What is Gabapentin? | Uses, Side Effects & Nursing Considerations

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Are you curious about the effects of Gabapentin, an anticonvulsant medication? Looking for a guide that would provide a comprehensive overview with helpful information on gabapentin and its uses, benefits, possible side effects, and nursing considerations? Look no further! In this article, we’ll discuss in detail what gabapentin is, how it affects your body, and provide an overview of its potential medical uses and typical side effects.

We’ll tackle the tricky questions like why it’s being prescribed across medical disciplines – from Neurology to Psychiatry to Pain Medicine – taking into account issues like safety concerns when using Gabapentin. Additionally, we’ll provide professional guidance on best practices for the nursing care of patients taking Gabapentin. With so much ground to cover, let’s dive right into our exploration.

What is Gabapentin?

Gabapentin, or Neurontin, is a medication used to treat epilepsy and neuropathic pain associated with conditions such as diabetes, spinal cord injury, and chemotherapy-induced nerve damage. It belongs to the class of medications called anticonvulsants or anti-seizure drugs (ASDs). Gabapentin works by blocking the release of certain neurotransmitters in the brain. It effectively controls seizures and reduces pain, but not as much as other anticonvulsants like phenytoin and carbamazepine.

SUMMARY PRODUCT INFORMATION
Route of Administration Dosage Form / Strength All Nonmedicinal Ingredients
Oral Tablets/ 600 mg and 800 mg Maize Starch (Extra White Maize Starch), Crospovidone (Type A), copovidone (VA 64), Microcrystalline Cellulose (KG-1000), Microcrystalline Cellulose (PH-102), Magnesium Stearate, Hydroxypropyl Cellulose, and Talc.
Generic names Gabapentin/Gabapentin Enacarbil
Brand names Gralise, Neurontin, Horizant
Pharmacologic class 1-amino-methyl cyclohexane acetic acid
Therapeutic class Anticonvulsant
Classification

 

 Antiepileptic

Uses

Gabapentin has several potential medical uses, such as:

Adjunctive treatment for

  • Seizure control
  • Postherpetic neuralgia
  • Moderate to severe primary restless legs syndrome.

Off-label uses include

  • Bipolar disorder
  • Migraine prophylaxis
  • Tremor associated with multiple sclerosis
  • Neuropathic pain
  • Diabetic peripheral Neuropathy
  • Vasomotor symptoms (hot flashes)
  • Fibromyalgia
  • Adjunct treatment of postoperative pain
  • Anxiety

It is also used to treat alcohol withdrawal symptoms and other forms of substance abuse. In addition to treating epilepsy or neuropathic pain, gabapentin has been increasingly prescribed off-label for managing many different conditions, such as chronic pain disorders.

Mechanism of action

Gabapentin binds to a specific subunit of voltage-gated calcium channels in the central nervous system. It stabilizes electrical activity in the brain, which helps control seizures and reduce neuropathic pain.

Benefits

Gabapentin is generally effective at controlling seizures and reducing neuropathic pain, but not as much as other anticonvulsants like phenytoin and carbamazepine. It may also effectively treat bipolar disorder, migraine prevention, MS-related tremor, neuropathic pain, postoperative pain, anxiety, diabetic peripheral neuropathy, and vasomotor symptoms (hot flashes).

Side Effects

As with any medication, there are potential side effects associated with gabapentin.

The most common side effects are

  • Drowsiness
  • Dizziness
  • Confusion
  • Depression
  • Nausea

While these can be mild in some people, they can cause serious complications such as seizures and vision or balance problems in others. Additionally, long-term use of Gabapentin can lead to dependence and may cause withdrawal symptoms if suddenly stopped. It is, therefore, important to speak with a doctor before taking Gabapentin or any other medications.

Precautions and Contraindications

Gabapentin is not recommended for people with certain medical conditions such as liver or kidney disease, an allergy to gabapentin, or any other medication, pregnant women, and breastfeeding mothers. It is also essential to inform your doctor if you are taking any prescription or over-the-counter medications before starting a course of Gabapentin.

Drug Interactions

Gabapentin can interact with certain medications, such as:

• Opioids (e.g., morphine, oxycodone)

• Antidepressants (e.g., citalopram, amitriptyline)

• Anti-seizure medications (e.g., phenytoin, valproic acid)

• Calcium channel blockers (e.g., verapamil, felodipine)

It is essential to inform your doctor of any medications you are taking before starting a course of Gabapentin, as these interactions could lead to serious medical complications.

Adverse Effects

• Allergic reaction (hives, difficulty breathing, or swelling of the face, lips, tongue, or throat)

• Changes in mood or behavior

• Seizures

• Reduced alertness

• Difficulty walking/speaking

• Vision problems

• Anxiety/agitation

• Uncontrollable shaking

• Abnormal liver function

• Abnormal kidney functions

• Reduced white blood cell count (neutropenia)

• Low sodium levels (hyponatremia)

• Increased blood pressure

Administration Considerations

Available preparations: Capsules, oral solution, tablets, extended-release tablets (Horizant)

Dosage instructions for adults: The recommended dose is between 900-1800 mg per day to treat partial seizures. A dosage of 300-1800 mg each day is suggested for postherpetic neuralgia. For moderate to severe primary restless legs syndrome (Horizant), 600 mg should be taken orally in the evening.

Dosages for children 12 years old and older:  The recommended dose for treating partial seizures is 900-1800 mg daily.

Dosages for children 5-12 years old: Dosage depends on weight. For treatment of partial seizures: 10-35 mg/kg/day

Similarly, for 3-4-year-olds, the dosage should be 10-40mg/kg daily for partial seizures.

Route Onset Peak Duration
PO (capsules, oral solution, suspension)

 

 Rapid 2-4 hours 8 hours
PO tablets (Gralise)

 

 Unknown

 

 8 hours

 

 Unknown
PO (extended-release) (Horizant)

 

 Unknown Unknown Unknown

Gabapentin Nursing Considerations

Related Nursing Diagnoses

  • Acute pain
  • Risk for injury
  • Risk for infection (related to decreased white blood count)
  • Risk for suicide impaired oral mucous membrane, and constipation as potential side effects of Gabapentin

Nursing Assessment

Nurses should assess patients for potential side effects and interactions with other medications. They should also monitor patients for any changes, such as:

  • Look for any allergies to Gabapentin.
  • Monitor changes in neurological status, mood, and suicidal thoughts.
  • Assess the patient’s history of seizures.
  • Determine pain scale and characteristics.
  • Note for signs of infection.
  • Check WBC count (white blood cell).
  • Observe for renal impairment.

Nursing Interventions

  • Administer with or without food, may give with food to reduce gastrointestinal upset.
  • Do not exceed the maximum interval of 12 hours in between doses when administered 3 times per day.
  • Titrate gradually for at least one week to reduce seizure risk when discontinuing Gabapentin or starting an anticonvulsant.
  • Implement seizure precautions.
  • Adhere to strict hand hygiene and infection control measures.
  • Report observations of depression, suicidal thoughts, or unusual behavior.
  • Notify the provider if signs of allergic reactions (difficulty breathing, coughing, facial swelling) are present.

Patient Teaching Associated with Gabapentin

  • Advise taking Gabapentin with or without food.
  • Swallow extended-release tablets without breaking, crushing, dissolving, or chewing them.
  • Instruct to take it at bedtime to minimize adverse effects.
  • Avoid sudden stoppage of Gabapentin as it increases the risk of seizure.
  • Avoid driving and activities that require concentration until the effects have been evaluated.
  • This drug may cause joint, muscle, or bone pain.
  • Immediately report signs of depression, suicidal thoughts, or unusual behavior to a healthcare provider.
  • Recommend avoiding alcohol intake.
  • Suggest carrying identification noting seizure disorder/anticonvulsant therapy at all times.
  • Report any signs of hypersensitivity, such as fever or enlarged lymph nodes, immediately to a doctor.

Drug Administration

When administering Gabapentin to a patient, nurses need to pay special attention to the dosage instructions provided by the doctor. Gabapentin should be taken with or without food and can be taken at any time of day.

Follow Up

Nurses should follow up with their patients regularly to monitor for any changes in symptoms and any side effects that may occur. They should also assess the effectiveness of the medication in controlling seizures or reducing pain.

FAQs:

Does Gabapentin increase dopamine?

It does not directly increase dopamine levels, several studies suggest that it may indirectly affect dopamine by modulating its release and uptake in certain brain parts. This may underlie some of the therapeutic effects of Gabapentin, including its ability to reduce anxiety, improve mood, and alleviate symptoms of addiction. However, more research is needed to fully understand the mechanisms by which Gabapentin influences dopamine and how this may impact its clinical use.

Does Gabapentin Affect Serotonin?

Yes, Gabapentin has been shown to modulate serotonin levels in various parts of the brain. Studies have suggested that it can increase the concentrations of serotonin and its metabolites in the prefrontal cortex and hippocampus, which may be responsible for its anxiolytic and antidepressant effects. However, additional research is needed to understand how Gabapentin affects serotonin levels and how this may influence its clinical use.

Does Gabapentin Increase Serotonin?

Gabapentin can increase serotonin levels in the human blood, potentially affecting neurobehavioral function. However, its effects on serotonin levels within the body have not been studied in depth. It is possible that Gabapentin could indirectly influence serotonin levels through its effects on other neurotransmitters, such as dopamine and gamma-aminobutyric acid (GABA). More research is needed to understand how Gabapentin affects serotonin release and uptake and how this may contribute to its therapeutic effects.

Final Words

Gabapentin is an effective treatment for many types of pain and anxiety disorders. However, it should be taken cautiously, as it can cause side effects such as dizziness, nausea, and drowsiness. Nurses should closely monitor a patient’s vital signs when administering Gabapentin and assess for any changes in neurological status, mood, and suicidal thoughts.

Additionally, they should provide patient education about taking the medication and its potential side effects. It is important to note that Gabapentin should not be used as a first-line treatment for any mental health condition; it is best used with other therapies prescribed by your doctor.

References

  • https://en.wikipedia.org/wiki/Gabapentin
  • https://www.ncbi.nlm.nih.gov/books/NBK493228/
  • https://pubmed.ncbi.nlm.nih.gov/