AANP Family Nurse Practitioner (FNP) Certification ExamEvaluationHard
A 40-year-old male with new-onset seizure disorder is started on levetiracetam. He is concerned about potential side effects. The FNP should advise him to report which of the following symptoms immediately, as it may indicate a serious adverse reaction?
- AFatigue
- BIrritability or aggression
- CMild dizziness
- DHeadache
Show answer & explanationAnswer & explanation
Correct answer: B. Irritability or aggression
Levetiracetam is known to cause psychiatric side effects such as irritability, aggression, agitation, and mood changes, which can be severe and require immediate attention and potential medication adjustment or discontinuation. These are considered serious adverse reactions.
Why the other options are wrong
- A. Fatigue is a very common side effect of levetiracetam and other antiepileptic drugs, usually managed with dose titration or timing, not typically an 'immediate' concern unless severe.
- C. Mild dizziness is a common and usually transient side effect of many antiepileptic drugs, including levetiracetam, and typically does not require immediate intervention.
- D. Headache is a common and usually mild side effect of many medications and is not typically indicative of a serious adverse reaction to levetiracetam.
Levetiracetam Adverse Effects
Levetiracetam (Keppra) is an antiepileptic drug with a generally favorable side effect profile, but it is notably associated with significant neuropsychiatric adverse effects, including irritability, aggression, and mood changes.
- Common side effects: somnolence, dizziness, fatigue.
- Serious side effects: behavioral changes (irritability, aggression), psychotic symptoms, suicidal ideation.
- Monitor for mood and behavioral changes, especially during initiation or dose changes.
Memory trick: Keppra helps the brain, but watch for a sudden strain on the mood, or aggressive gain.