Seizures:
Phenytoin Dilantin
*Do not mix with d5w
*monitor for adverse reaction monitor serum drug levels
*do not stop suddenly
Class anticonvulsant	medication often controls seizure by acting on the CNS to reduce the number and severity. Used to prevent seizure disorders or following brain trauma or surgery
Adverse- may cause vomiting, drowsiness tremors or confusion
Carbamazepine (tegretol)
*take with food
Action: inhibit the influx of sodium through sodium channels, decrease the discharge of neurons around the areas of increased activity
Low dose, give mos of the dose at bedtime. orally 
monitor WBC, CBC and monitor for skin rash
Class anticonvulsant/anagesic
*inhibits seizure activity, specific analgesic for trigeminal neuralgia
Contraindiciations: hypersensitivity to drug, bone marrow suppresion
Adverse: vomiting, dizziness, vertigo, drowsiness, anemia
No grapefruit juice; may alter birth control or monitor for pregnancy
Valproic Acid (Depakote, Depacon, Depakene)
Inhibits the influx of sodium through sodium channels, inhibits the influx of calcium through channels too, enchaces the inhibitory effects of GABA
Side Effects-GI upsets, skin rash, bruising, bleeding, liver toxicity, hyperammonemia
Interventions-Monitor INR, PT, PTT, ammonia blood levels; vomiting, confusion, liver fuction tests, take lowest effective dose
-IV/Oral give with food and dilute drug if given IV
-Contraindications: liver disorder, pregnancy, thrombocytopenia, kidney disease, children on other anticonvulsants
Alzheimer's Disease
Cholinesterase Inhibitors donepezil(Aricept, Aricept ODT) rivastigmine(Exelon) galantamine(Razadyne)
-Prevent the acetylcholinesterease from inactivating acetylcholine.  Increase acetylcholone available receptors in the brain
Side Effects: Nausea, gastro problems, CNS effects insomnia, headache, bradycardia, syncope loss of conciousness
Interventions- give with food, monitor weight loss, GI bleeding, CNS effects , assist with ambulation, monitor HR
Admin- at BEDTIME with or without food
Contraindications- Children, jaundice, GI bleeds, allergy to donepezil, pulmonary disorders, hyper thryroidism, seizures. 
Interactions- Anticholinergic drugs(antihistamines) NSAIDS 
NMDA Receptor Antagonists memantine(Namenda)
Action- Block excess glutamate from NMDA receptors, decreases overstimulation of NMDA, slows the progression of Alzheimer's disease and decreases intracellular calcium
Side Effects: dizziness, headache, increased confusion, constipation
Interventions:  dizziness, headache, confusion, monitor for constipation give stool softeners as needed or laxatives
Administration:  with or without food
Teaching: increase fluids and fiber with diet, report to provider if dizzy or increased confusion, or headache current
Contrindication/Prec: renal failure, caution liver or renal disorders, older adults, seizure disorders, Diabetes mellitus
Interactions: antiacids, possible toxicity, adverse effects of levadopa.  
Multiple Sclerosis Drugs
Immunodmodulators---- Interferon beta-1a(Avonex, Rebif); beta-1b(Betasterone) glatiramer acetate(Copaxone)
Action: inhibit the movement of leukocytes across the blood brain barrier protects the myelin sheath from damage from the effect of leukocytes
Side/Advers Effects:  flu like symtoms, bone marrow suppression, liver toxicity, pain, redness at injection site
Interventions:  begin with a low dose, titrate to higher dose.  acetaminophen or NSAID for flu like symptoms. Monitor liver function, CBC (decreased WBC's and platelet counts) 
Admin- Injection beta1a IM weekly
                  Injection Rebif, SC 3 days late in day and 48 hours between each injection
                   Beta-1b Betaser SC every other day 3 hours after reconstituting. 
Instructions: NSAID's flu like symptoms, report bleeding/bruising, rotate sites, apply warm mosit compress after and cool before.  Report skin ulceration.  Report abdominal tenderness jaundice
Contraindications/Prec- previous allergies, suicidal tendencies, mental health disorders, pre-existing hx of seizures, thyroid disorder, alcohol abuse, > 18
Interactions- no administration with other drugs that suppress the immune system

Migraines
Serotinin Agonists:  Sumatriptan (Imitrex) zolmitriptan(Zomig)
Action: causes vasoconstriction, suppress the releaseof CGRP, prevents inflammatory response
Side/Adverse Effects- chest pressure/heaviness, coronary vasospasm, tingling sensation
Interventions- reports of heaviness of the chest, vital signs after first dose, chest pain
Admin- oral, SC or spray, single does at first then repeat if no relief.  No more than 300mg orally in 24 hours
Patient Insructions- notify STAT for chest pressure/tightness
Contraindications: angina, previous MI, severe HTN, Stroke, Cerebraovascular accident; precautions with liver/kidney insuffiency
Interactions with other sumatriptans 

Parkinson's Disease
Dopamine replacement drugs levodopa (Dopar, Larodopa)  levodopa/cabidopa (Sinemet) 
Action: Cross the blood brain barrier where they are taken up by dopaminergic nerves and then converted to dopamine and available for use in the body
Side/Adverse affects:  nausea, vomiting, othostatic/postural hypotension, tremor, twitching, darkening or urine, paranoia, psychosis/hallucinations
Interventions: GI, Dyskinesias, Hallucinations
Administration: low doses, may take up to 6 months for full response. Only 8g er day.  monitor for any loss of drug effect that indicate periods of too little dopamine inthe system
Instructions: with food, avoid high protein, urine/sweat may darken, move slowly from sitting to standing
Contrindications/Precautions: narrow angle glaucoma, melanoma, psychosis, suicidal thoughts. Prec: older adults, renal/hepatic/resp/endo disorders, peptic ulcers, or depression
Interactions: do not take with 2 weeks of antidepressants
Direct acting dopamine recptor agonists    Parkinsons' and restless leg syndrome
pramipexole(Mirapex) ropinirole (Requip)
Action: bind to dopamine receptors, mimic to the bodies' actions 
Side Effects: nausea, ortho hypotension, dyskinesia
Interventions: with food, muscle weakness, sudden sleepiness, drowsiness, safety measures
ADministration: when increasing allow 4-7 days, give 3 hours before bedtime
Patient Instructions:  with food if nauseated, avoid alcohol, report weakness, dc slowly over time
Contraindications/Precautions: renal (pramipex) liver(ropinrole) children
Indirect acting dopamine receptor agonists/MAOI's
selegiline(Elodepryl, Zelapar ODT) rasagiline(Azilect)
Action: makes dopamine more available in the brain, lessons the parkinson's disease symptoms
Side/Adverse Effects:  insomnia, orthostatic hypotension, hypertensive crisis as an interaction with other drugs, irritation of oral membrane
Interventions: monitor for insomnia, blood pressure(hypo/hyper) assist with menu selection no caffiene, if ODT inspect toungue/mouth
Admin.- tablets orally disintergrating form, before morning meals, none after noon. And wait 5 mintues to eat or drink
Instructions: by noon, report irratation, notify dr before new drugs, 
Contraindications/prec:  Uncontrolled HTN, suicidal thoughts meperidine, Prec: lactation hypertension, bipolar disorder
Interactions: high fever with demerol