DRUG STUDIES DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATION ADVERSE EFFECT Dry eyes Blurred vision Constipation Dry

Dry mouth Urinary Retention NURSING CONSIDERATION

GENERIC NAME: Biperiden HCl

It is a tertiary amine antimuscarinic

Adjunctive treatment of all forms of Parkinsons Disease, including drug induced extrapyramidal effects and acute dystonic reactions.

Hypersensitivity Narrow angle glaucoma Bowel obstruction Megacolon Tardive Dyskinesia

Assess Parkinson and extrapyramidal symtoms (restlessness or desire to keep moving, rigidity, tremors, pill rolling, masklike face, shuffling gait, muscle spasms, twisting motions, difficulty speaking or swallowing, loss of balance control) prior to and throughout course of therapy. Assess bowel function daily. Monitoring for constipation, abdominal pain, distention or the absence of bowel sounds. Monitor intake and output ratios and assess patient for urinary retention. Advice patient to make position changes slowly to minimize orthostatic hypotension.

BRAND NAME: Akineton

with central and peripheral actions. It

CLASSIFICATION: Antiparkinson Agent

stimulates and then depresses the CNS, it also

ROUTE: Oral

has antispasmodic actions on

DOSAGE/ FREQUENCY: 2o mg tab PO, OD & PRN

smooth muscle and reduces secretions, especially salivary and bronchial secretions.

 Withhold drug and notify physician or other health care provider if significant behavioral changes occurs. Administer with foods or immediately after meals to minimize gastric irritation. Advise patient to take medication as directed. Advise the patient that frequent mouth rinses, good oral hygiene and sugar less gum or candy may decrease dry mouth. Caution patient that this medication decreases perspiration. Emphasize the importance of routine follow- up examinations.

DRUG

MECHANISM OF ACTION

INDICATION

CONTRAINDICATION

ADVERSE EFFECT

NURSING CONSIDERATION

GENERIC NAME: Clonazepam

It facilitates GABAergic transmission in

Prophylaxis for petit mal, petit mal variant, akinetic, myoclonic seizures and uncontrolled leg movement during sleep.

Hypersensitivity to the drug or other benzodiazepines Severe liver disease

Drowsiness Ataxia Behavioral changes

Observe and record intensity, duration and location of seizure activity. Assess patient for drowsiness, unsteadiness and clumsiness. Instruct patient to take medication exactly as directed. Inform patient medication

BRAND NAME: Klonopin

the brain by a direct effect on benzodiazepine

CLASSIFICATION: Anticonvulsant

receptors.

ROUTE: Oral

may cause drowsiness or dizziness. Caution patient to avoid

DOSAGE/ FREQUENCY: 2mg tab @ 4:55pm

taking alcohol or other CNS depressant concurrently with this medication. Advise patient to notify the physician, dentist or other health care provider of medication regimen prior to

treatment. Instruct patient and family to notify the physician or other health care provider of unusual tiredness, bleeding, sore throat, fever, claycolored stool, yellowing of skin or behavioral changes. Emphasize the importance of follow- up examinations to determine effectiveness of the medication.

GENERIC NAME: Risperidone

Act by antagonizin g dopamine

Symptoms of psychosis including

Hypersensitivity Lactation Dysrhythmias

Sedation Weight gain Headache

Direct client to avoid potentially dangerous situations, such as driving,

BRAND NAME: Risperdal Quicklet

and serotonin in the CNS. Decrease symptoms of

schizophrenia.

Blood dyscrasias Liver damage

Dry mouth Photosensitivity Urinary retention Sexual dysfunction Orthostatic hypotension Convulsion

until drug dosing has been stabilized. Inform client about EPS; instruct the client to promptly report symptoms to the health care provider. Instruct client to avoid direct sunlight to prevent photosensitivity and to use

CLASSIFICATION: Atypical Antipsychotic

ROUTE: Oral

psychoses

DOSAGE/ FREQUENCY: 2mg 1 tab @ 4:55pm

sunscreen and protective clothing to prevent a skin rash. Teach client who is taking aliphatic phenothiazines, such as chlorpromazine, that the urine might be pink or red brown; this discoloration is harmless. Inform client that changes may occur related to sexual functioning and menstruating. Suggest lozenges or hard candy if mouth dryness

occurs. Encourage client to avoid extremes in temperatures and increased exercise. Advise client to rise slowly from sitting or lying to standing to prevent a sudden decrease in blood pressure. Evaluate the effectiveness of the drug and whether the client has acceptably reduced psychotic symptoms at the lowest dose possible.

DRUG

MECHANISM OF ACTION Block dopamine receptors in

INDICATION

CONTRAINDICATION

ADVERSE EFFECT

NURSING CONSIDERATION Assess mental status prior to and periodically during therapy. Monitor BP and pulse prior to and frequently during the period of dosage adjustment. May cause QT interval changes on ECG. Observe patient carefully when administering medication, to ensure that medication is actually taken and not hoarded. Monitor intake and output ratios and daily eight. Assess patient for signs and symptoms of dehydration. Monitor for development

GENERIC NAME: Chlorpromazine

Acute and chronic psychoses, particularly when accompanied by increased psychomotor activity. Nausea and vomiting Treatment of intractable

Hypersensitivity Cross-sensitivity may exist among phenothiazines Should not be used in narrow-angle glaucoma Should not be used in patients who have CNS depression

CNS: neuroleptic malignant syndrome sedation extrapyramidal reactions tardive dyskinesia CV: hypotension (increased with IM, IV) EENT: blurred vision dry eyes lens opacities GI: constipation

BRAND NAME: Thorazine

the brain and also alter dopamine

CLASSIFICATION: Antipsychotics

release and turnover. Prevention of

Route: Oral

seizures

DOSAGE/ FREQUENCY: 100mg 1 tab PO, HS

hiccups

 dry mouth anorexia hepatitis ileus GU: urinary retention Hematologic: agranulocytosis leukopenia Skin: photosensitivity pigment changes rashes

of neuroleptic malignant syndrome (fever, respiratory distress, tachycardia, seizures, diaphoresis, hypertension or hypotension, pallor, tiredness, severe muscle stiffness, loss of bladder control. Report symptoms immediately. May also cause leukocytosis, elevated liver function tests, elevated CPK. Advise patient to take medication as directed. Take missed doses as soon as remembered, with remaining doses evenly spaced throughout the day. May require several weeks to obtain desired effects. Do not increase dose or discontinue medication

without consulting health care professional. Abrupt withdrawal may cause dizziness, nausea and vomiting, GI upset, trembling, or uncontrolled movements of mouth, tongue or jaw.

DRUG

MECHANISM OF ACTION

INDICATION

CONTRAINDICATION

ADVERSE EFFECT

NURSING CONSIDERATION Remind patient that before having any surgery, including dental or emergency treatment, tell the surgeon, doctor or dentist that they are taking flupentixol. Inform client that Flupentixol can occasionally cause dry mouth. If patient experiences this; try chewing sugar-free gum, sucking sugar-free sweets or pieces of ice. Flupentixol can cause some people's skin to become more sensitive to sunlight than it usually is. Avoid strong sunlight and

GENERIC NAME: Flupentixol Decanoate

Inhibits dopaminemediated effects by blocking

Schizophrenia Psychoses Depression with or without anxiety

Hypersensitivity Extremely excitable and overactive patients Mania Porphyria Coma Preexisting CNS depression Bone-marrow suppression Phaeochromocytoma

Rigidity Tremors Restlessness Tardive dyskinesia Insomnia Dryness of mouth Weight gain Sexual dysfunction Galactorrhoea Menstrual disturbances Neuroleptic malignant syndrome (hyperthermia, hypertonicity of skeletal muscles, unconsciousness and autonomic nervous system

BRAND NAME: Fluanxol

postsynaptic dopamine receptors in the

CLASSIFICATION: Antipsychotics

CNS.

ROUTE: Intravenous

DOSAGE/ FREQUENCY: 1cc with BP 110/80

Lactation

instability)

sun beds until you know how your skin reacts and use a sun cream higher than factor 15. If client experience 'flu like' symptoms such as stiffness, high temperature, abnormal paleness, leaking bladder and a racing heartbeat contact their doctor or go to the accident and emergency department of your local hospital immediately. Educate the patient that the symptoms of overdose may include seizers, muscle spasms, weakness, fast heartbeat, fever, difficult breathing, severe dizziness, drowsiness, convulsions,

irregular heartbeat, disturbed concentration, constipation and coma. Inform patient to take the medicine with a full glass of water. Remind the patient that the medicine can be taken with or without food. Instruct to the patient that he can swallow the medicine as whole. Dont cut or chew the medicine.