MEDICATION

NAME OF DRUG Brand Name: Topamax Generic Name: Topiramate Dosage: Tablet 100mg Classification: anticonvulsant (antiepilepsy) drug THERAPEUTIC EFFECTS Unknown. May block a sodium channel, potentiate the activity of gammaaminobutyrate, and antagonize the ability of kainate to activate an excitatory amino acid (glutamate) receptor. INDICATIONS CONTRAINDICATIONS ADVERSE EFFECT NURSING CONSIDERATIONS If needed, withdraw antiepileptics (including topiramate) gradually to minimize risk of increased seizure activity. Monitoring topiramate level isnt necessary. Oligohidrosis and hyperthermia have have been infrequently reported, mainly in pediatric patients taking topiramate. Monitor patient closely, especially in hot weather. Drug is rapidly cleared by dialysis may

Adjunct treatment for primary generalized tonicclonic seizures.

Contraindicated in patients hypersensitive to drug or its components.

CNS: fever, abnormal coordination, aggressive reaction, agitation, apathy, confusion, depression, generalized tonicclonic seizures, suicide attempts, insomnia, mood problems, fatigue, vertigo, malaise, difficulty with concentration. CV: chest pains, palpitations, vasodilation, edema. EENT: abnormal vision, conjunctivitis, diplopia, eye pain, epistaxis, hearing problems, tinnitus, pharyngitis, sinusitis, nystagmus. GI: abdominal pain, anorexia, constipation, diarrhea, dry mouth, dyspepsia, flatulence, gastroenteritis, gingivitis, nausea,

vomiting, taste perversion. GU: amenorrhea, dysuria, dysmenorrheal, hematuria, impotence, intermenstrual bleeding, menstrual disorder, menorrhagia, urinary frequency, renal calculi, urinary incontinence, UTI, vaginitis, leucorrhea. Hematologic: anemia, leucopenia. Metabolic: increased or decreased weight. Musculoskeletal: arthralgia, back or leg pain, muscle weakness, myalgia, rigors. Respiratory: Bronchitis, coughing, dyspnea, increased sweating, pruritus, rash. Other: Decreased libido, breast pain, body odor, flulike syndrome, hot flashes, lymphadenopathy.

result in low drug levels and seizures. A supplemental dose may be needed. Stop drug if an ocular adverse event occurs, characterized by acute myopia and secondary angle closure glaucoma. Alert: dont confuse Topmax with Toprol-XL.

Brand Name: Zyprexa Generic Name: Olanzapine 10mg

Unknown. May block dopamine and 5-HT2 receptors.

Long term treatment of schizophrenia.

Contraindicated in patients hypersensitive to drugs. Use cautiously in patients with heart disease, cerebrovascular disease, conditions that predispose patient to hypotension, history of seizures or conditions that might lower the seizure threshold, and hepatic impairment .Also use cautiously in in elderly patients, those with a history of paralytic ileus, and those at risk for aspiration pneumonia, prostatic hyperplasia, or angle-closure glaucoma.

CNS: somnolence, asthenia, abnormal gait, insomnia, parkinsonism, dizziness, personality disorder, akathisia, tremor, articulation impairment, suicide attempt, tardive dyskinesia, neurolyptic malignant syndrome, fever. CV: orthostatic hypotension, tachycardia, chest pain, hypertension, ecchymosis, peripheral edema. EENT: amblyopia, rhinitis, pharyngitis, conjunctivitis. GI: constipation, dry mouth, dyspepsia, increased appetite, increased salivation, vomiting, thirst. GU: hematuria, metrorrhagia, urinary incontinence, urinary tract infection, amenorrhea, vaginitis. Hematologic: leucopenia

Monitor patient for abnormal body temperature regulation, especially if he excercises, is exposed to extreme heat, takes anticholinergic s, or is dehydrated. Obtain baseline and periodic liver function test results. Monitor patient for weight gain. Alert: watch for evidence of neuroleptic malignant syndrome (hyperpyrexia, muscle rigidity, altered mental status, autonomic instability), which is rare but commonly fatal. Stop

Metabolic: weight gain Musculoskeletal: joint pain, extremity pain, back pain, neck rigidity, twitching, hypertonia. Respiratory: increased cough, dyspnea Skin: sweating Other: flulike syndrome, injury.

drug immediately; monitor and treat patient as needed. Monitor patient for tardive dyskinesia, which may occur after prolonged use. It may not appear unil months or years later and may disappear spontaneously for life despite stopping drug. Alert: dont confuse olanzapine with olsalazine or Zyprexa with Zyrtec. Alert: neuroleptic malignant syndrome may occur with aripiprazole use. Monitor

Brand Name: Abilify 15mg Generic Name: Aripiprazole

Thought to exhibit its antipsychotic effects through partial agonist activity at D2 and serotonin 1A receptors and antagonist activity at serotonin 2A

A prescription drug often used for the treatment of bipolar disorder, schizoph renia, autism, and depression (when used along with antidepressan

Contraindicated in patients hypersensitive to aripiprazole. Use cautiously in patients with CV disease. Use cautiously in patients at risk

CNS: headache, anxiety, insomnia, light headedness. CV: peripheral edema, chest pain hypertension, tachycardia, orthostatic hypotension,

receptors.

ts).

for aspiration pneumonia, sucha s those with alzheimers disease.

bradycardia. EENT: rhihitis, blurred vision, increased salivation, conjuncyivitis, ear pain. GI: nausea, vomiting, constipation, anorexia, diarrhea, abdominal pain, esophageal dysmotility, GU: urinary incontinence. Hematologic: ecchymosis, anemia. Metabolic: weight gain, weight loss. Musculoskeletal: neck pain, neck stiffness, muscle cramps. Respiratory: dyspnea, pneumonia, cough. Skin: rash, dry skin, pruritus, sweating, ulcer. Other: flulike syndrome.

patient for signs and symptoms of dyskinesia. Treat patient with the smallest dose for the shortest time and periodically reevaluated for continued treatment. Give prescriptions only for small quantities of tablets, to reduce risk of overdose.

Reference: Nursing2009 Drug Handbook by Lippincott Williams & Wilkins