Therapeutic Classification

Seroquel xr Generic Name quetiapine fumarate Classification Antipsychotic Drugs

Action
he mechanism of action of SEROQUEL, as with other antipsychotic drugs, is unknown. However, it has been proposed that this drug's therapeutic activity in schizophrenia is mediated through a combination of dopamine type 2 (D2) and serotonin type 2 (5HT2) antagonism. Antagonism at receptors other than dopamine and 5HT2 with similar receptor affinities may explain some of the other effects of SEROQUEL. SEROQUEL's antagonism of histamine H1 receptors may explain the somnolence observed with this drug. SEROQUEL's antagonism of adrenergic a1 receptors may explain the orthostatic hypotension observed with this drug.

Contraindication
SEROQUEL is contraindicated in individuals with a known hypersensitivity to this medication or any of its ingredients.

Toxicity Effect
very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors; feeling like you might pass out; jerky muscle movements you cannot control, trouble swallowing, problems with speech;

Indication
indicated in adults for (1) adjunctive therapy to antidepressants in major depressive disorder; (2) acute depressive episodes in bipolar disorder; (3) acute manic or mixed episodes in bipolar I disorder, as either monotherapy or adjunct therapy to lithium or divalproex; (4) maintenance treatment of bipolar I disorder as an adjunct to lithium or divalproex; and (5) schizophrenia. SEROQUEL is indicated in adults for the treatment of (1) acute depressive episodes in bipolar disorder; (2) acute manic episodes in bipolar I disorder, as either monotherapy or adjunct therapy to lithium or divalproex; (3) maintenance treatment of bipolar I disorder as an adjunct to lithium or divalproex, and (4) schizophrenia. Patients should be periodically reassessed to determine the need for treatment and the appropriate dose.

Safety Dose
Psychosis initiate with 25 mg bid, may increase by 25 50 mg bid to tid on the second or third day as tolerated toa target dose of 300 400 mg/d divided by bid to tid, may adjust dose by 25 50 mg bid qd as needed (max. 800 mg/d)Agitation/Dementia initiate with 25 mg bid, may increase by 25 50 mg bid, q 2-7 if needed, (max 200 mg/d)

tremors, or restless muscle movements in your eyes, tongue, jaw, neck, arms, or legs; mask-like appearance of the face, trouble swallowing, problems with speech; blurred vision, eye pain, or seeing halos around lights; increased thirst and urination, excessive hunger, fruity breath odor, weakness, nausea and vomiting; or fever, chills, body aches, flu symptoms, white patches or sores inside your mouth or on your lips. Less serious side effects may include:

dizziness, drowsiness, tired feeling; dry mouth, sore throat; stomach pain, upset stomach, nausea, vomiting, constipation; breast swelling or discharge; missed menstrual periods; or increased appetite, weight gain.

Decolgen(No Drowse) Generic Name Phenylephrine HCl + Paracetamol Classification Nasal Decongestant / Analgesic-Antipyretic

The mechanism of action is associated with inhibition of prostaglandin synthesis, the predominant influence on the thermoregulation center in the hypothalamus, enhances heat transfer.

Severe HTN, severe coronary artery disease. Concomitant or w/in 14 days of MAOIs

Phenylephrine HCl Increased blood pressure Headache Seizures Palpitation Paresthesia (sensation of tingling, pricking, or numbness of the skin) Vomiting Cerebral hemorrhage (bleeding from a ruptured blood vessel in the brain) Paracetamol Overdosage of paracetamol usually involves 4 phases with the following signs and symptoms: I. Eating disorder, nausea, vomiting, malaise, and excessive sweating II. Right upper abdominal pain or tenderness, liver enlargement which may be characterized by abdominal discomfort of feeling full, elevated bilirubin and liver enzyme concentrations, prolongation of prothrombin time, and occasionally decreased urine output III. Eating disorder, nausea, vomiting, and malaise recur and signs of liver (e.g., jaundice) and possibly kidney failure IV. Recovery or progression to fatal complete liver failure

Headache, muscle & joint pains,general malaise, fever & chillsassociated w/ upper resp infections

Adults and Children 12 years and older: Orally, 1 tab every 6 hrs, or, as recommended by a doctor.

Co-Trimoxazole Generic Name Trimethoprim/Sulfamethox azole Classification Antibacteria

Inhibits formation of dihydrofolic acid from PABA; trimethoprim component inhibits dihydrofolate reductase. BOTH DECREASE BACTERIAL FOLIC ACIDSYNTHESIS

hematologictoxicity:neutropenia,thrombocytopenia,agranu locytosis, aplasticanemia

Contraindicated in patients with known hypersensitivity to trimethoprim or sulfonamides,or with documented megaloblastic anemia secondary to folate deficiency

diarrhea that is watery or bloody; fever, chills, swollen glands, body aches, flu symptoms, sores in your mouth and throat; new or worsening cough; pale skin, feeling lightheaded, rapid heart rate, trouble concentrating; easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin; severe tingling or numbness, slow heart rate, weak pulse, muscle weakness; nausea, upper stomach pain, itching, loss of appetite, dark urine, claycolored stools, jaundice (yellowing of the skin or eyes); urinating less than usual or not at all; hallucinations, seizure (convulsions); low blood sugar (headache, hunger, weakness, sweating, confusion, irritability, or feeling jittery); the first sign of any skin rash, no matter how mild; or severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

treatment of infections due to susceptible organisms

use with cautionin patients with impairedrenal orhepatic function or with possible folate or G-6-PDdeficiency

It is a fixed combination product containing sulfamethoxazole and trimethoprim in 5:1 ratio. Adult- PO- The recommended dose is 2 tablets every 12 hours for a period of 10 to 14 days. Child- The recommended dose is 8 mg/kg of trimethoprim and 40 mg/kg of sulfamethoxazole daily in 2 divided doses every 12 hours.

Akidin Generic Name Biperiden HCL Classification Antiparkinsonian drugs/ anticholinergic

Parkinsonism is thought to result from an imbalance between the excitatory (cholinergic) and inhibitory (dopaminergic) systems in the corpus striatum. The mechanism of action of centrally active anticholinergic drugs such as biperiden is considered to relate to competitive antagonism of acetylcholine at cholinergic receptors in the corpus striatum, which then restores the balance.

You cannot take biperiden if you have ever had an allergic reaction to it, have narrow-angle glaucoma, have an obstruction in your bowel or a complication of bowel disease known as megacolon; or have myasthenia gravis.

f you experience any of the following serious side effects, stop taking biperiden and seek emergency medical attention: an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives); unusual fever; fast or irregular heartbeat; anxiety, hallucinations, confusion, agitation, hyperactivity, or loss of consciousness; seizures; a rash; or eye pain.

As an adjunct in the therapy of all forms of parkinsonism (idiopathic, postencephalitic, arteriosclerotic) Control of extrapyramidal disorders secondary to neuroleptic drug therapy (e.g., phenothiazines)

Oral: One tablet one to three times daily. Parkinson's Disease: Oral: The usual beginning dose is one tablet three or four times daily. The dosage should be individualized with the dose titrated upward to a maximum of 8 tablets (16 mg) per 24 hours.

Haloperidol Classification Antipsychotic

Alter the effects of dopamine in the cns Also has Anticholinergic and alphaadrenergic blocking activity. Diminished signs and symptoms of psychoses

Seizure Disorder Glaucoma Elderly Client

Extrapyramidal symptoms such as muscle rigidity or spasm ,shuffling gait,posture leaning forward.drooling,masklike facial appearance ,dysphagia,akithesia ,tardice dyskinesia, headache, seizures. Tachycardia Arrythmias Hypertension Blurred Vision Glaucmoa

Organic Pschoses Acute Psychotic Symptoms Relieve Hallucinations,Delusion, Disorganized Thinking Severe anxiety Seizures

@.5Mg OD

Nozinan Generic Name Levomepromazine Classificaiton analgesic and antiemetic

Exert its action through a central adrenergic blocking.a dopamine blocking,a serotonin blocking and a anticholinergic blocking.

There are no absolute contraindication

The most common side effect is akathisia. Levomepromazine has prominent sedative and anticholinergic/sympatholytic effects (dry mouth, hypotension, sinus tachycardia, night sweats) and may cause weight gain. These side effects normally preclude prescribing the drug in doses needed for full remission of schizophrenia, so it has to be combined with a more potent antipsychotic. In any case, blood pressure and EKG should be monitored regularly.

Levomepromazine is used for the treatment of psychosis, particular those of schizophrenia, and manic phases of bipolar disorder. It should be used only with caution in the treatment of agitated depressions, as it can cause akathisia as a side effect, which could worsen the agitation. Levomepromazine is also used at lower doses for the treatment of nausea and insomnia.

PATIENTS DATA Name: patient X Age: 25 years old Gender: Male Civil Status: Single Address: Marville Homes Subdivision Lucena City Nationality: Filipino Birthday: October 4, 1987 Educational Attainment: Bachelor of Science in Nursing Previous Admission: 4/23/2012 Present Admission: 01/30/2013 Chief complaint: Changes in Behavior Admitting diagnosis: Psychosis History of Present Illness: Patient as diagnosed with psychosis with meds seroquil XR OD December 2012- (+) changes in behaviour to be stressed related @ work. Resistance of the above condition, with frequent striking often talks to himself alone and inability to sleep hence prompted admitted. Physical and Mental Assessment Name: PATIENT X Age: 25y/o Gender: Male 1. General Description: The client appears stated with his age of 25 years old, black t-shirt, seems thirsty as evidence by his frequent drinking of water, well groomed and with good personal hygiene. Hes taking a bath everyday with a good daily routine. The client has a good posture, gait and coordination. During interaction, he has a good eye to eye contact and facial expression with regards to a certain situation. He was well nourished and has a fair skin as evidenced by his good body built and has no sleeping difficulties by the absence of dark circles under his eyes .He was well oriented with time, place, date and reality. The client considered the interview as a normal thing and he was guided accordingly with no harsh or offending questions thrown to him during the interview. He was cooperative with consistency of speech and behavior. 2. Mood and Affectivity: The client show appropriate affect with regards to a certain situation. 3. Speech Characteristics: Low pitch tone 4. Perception: Hallucinations: no Illusion: no 5. Thought Content and Mental Trends: a. Flight of ideas- no b. Looseness of associations- no

c. Circumstantiality- yes d. Tangentiality- no e. Delusion- no f. Preoccupations- no g. Suicidal- no 6. Sensorium and Cognition a. Consciousness: alert b. Oriented to time: yes c. Oriented to person: yes d. Oriented to place: yes e. Remote memory: intact f. Recent past memory: intact g. Recent memory: intact h. Immediate retention and recall: intact i. Confabulation: no 7. Concentration and attention a. Reading and writing: not assessed b. Visual spatial ability: not assessed c. Abstract thought: not assessed d. Serial 7s: not assessed 8. Impulsivility a. Impulse control 9. Judgement ad insight: a. Judgement: poor b. Insight: denial 10. Reliability: Fair Treatment Plan: Pharmacological treatment