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NURS 2516 Clinical Medications Worksheets

(You will need to make additional copies of these forms)

Generic Name Trade Name Classification Dose Route Time/frequency


clonazepam Klonopin anticonvulsants 1mg IV 0900, 2100; twice daily
Peak Onset Duration For IV meds, compatibility with IV drips and /or solutions
1-2 hr 20-60 min 6-12 hr N/A

Mechanism of action and indications Nursing Implications (what to focus on)


(Why med ordered) Contraindications/warnings/interactions
Anticonvulsant effects may be due to presynaptic Hypersensitivity to clonazepam or other benzodiazepines
inhibition • Severe liver disease
Produces sedative effects in the CNS, probably by Use Cautiously in:
stimulating inhibitory GABA receptors. Muscle spasms, • Narrow-angle glaucoma
associated anxiety. • Chronic respiratory disease
• History of
porphyria
• Do not discontinue abruptly

Common side effects


Behavioral side effects, drowsiness, ataxia

Interactions with other patient drugs, OTC or herbal Lab value alterations caused by medicine
medicines (ask patient specifically) Patients on prolonged therapy should have CBC and liver
Alcohol, antidepressants , antihistamines , function test results evaluated periodically. May cause an ↑
otherbenzodiazepines, and opioid analgesics --concurrent in serum bilirubin, AST, and ALT
use results in ↑ CNS depression ○ May cause ↓ thyroidal uptake of sodium iodide, 123I,
and 131I

Be sure to teach the patient the following about this


medication
Instruct patient to take medication exactly as directed. Take
missed doses within 1 hr or omit; do not double doses.
Abrupt withdrawal of clonazepam may cause status
epilepticus, tremors, nausea, vomiting, and abdominal and
muscle cramps
• Medication may cause drowsiness or dizziness. Advise
patient to avoid driving or other activities requiring
alertness until response to drug is known
• Caution patient to avoid taking alcohol or other CNS
depressants concurrently with this medication
• Advise patient to notify health care professional of
medication regimen prior to treatment or surgery
• Instruct patient and family to notify health care
professional of unusual tiredness, bleeding, sore throat,
fever, clay-colored stools, yellowing of skin, or
behavioral changes
• Patient on anticonvulsant therapy should carry
identification at all times describing disease process and
medication regimen
• Emphasize the importance of follow-up exams to
determine effectiveness of the medication

Nursing Process- Assessment Assessment Evaluation


(Pre-administration assessment) Why would you hold or not give this Check after giving
• Assess degree and manifestations of med? Decrease in frequency and
anxiety and mental status prior to and Problematic side effects severity of panic attacks
periodically during therapy • Relief of leg movements
• Assess patient for drowsiness, during sleep
unsteadiness, and clumsiness. These • Decrease in pain from
symptoms are dose related and most neuralgia
severe during initial therapy; may
decrease in severity or disappear with
continued or long-term therapy