Patient and caregiver educated on precautions to be exercised while taking Topiramat (Topamax). Topamax can induce extreme dry mouth and diarrhea. Sucking on a sugar free hard candy can help with symptomatic relief of dry mouth. Proper hydration measures and compliance with daily fluid intake recommendations can help with fluid supplementation. Topamax intake can induce some dizziness. Also, Topamax use can result in a side-effect of increased ammonia in the blood, which also contributes to increased nausea, confusion, and dizziness. Patient instructed to avoid activities where loss of consciousness (passing out) could result in serious danger to self or those around you (including swimming, driving a car, climbing in high places, etc.). Patient instructed to talk to his doctor before engaging in such activities.
Sn instructed that Carbamazepine toxicity frequently presents with neurologic, cardiovascular, and anticholinergic symptoms. Patients with mild carbamazepine toxicity or those presenting shortly after the ingestion when absorption remains incomplete may demonstrate drowsiness, nystagmus, and tachycardia. More severe intoxication may manifest as lethargy, seizure, coma, hypotension, or arrhythmia. Signs and symptoms of anticholinergic toxicity are expected. Toxicity may be prolonged due to carbamazepine's delayed and erratic absorption.
SN instructed that a seizure that begins in the occipital cortex may result in flashing lights, while a seizure that affects the motor cortex will result in rhythmic jerking movements of the face, arm, or leg on the side of the body opposite to the involved cortex (Jacksonian seizure). A seizure that begins in the parietal cortex may cause distortion of spatial perception; a seizure that begins in the dominant frontal lobe may cause sudden speech difficulties.
Anticonvulsants should not be discontinued abruptly because of the possibility of increasing seizure frequency; therapy should be withdrawn gradually to minimize the potential of increased seizure frequency, unless safety concerns require a more rapid withdrawal.
SN instructed patient / caregiver what should be done in the event of seizure. Place a pillow or something soft under her head to protect it. Remove and hard objects or furniture that may get in the way and cause injury. Turn her on her side to help avoid aspiration of secretions into the lungs. Never place anything in her mouth or try to restrain her in any way. Notify physician ( MD ) of any seizure activity as well as duration of the seizure. When the seizure has subsided, she may feel disoriented or tired so it’s okay to allow her to rest and sleep. Patient and caregiver verbalized understanding of all teaching.
Sn instructed patient on seizures and precautions for safety at home. replace glass tables or furniture with wood, glass can break and cause injury, leave interior doors open, don't take shower unless someone is in the house and make sure family and friends are aware of your seizures and know what to do to help if you have a seizure. Notify nurse or Physician if seizures occur. If a grand mal seizure occurs go to ED after recovery.
