Drug Name Therapeutic Class

Action Indication Contraindication Adverse Effect

Nursing Responsibility

Generic Name

CLOZAPINE

Brand Name Clozaril Denazapine Zaponex

Antipsychotic agent

Unclear. Thought to interfere with dopamine binding in limbic system of CNS, with high affinity for dopamine4 receptors. May antagonize adrenergic , cholinergic , histaminerg-ic and serotonergi-c receptor.

Schizophrenia in patients unresponsive to therapies.

Hypersensitivity to drug

Uncontrolled seizures

Severe CNS depression or coma

Concurrent use of drugs that can cause agranulocytosis or bone marrow depression.

CNS: Sedation, drowsiness, dizziness, headache, tremor, insomnia, slurred speech, restlessness, tardive dyskenisia, akathisia, seizures.CV:Hypotension, tachycardia, chest pain. myocarditis.EENT:Blurred vision, dry eyes, nasal congestion, and sinusitis.GU:Urinary retention, incontinence, frequency, urgency and inhibited

♦Monitor WBC count weekly for 6 months of therapy, If its normal, WBC testing can be reduced to every other week. Notify prescriber immediately if WBC counts decreases.♦Monitor ECG and liver function test.♦If drug must be withdrawn abruptly monitor for patient for psychosis and cholinergic rebound.♦Continue to monitor WBC count weekly for 4 weeks, after therapy ands.♦Tell patient to allow orally disintegrating tablet to dissolve in mouth.

ejaculation.Musculoskeletal:Muscle spasm, rigidity,back and muscle pain.Hematlogic:Agranulocytosis, leucopenia, hemolytic anemia, neutropenia, eosinphilia.Respiratory:Dyspnea, respiratory arrest.Skin:Rash, sweating, Steven_johnson Syndrome.Other:Weigth gain, Fever.

♦Advice patient to immediately report new onset of lethargy,Weakness, fever, sore throat, malaise, mucus membrane ulcers, flulike symptoms of infection.

Drug Name Therapeutic Class

Action Indication Contraindication Adverse Effect

Nursing Responsibility

Generic Name

HALO-PERIDOL

Brand Name Haldol Peridol Serenace

Antipsychotic Unknown.Thought to block postsynaptic dopamine receptor in brain and increase dopamine turnover rate, inhibiting signs and symptoms of psychosis.

♦Symptomatic treatment of psychotic disorder or Tourrete syndrome.♦Schizophrenia in patients who need prolonged parenteral antipsychotic therapy.♦Psychotic disorder♦Nonpsychotic behavior disorder; Tourrete Syndrome.

Hypersensitivity to drugs, tartrazine, sesame oil, o benzyl alcohol.

Severe CNS depression.

CNS:Confusion, drowsiness, EPR, sedation, insomnia, tardive dyskinesia, seizure, lethargy.CV:Hypotension, hypertension, tachycardia, torsades de pointes.EENT:Blurred vision, dry eyes.GU:Urinary retention, menstrual irregularities, gyecomastia.GI: Constipation,

♦Monitor CNS status closely, especially for seizures and neuroleptic malignant syndrome.♦Monitor cardiovascular status, particular for ECG changes, blood pressure changes, torsades de pointes, and atypical rapid ventricular tachycardia, w/c may progress to ventricular tachycardia.♦Asses respiration♦Monitor liver function test results and CBC with white cell deferential.♦Tell patient to dilute oral

ileus, dry mouth, anorexia.Hematologic:Anemia, leukocytosis, leukopenia.Hepatic:Jaundice, drug-induced-hepatitis.Metabolic:GalactorreaRespiratory:Bronchospas-m, dyspnea, respiratort depression.Skin:Diaphoresis, photosensitivity, rash.Other:Hyperpyrexia, hypersensitivity reaction.

concentrate with water, cola, juice immediately before taking.♦Instruct patient to immediately report serious adverse reaction.♦Advise patient to minimize GI upset by eating frequent, small serving of food and drinking adequate fluids.

Drug Name Therapeutic Class

Action Indication Contraindication Adverse Effect

Nursing Rsponsibility

Generic Name

LOXAPINE

Brand Name Loxitane Loxapac

Antipsychotic Unknown. Thought to block neurotransmission of postsynaptic dopamine receptors in brain, alleviating psychotic symptoms.

●Psychotic disorders

● Hypersensitivity to drugs or other dibenzoxapines.●Coma or severe depression from any cause.

CNS:Drowsiness,Insomia, shuffling gait,Staggering, slurred speech, tardive dyskinesia, confusion, parkinsonism, seizures.CV:Orthostatic hypotension, hypertension, ECG changes.EENT:Blurred vision, ptosis, and nasal congestion.GI:N/V, constipation, dry mouth, paralytic ileus.GU: Urinary retention.Hematologic:Leukopenia,

♦Measure blood pressure before and periodically during therapy.♦Monitor hematologic studies and liver function test.♦Stay alert for evidence of neuroleptic malignant syndrome.♦Asses for tardive dyskinesia, especially in elderly woman.♦Tel patient to take with or without food. ♦Inform patient that drug may cause tardive dyskinesia. ♦Avoid activities requiring mental concentration until drug effect are known.♦Teach patient to

agranulocytosis, thrombocytopenia.Hepatic:Hepatocellular injury with hepatic enzyme elevations.Meatbolic:Polydipsia.Musculoskeletal:Muscle twitching.Skin:Rash, pruritus, sobrrhea, photosensitivity, alopecia.Other: Weight gain or loss, hyperpyrexia, facial edema, hypersensitivity reaction.

immediately report sore throat, fever, rash, impaired vision, tremors, involuntary muscle twitching or yellowing of eyes or skin.♦Instruct patient to move slowly when sitting up or standing, to avoid dizziness from sudden blood pressure decrease.

Drug Name Therapeutic Class

Action Indication Contraindication

Adverse Effect

Nursing Responsibilit

y

Generic Name

OLANZIPINE

Brand Name Zyprexa Olanzapro

Antipsychotic Unknown.Though antagonize dopamine and serotonin type 2 in CNS. Also antagonizes muscarinic receptors in respiratory tract, causing cholinergic activation.

●Schizophrenia ●Hypersensitivity to drugs.

CNS:Dizziness, headache, weakness, fatigue, mood changes, tremor, tardive dyskinesia, dystonia, extra-pyramidal effect, neurologic malignant syndrome, coma.CV:Orthostatic hypotension, chest pain, tachycardia.EENT:Amblyopia, rhinitis, pharyngitis.GI:Nausea, constipation, abdominal pain, increased

♦Assess mental patient during therapy.♦Monitor vital signs during dosage adjustment.♦Make sure that the patient takes drug and doesn’t hoard it.♦Watch for sign and symptoms of neuroleptic malignant syndrome.♦Watch for signs of decreasing depression.♦Monitor blood glucose level closely especially with DM.♦Watch for orthostatic

salivation, dry mouth.

GU:Urinary incontinence, UTI.Hematologic:Leukopenia.Metabolic:Goiter, increased thirst, severe hyperglycemia.Musculoskeletal:Hypertonia, joint pain.Respiratory:Cough dyspnea.Skin:Ecchymosis, photosensitivity.Other:Increase appetite, weight gain or loss, fever.

hypotension. Before I.M. injection.Tell patient he take without regard to meal.♦Advise patient to avoid smoking, alcohol, and other can depress CNS .♦Tell patient to slowly sitting up and standing to avoid dizziness.♦Tell patient that drug may cause extra pyramidal symptoms. akathisia, tardive dyskinesia etc.

Drug Name Therapeutic Class

Action Indication Contraindication

Adverse Effect

Nursing Responsibilit

y

Generic Name

Prochlorperazine

Brand Name Compazine Compro Stemil

AntipsychoticAntiemeticAnxiolytic

Exerts anticholinergic, CNS depressant and antihistaminic effects. Depresses release of hypothalamic and hypophyseal hormones, decrease sensitivity of middle-ear labyrinth, and reduces conduction in vestibular cerebelar pathways.

●NauseaNausea and vomiting related to surgery.●Schizophrenia●Anxiety

●Hypersensitivity to phenothiazines, comatose states, ●Do not use in children for conditions for which dosage has not been established.

CNS: Sedation, tardive dyskinesia, neuroleptic malignant syndrome,CV:Orthostatic hypertension, tachycardia.EENT:Blurred vision, lens opacities, dry eyes.GI:Constipation, ileus, dry mouth, anorexia.GU:Pink & reddish-brown urine, Urinary retention galactorrhea.Hematologic:Agranulocytosis,

♦Monitor patient closely if he’s receiving drug for nausea and vomiting associated with chemotherapy.♦Instruct patient to dilute oral solution with tomato or fruit juice, milk, coffee, soda, or tea.♦Monitor neurologic status, especially for signs and symptoms of neuroleptic malignant syndrome.

leucopenia.Hepatic:Cholestatic jaundice, hepatitis.Metabolic:Hyperthermia.Skin:Photosensitivity, pigmentation changes, rashes.Other:Allergic. Reactions.

Drug Name Therapeutic Class

Action Indication Contraindication Adverse Effect

Nursing responsibility

Generic Name

Promazine

Brand Name Sparine Prozine

Antipsychotic Uses may include the treatment of obsessive-compulsive disorder and severe behavioral disorders in autism

●Mania●Agitation organic brain syndrome●Alcoholic ●Hallucinosis●Drug induced emesis●Radiation sickness●Intractable hiccough

●Promazine is contra-indicated in comatose patients (particularly those under the influence of alcohol, barbiturates, narcotics or other central nervous system depressants) an in patients with bone marrow depression.

●Side-effects include drowsiness, dryness of mouth, pallor of the skin, postural hypotension, weakness, lowering of body temperature (occasionally pyrexia), tachycardia,

♦Monitor blood pressure daily in a supine position♦Anticipate the development of postural hypotension. ♦Monitor cardiovascular status, particular for ECG changes, blood pressure

●Promazine should not be given to patients being treated with drugs that might cause leucopenia. Women who may become pregnant.

arrhythmias, agitation, insomnia, depression, photosensitivity and skin rashes.

changes, torsades de pointes, and atypical rapid ventricular tachycardia, w/c may progress to ventricular tachycardia.♦Asses respiration♦Monitor liver function test results and CBC with white cell deferential.

Drug Name Therapeutic Class

Action Indication Contraindication Adverse Effect

Nursing responsibility

Generic Name

Thioridazine HCl

BrandName Mellaril Novo-

Ridazine Apo-Thiori

dazine

Anti psychotic Blocks dopamine receptors in CNS. Exerts strong alpha-adregenic and an ticholinergic blocking activity; also depress ceredral cortex,

●Schizophrenia ●Hypersensitivity to drugs, its component, or other phenothiazine.●Severe CNS depression●Severe hypotension and hypertension●History of arrhythimias

●Akathisia●Tardive dyskinesia●Rabbit syndrome●Sialadenitis●Impotence●Anorgasmia●Sedation●Urinary retention● Neuroleptic malignant

♦monitor the neurologic status of the patient.♦Assess for urinary retention, constipation and blurred vision.♦Closely monitor depressed patient for suicidal attack.♦Monitor

hypothalamus and limbic system.

syndrome●Agranulocytosis

bilirubin level, CBC, liver function test and vision exams.

Drug Name Therapeutic Class

Action Indication Contraindication

Adverse Effect

Nursing Responsibilit

y

Generic Name

Trifluoperazine HCl

Brand Name Solazine stelazine Terfluzine

Antipsychotic Unknown. Though to act on subcortical level of hypothalamic and limbic system by producing antidopaminergic effects. Also lower seizure threshold and exibit some adrenergic , muscaranic, and anticholnergic activity.

●Schizophrenia●Nonpsychotic anxiety

●Hypersensityvity to drug, other phenothiazines or bisufites●Severe hepatic disease●Bone marrow depression●Blood dyscasias●Coma●Concomitant use of other CNS depressants in high school

●Drowsiness, dizziness,skin reactions, rash, dry mouth, insomnia, amenorrhea, fatigue, muscular weakness, anorexia, lactation, blurred vision andneuromuscular  (extrapyramidal) reactions.

♦Monitor neurologic status, especially for indication of neuroleptic malignant syndrome (unstable blood pressure, high fever, sweating, stupor, muscle rigidity and autonomic dysfunction.)♦Monitor for ECG and blood pressure.♦Instruct patient taking oral solution to add solution to 60ml or more

of liquid.♦Tell patient to avoid alcohol and certain herbs.♦Instruct patient to move slowly when sitting up or standing, to avoid dizziness.

Drug Name Therapeutic Class

Action Indication Contraindication

Adverse Effect

Nursing Responsibilit

y

Generic Name

Triflupromazine

Brand Name Vesperin

Antipsychotic Used in the treatment of disorganized and psychotic thinking

●Management of psychoses. Also used to control nausea and vomiting

●Use for psychoses in children less than 2.5 years of age.

●Skin rash, itching, or hives●Trouble breathingFast or irregular heartbeat●Unexplained high fever, muscle stiffness●Uncontrollable movements of the face, neck, or tongue

♦Monitor vital sign♦Asses neurologic status of the patient.♦Tell patient to slowly sitting up and standing to avoid dizziness.♦If drug must be withdrawn abruptly monitor for patient for psychosis and cholinergic

rebound.

Drug Name Therapeutic Class

Action Indication Contraindication

Adverse Effect Nursing Responsibilit

y

Generic Name

Thiothixene

Brand Name Novane

Antipsychotic An antipsychotic of the thioxanthene series. Navane possesses certain chemical and pharmacological similarities to the piperazine phenothiazines and differences from the aliphatic group of phenothiazines.

●Effective in the management of schizophrenia. Navane has not been evaluated in the management of behavioral complications in patients with mental retardation.

●Hypersensitivity to drug, circulatory collapse, comatose states, central depression due to any cause, and blood dyscrasias

●Tachycardia, ●hypotension, ●lightheadedness, and syncope, ●Drowsiness, ●Restlessness, ●Agitation and insomnia 

♦Monitor neurologic status, especially for indication of neuroleptic malignant syndrome (unstable blood pressure, high fever, sweating, stupor, muscle rigidity and autonomic dysfunction.)Tell patient to avoid alcohol and certain herbs.♦Instruct patient to move slowly when sitting up

or standing, to avoid dizziness.

Drug Name Therapeutic Class

Action Indication Contraindication

Adverse Effect

Nursing Responsibilit

y

Generic Name:

Risperidone

Brand Name: Risperdal, Risperdal Consta

Antipsychotic Has antipsychotic effect, apparently caused by dopamine- and serotonin-receptor blocking in CNS.

●Schizophrenia

●Bipolar Mania

●Irritability symptoms of aggression toward others, deliberate self-injury, and temper tantrums associated with autistic disorder

●Hypersensitivity to drug.

●Aggressive behavior, dizziness, headache, fatigue, anxiety, transient ischemic attack, cerebrovascular accident, neuroleptic syndrome, Tachycardia, chest pain, bradycardia, orthostatic hypotension, arrhythmia, Rash, skin discoloration, skin ulceration, acne, dry skin,

♦Instruct patient to take prescribed dose once or twice daily as prescribed, without regard to meals. Advise patient to take with food if GI upset occurs.♦Instruct patient using oral solution to use calibrated pipette to measure each dose. Advise patient that solution may be mixed with 3 to

seborrhea, pruritus, Rhinitis, abnormal vision, pharyngitis, conjunctivitis, otitis media, blurred vision, earache. Vomiting increased salivation, constipation, abdominal pain. Dyspepsia, nausea, dry mouth, anorexia.

4 oz of water, coffee, orange juice, or low-fat milk (but not with cola or tea) prior to administration.♦Caution patient using orally disintegrating tablet not to open the blister until ready to take the dose.♦Advise patient that dose will be started low and then increased until max benefit is obtained.♦Instruct patient not to stop taking risperidone when feeling better.Tell patient to immediately report altered mental status, high fever, irregular pulse,

muscle rigidity, rash, seizures, or sweating to health care provider.

Drug Name Therapeutic Class

Action Indication Contraindication

Adverse Effect

Nursing Responsibilit

y

Generic Name

Chlorpromazine HCl

Brand Name Thorazine Largactil

Chlorpro-manyl

AntipsychoticAntiemeticAnxiolytic

Unknown. May block postsynaptic dopamine receptors in brain and depressareas involved in wakefulness and emesis. Also possesses anticholinergic, antihistamine, and adrenergic blocking properties.

●For the treatment of schizophrenia.●To control nausea and vomiting.●For relief of restlessness and apprehension before surgery.●For acute intermittent porphyria.●As an adjunct in the treatment of tetanus.●To control the

●Do not use in patients with known hypersensitivity to phenothiazines.●Do not use in comatose states or in the presence of large amounts of central nervous system depressants (alcohol, barbiturates, narcotics, etc.).

CardiovascularHypotensive Effects, EKG Changes

CNS ReactionsNeuromuscular (Extrapyramidal) ReactionsDystonias, Motor Restlessness, Pseudo-parkinsonism, 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. May cause QT interval changes on ECG.♦Observe patient carefully when administering

manifestations of the manic type of manic-depressive illness.●For relief of intractable hiccups.

medication, to ensure that medication is actually taken and not hoarded.♦Monitor I&O ratios and daily eight. Assess patient for signs and symptoms of dehydration.♦ 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, with remaining doses evenly spaced throughout the day. May require several weeks to obtain desired effects.

Drug Name Therapeutic Class

Action Indication Contraindication

Adverse Effect

Nursing Responsibilit

y

Generic Name

Fluphenazine hydrochloride

Antipsychotic Unknown.Though antagonize dopamine and serotonin type

●PROLIXIN is indicated in the management of manifestations of psychotic

●Phenothiazines are contraindicated in patients with suspected or

Central Nervous System pseudoparkinsonism, 

♦Use exactly as directed; do not increase dose or

Brand Name Prolixin Permitil

2 in CNS. Also antagonizes muscarinic receptors in respiratory tract, causing cholinergic activation.

disorders.

●PROLIXIN has not been shown effective in the management of behavioral complications in patients with mental retardation.

established subcortical brain damage, in patients receiving large doses of hypnotics, and in comatose or severely depressed states. The presence of blood dyscrasia or liverdamage precludes the use of fluphenazine hydrochloride. ●PROLIXIN (fluphenazine hydrochloride) is contraindicated in patients who have shown hypersensitivity to fluphenazine; cross-sensitivity to phenothiazine derivatives may occur.

dystonia, dyskinesia,akathisia, oculogyric crises, opisthotonos, and hyperreflexia. Autonomic Nervous SystemHypertension and fluctuation in blood pressure have been reported with fluphenazine hydrochloride.Metabolic and EndocrineWeight change, peripheral edema, abnormal lactation, gynecomastia, menstrual irregularities, false results on pregnancy tests, impotency in men

frequency.

♦Do not discontinue without consulting prescriber.

♦Dilute with water, milk, orange or grapefruit juice; do not dilute with beverages containing caffeine, tannin, or pectinate (eg, coffee, colas, tea, or apple juice). ♦Do not take within 2 hours of any antacid. ♦Avoid alcohol or caffeine and other prescription or OTC medications not approved by prescriber.

and increasedlibido in women have all been known to occur in some patients on phenothiazine therapy.Allergic ReactionsSkin disorders such as itching, erythema, urticaria, seborrhea, photosensitivity,eczema and even exfoliative dermatitis have been reported with phenothiazine derivatives.

♦Avoid skin contact with medication; may cause contact dermatitis (wash immediately with warm, soapy water).

♦Maintain adequate hydration unless instructed to restrict fluid intake. You may experience excess drowsiness, lightheadedness, dizziness, or blurred vision (use caution driving or when engaging in tasks requiring alertness until response to drug is known); dry mouth, upset stomach, nausea,

vomiting (small frequent meals, frequent mouth care, chewing gum, or sucking lozenges may help); constipation (increased exercise, fluids, fruits, or fiber may help); postural hypotension (use caution climbing stairs or when changing position from lying or sitting to standing); urinary retention (void before taking medication); ejaculatory dysfunction (reversible); decreased perspiration (avoid strenuous exercise in hot

environments); or photosensitivity (use sunscreen, wear protective clothing and eyewear, and avoid direct sunlight).

Drug Name Therapeutic Class

Action Indication Contraindication

Adverse Effect

Nursing Responsibilit

y

Generic Name

Perphenazine

Generic Name Trilafon

Antipsychotic Unknown. Thought to block neurotransmission of postsynaptic dopamine receptors in brain,

●Perphenazine is indicated for use in the treatment of schizophrenia and for the control of severe nausea and vomiting in

●Perphenazine products are contraindicated in comatose or greatly obtunded patients and in patients receiving large doses of central nervous

CNS EffectsExtrapyramidal Reactionsopisthotonus, trismus, torticollis, retrocollis, aching and numbness

♦Monitor neurologic status, especially for indication of neuroleptic malignant syndrome (unstable blood

alleviating psychotic symptoms.

adults.

●Perphenazine has not been shown effective for the management of behavioral complications in patients with mental retardation.

systemdepressants (barbiturates, alcohol, narcotics, analgesics, or antihistamines); in the presence of existing blood dyscrasias, bone marrow depression, or liver damage; and in patients who have shown hypersensitivity to perphenazine tablets, their components, or related compounds.

●Perphenazine products are also contraindicated in patients with suspected or established subcortical brain damage, with or without hypothalamic

of the limbs, motor restlessness, oculogyric crisis, hyperreflexia, dystonia, including protrusion, discoloration, aching and rounding of the tongue, tonic spasm of the masticatory muscles, tight feeling in the throat,slurred speech, dysphagia,akathisia, dyskinesia, parkinsonism, and ataxia.Persistent Tardive DyskinesiaOther CNS Effectsinclude cerebral edema;

pressure, high fever, sweating, stupor, muscle rigidity and autonomic dysfunction.)♦Monitor for ECG and blood pressure.♦Instruct patient taking oral solution to add solution to 60ml or more of liquid.♦Tell patient to avoid alcohol and certain herbs.

damage, since a hyperthermic reaction with temperatures in excess of 104°F may occur in such patients, sometimes not until 14 to 16 hours after drug administration. Total body ice-packing is recommended for such a reaction; antipyretics may also be useful.

abnormality of cerebrospinal fluid proteins; convulsive seizures, particularly in patients with EEG abnormalities or a history of such disorders; and headaches.Autonomic Effectsdry mouth or salivation, nausea, vomiting, diarrhea, anorexia, constipation, obstipation, fecal impaction, urinary retention, frequency or incontinence, bladder paralysis, polyuria, nasal

congestion, pallor, myosis, mydriasis, blurred vision,glaucoma, perspiration, hypertension, hypotension, and change in pulse rate occasionally may occur

Drug Name Therapeutic Class

Action Indication Contraindication

Adverse Effect

Nursing Responsibility

Generic Name

Ethosuximide

Brand name

Zarontin

Anticonvulsant The mechanism of action of the succinimides is unknown.

The control of

absence (petit

mal) epilepsy.

Ethosuximide should not be used in patients with a history of hypersensitivity to succinimides.

Gastrointestin

al:

Gastrointestinal

symptoms

occur

frequently and

♦When initiating

therapy or

changing a dose,

monitor the drug

serum level to

include

anorexia, vague

gastric upset,

nausea and

vomiting,

cramps,

epigastric and

abdominal pain,

weight loss, and

diarrhea.

Hemopoietic:

Leukopenia,

agranulocytosis

, pancytopenia,

aplastic anemia,

eosinophilia.

Nervous

system:

drowsiness,

headache,

dizziness,

euphoria,

hiccups,

determine

whether a

therapeutic

range has been

obtained

♦Assess

complete blood

counts regularly

to determine

whether any low

blood cell

counts are

present

♦Notify

physician if

there are

presence of skin

rashes, joint

pain,

unexplained

fever, sore

throat, unusual

bleeding or

irritability,

hyperactivity,

lethargy,

fatigue, and

ataxia.

Psychiatric or

psychological

aberrations

associated with

ethosuximide

administration

have included

disturbances of

sleep, night

terrors, inability

to concentrate,

and

aggressiveness.

Integumentar

y:

Dermatologic

manifestations

which have

occurred with

bruising, severe

drowsiness,

severe dizziness,

blurred vision or

pregnancy.

the

administration

of ethosuximide

have included

urticaria,

Stevens-

Johnson

syndrome,

systemic lupus

erythematosus,

and pruritic

erythematous

rashes.

Genitourinary

:

Microscopic

hematuria.

Miscellaneous:

Myopia,

vaginal

bleeding,

swelling of the

tongue, gum

hypertrophy.

Drug Name Therapeutic Class

Action Indication Contraindication

Adverse Effect

Nursing Responsibilit

y

Generic Name

Methsuximide

Brand Name Celontin

Anticonvulsant The mechanism of action of succinimides is unknown.

●Celontin is indicated for the control of absence (petit mal) seizures that arerefractory to other drugs.

● Methsuximide should not be used in patients with a history of hypersensitivity to succinimides.

●Nausea●Vomiting●Indigestion●Sedation●Drowsiness●Dizziness●Fatigue●Lethargy

♦Encourage maintenance of a regular lifestyle and moderate activity. ♦Avoid excessive exercise that would lead to excessive fatigue.♦Avoid excessive use of stimulants. Seizures are also known to follow the significant intake of alcoholic beverages; therefore ingestion should be avoided or restricted. ♦Monitor vital

signs and neurologic status. ♦Administer oxygen; have suction and resuscitation equipment available.

Drug Name Therapeutic Class

Action Indication Contraindication

Adverse Effect

Nursing Responsibilit

y

Generic Name

Pheytoin

Anticonvulsant Thought limit seizures activity by promoting

●Status epilipticus●Generalized tonic – clonic

●Hypersentivity to drug●Sinus bradycardia,

●Head acheFatigue, coma, confusion, agitation, CNs

♦Asses blood pressure, ECG, and heart rate, especially

Brand Name Dilantin Phenytek Epanutin

sodium efflux from neurons in motor cortex and reducing activity in brainstem centers responsible for tonic phase of tonic clonic

( grand mal) and complex partial 9 psychomotor, temporal lobe) seizures.●To prevent seizure during neurosurgery.

sinoatrial block, second or third degree antrioventricular block. Adams stokes syndrome.

depression.●Edema, vasodilation, chest pain, tachycardia, hypotension.●Dipophia, sinusitis, amblyopia, visual field defect.●N/V, diarrhea, constipation, lip enlargement.●Pink, red, or reddish-brown urine.●hypocalcemia, diabetes insipidus, hyperglycemia, ●back pain,Pelvic pain, osteomalacia.●dyspnea, apnea

during I.V. loading dose.♦Monitor phenytoin blood level therapeutic range is 10-20mcg/ml.♦Evaluate CBC and kidney and liver function tests.♦Closely monitor prothrombin time.♦Monitor drug efficacy.♦Avidest patient to avoid alcohol.♦Inform patient that drug may discolor urine.

Drug Name Therapeutic Class

Action Indication Contraindication

Adverse Effect

Nursing responsibility

Brand Name Antipsychotic Unknown. Through the

Schizophrenia and for the

●Contraindicated inn comatose or

CNS Effects ●Evaluate respiratory status

Perphenazine

Generic Name Phenazine Fentazin

antagonize dopamine and serotonin type 2 in CNS. Also antagonize muscarinic receptors in respiratory tract, causing cholinergic activation.

control of severe nausea and vomiting in adults.

Management of behavioral complications in patients with mental retardation

greatly obtunded patients and in patients receiving large doses of central nervous systemdepressants (barbiturates, alcohol, narcotics, analgesics, or antihistamines); in the presence of existing blood dyscrasias, bone marrow depression, or liver damage; and in patients who have shown hypersensitivity to perphenazine tablets, their components, or related compounds

●Contraindicated in patients with suspected or established subcortical brain damage, with or without

●Extrapyramidal Reactions

opisthotonus, trismus, torticollis, retrocollis, aching and numbness of the limbs, motor restlessness, oculogyric crisis, hyperreflexia, dystonia, including protrusion, discoloration, aching and rounding of the tongue, tonic spasm of the masticatory muscles, tight feeling in the throat, slurred speech, dysphagia,akathisia, dyskinesia, parkinsonism, and ataxia.

●Persistent Tardive

especially for dyspnea and airway spasm.●Monitor CBC, glucose, level and liver function test. watch for evidence of blood dyscrasias.

hypothalamic damage, since a hyperthermic reaction with temperatures in excess of 104°F may occur in such patients, sometimes not until 14 to 16 hours after drug administration. Total body ice-packing is recommended for such a reaction; antipyretics may also be useful

Dyskinesia

Other CNS Effects

●Include cerebral edema; abnormality of cerebrospinal fluid proteins; convulsive seizures, particularly in patients with EEG abnormalities or a history of such disorders; and headaches.

●Autonomic Effects

●Dry mouth or salivation, nausea, vomiting, diarrhea, anorexia, constipation, obstipation, fecal impaction, urinary retention, frequency or incontinence,

bladder paralysis, polyuria, nasal congestion, pallor, myosis, mydriasis, blurred vision,glaucoma, perspiration, hypertension, hypotension, and change in pulse rate occasionally may occur