DRUG Generic Name: Diphenhydramine Brand Name: Benadryl Classification Anticholinergic Dosage 50 mg/tab Frequency PRN Route Oral

Date Started: Sept. 21, 2010

INDICATION/ CONTRAINDICATIONS Diphenhydramine is used for its antimuscarinic properties in the control of parkinsonism and druginduced extrapyramidal effects CONTRA-INDICATIONS: cardiac disease or hypertension glaucoma gastric or duodenal ulcers

ACTION Blocks the action of acetylcholine (anticholinergic effect) and is used as a sedative because it causes drowsiness.

SIDE EFFECTS AND ADVERSE REACTION CNS: headache, fatigue, anxiety, tremors, vertigo, confusion, depression, seizures, hallucinations CV: tachycardia, palpitations, orthostatic hypotension EENT: blurred vision GI: dry mouth, nausea, vomiting, constipation, flatulence GU: urinary hesitancy or frequency, urine retention Skin: photosensitivity, dermatitis

NURSING CONSIDERATION Explain to the client that arising quickly from a lying or sitting position may cause orthostatic hypotension.

PATIENT TEACHING Avoid driving and doing any activities when feeling dizzy

Take the medication with food to decrease When taking these GI upset. medications, the client needs to have blood cells Slowly get up on bed counts, renal function, to avoid orthostatic hepatic function, and hypotension. blood pressure monitored. Keep it in a room History of glaucoma, temperature. Explain increased pressure in the to the client that use of eye, stomach ulcer, these drugs in warm enlarged prostate, weather may increase difficulty urinating, the likelihood of hyperthyroidism, heatstroke. hypertension, asthma

DRUG Generic Name: Levomepromazine Brand Name: Nozinan Classification: CNS/ Psychotropic Drugs/ Antipsychotics/ Phenothiazines Dosage 100 mg Frequency HS 10/24/10 Route Oral

INDICATIONS/ CONTRAINDICATIONS palliative care of terminally illness particularly in those marked by restlessness, anxiety, agitation, emotional disturbance, nausea, and vomiting In association with an antidepressant short-duration treatment of certain severe forms of major depressive episodes. Contraindications: liver dysfunction disease or cardiac

ACTION Potentiates the action of other central nervous system depressants but may be given in conjunction with appropriately modified doses of narcotic analgesics in the management of severe pain. It does not significantly depress respiration and is particularly useful where pulmonary reserve is low.

SIDE EFFECTS/ADVERSE REACTION somnolence asthenia dry mouth hypotension photosensitivity allergic skin reaction

NURSING CONSIDERATION *In high oral doses, complete bed rest necessary during the 1st few days.

HEALTH TEACHING * inform client that in case of the appearance of fever, throat infection or any other infection, it is imperative to inform at once the attending physician.

*the absorption of alcohol, as well as the administration of medicines containing alcohol, is strongly inadvisable during the entire period of the * tell client to avoid treatment. alcohol.

DRUG Generic Name: Amisulpride

INDICATIONS/ CONTRAINDICATIONS

ACTION Characterized by selective and predominant affinity for the D2 and D3 dopaminergic receptors of the limbic system.

Treatment of acute and chronic schizophrenia characterized by positive symptoms (delusions, Brand Name: hallucinations, thought Solian disorders) and/or negative symptoms (blurred effects, Classification: emotional and social CNS/ Psychotropic withdrawal) Drugs/ Antipsychotics/ Contraindications: Phenothiazines Confirmed or suspected pheochromocytoma. Dosage 100 mg Concomitant prolactindependent tumors Frequency BID 10/17/2010 OD 10/24/2010 Route Oral

SIDE EFFECTS/ ADVERSE REACTION Side effects: Drowsiness, weight gain, dizziness, increased appetite, constipation, dry mouth, insomnia, anxiety, agitation

NURSING CONSIDERATION *Since amisulpride is eliminated via the kidneys, the dose should be reduced in patients with renal insufficiency

HEALTH TEACHING *stress the importance of taking this drug to help client be well. *instruct client to be careful if he is unwell, some people may experience side effects such as drowsiness, confusion, dizziness and unsteadiness, which may increase the risk of a fall.

*Neuroleptics are Adverse reactions: known to reduce the CNS: Insomnia, anxiety, epileptogenic threshold. agitation Patients with history of seizures must be EPS: tremor, hypertonia, carefully monitored hypersalivation *Neuroleptics should Endocrine and only be prescribed for metabolic disorders: these patients if elevation of serum absolutely necessary. prolactin levels, and impotence GI: constipation, nausea, vomiting, dry mouth Cardiac disorders: hypotension, bradycardia Hepatic disorders: increase in liver enzymes, transaminases

DRUG Generic Name: Biperiden Brand Name: Akineton Classification Anticholinergic Dosage 2 mg/tab Frequency BID Sept 21, 2010 OD Oct 24, 2010 Route Oral

INDICATION/ CONTRAINDICATIONS

ACTION

SIDE EFFECTS AND ADVERSE REACTION CNS: skin rashes, dyskinesia, ataxia, twitching, impaired speech, micturition difficulties. Fatigue, dizziness, at higher doses, restlessness, agitation, anxiety, confusion.

NURSING CONSIDERATION Assess for tolerance over long term therapy, dosage may have to be increased or changed. Avoid activities that require alertness, may cause dizziness, drowsiness and blurring of vision. Instruct patient that doses should not be doubled, but missed dose may be taken up to 2 hrs before the next dose Explain to the client that arising quickly from a lying or sitting position may cause orthostatic hypotension. .

PATIENT TEACHING The drug should be taken without food. Avoid driving and doing any activities when feeling dizzy Avoid hot and humid places to reduce the risk for heatstroke Emphasize the need for periodic eye checkups so as to know if there is glaucoma forming in the patients eyes.

Counteract Blocks acetylcholine's muscular rigidity and tremor; action at the extrapyramidal symptoms. cholinergic receptor sites.it restores the CONTRA-INDICATIONS: brain's normal Untreated narrow angle dopamine and glaucoma, intestinal acetylcholine balance, stenosis or obstruction, which relaxes muscle mega colon, prostatic movements and hypertrophy, life decreases rigidity and threatening tachycardia tremors.