Generic name H A L O P E R I D O L

Brand name H A L D O L

CLASSIFICATION

ACTION Alters the effects of dopamine in the CNS Also has anticholiner gic and alphaadrenergic blocking activity. Diminished signs and symptoms of psychoses

Route of dosage

INDICATION / USES Organic Psychoses Treatment for acute psychotic symptoms Relieve hallucination s, delusions, disorganized thinking Severe anxiety Seizures

CONTRAINDICATIONS Contraindicated in: seizure disorder glaucoma elderly clients

Antipsychotics (typical)

1 tab 5mg./ta b 9 hours

COMMON ADVERSE EFFECTS CNS: extrapyra midal symptom such as muscle rigidity or spasm, shuffling gait, posture leaning forward, drooling, masklike facial appearanc e, dysphagia, akathisia, tardive dyskinesia , headache, seizures.

NURSING CONSIDERATIONS Assess mental status prior to and periodically during therapy. Monitor BP and pulse prior to and frequently during the period of dosage adjustment. Observe patient carefully when administering medication, to ensure that medication is actually taken and not hoarded. Monitor for development 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, witih remaining doses evenly spaced through out 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, or uncontrolled movements of mouth, tongue or jaw.

Generic name

Brand name

CLASSIFICATION

ACTION

Route of dosage

INDICATION / USES

CONTRAINDICATIONS

COMMON ADVERSE EFFECTS

NURSING CONSIDERATIONS

R I S P E R I D O N E

R I S P E R I D A L

Antipsychotics (atypical)

Mechanis 2mg./tab m of 1 tab action not HS fully understoo d: blocks dopamine and serotonin receptors in the brain, depresses the RAS; antic holinergic, antihistam inic, and alphaadrenergi c blocking activity may contribute to some of its therapeuti c and adverse actions.

Treatm ent of schizop hrenia Delayin g relapse in longterm treatme nt of schizop hrenia Unlabel ed uses: bipolar disorde r; treatme nt of patients with dementi arelated psychot ic

Contraindicat ed with hypersen sitivity to risperidone , lactation. Use cautiously with cardiovascula r disease, renal or hepatic impairment, hypotension.

CNS: Insomnia, anxiety, agitation, headache, s omnolence, aggression, dizziness, t ardive dyski nesias, neuroleptic malignant syndrome

Maintain seizure precautions, especially when initiating therapy and increasing dosage. Mix oral solution with 34 oz of water, coffee, orange juice, or low-fat milk. Do not mix with cola or tea. Follow guidelines for discontinuation or reinstitution of the drug carefully.

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Generic name

Brand name

CLASSIFICATION

ACTION

Route of dosage

INDICATION / USES

CONTRAINDICATIONS

COMMON ADVERSE EFFECTS

NURSING CONSIDERATIONS

C H L O R P R O M A Z I N E

T H O R A Z I N E

Antipsychotics (typical)

Block dopamin e receptors in the brain; also alter dopamin e release and turnover. Preventi on of seizures

200mg. /tab BID

Treatment for acute and chronic psychoses, particularly when accompanie d by increased psychomoto r activity. Nausea and vomiting. Also used in the treatment of intractable hiccups.

Contraindicat ed with: Hypersensiti vity. Crosssensitivity may exist among phenothiazin es. Should not be used in narrowangle glaucoma. Should not be used in patients who have CNS depression.

CNS: neuroleptic malignant syndrome, sedation, extrapyram idal reactions, tardive dyskinesia

Assess mental status prior to and periodically during therapy. Monitor BP and pulse prior to and frequently during the period of dosage adjustment. Observe patient carefully when administering medication, to ensure that medication is actually taken and not hoarded. Monitor for development 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, witih remaining doses evenly spaced through out 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, or uncontrolled movements of mouth, tongue or jaw.

Generic name

Brand name

CLASSIFICATION

ACTION

Route of dosage

INDICATION / USES

CONTRAINDICATIONS

COMMON ADVERSE EFFECTS

NURSING CONSIDERATIONS

B I P E R I D I N E

A K I N E T O N

Anticholinergic

Unknown. Blocks central cholinergic receptors, helping to balance cholinergic activity in the basal ganglia.

2mg./tab Parkinsonian Untreated BID x 3 syndrome narrow angle days especially to glaucoma, counteract intestinal muscular stenosis or rigidity and obstruction, tremor mega colon, ;extrapyrami prostatic dal hypertrophy, symptoms life threatening tachycardia

CNS and peripheral effects, skin rashes, dyskinesia, ataxia, twitching, impaired speech, micturition difficulties. Fatigue, dizziness, at higher dose s, restlessnes s, agitation, anxiety, confusion

Assess for Parkinso nism, EPS. Assess for mental status. Assess patient response if anticholin ergics are given. Assess for toleranc e over longterm therapy ,dosage may have to be increased or changed. Avoid activities that require alertness, may cause dizziness, drowsiness andb lurring of vision

Generic name

Brand name

CLASSIFICATION

ACTION

Route of dosage

INDICATION / USES

CONTRAINDICATIONS

COMMON ADVERSE EFFECTS

NURSING CONSIDERATIONS

D I V A L P R O E X S O D I U M

D E P A K O T E

Anticonvul sant Mood stabilizer

Increases 500mg/ It is amp prescribed level of to prevent gammaor reduce aminobut the number yric acid of seizures in brain, by reducing decreasing seizure the activity activity of nerve impulses in the brain and central nervous system. It is converted to valproic acid in the body.

It should not be given to patients with an allergy to valproic acid, sodium valproate, or divalproex or to those with liver disease.

CNS: conf usion, dizziness, headache, sedation, ataxia, paresthesi a, asthenia, tremor, drowsines s, emotional lability, abnormal thinking, amnesia

Closely monitor neurologic status. Watch for seizures. Instruct patient to take with food to minimize GI upset. Tell patient taking extendedrelease tablets to swallow them whole without chewing or breaking. Inform patient taking capsules that he may swallow

them whole or open them and sprinkle contents onto a teaspoon of semisolid food, such as pudding or applesauce. Tell patient (or parents) that valproate syrup shouldn't be taken with carbonated beverages. Advise patient to immediately report malaise, weakness, lethargy, appetite loss, vomiting, or yellowing of skin or

eyes. If patient's taking drug for seizure control, tell him to avoid driving and other hazardous activities. Caution patient not to stop therapy abruptly. Instruct patient to avoid alcohol. Stress importance of follow-up laboratory tests. As appropriate, review all other significant and lifethreatening adverse reactions

and interactions, especially those related to the drugs, tests, and behaviors mentioned above.