REPUBLIC of the PHILIPPINES

City of Makati
UNIVERSITY OF MAKATI
COLLEGE OF ALLIED HEALTH STUDIES
J. P. Rizal Extension, West Rembo, Makati City 1215
Telephone No. : (+632) – 881 – 1571
CENTER OF NURSING

DRUG STUDY
Peñoso, Krystel B.
NAME: _______________________________________________________ 3-BN
YEAR/GROUP:___________________

CONCEPT: ____________________________________________________ Psychiatric Ward

AREA: __________________ March 2, 2022
DATE: __________________

SIDE EFFECTS/ ADVERSE NURSING

DRUG NAME MECHANISM OF ACTION INDICATION REACTION CONTRAINDICATION CONSIDERATION
Generic Name: The precise mechanisms by which  Postherpetic Neuralgia  CNS: fatigue, somnolence, Neurontin is contraindicated If a patient develops
 Gabapentin gabapentin produces its analgesic Adult: in adults with dizziness, ataxia, tremor, in patients who have symptoms of mania,
and antiepileptic actions are postherpetic neuralgia, nervousness, dysarthria, demonstrated notify prescriber
Brand Name: unknown. Gabapentin is NEURONTIN may be amnesia, depression, hypersensitivity to the drug immediately and expect
 Neurontin structurally related to the initiated on Day 1 as a abnormal thinking, or its ingredients. to discontinue citalopram.
neurotransmitter gamma- single 300 mg dose, twitching, incoordination.
aminobutyric acid (GABA) but has on Day 2 as 600  CV: peripheral edema,
no effect on GABA binding, uptake, mg/day (300 mg two vasodilation. If patient (especially a
or degradation. In vitro studies times a day), and on  EENT: diplopia, rhinitis, child or adolescent) takes
have shown that gabapentin binds Day 3 as 900 mg/day pharyngitis, dry throat, citalopram for
with high-affinity to the α2δ subunit (300 mg three times a coughing, dental depression, monitor him
of voltage-activated calcium day). The dose can abnormalities, amblyopia, closely for suicidal
channels; however, the relationship subsequently be nystagmus. tendencies, especially
of this binding to the therapeutic titrated up as needed  GI: nausea, vomiting, when therapy starts or
effects of gabapentin is unknown. for pain relief to a dose dosage changes,
dyspepsia, dry mouth,
of 1800 mg/day (600 because depression may
constipation, increased
mg three times a day). worsen at these times.
appetite.
 Epilepsy With Partial  GU: impotence.
Onset Seizures  Hematologic: leukopenia.
Patients 12 Years of  Metabolic: weight gain. Inform the patient to
Age and Above: The  Musculoskeletal: back pain, report sudden, severe, or
starting dose is 300 myalgia, fractures. unusual adverse
mg three times a day.  Skin: pruritus, abrasion. reactions promptly to the
The recommended prescriber. Although
maintenance dose of uncommon, life-
NEURONTIN is 300 threatening adverse
mg to 600 mg three effects may occur.
times a day. Dosages
up to 2400 mg/day
have been well
tolerated in long-term
clinical studies. Doses
of 3600 mg/day have
also been
administered to a
small number of
patients for a relatively
short duration and
have been well
tolerated. Administer
NEURONTIN three
times a day using 300
mg or 400 mg
capsules, or 600 mg or
800 mg tablets. The
maximum time
between doses should
not exceed 12 hours.

Pediatric Patients Age

3 To 11 Years
The starting dose
range is 10 mg/kg/day
to 15 mg/kg/day, given
 in three divided doses,
and the recommended
maintenance dose
reached by upward
titration over a period
of approximately 3
days. The
recommended
maintenance dose of
NEURONTIN in
patients 3 to 4 years of
age is 40 mg/kg/day,
given in three divided
doses. The
recommended
maintenance dose of
NEURONTIN in
patients 5 to 11 years
of age is 25 mg/kg/day
to 35 mg/kg/day, given
in three divided doses.

Reference:

Generic Name: The mechanism of action of  Depression. Adults:  CNS: tremor, somnolence, Contraindicated in patients In patients taking
 Citolopram citalopram HBr as an Initially, 20 mg P.O. insomnia, anxiety, agitation, hypersensitive to drug or its fluoxetine for depression
hydrobromide antidepressant is presumed to be once daily, increasing dizziness, paresthesia, components, in those taking (especially children,
linked to potentiation of serotonergic to 40 mg daily after no migraine, impaired MAO inhibitors, and within adolescents, and young
Brand Name: activity in the central nervous less than 1 week. concentration, amnesia, 14 days of MAO inhibitor adults), watch closely for
 Celexa system resulting from its inhibition of Maximum depression, apathy, suicide therapy. suicidal tendencies,
CNS neuronal reuptake of serotonin recommended dose is attempt, confusion, fatigue, particularly when therapy
(5-HT) 40 mg daily. fever. starts and dosage
 CV: tachycardia, orthostatic changes, because
Geriatric patients: 20 hypotension, hypotension. depression may worsen
 mg P.O. daily adjusted  EENT: rhinitis, sinusitis, temporarily during those
to 40 mg daily for abnormal accommodation. times.
nonresponding  GI: dry mouth, nausea,
patients. diarrhea, anorexia,
dyspepsia, vomiting, Expect the patient to be
Dosage adjustment: abdominal pain, taste reevaluated periodically
For patients with perversion, increased to determine continued
hepatic impairment, saliva, flatulence, increased need for therapy.
give 20 mg P.O. daily appetite.
and adjust to 40 mg  GU: dysmenorrhea,
daily only if patient Inform family or caregiver
amenorrhea, ejaculation
fails to respond. to watch patient closely
disorder, impotence,
for suicidal tendencies,
polyuria.
especially when therapy
 Metabolic: hyponatremia,
starts or dosage
weight changes.
changes, and particularly
 Musculoskeletal: arthralgia, if patient is a child,
myalgia. teenager, or young adult.
 Respiratory: upper
respiratory tract infection,
cough. Caution the patient to
 Skin: rash, pruritus. avoid hazardous
 Other: increased sweating, activities until CNS
yawning, decreased libido, effects of the drug are
SIADH. known.
Generic Name: Presynaptic serotonin (5HT1A) Depression, bipolar  CNS: tremor, somnolence,  overactive thyroid gland Be aware that effective
 Fluoxetine receptors are in the dorsal raphe disorder, alcohol insomnia, anxiety, agitation,  schizophrenia antidepressant therapy
nucleus and project to the dependence, cataplexy, dizziness, paresthesia,  manic-depression can promote
Brand Name: prefrontal cortex. Fluoxetine exerts myoclonus Adults: 20 mg migraine, impaired  suicidal thoughts development of mania in
 Prozac its effects by blocking the reuptake concentration, amnesia,  alcoholism predisposed people.
P.O. daily in the morning.
of serotonin into presynaptic depression, apathy, suicide  serotonin syndrome, a
Increase dosage, p.r.n.,
serotonin neurons by blocking the attempt, confusion, fatigue, type of disorder with high If mania develops, notify
reuptake transporter protein after several weeks to 40 fever.
mg daily with a dose serotonin levels prescriber immediately
located in the presynaptic terminal.  CV: tachycardia, orthostatic
morning and midday. Don’t  a low seizure threshold and expect to withhold
hypotension, hypotension.
exceed 80 mg daily.  EENT: rhinitis, sinusitis,  closed angle glaucoma sertraline.
abnormal accommodation.  heart attack within the last
Maintenance therapy for  GI: dry mouth, nausea, 30 days
diarrhea, anorexia,  torsades de pointes, a Watch closely for suicidal
depression in stabilized
dyspepsia, vomiting, type of abnormal heart tendencies, especially
patients (not for newly when therapy starts and
diagnosed depression). abdominal pain, taste rhythm
perversion, increased  prolonged QT interval on dosage changes and
Prozac Weekly. Adults: 90 especially in children and
saliva, flatulence, increased EKG abnormal heart
mg P.O. once weekly. appetite. adolescents.
rhythm
Initiate once weekly dosing  GU: dysmenorrhea,  abnormal EKG with QT
7 days after the last daily amenorrhea, ejaculation changes from birth Inform family or
dose of Prozac 20 mg. disorder, impotence,  a stroke caregiver to watch patient
polyuria.  liver problems closely for evidence of
Obsessive-compulsive  Metabolic: hyponatremia,  decreased kidney suicidal thinking or
disorder. Prozac. Adults: weight changes. function behavior, especially
Initially, 20 mg P.O. daily.  Musculoskeletal: arthralgia,  enlarged prostate when therapy starts or
Gradually increase dosage myalgia.  seizures dosage changes, and
after several weeks as  Respiratory: upper  an inability to completely especially if patient is a
needed and tolerated to 60 respiratory tract infection, empty the bladder child or adolescent.
to 80 mg daily. cough.  CYP2D6 poor
 Skin: rash, pruritus. metabolizer
Bulimia nervosa. Prozac.  Other: increased sweating,  risk of angle-closure
yawning, decreased libido, glaucoma due to narrow
Adults: 60 P.O. daily in the
SIADH. angle of anterior chamber
morning.
of eye
Premenstrual dysphoric
disorder (PMDD). Sarafem.
Adults: 20 mg P.O. daily.
Maximum dose is 80 mg
P.O. daily. Drug may be
given in a continuous or
cyclic regimen.
 Short-term treatment of
panic disorders with or
without agoraphobia.
Adults: 10 mg P.O. once
daily for 7 days; then
increase as needed to 20
mg daily. Maximum daily
dose is 60 mg.

Generic Name: The mechanism of action of Post-traumatic stress  CNS: headache, tremor, Contraindicated in patients Monitor the patient for 2
 Sertraline sertraline is presumed to be linked disorder (PTSD) or panic dizziness, insomnia, receiving MAO inhibitors. to 4 weeks to ascertain
hydrochloride to its inhibition of CNS neuronal disorder. Adults: Initially, somnolence, paresthesia, Use cautiously in patients at onset of full therapeutic
uptake of serotonin (5HT). Studies 25 mg P.O. once daily. hypoesthesia, fatigue, risk for suicide and in those effect.
Brand Name: at clinically relevant doses in man Increase to 50 mg P.O. nervousness, anxiety, with seizure disorders, major
 Zoloft have demonstrated that sertraline daily after 1 week. If no agitation, hypertonia, affective disorder, or
blocks the uptake of serotonin into improvement, dose may twitching, confusion. diseases or conditions that Educate the client on a
human platelets. be increased up to a  CV: palpitations, chest pain, affect metabolism or low tyramine-containing
maximum of 200 mg P.O. hot flashes. hemodynamic responses. diet. Provide a list of
daily. Maintain patient on  GI: dry mouth, nausea, Avoid using the oral potential drug-food
lowest effective dosage. diarrhea, loose stools, concentrate dropper, which interactions that can
dyspepsia, vomiting, is made of rubber, if patient cause severe toxicity to
Depression, obsessive- constipation, thirst, has a latex allergy. decrease the risk of a
compulsive disorder flatulence, anorexia, serious drug-food
(OCD). Adults: Initially, 50 abdominal pain, increased interaction.
mg P.O. once daily. Adjust appetite.
dose as needed and  GU: male sexual
tolerated. Dosage Provide comfort
dysfunction, polyuria, measures to help the
adjustments should be nocturia, dysuria.
made at intervals of no patient tolerate drug
 Musculoskeletal: myalgia. effects.
less than 1 week.
 Skin: rash, pruritus,
Children ages 13 to 17
diaphoresis. Provide safety measures
(OCD only): Initially, 50 mg
P.O. once daily. Increase (e.g. adequate lighting,
at intervals no less than 1 raised side rails, etc.) to
 week. Maximum, 200 mg prevent injuries.
daily.
Children ages 6 to 12
(OCD only): Initially, 25 mg Educate the client on
P.O. once daily. Increase drug therapy to promote
at intervals no less than 1 compliance.
week. Maximum, 200 mg
daily.

Premenstrual dysphoric
disorder. Adults: 50 to 150
mg P.O. daily.

Premature ejaculation.
Adults: 25 to 50 mg P.O.
daily or p.r.n.

Dosage adjustment. For

patients with hepatic
impairment, use lower
dose or less frequent
delivery. Take particular
care in patients with renal
failure.

Generic Name: The mechanism of action of Depressive syndromes:  Metabolism and nutrition  Use in patients with
 Moclobemide moclobemide involves the The recommended dose disorders: Very rare: known hypersensitivity to
selective, reversible inhibition of range of Aurorix is 300-600 Hyponatraemia. moclobemide or to any
Brand Name: MAO-A. This inhibition leads to a mg daily usually  Psychiatric disorders: component of the
 Aurorix decrease in the metabolism and administered in 2-3 divided Frequency not known: Sleep product.
destruction of monoamines in the doses. The initial dose is distrubances, agitation,  Acute confusional states.
neurotransmitters. This results in 300 mg daily and may be anxiety, restlessness,  Aurorix should not be
an increase in the monoamines, increased to 600 mg/day suicidal ideation and suicidal used in pediatrics at
relieving depressive symptoms. for severe depression. behaviours. present, as clinical
The dose should not be  Very rare: Confusional state experience of the drug's
raised until after the first (these have resolved quickly action in children is
week, as bioavailability on discontinuation of lacking.
increases during this therapy).  Co-administration of
period. Treatment should  Nervous system disorders: Aurorix with selegiline is
continue for at least 4-6 Frequency not known: contraindicated
weeks to assess the Dizziness headache,
efficacy of the drug. paraesthesia.
 Eye disorder: Frequency not
Special Dosage known: Visual disturbances.
Instructions: The dose  Vascular disorders:
should be taken after a Frequency not known:
meal. The dose of Aurorix Flushing.
does not need to be  Gastrointestinal disorders:
specially adjusted in elderly Frequency not known: Dry
patients or patients with mouth, gastrointestinal
reduced renal function. disorders (nausea, vomiting,
When hepatic metabolism diarrhea, constipation).
is severely impaired by  Skin and subcutaneous
hepatic disease or inhibited tissue disorders: Frequency
by a drug that inhibits not known: Oedema, rash,
microsomal mixed function pruritus, urticaria.
oxidase activity (e.g.
 General disorders and
cimetidine), the daily dose
administration site
of Aurorix should be
conditions: Frequency not
reduced to half or one third.
known: Irritability.
 Investigations: Very rare:
Increased hepatic enzymes
(without associated clinical
sequelae). Frequency not
known: Serotonin syndrome
(co-administered with drugs
that enhance serotonin,
such as serotonin re-uptake
inhibitors and many other
 antidepressants).

DRUG NAME MECHANISM OF ACTION INDICATION SIDE EFFECTS/ ADVERSE CONTRAINDICATION NURSING
REACTION CONSIDERATION

Generic Name: ● Description: Haloperidol Haloperidol is Side effects: ● Severe toxic Before:
● Haldol is a butyrophenone. It used to treat ● drowsiness; CNS • Check for the doctor’s
nonselectively inhibits certain ● headache; depression order for the medications
Brand Name: postsynaptic mental/mood ● dizziness, spinning ● comatose given.
● Haloperidol dopaminergic D2 disorders (such sensation; states • Assess knowledge of the
receptors in the brain. as ● uncontrolled muscle ● Parkinson’s patient on the medication.
Dosage, Route and ● Pharmacokinetics: schizophrenia, movements; disease • Prepare the medicine
Frequency: ● Absorption: Readily schizoaffective ● feeling restless or ● basal ganglia according to instructions.
Intramuscular absorbed from the disorders). This anxious; lesions • Assess patient’s 14
Psychoses, Schizophrenia gastrointestinal tract. medicine helps ● sleep problems ● thyrotoxicosis rights.
Adult: Initially, 2-10 mg in Bioavailability: Approx you to think (insomnia); or ● significant • Be aware of purpose,
subsequent doses given 60-70% (oral). Time to more clearly, ● breast enlargement, cardiac contraindications and
as often as every 60 peak plasma feel less irregular menstrual disorders anticipated effect of
minutes until symptoms concentration: 2-6 hours nervous, and periods. (e.g. acute haloperidol
are controlled, administer (oral); 20 minutes (IM). take part in Adverse effects MI, • Record BP and other vital
with a dosage interval of 4- ● Distribution:Crosses the everyday life. It ● Significant: uncompensat signs.
8 hours. Adjust dose blood-brain barrier; can also help Extrapyramidal ed heart •Tell doctor for use of other
according to response and enters breast milk. prevent suicide syndrome (e.g. failure, medications
tolerability. Max: 18 mg Plasma protein binding: in people who pseudoparkinsonis arrhythmias, •Report the following to
daily. Approx 92%. are likely to m, akathisia, tardive clinically your doctor:
● Metabolism: Extensively harm dyskinesia, significant ● dementia-related
Oral metabolised in the liver themselves. It dystonia), CNS bradycardia, psychosis
Severe tics, Tourette's via oxidative also reduces depression, 2nd or 3rd ● bipolar disorders,
syndrome dealkylation and aggression and anticholinergic degree heart seizures or EEG
Adult: 0.5-5 mg 2-3 times ultimately conjugated the desire to effects (e.g. block, abnormalities
daily. Maintenance dose: 4 with glycine. hurt others. It constipation, uncorrected ● risk of falls
mg once daily. Adjust dose ● Excretion: Via urine can decrease xerostomia, blurred hypokalaemia ● risk of QT
according to response and (30%, 1% as unchanged negative vision, urinary ) prolongation
tolerability. Max: 30 mg drug). Elimination half- thoughts and retention), ● Lactation ● risk factors for
daily. life: Approx 12-38 hours hallucinations. esophageal stroke
Child: 3-12 years Initially (oral). Haloperidol dysmotility and ● severe CV
0.25 mg daily, increased to can also be aspiration, disease
0.5-3 mg daily. Max: 3 mg used to treat somnolence, ● decreased
daily; 13-17 years 0.25 mg uncontrolled orthostatic gastrointestinal
daily, increased to 2-6 mg movements hypotension, motor motility
daily. Max: 6 mg daily. and outbursts or sensory ● paralytic ileus
of instability, ● urinary retention
Oral words/sounds hyperprolactinaemia ● BPH
Mania, Psychoses, related to . ● xerostomia
Schizophrenia Tourette's ● Cardiac disorders: ● visual problems,
Adult: 0.5-5 mg 2-3 times syndrome. Cardiac arrhythmia, and narrow angle
daily. Maintenance: 3-10 Haloperidol is tachycardia. glaucoma.
mg daily. Adjust dose also used for ● Eye disorders: ● Concomitant use
according to response and severe Visual disturbance. with
tolerability. behavior ● Gastrointestinal antidepressants
Child: Schizophrenia: 3-12 problems in disorders: and anticholinergic
years Initially 0.5 mg daily, hyperactive Diarrhoea, nausea, agents.
increased to 1-4 mg daily. children when sialorrhoea,
Max: 6 mg daily; 13-17 other vomiting. During:
years 0.5 mg daily, treatments or ● General disorders ● Check the right
increased to 1-6 mg daily. medications and administration dose, right route,
Max: 10 mg daily. have not site conditions: right frequency
Elderly: 0.5-2 mg 2-3 times worked.Halope Injection site ● May administer
daily. Adjust dose ridol is a reaction. with or without
according to response and psychiatric ● Hepatobiliary food.
tolerability. Max: 20 medication disorders: Jaundice. ● Avoid abrupt
mg/day in divided doses. (antipsychotic- ● Metabolism and withdrawal
type) that nutrition disorders: ● Renal and hepatic
Classification: works by Anorexia, impairment.
Antipsychotic 1st helping to hypoglycaemia. ● Do not operate
Generation, CYP3A4 restore the ● Nervous system heavy machinery
Inhibitor, Moderate. balance of disorders: Agitation, under haloperidol
certain natural restlessness, ● Avoid strenuous
Pregnancy Category: substances in headache. activities
Category C the brain ● Psychiatric ● Do not take
(neurotransmitt disorders: alcohol or caffeine
ers). Confusion, with haloperidol
depression, After:
insomnia. •Store away from moisture
● Renal and urinary and heat
disorders: Urinary •Do not freeze
retention. •The patient may
● Reproductive experience these side
system and breast effects:
disorders: Erectile ● drowsiness;
dysfunction, ● headache;
gynaecomastia, ● dizziness,
priapism. spinning
● Respiratory, sensation;
thoracic and ● uncontrolled
mediastinal muscle
disorders: movements;
Bronchospasm, ● feeling restless or
dyspnoea. anxious;
● Skin and ● sleep problems
subcutaneous (insomnia); or
tissue disorders: ● breast
Acneiform rash, enlargement,
maculopapular rash. irregular menstrual
● Vascular disorders: periods.
Hypotension. • Report the following
● Potentially Fatal: immediately
Neuroleptic ● uncontrolled
malignant muscle
syndrome, movements in
bronchopneumonia, face (chewing, lip
blood dyscrasias smacking,
(e.g. leucopenia, frowning, tongue
neutropenia, movement,
agranulocytosis), blinking or eye
QT prolongation, movement);
torsade de pointes. ● muscle spasms in
neck, tightness in
throat, trouble
swallowing;
● rapid changes in
mood or behavior;
● fast or pounding
heartbeats,
fluttering in chest,
shortness of
breath, and
sudden dizziness,
feeling faint
● cough with mucus,
chest pain, feeling
short of breath;
● low white blood
cell counts--fever,
chills, mouth
sores, skin sores,
sore throat, cough,
trouble breathing;
or
● severe nervous
system reaction--
very stiff (rigid)
muscles, high
fever, sweating,
confusion, fast or
uneven
 heartbeats,
tremors, feeling
faint.

DRUG NAME MECHANISM OF ACTION INDICATION SIDE EFFECTS/ ADVERSE CONTRAINDICATION NURSING
REACTION CONSIDERATION

Generic Name: ● Description: Loxapine is a For the Side Effects: ● Severe drug- Before:
● Loxapine tricyclic dibenzoxazepine- management of ● dry mouth induced CNS • Check for the doctor’s
derivative antipsychotic the manifestations ● taste perversion ● depression order for the medications
Brand Name: agent. It blocks postsynaptic of psychotic ● blocked nose ● coma (oral) given.
● Loxitane mesolimbic dopamine D1 and disorders such as ● tiredness ● current • Assess knowledge of the
D2 receptors in the brain. It schizophrenia ● difficulty urinating diagnosis or patient on the medication.
Dosage, Route and also inhibits serotonin 5-HT2 ● constipation history of • Prepare the medicine
Frequency: receptors. ● nausea asthma, according to instructions.
Inhalation/Respiratory ● Pharmacokinetics: ● vomiting COPD, • Assess patient’s 14
Acute agitation ● Absorption: Rapidly and ● difficulty sleeping bronchospas rights.
Adult: In patients w/ completely absorbed. Time to ● confusion m, or acute • Be aware of purpose,
schizophrenia or bipolar peak plasma concentration: ● weight gain or resp contraindications and
disorder: 10 mg/24 hr via W/in 1-2 hr (oral); w/in 2 min weight loss. symptoms anticipated effect of
inhaler device. (inhalation) Adverse Reactions: (inhalation). loxapine
● Distribution: Widely ● Significant: • Record BP and other vital
Intramuscular distributed in body tissues. Anticholinergic signs.
Acute psychosis Plasma protein binding: 97% effects (e.g. •Tell doctor for use of other
Adult: 12.5-50 mg at (inhalation) constipation, medications
intervals of 4-6 hr. Dosage ● Metabolism: Metabolised xerostomia, blurred •Drug interactions with:
and dosing interval may be rapidly and extensively in the vision, urinary Additive effect w/ other
adjusted based on patient liver via hydroxylation into 8- retention), CNS CNS or resp depressants
response. OH-loxapine and 7-OH- depression, (e.g. benzodiazepines,
loxapine metabolites, further oesophageal barbiturates, opioids)
Oral metabolised via N-oxidation dysmotility/aspiratio leading to excessive
Psychoses to form loxapine N-oxide n, extrapyramidal sedation and resp
Adult: Initially, 20-50 mg metabolites, and via N- symptoms (e.g. depression or resp failure.
daily in 2 divided doses, demethylation into amoxapine pseudoparkinsonis Loxapine may enhance the
increased over the next 7- metabolite. Undergoes first- m, acute dystonic effect of anticholinergic
10 days to 60-100 mg daily pass metabolism. reactions, akathisia, drugs (e.g. aclidinium,
in 2-4 divided doses, ● Excretion: Mainly via urine tardive dyskinesia), cimetropium, ipratropium).
according to response. (40%, as conjugated risk of fall due to •Report the following to
Max: 250 mg daily. metabolites); via faeces somnolence and your doctor:
Maintenance: Use the (10%, as unconjugated motor or sensory ● heart disease
lowest effective dose metabolites). Elimination half- instability, ● dementia-related
between 20-60 mg daily in life: 6-8 hr (inhalation). Oral: hyperprolactinaemia psychosis in
divided doses. Biphasic: Initial: 5 hr; , neuroleptic elderly e.g.
terminal: 19 hr. malignant delusions,
Classification: syndrome, hallucinations
Antipsychotic pigmentary ● liver disease
Pregnancy Category: C retinopathy, ● epilepsy (fits or
lenticular and seizures)
corneal deposits, ● Parkinson's
orthostatic disease (a
hypotension, disorder that
hypotension, affects movement
syncope, impaired of a , causing
core body temp symptoms such as
regulation. tremors, muscle
● Nervous: Sedation, stiffness, slowed
agitation, confusion, movement and
dizziness, impaired balance
drowsiness, or walking)
headache, During:
insomnia, ● Check the right
numbness, dose, right route,
paraesthesia, right frequency
seizure, slurred ● Should be
speech, tension, administered with
 unsteady gait. food.
● CV: ECG changes, ● Avoid abrupt
oedema, HTN, withdrawal.
tachycardia. ● Do not operate
● GI: Polydipsia, heavy machinery
constipation, under loxapine
nausea, paralytic ● Avoid strenuous
ileus, vomiting, activities
xerostomia and ● Do not take
dysgeusia alcohol or caffeine
(inhalation). with haloperidol
● Resp: Dyspnoea, After:
nasal congestion. •Store away from moisture
● Hepatic: Hepatitis, and heat
increased serum •Do not freeze
ALT/AST, jaundice. •The patient may
● Genitourinary: experience these side
Impotence, urinary effects:
retention, priapism. ● dry mouth
● Endocrine: ● taste perversion
Amenorrhoea, ● blocked nose
galactorrhoea, ● tiredness
gynaecomastia, ● difficulty urinating
menstrual disease, ● constipation
wt gain, wt loss. ● nausea
● Musculoskeletal: ● vomiting
Muscle twitching, ● difficulty sleeping
muscle weakness. ● confusion
● Dermatologic: ● weight gain or
Flushing, alopecia, weight loss.
dermatitis, pruritus, • Report the following
seborrhoea, skin immediately
photosensitivity, ● fast or irregular
rash. heartbeat
 ● Immunologic: ● uncontrollable
Hypersensitivity twitching
(inhalation). movements of the
● Others: mouth, tongue and
Hyperpyrexia. limbs
● Potentially Fatal: ● unusual changes
Bronchospasm in mood or
leading to resp behaviour (being
distress and resp too depressed,
arrest. Blood agitated, or having
dyscrasias (e.g. compulsive and
leucopenia, impulsive
neutropenia, behaviour)
agranulocytosis). ● fever, sore throat,
mouth ulcers,
unusual bleeding
or bruising
● muscle stiffness,
fever, blood
pressure changes
● yellowing of the
skin or eyes
● difficulty breathing,
chest pain or
tightness,
wheezing,
coughing

DRUG NAME MECHANISM OF ACTION INDICATION SIDE CONTRAINDICATIONS NURSING

EFFECTS/ADVERSE CONSIDERATIONS
REACTIONS

Generic Name: ● Description: Mesoridazine is used to Side Effects: ● Severe CNS Before:
 ● Mesoridazine Mesoridazine is a treat schizophrenia. ● Drowsiness depression and • Check for the doctor’s
phenothiazine ● Upset stomach, coma order for the medications
Brand Name: antipsychotic. It vomiting, ● prolonged QT given.
● Serentil has a piperidine nausea, or interval (>450 • Assess knowledge of the
side-chain and is a diarrhea msec), including patient on the medication.
Dosage, Route and metabolite of ● Dry mouth and congenital • Prepare the medicine
Frequency: thioridazine. It acts nasal congestion prolongation according to instructions.
Intramuscular by blocking ● Constipation ● history of • Assess patient’s 14
Resistant schizophrenia, postsynaptic CNS ● Anxiety or arrhythmias. rights.
Severe schizophrenia dopamine restlessness ● Lactation. • Be aware of purpose,
Adult: Initially, 25 mg. receptors. ● Changes in contraindications and
Repeat after 30-60 min if ● Onset: 30 min to 1 appetite or anticipated effect of
necessary; up to 200 mg hr. weight gain serentil
daily has been given. ● Duration: 4-6 hr. ● Increased skin • Record BP and other vital
● Pharmacokinetics: sensitivity to signs.
Oral ● Absorption: sunlight •Tell doctor for use of other
Resistant schizophrenia, Tablet: Erratic; ● Loss of interest medications
Severe schizophrenia Liquid: More in sex •Drug interactions with:
Adult: Initially, 25-50 mg dependable. Peak ● Menstrual ● Increased risk of
tid. May adjust dose to serum irregularities extrapyramidal
100-400 mg according to concentrations in Adverse Reactions: symptoms (EPS)
response. 2-4 hr. ● Hypotension with central
● Distribution: ● orthostatic acetylcholinestera
Classification: Widely distributed hypotension se inhibitors.
Antipsychotic into body including ● tachycardia Reduced
Pregnancy Category: breast milk. ● cardiac absorption with
Protein-binding: arrhythmias aluminium salts.
91-99%. ● sinus Reduced efficacy
● Metabolism: tachycardia of amphetamines;
Hepatic. ● sedation increased risk of
● Excretion: Mainly ● drowsiness psychotic
via urine; 24-48 hr ● restlessness symptoms with
(elimination half- ● anxiety amphetamines.
life). ● extrapyramidal Reduced efficacy
 symptoms or excess
● pseudoparkinson anticholinergic
ian signs effects with
● tardive anticholinergics.
dyskinesia Additive
● neuroleptic hypotensive
malignant effects with
syndrome antihypertensives,
● seizures trazodone. May
● altered central inhibit effects of
temperature bromocriptine on
regulation serum prolactin
● akathisia levels. Additive
● dystonias sedative effects
● dizziness with CNS
● hyperthermia depressants. May
● hypersensitivity diminish effects of
reactions epinephrine. May
● amenorrhoea inhibit the
● galactorrhoea antiparkinsonian
● gynaecomastia effect of levodopa.
● syndrome of May increase risk
inappropriate of EPS with
antidiuretic metoclopramide.
hormone Increased risk of
● GI upset neurotoxicity with
● xerostomia lithium (rare).
● constipation Increased serum
● weight gain levels with
● urinary retention sulfadoxime-
● impotence pyrimethamine.
● agranulocytosis Increased toxicity
● leukopenia or altered
● thrombocytopeni response with
 a TCAs. May
● haemolysis increase serum
● eosinophilia levels of valproic
● cholestatic acid.
jaundice ● Potentially Fatal:
● trismus Increased risk of
● retinal malignant
pigmentation arrhythmias with
● nystagmus other QTc-
● blurred vision prolonging agents.
● nasal congestion •Report the following to
● decreased your doctor
diaphoresis ● CNS Depression
● SLE ● Parkinson's
disease
● haemodynamic
instability
● bone marrow
suppression
● predisposition to
seizures
● subcortical brain
damage
● severe cardiac,
hepatic, renal or
respiratory
disease
● patients at risk of
pneumonia (e.g.
Alzheimer's
disease)
● breast cancer or
other prolactin-
dependent
 tumours.
● risk of orthostatic
hypotension
● cerebrovascular
disease
● CVD
● Decreased GI
motility
● urinary retention
● benign prostatic
hyperplasia
● xerostomia or
visual problems.
● Narrow-angle
glaucoma and
myasthenia gravis.
● Pregnancy
During:
● Check the right
dose, right route,
right frequency
● Administer with or
without food.
● Avoid abrupt
withdrawal.
● Do not operate
heavy machinery
under serentil
● Avoid strenuous
activities
● Do not take
alcohol or caffeine
with haloperidol
● Take with a full
 glass of water
● Monitor potassium
levels
After:
•Store away from moisture
and heat
•Do not freeze
•Throw discolored
medication
•Avoid long sunlight
exposure
•The patient may
experience these side
effects:
● dry mouth or stuffy
nose
● constipation
● mild restlessness,
drowsiness, or
tremor
● difficult urination
or dark urine
● decreased sex
drive
● increased appetite
● menstrual
irregularities or
swollen breasts
•Report the following
immediately:
● an allergic
reaction (difficulty
breathing; closing
of your throat;
 swelling of your
lips, tongue, or
face; or hives)
● uncontrollable
movements of the
mouth, tongue,
cheeks, jaw, arms,
or legs
● fever
● muscle rigidity
● muscle spasms of
the face or neck
● sweating
● irregular pulse
● fast or irregular
heartbeats.
● severe
restlessness or
tremors
● severe drowsiness
● blurred vision
● dizziness or
fainting;
● a rash.

DRUG NAME MECHANISM OF ACTION INDICATION SIDE EFFECTS/ADVERSE CONTRAINDICATIONS NURSING

REACTIONS CONSIDERATIONS

Generic Name: ● Description: treatment of acute and Adverse Reactions ● Phaeochromocyto Before:
● Amilsupride Amisulpride is a chronic schizophrenic ● Insomnia, anxiety, ma • Check for the doctor’s
substituted disorders agitation, ● concomitant order for the medications
Brand Name: benzamide drowsiness, wt prolactin- given.
● Solian atypical gain, acute dependent • Assess knowledge of the
 antipsychotic dystonia, tumours (e.g. patient on the medication.
Dosage, Route and which binds parkinsonism, pituitary gland • Prepare the medicine
Frequency: Acute selectively w/ a akathisia, tardive prolactinomas or according to instructions.
psychosis high affinity to dyskinesia, QT breast cancer) • Assess patient’s 14
Adult: 400-800 mg bid. human prolongation, ● Pre-pubertal rights.
Max: 1.2 g daily. Patients dopaminergic D2 hypotension, children • Be aware of purpose,
w/ predominantly negative and D3 receptor bradycardia, GI ● Combination w/ contraindications and
symptoms: 50-300 mg subtypes. disorders (e.g. levodopa. anticipated effect of
daily. ● Pharmacokinetics: constipation, serentil
Classification:N05AL05 - ● Absorption: nausea, vomiting, • Record BP and other vital
amisulpride ; Belongs to Absorbed from GI dry mouth), signs.
the class of benzamides tract. hyperglycaemia; •Tell doctor for use of other
antipsychotics. Bioavailability: breast pain, erectile medications
Pregnancy Category: Approx 48%. Time dysfunction, •Drug interactions with:
to peak plasma amenorrhoea, ● Increased risk of
concentration: 1 hr gynaecomastia, arrhythmias w/
(initial); 3-4 hr galactorrhoea. cisapride,
(2nd). Rarely, allergic thioridazine,
● Distribution: reactions, abnormal halofantrine,
Volume of LFTs, seizures. erythromycin,
distribution: 5.8 Potentially Fatal: some
L/kg. Plasma Neuroleptic malignant antiarrhythmics,
protein binding: syndrome pimozide,
Approx 16%. haloperidol, TCAs,
● Metabolism: β-blockers, some
Limited Ca channel
metabolism. blockers,
● Excretion: Mainly clonidine,
via urine as guanfacine,
unchanged drug. digoxin, K-
Terminal depleting diuretics,
elimination half- lithium,
life: Approx 12 hr. antimalarials. May
enhance effects of
 antihypertensives
and CNS
depressants (e.g.
sedative H1-
antihistamines,
narcotics,
anaesthetics,
analgesics,
barbiturates,
benzodiazepines,
other anxiolytics,
clonidine and
derivatives).
● Potentially Fatal:
Reciprocal
antagonism
between levodopa
and neuroleptics
•Report the following to
your doctor:
● history of epilepsy
● Parkinson's
disease
● CV disease
● Renal impairment.
● Elderly
● Pregnancy and
lactation.

During:
● Check the right
dose, right route,
right frequency
● Should be
 administered
without food, on an
empty stomach,
before meals
● Do not operate
heavy machinery
under solian
● Avoid strenuous
activities
● Do not take
alcohol or caffeine
with solian
After:
•Store away from moisture
and heat
•Do not freeze
•The patient may
experience these side
effects:
● restlessness
● dizziness
● sleepiness
● dry mouth
● nausea or vomiting
● constipation
•Report the following
immediately:
● sudden dizziness
● feeling faint
● fast or pounding
heartbeats
● shortness of
breath
● low potassium
 level--leg cramps,
constipation,
irregular
heartbeats,,
increased thirst or
urination,
numbness or
tingling, muscle
weakness or limp
feeling.

DRUG NAME MECHANISM OF ACTION INDICATION SIDE EFFECTS/ADVERSE CONTRAINDICATIONS NURSING

REACTIONS CONSIDERATIONS

Generic Name: ● Description: Treatment of Side Effects: ● breast cancer Before:

● Risperdone Risperidone is a schizophrenia & ● dizziness ● diabetes • Check for the doctor’s
benzisoxazole schizoaffective disorder ● drowsiness ● a high prolactin order for the medications
Brand Name: atypical Risperidone is indicated ● blurred vision level given.
● Risperdal antipsychotic and a for the treatment of ● headache ● excessive fat in • Assess knowledge of the
selective schizophrenia and ● tiredness the blood patient on the medication.
Dosage, Route and monoaminergic irritability associated ● nausea ● dehydration • Prepare the medicine
Frequency: antagonist that has with autistic disorder.15 ● vomiting ● overweight according to instructions.
Intramuscular high affinity for It is also indicated as ● stomach pain or ● very low levels • Assess patient’s 14
Bipolar disorder serotoninergic 5- monotherapy, or discomfort of granulocytes, rights.
Adult: Patient naive to HT2, dopaminergic adjunctly with lithium or ● diarrhoea a type of white • Be aware of purpose,
risperidone use must D2, adrenergic (α1 valproic acid, for the ● indigestion blood cell contraindications and
receive oral risperidone 1st and α2), and treatment of acute ● dry mouth ● low levels of anticipated effect of
to establish tolerability histaminergic H1 mania or mixed ● toothache white blood cells risperidal
before initiation of inj. As receptors. It has no episodes associated ● muscle pain or ● low levels of a • Record BP and other vital
monotherapy or adjunctive affinity for cholinergic with bipolar I disorder.15 spasm type of white signs.
therapy to lithium or receptors. ● joint pain blood cell called •Tell doctor for use of other
valproate for maintenance ● Pharmacokinetics: ● difficulty sleeping neutrophils medications
treatment: Initially, 25 mg ● Absorption: Rapidly ● weight gain, and ● confusion •Drug interactions with:
every 2 weeks. Dose may and well absorbed changes in appetite. ● drug abuse •Report the following to
be increased, if necessary, from the Adverse Reactions: ● a type of your doctor
in increments of 12.5 mg gastrointestinal tract. ● Significant: Altered movement ● known CV disease
at intervals of at least 4 Bioavailability: 70% cardiac conduction, disorder called (e.g. conduction
weeks. Max: 50 mg every (oral). Time to peak prolonged QT parkinsonism abnormalities,
2 weeks. Continue oral plasma interval; ● tardive heart failure, prior
supplementation for 3 concentration: oesophageal dyskinesia, a MI or ischaemic
weeks after the 1st inj. Risperidone: Oral: dysmotility and disorder heart disease)
Within 1-2 hours. aspiration; venous characterized by ● cerebrovascular
Intramuscular SC: 4-6 hours (1st thromboembolism, involuntary diseases
Schizophrenia peak); 10-14 days neutropenia, movements of ● risk factors for
Adult: Patient naive to (2nd peak). leucopenia, the face, mouth stroke
risperidone use must ● Distribution: Rapidly extrapyramidal and tongue ● family history of
receive oral risperidone 1st distributed. Enters symptoms (e.g. ● neuroleptic QT prolongation
to establish tolerability breast milk (small parkinsonism, acute malignant ● history of clinically
before initiation of inj. amounts). Volume of dystonic reactions, syndrome, a significant low
Initially, 25 mg every 2 distribution: 1-2 L/kg. akathisia, tardive reaction WBC or drug-
weeks. For patients on Plasma protein dyskinesia); falls, characterized by induced
fixed dose of oral binding: Approx 90% hyperglycaemia, fever, muscle leucopenia or
risperidone treated with >4 (risperidone), 77% diabetes mellitus or rigidity and neutropenia
mg daily for ≥2 weeks: (9- exacerbation of pre- confusion ● Lewy body
Initially, 37.5 mg every 2 hydroxyrisperidone); existing diabetes, ● a heart attack dementia
weeks. Doses may be mainly to albumin hyperprolactinaemia ● a low supply of ● Parkinson’s
increased in increments of and α1-acid , hypersensitivity oxygen rich disease
12.5 mg at intervals of at glycoprotein reactions, blood to the ● history of seizures
least 4 weeks. Max: 50 mg (risperidone). intraoperative floppy heart or at risk of
every 2 weeks. Continue ● Metabolism: iris syndrome (in ● abnormal heart seizures (e.g.
oral supplementation for 3 Extensively patients undergoing rhythm head trauma, brain
weeks after the 1st inj. metabolised in the cataract surgery), ● chronic heart damage,
liver via orthostatic failure alcoholism)
Oral hydroxylation hypotension, ● a stroke ● diabetes mellitus
Schizophrenia mediated by priapism, impaired ● a disorder of the or its risk factors
Adult: Initially, 2 mg daily, CYP2D6 isoenzyme core body blood vessels of (e.g. obesity,
may be increased to 4 mg to 9- temperature the brain family history)
on the 2nd day. hydroxyrisperidone regulation, weight ● hardening of the ● other disorders of
Subsequent dosage may (main active gain. arteries due to glucose regulation
be maintained or adjusted metabolite); ● Blood and lymphatic plaque buildup ● pre-existing
further if needed in oxidative N- system disorders: ● orthostatic hyperprolactinaem
increments of 1-2 mg, as dealkylation is a Anaemia. hypotension, a ia
tolerated, at intervals of at minor metabolic ● Cardiac disorders: form of low ● possible prolactin-
least 24 hours. Usual dose pathway. Tachycardia. blood pressure dependent
range: 4-6 mg daily. Doses ● Excretion: Via urine ● Ear and labyrinth ● low blood tumours
may be given once or (70%; 35-45% disorders: Ear pressure ● at risk of
twice daily. Max: 16 mg risperidone and 9- infection, tinnitus, ● liver problems orthostatic
daily. hydroxyrisperidone); ear pain. ● severe liver hypotension
Child: 13-17 years Initially, faeces (14%). ● Eye disorders: disease ● suicidal ideation
0.5 mg once daily, may be Elimination half-life: Blurred vision, ● priapism, a (during initiation of
increased in increments of Risperidone: Approx conjunctivitis. prolonged therapy)
0.5-1 mg daily at intervals 3 hours (oral); 9-11 ● Gastrointestinal erection of the ● aspiration
of at least 24 hours, as days (SC). Active disorders: penis pneumonia.
tolerated, to a target dose antipsychotic Abdominal pain or ● a condition with ● dehydration or
of 3 mg daily. Dose range: fraction: Approx 20 discomfort, muscle tissue strenuous exercise
1-6 mg daily. hours (oral); 3-6 vomiting, nausea, breakdown ● exposed to
Elderly: Initially, 0.5 mg days (IM). diarrhoea, called extreme heat
bid, gradually increased in dyspepsia, dry rhabdomyolysis ● receiving drugs
0.5 mg bid increments to mouth, toothache. ● seizures with
1-2 mg bid. ● General disorders ● fever anticholinergic
and administration ● weight gain effects
Oral site conditions: ● difficulty ● undergoing
Persistent aggression Oedema, pyrexia, swallowing cataract surgery.
associated with dementia chest pain, ● an inability to ● Renal and hepatic
in Alzheimer’s disease asthenia, fatigue; completely impairment.
Adult: Short-term treatment injection site empty the ● Pregnancy and
in patients with moderate reaction (e.g. pain, bladder lactation.
to severe dementia who induration, swelling). ● low body ● CYP2D6 ultrarapid
are unresponsive to non- ● Infections and temperature or poor
pharmacological infestations: ● susceptible to metabolisers.
intervention, and when Influenza. breathing fluid ● Concomitant use
there is a risk of harm to ● Investigations: into lungs with enzyme
self or others: Initially, 0.25 Decreased weight, ● decreased blood inhibitors or
mg bid. Adjusted increased volume inducers
individually in increments transaminases and ● metabolic During:
of 0.25 mg bid on alternate gamma- syndrome x ● Check the right
days, if required. Usual glutamyltransferase. ● dementia in an dose, right route,
dose: 0.5 mg bid (up to 1 ● Metabolism and elderly person right frequency
mg bid, if needed). Max nutrition disorders: ● diffuse Lewy ● Administer with or
treatment duration: 6 Increased or body disease without food.
weeks. decreased appetite. ● cataract surgery ● Avoid abrupt
● Musculoskeletal and ● floppy iris during withdrawal
Oral connective tissue eye surgery ● Do not operate
Acute manic episodes of disorders: Muscle ● chronic kidney heavy machinery
bipolar disorder, Acute spasms, disease stage under risperidal
mixed episodes of bipolar musculoskeletal 3A (moderate) ● Avoid strenuous
disorder pain, back pain, ● chronic kidney activities
Adult: As monotherapy or arthralgia. disease stage ● Do not take
adjunctive therapy with ● Nervous system 3B (moderate) alcohol or caffeine
lithium or valproate: disorders: ● chronic kidney with risperidal
Initially, 2-3 mg once daily. Headache, sedation disease stage 4 After:
Dosage may be increased or somnolence, (severe •Store away from moisture
in increments of 1 mg daily dizziness, tremor. and heat
at intervals of at least 24 ● Psychiatric •Do not freeze
hours. Max: 6 mg daily. disorders: Insomnia, •The patient may
Child: 10-17 years As sleep disorder, experience these side
monotherapy: Initially, 0.5 agitation, effects:
mg once daily, may be depression, anxiety. ● dizziness
increased in increments of ● Renal and urinary ● drowsiness
0.5-1 mg daily at intervals disorders: Urinary ● blurred vision
of at least 24 hours, as incontinence, UTI, ● headache
tolerated, to a target dose urinary retention. ● tiredness
of 1-2.5 mg daily. Max: 6 ● Reproductive ● nausea
mg daily. system and breast ● vomiting
Elderly: Initially, 0.5 mg disorders: ● stomach pain or
bid, gradually increased in Amenorrhoea, discomfort
0.5 mg bid increments to galactorrhoea, ● diarrhoea
1-2 mg bid. decreased libido. ● indigestion
● Respiratory, ● dry mouth
Oral thoracic and ● toothache
Conduct disorder mediastinal ● muscle pain or
Child: Short-term disorders: spasm
symptomatic treatment (up Dyspnoea, ● joint pain
to 6 weeks) of persistent pharyngolaryngeal ● difficulty sleeping
aggression in patients with pain, cough, ● weight gain, and
subaverage intellectual epistaxis, nasal changes in
functioning or mental congestion, appetite.
retardation, in whom the pneumonia, •Report the following
severity of condition bronchitis, upper immediately:
requires pharmacologic respiratory tract ● fast or irregular
treatment: 5-18 years <50 infection, sinusitis. heartbeat
kg: Initially, 0.25 mg once ● Skin and ● chest pain
daily. Adjusted individually subcutaneous tissue ● fever, confusion,
in increments of 0.25 mg disorders: Rash, change in thinking,
once daily on alternate erythema. excessive
days, if required. Usual ● Vascular disorders: sweating
dose: 0.5 mg once daily; Hypertension. ● muscle stiffness,
some may require up to ● Potentially Fatal: uncontrolled
0.75 mg once daily. ≥50 Cerebrovascular muscle
kg: Initially, 0.5 mg once events (e.g. TIA, movements of
daily. Adjusted individually stroke), neuroleptic your body or face
in increments of 0.5 mg malignant such as sticking
once daily on alternate syndrome, out of the tongue,
days, if required. Usual agranulocytosis smacking of the
dose: 1 mg once daily; lips
some may require up to ● rashes,
1.5 mg once daily. breathlessness,
swelling of the
Oral face, eyes or
Irritability associated with mouth
autistic disorder
Child: 5-17 years Dosage
is individualised according
to patient response and
tolerability. 15-<20 kg:
Initially, 0.25 mg daily, may
be increased to 0.5 mg
daily after at least 4 days;
maintain dose for at least
14 days. If response is
insufficient, dose may be
increased in increments of
0.25 mg daily at intervals
of ≥2 weeks. ≥20 kg:
Initially, 0.5 mg daily, may
be increased to 1 mg daily
after at least 4 days;
maintain dose for at least
14 days. If response is
insufficient, dose may be
increased in increments of
0.5 mg daily at intervals of
≥2 weeks. All doses may
be given as single or in 2
divided doses. Max: 3 mg
daily. Consider gradually
reducing the dose to
lowest effective dose once
sufficient response has
been achieved.

Subcutaneous
Schizophrenia
Adult: Patient naive to
risperidone use must
receive oral risperidone 1st
to establish tolerability
before initiation of inj.
Usual dose: 90 mg or 120
mg once monthly. Patients
on stable oral risperidone
doses of <3 mg daily or >4
mg daily may not be
eligible for this route.
Classification:
Antipsychotic
Pregnancy Category: C

Drug Name Mechanism of Action Indication Side Effects/Adverse Contraindications Nursing Consideration
Reactions
Generic Name: Quetiapine Quetiapine mechanism of Acute treatment of manic Constipation, drowsiness, Before: Assess client for
Brand Name: Seroquel action might involve rapid episodes in bipolar I upset stomach, tiredness, neuroleptic malignant neurologic function.
Dosage, route and dissociation from D2 disorder, as monotherapy weight gain, blurred vision, syndrome, a reaction During: monitor patient
frequency: 400-800mg/per receptors.[/caption] PET and as an adjunct to or dry mouth may occur. characterized by fever, closely in any setting that
PO in sigle dose studies show that there is a lithium or divalproex. Dizziness or muscle rigidity and would promote
Classification: relationship between D2 Depressive episodes lightheadedness may occur, confusion. a low seizure overheating, Consult
Antipsychotics, 2nd receptor occupancy and associated with bipolar especially when you first threshold. clouding of physician about dosage
Generation; Antimanic antipsychotic effects [1]. D2 disorder in adults. start or increase your dose the lens of the eye called reduction and use of
Agents. receptor occupancy in the Maintenance treatment of of this drug. cataracts. high blood anticholinergic
Pregnancy category: ranges of 60 % to 75% is bipolar I disorder, as an pressure. a heart attack. antiparkinsonians
Category C associated with adjunct to lithium or (controversial) if
antipsychotic efficacy. divalproex in adults. extrapyramidal effects
Interestingly, quetiapine has occur. 
been shown to occupy After: assess client for any
approximately 30% of D2 delayed adverse
 receptors at therapeutic reactions, teach the client
doses [2]. To explain the about taking the drug as
apparent discrepancy, prescribed.
Kapur proposed the “kiss
and run” hypothesis. In a
series of studies they found
that in contrast to other
antipsychotics, quetiapine
had a more rapid “run-off”,
or rapid dissociation, from
D2 receptors

Drug Name Mechanism of Action Indication Side Effects/Adverse Contraindications Nursing Consideration
Reactions
Generic Name: carbamazepine exerts its Carbamazepine is  nausea,  a disorder with Before: assess for mental
Carbamazepine effects by lowering indicated for the treatment  vomiting, excess state before administering
Brand Name: Tegretol polysynaptic nerve of epilepsy and pain  dizziness, antidiuretic the medication
Dosage, route and response and inhibiting associated with true  drowsiness, hormone called During: observe for
frequency: 200 mg/day post-tetanic potentiation. In trigeminal neuralgia. In  dry mouth, syndrome of confusion and agitation
PO on day 1 divided both cats and rats, particular, carbamazepine  swollen tongue, inappropriate while administering the
q12hr carbamazepine was shown has shown efficacy in  loss of balance or antidiuretic medication, observe for
Classification: Anti- to decrease pain caused by treating mixed seizures, coordination, or. hormone. allergic reaction
convulsants, Antimanic infraorbital nerve partial seizures with  unsteadiness.  high cholesterol. After: observe for any
Agents stimulation. A decrease in complex symptoms, and  low amount of delayed adverse effects
Pregnancy Category: the action potential in the generalized tonic-clonic sodium in the
category D nucleus ventralis of the seizures. Carbamazepine blood.
thalamus in the brain and is also indicated for the  hepatic
inhibition of the lingual treatment of manic porphyria.
mandibular reflex were episodes and mixed  decreased
observed in other studies manic-depressive function of bone
after carbamazepine use episodes caused by marrow.
bipolar I disorder. Some  low blood counts
off-label, unapproved uses due to bone
of carbamazepine include marrow failure.
the treatment of alcohol  decreased blood
 withdrawal syndrome and platelets.
restless leg syndrome

Drug Name Mechanism of Action Indication Side Effects/Adverse Contraindications Nursing Consideration
Reactions
Generic Name: The basic mechanism of indications for phenelzine  drowsiness.  pheochromocyto Before: Assess mental
Phenelzine action of phenelzine acts as include the management  weakness. ma. state of the patient before
Brand Name: Nardil an inhibitor and substrate of of treatment-resistant  dizziness.  overactive administering the
Dosage, route and monoamine oxidase which depression, panic  dry mouth. thyroid gland. medication.
frequency: Initial 15 mg subsequently causes an disorder, and social  constipation.  diabetes. During: assess dizziness
PO q8hr, increase not to elevation in brain levels of anxiety disorder.  weight gain.  low blood sugar. and drowsiness that might
exceed 20-30 mg q8hr. catecholamines and Phenelzine is also  decreased sexual  schizophrenia. affect gait, balance, and
Classification: serotonin. It also presents a specifically useful for ability.  manic- other functional activities.
antidepressant similar structure to young women with  uncontrollable depression. After: monitor for any
Pregnancy Category: amphetamine which depression and mood shaking of any part  suicidal delayed adverse effects.
Category B explains the effect on the disorders of the body. thoughts.
uptake and release of  alcoholism.
dopamine, noradrenaline,
and serotonin. Phenelzine
has been reported to inhibit
tyrosine aminotransferase,
aromatic amino acid
decarboxylase, and
dopamine B-hydroxylase

Drug Name Mechanism of Action Indication Side Effects/Adverse Contraindications Nursing Consideration
Reactions
Generic Name: Isocarboxazid works by Isocarboxazid is indicated  sudden and severe  pheochromocyto Before: Monitor I&O and
Isocarboxazid irreversibly blocking the for the treatment of the headache, rapid ma. bowel elimination patterns,
Brand Name: Marplan action of monoamine enduring and debilitating heartbeat, stiffness  overactive assess the mental state of
Dosage, route and oxidases (MAO) in the symptoms of depression in your neck, thyroid gland. the patient before
frequency: PO 10-30 mg/d nervous system. MAO that have not responded nausea, vomiting,  diabetes. administering the
in 1-3 divided doses (max. subtypes A and B are to other antidepressant cold sweat, vision  low blood sugar. medication
30 mg/d) involved in the metabolism drugs problems,  schizophrenia.
Classification: of serotonin and sensitivity to light;  manic- During: assess dizziness
 antidepressant catecholamine  chest pain, fast or depression.
Pregnancy Category: neurotransmitters such as slow heart rate;  suicidal and drowsiness that might
Category C epinephrine,  swelling, rapid thoughts. affect gait, balance, and
norepinephrine, and weight gain;  alcoholism. other functional activities.
dopamine.  jaundice (yellowing
of the skin or eyes); After: monitor for any
or. delayed adverse effects.
 a light-headed Note: Toxic symptoms
feeling, like you from overdosage or from
might pass out. ingestion of
 . contraindicated
substances (e.g., foods
high in tyramine) may
occur within hours.
Monitor BP. Monitor for
orthostatic hypotension by
evaluating BP with patient
recumbent and standing.
Monitor for therapeutic
effectiveness: May be
apparent within 1 wk or
less, but in some patients
there may be a time lag of
3–4 wk before
improvement occurs.

NAME OF PATIENT: ______________________________________ DIAGNOSIS: _________________________________________ WARD/ROOM: WARD

_________________