heart block and coma.
✓ extreme caution in paediatric patients.
✓medical history must be thoroughly checked to know any hypersensitivity to the drug.
✓ look for any adverse reactions.

•PATIENT EDUCATION -
✓ swallow the drug, do not chew.
✓ must be warned about possible hepatotoxicity and educated about its symptoms. Ask him to immediately consult a healthcare provider, if such symptoms arise.
✓educate about possibility of increased suicidal thoughts.
✓ educate about all other adverse drug reactions and what should the patient do in that situation.