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clonazepam Nursing Considerations & Management

Drug Name
Generic Name : clonazepam Brand Name: Apo-Clonazepam (CAN), Gen-Clonazepam (CAN), Klonopin, Klonopin Wafers, Nu-Clonazepam (CAN), Rivotril (CAN) Classification: Benzodiazepine, Antiepileptic Pregnancy Category X Controlled Substance C-IV
Dosage & Route
  • Individualize dosage; extension dosage partially to abandon counteractive proceeds; refuse is helpful simply in vocal dosage forms.
Adults
  • Seizure conjectures: Initial dose should not achieve 1.5 mg/day PO disconnected into three doses; extension in increments of 0.5–1 mg PO integral 3 days until spoils are adequately controlled or until verge proceeds hinder elevate extensions. Maximum recommended dosage is 20 mg/day.
  • Panic conjectures: Initial dose 0.25 mg PO bid; partially extension to a target dose of 1 mg/day.
Pediatric Patients> 10 YR OR 30 KG
  • Initially, 0.01–0.03 mg/kg/day PO; do not achieve 0.05 mg/kg/day PO, ardent in two or three doses. Extension dosage by not more than 0.25–0.5 mg integral third day until a daily subsistence dose of 0.1–0.2 mg/kg has been reached, cosmical spoils are controlled by inferior dosage or verge proceeds hinder extensions. Whenever feasible, bisect daily dose into three similar doses, or afford largest dose at bedtime.
Therapeutic actions
  • Clonazepam is an serviceable anticonvulsant. It raises the start for propagation of spoil essence and prevents generalization of focal or topical essence. Clinically, it improves focal epilepsy and generalized spoils. It is so believed to repair the essence of GABA, and acts as anxiolytic.
Indications
  • Used unmatched or as addition in tenor of Lennox-Gastaut syndrome (petit mal contradictory), akinetic and myoclonic spoils; may be profitable in resigneds delay lack (petit mal) spoils who feel not tallyed to succinimides; up to 30% of resigneds parade detriment of serviceableness of refuse, repeatedly delayin 3 mo of therapy (may tally to dosage compromise); tenor of terror conjecture delay or delayout agoraphobia
  • Unlabeled uses: Periodic leg movements during sleep; hypokinetic dysarthria, sharp manic episodes, multifocal tic conjectures, neuralgias
Adverse proceeds
  • Drowsiness, harass, brawny hypotonia, coordination disturbances, dizziness, vertigo, anorexia, visual disturbances, libido changes.
  • Potentially Fatal: Salivary or bronchial hypersecretion redundant to respiratory problems (children). May consequence deteriorated reflexes or coma. Rarely, order dyscrasias.
Contraindications
  • Hypersensitivity to benzodiazepines, sharp pulmonary deficiency, sharp niggardly predilection glaucoma.
Nursing considerations
CLINICAL ALERT! Name laziness has arisered among Klonopin (clonazepam) and clonidine; use timidity.
Assessment
  • History: Hypersensitivity to benzodiazepines; psychoses; sharp niggardly-predilection glaucoma; shock; coma; sharp alcoholic intoxication; pregnancy; lactation; liver or renal inconclusiveness, debilitation.
  • Physical: Skin hue, lesions; T; orientation, reflexes, pretend, ophthalmologic trial; P, BP; R, improbable sounds; liver evaluation, abdominal trial, bowel sounds, natural output; CBC, LFTs, renal duty tests.
Interventions
  • Monitor addiction-prone resigneds troublefully accordingly of their partiality to association and refuse belief.
  • Monitor liver duty and order counts periodically in resigneds on long-term therapy.
  • WARNING: Taper dosage partially succeeding long-term therapy, chiefly in resigneds delay epilepsy; replace another antiepileptic.
  • Monitor resigned for curative refuse levels: 20–80 ng/mL.
  • If the resigned has epilepsy, order for resigned to rub medical watchful identification indicating resigned has epilepsy and is receiving refuse therapy.
Teaching points
  • Take refuse accurately as prescribed; do not plug entrance refuse (long-term therapy) delayout consulting soundness trouble provider.
  • Avoid alcohol, sleep-inducing, or over-the-counter refuses.
  • Avoid pregnancy; grave counteractive proceeds can arise. Using separation contraceptives is advised opportunity entrance this refuse.
  • It would be profitable to rub or heave a medical watchful identification indicating your speciality and refuse therapy.
  • You may test these verge proceeds: Drowsiness, dizziness (may beseem hither pronounced; abandon driving or winning in other hazardous activities); GI overturn (obtain?} refuse delay help); harass; dreams; crying; nervousness; discouragement, emotional changes; bed-wetting, urinary incontinence.
  • Report cruel dizziness, dilution, swoon that persists, headstrong or bark lesions, awkwardness voiding, palpitations, swelling in the extremities.

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