Mosby's 2014 Nursing Drug Reference (303 page)

• Adult:
PO
10-30 mg tid-qid, max 120 mg/day

• Geriatric:
PO
5 mg daily-bid initially, may increase, max 15 mg qid

• Adult:
PO
15-30 mg tid-qid

• 
Without regard to food

Increase:
oxazepam effects—CNS depressants, alcohol, disulfiram, oral contraceptives

Decrease:
oxazepam effects—oral contraceptives, phenytoin, theophylline, valproic acid

Decrease:
effects of levodopa

Increase:
CNS depression—kava, melatonin, valerian

Increase:
AST, ALT, serum bilirubin

Decrease:
WBC

• 
B/P (lying, standing), pulse; if systolic B/P drops 20 mm Hg, hold product, notify prescriber

 
Mental status: mood, sensorium, affect, sleeping pattern, drowsiness, dizziness,
suicidal thoughts/behaviors

 
Physical dependency, withdrawal symptoms:
headache, nausea, vomiting, muscle pain, weakness, tremors, seizures (long-term use)

• 
Assistance with ambulation during beginning therapy because drowsiness, dizziness occurs

• 
Safety measures, including side rails

• 
Therapeutic response: decreased anxiety, restlessness, insomnia

• 
That product may be taken without regard to food

• 
That medication not to be used for everyday stress or used >4 mo unless di
rected by prescriber; not to take more than prescribed dose because product may be habit forming

• 
To avoid OTC preparations (cough, cold, hay fever) unless approved by prescriber

• 
To avoid driving, activities that require alertness because drowsiness may occur

• 
To avoid alcohol, other psychotropic products unless directed by prescriber

• 
Not to discontinue product abruptly after long-term use

• 
To rise slowly because fainting may occur, especially among geriatric patients

• 
That drowsiness may worsen at beginning of treatment

• 
To notify prescriber if pregnancy is planned or suspected pregnancy (D)

• Adult:
PO
300 mg bid, may be increased by 600 mg/day in divided doses bid at weekly intervals; maintenance 1200 mg/day

• Child 4-16 yr:
PO
8-10 mg/kg/day divided bid; dose determined by weight, increase by 5 mg/kg/day q3days, max doses weight dependent

• Adult:
PO
300 mg bid with reduction in other anticonvulsants; increase OXcarbazepine by 600 mg/day each week over 2-4 wk; withdraw other anticonvulsants over 3-6 wk; max 2400 mg/day

• Adult:
PO
300 mg bid, increase by 300 mg/day q3days to 1200 mg in divided doses bid

• Adult:
PO
CCr <30 ml/min, 150 mg bid, increase slowly

• Adult:
PO
300 mg bid, may increase by ≤600 mg/day

Increase:
CNS depression—alcohol

Decrease:
effects—felodipine, oral contraceptive, carBAMazepine

Decrease:
OXcarbazepine levels—carBAMazepine, PHENobarbital, phenytoin, valproic acid, verapamil

Increase:
anticonvulsant effect—ginkgo

Decrease:
anticonvulsant effect—ginseng, santonica

Decrease:
sodium

• 
Description of seizures: frequency, duration, aura

• 
Hyponatremia: headache, nausea, confusion, usually within the first 3 mo of treatment, but may occur ≤1 yr, if this product is being used with other products that decrease sodium, monitor sodium levels

• 
Electrolyte: sodium; T
₄
; phenytoin (when given together)

 
Serious reactions:
angioedema, anaphylaxis, Stevens-Johnson syndrome

• 
CNS/mental status: mood, sensorium, affect, behavioral changes, confusion,
suicidal thoughts/behaviors;
if mental status changes, notify prescriber

• 
Eye problems: need for ophthalmic exams before, during, after treatment (slit lamp, funduscopy, tonometry)

• 
Pregnancy:
lack of seizure control due to MHD, a metabolite of OXcarbazepine, monitor seizure control

• 
Storage at room temp

• 
Therapeutic response: decreased seizure activity

• 
To avoid driving, other activities that require alertness

• 
To take twice a day at same intervals

• 
Not to discontinue medication quickly after long-term use, seizures may increase

• 
To inform prescriber if hypersensitive to carBAMazepine; multisystem hypersensitivity may occur, to report fever, other allergic symptoms

• 
To avoid use of alcohol while taking product

• 
To use alternative contraception if using hormonal method, to report if pregnancy is planned or suspected pregnancy (C)

• 
To report skin rashes immediately, serious skin reactions can occur