Nursing Pharmacology - Antiepileptic, Glaucoma, Otitis Externa Medications

all right we're gonna start off this video by talking about some antiepileptic medications so the key one I'm gonna focus on here is phenytoin some other antiepileptic medications that you should know though include carbamazepine as well as valproic acid those two medications we actually already covered in the video where I talked about bipolar medications because those two can be used for both bipolar disorders as well as to prevent seizures another one that I'd be familiar with is lamotrigine so that would also be used to prevent seizures so what's really important to know about phenytoin are some of the key side effects so one key side effect that I would definitely know is gingival hyperplasia so this means the gums are getting like enlarged hyper plays yes they're enlarging so if you see that on a test something about gums and they're saying receding gums that is not correct it should be enlarged gums or hyperplasia other side effects can include diplopia which is double vision the stigmas rash ataxia and hypotension key point another key point so definitely know about the gums and then know that serum phenytoin levels will need to be monitored routinely because it has a very narrow therapeutic range meaning it takes this much to get to a therapeutic level but the toxic level is not too much farther behind right like it's just this much higher so we gotta hit that very narrow range that range is 10 to 20 micrograms per milliliter so that is one lap value I don't recommend memorizing like all the ranges for all medications but for phenytoin I would probably keep that one in the back of your mind 10 to 20 is roughly the range so we're going to have the patient do frequent blood draws to make sure we're staying within that therapeutic range also phenytoin will decrease the effectiveness of oral contraceptives so that's another thing to definitely educate your patient on okay so now we are going to move to some eye and ear type medications so we're going to talk about an anti glaucoma agent which is a topical beta blocker so timolol is the one that I would know we know it's a beta blocker because it ends in that Oh lol right so timolol it is used primarily for open angle glaucoma it's motive action is that it's a non-selective beta blocker it decreases aqueous humor production which in turn decreases inter ocular pressure or IOP so side effects are minimal usually just some temporary stinging of the eye key points in terms of administration you want to make sure you don't touch the applicator to the eye you want after you do the drops you want to hold gentle pressure at the nasolacrimal duct or puncta for about 30 to 60 seconds and if you really overdose on the timolol you could end up with systemic effects of a non-selective beta blocker but as long as you follow directions and put the proper number of drops etc then you shouldn't have those systemic side effects okay so that's timolol let's talk about another anti glaucoma agent which is a carbonic anhydrase inhibitor it's acetazolamide so acetazolamide is not only used to treat glaucoma it can also treat heart failure as well as altitude sickness so the mode of action of acetazolamide is that it causes diuresis and lowers inner ocular pressure by decreasing aqueous humor secretion so side effects could include flu-like symptoms GI upset and then sometimes electrolyte imbalances specifically with sodium and potassium so key points you want to administer this medication with food to minimize GI upset and definitely monitor your patients electrolytes and specifically their well all the electrolytes but in particular definitely monitor their sodium and potassium levels so the way that I remember this one is acetazolamide looks like I see a su a little bit it I know it's a stretch guys but you got to come up with something here I see a zoo it kind of looks like that and the reason why you can see the zoo is because now your glaucoma is fixed because you took a seat Azolla mine okay so hang in there with me some of my tricks are better than others okay we are not gonna talk about mannitol which is also a diuretic that can lower very quickly inner ocular pressure because we're gonna cover mannitol when we talk about all the rest of the diuretics in the cardiovascular unit of of this series okay so let's now talk about ear drops used to treat otitis externa so ear infection so we would use some drops that are called it well the drops are ciprofloxacin with hydrocortisone so the ciprofloxacin is the antibiotic part of that drop and the hydrocortisone is the steroid part of that drop so you would use it for like swimmers ear which is otitis externa key points when you're administering this medication you want to roll the container gently or gently shake if it's in a suspension form position the patient on their unaffected side right so you can treat their affected side and then you want to keep them on their side for about five minutes after you instill the drops you can lightly pack the ear with cotton and be sure to educate the patient or the patient's parents to dry the ear canal after swimming or bathing so we really want to try to keep that ear canal as dry as possible to prevent future infections so I'm gonna stop here thanks so much for watching and we'll pick it up with more med soon thanks

Channel: Level Up RN

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Keywords: Ati, Ati testing, Atitesting, Nclex, Nclex rn, Hesi, Hesi exam, Nursing, Nursing exam, Comprehensive exam, Nursing school, Nursing student, Registered Nurse, RN, Practical Nurse, PN, Cathy Parkes, Cathy Parkes RN, Cathy Parkes videos, nursing pharmacology made easy, nursing pharmacology review, nursing pharmacology lecture, cathy parkes pharmacology, Cathy parks antiepileptic glaucoma otitis externa meds, otitis externa, cathy parks glaucoma, cathy parks otitis externa meds

Id: twCHJKermqY

Length: 6min 37sec (397 seconds)

Published: Wed Jun 26 2019