ANTI-DEPRESSANTS

1. Sertraline (Zoloft)

DRUGS INDICATION MODE OF ACTION SIDE/ADVERSE EFFECTS NURSING CONSIDERATION PATIENT TEACHINGGeneric name: Sertraline

Brand name: Zoloft

Classification: Anti-depressants

Dosage: 50mg

Symptoms of depression in patients with or without history of mania. Obsessive-compulsive disorders.

Inhibits serotonin reuptake in CNS, thus increasing in action of serotonin, does not affect dopamine, norepinephrine.

Nausea, loose stools, dyspepsia, tremor, dizziness, insomnia, somnolence, dry mouth, increased sweating and male sexual dysfunction (ejaculatory delay)

1. Assess other medications patient may be taking for effectiveness and interactions.

2. Asses mental status for worsening of depression, suicidal ideation, anxiety, social functioning, ,ania, or panic attack (especially during initiation of therapy and when dosage is changed)

3. Taper dosage slowly whe discontinuing.

4. Assess knowledge/ teach patient appropriate use , interventions to reduce side effects, and adverse symptoms to report.

1. Take in the morning to reduce risk of anemia.

2. Maintain adequate hydration (2-3 L/day of fluids) unless instructed to restrain fluid intake.

3. Report persistent insomnia or daytime sedation, agitation, nervousness, fatigue; muscle crampning, tremors, weakness or change in gait; chest pain, palpitations, or swelling of extremities; vision changes or eye pain; hearing changes; respiratory difficulty or breathlessness; skin rash or irritation; suicidal ideation; or worsening of condition.

2. Flouxetine (motivest)

DRUG INDICATION MODE OF ACTION

SIDE & ADVERSE EFFECT NURSING CONSIDERATION PATIENT TEACHING

Brand name:Motivest

Generic name:Flouxetine

Dosage:20 mg

Depression; OC disorders; bulimia nervosa.

Inhibits CNS neuron uptake of serotonin, but not of norepinephrine

Hot flashes, palpitations, angina, heart block, cerebral ischemia, MI, ventricular arrhythmias, agitation, anxiety, nervousness, headache, insomnia, abnormal dreams, drowsiness, dizziness, tremor, fatigue, decreased libido, decreased concentration, seizures, delusions, hallucinations, coma.

- Monitor B, pulse every 4 hours, if systolic BP drops 20 mmhg, hold drug and notify physician; take VS every 4 hours in patients with CV disease.

- Monitor blood studies.

- Monitor hepatic studies.

- Assess ECG flattening of T wave, bundle branch block, AV block, dysrhythmias in cardiac pattern

- Monitor urinary retention, constipation

- Assess appetite in bulimia nervosa, weight every day, increase nutritious food in

- Instruct patient to use caution in driving

- Advise patient to use sunscreen to prevent photosensitivity.

- Caution patient to avoid alcohol ingestion

- Instruct patient to increase fluids.

- Advise patient not to discontinue drugs abruptly.

diet.

3. Mitrazapine (remerson)

DRUG INDICATION ACTION SIDE/ADVERSE EFFECT NURSING CONSIDERATION PATIENT TEACHINGS

Generic Name:

Mirtazapine

Brand Name: Remerson

Classification: Antidepressants

Dosage: 30 mg

Relief of symptoms of depression (endogenous depression most responsive)

Mechanism of action unknown; appears to act similarly to TCAs, which inhibit the presynaptic reuptake of the neurotransmitters norepinephrine and serotonin; anticholinergic at CNS and peripheral receptors; sedating; relation of these effects to clinical efficacy is unknown.

dizziness, blurred vision, sedation, somnolence, malaise/lassitude, increased appetite and subsequent weight gain,[107]

dry mouth, constipation, enhanced libido and sexual function, and vivid, bizarre, lucid dreams or nightmares.

Rarer side effects: agitation/restlessness, irritability, aggression, apathy and/or anhedonia (emotional blunting), excessive mellowness or calmness, difficulty swallowing, shallow breathing, decreased body temperature, miosis, nocturnal emissions, spontaneous orgasm, loss of balance, and restless legs syndrome.

History: Hypersensitivity to any antidepresssant; concomitant therapy with MAOI; recent MI; myelography within previous 24 hr or scheduled within 48 hr; lactation; ECT; preexisting CV disorders; angle-closure glaucoma; increased IOP, urinary retention, ureteral or urethral spasm; seizure disorders; hyperthyroidism; impaired hepatic, renal function; psychiatric problems; manic-depressive patients; elective surgery; pregnancy, lactation

Physical: Body weight; T; skin color, lesions; orientation, affect, reflexes, vision and hearing; P, BP, orthostatic BP, perfusion; bowel sounds, normal output,

Take this drug exactly as prescribed; do not stop taking the drug abruptly or without consulting your health care provider.

Place orally disintegrating tablet on tongue; it can be swallowed without water. Open blister pack with dry hands and use tablet immediately; do not cut or break tablet.

Avoid using alcohol, other sleep-inducing drugs, or OTC drugs while using this drug.

Avoid prolonged exposure to sunlight or sunlamps; use a sunscreen or protective garments if long exposure to sunlight is unavoidable.

liver evaluation; urine flow, normal output; usual sexual function, frequency of menses, breast and scrotal examination; liver function tests, urinalysis, CBC, ECG

You may experience these side effects: Headache, dizziness, drowsiness, weakness, blurred vision (reversible; avoid driving or performing tasks that require alertness); nausea, vomiting, loss of appetite, dry mouth (eat frequent small meals; use frequent mouth care, suck on sugarless candies); nightmares, inability to concentrate, confusion; changes in sexual function.

Report fever, flulike illness, any infection, dry mouth, difficulty urinating, excessive sedation.

ANTI-EXPRAPYRAMIDAL SYNDROME

1. Biperiden HCL (akineton) 

DRUGS INDICATION MODE OF ACTION SIDE/ADVERSE EFFECTS NURSING CONSIDERATION

PATIENT TEACHING

Generic name:Biperiden HCL

Brand name:Akineton

Classification:Anti-parkinson agent, anti-cholinergic

Dosage:2mg

Parkinsonian syndrome especially to counteract muscle rigidity and tremor; extrapyramidal symptoms

Synthetic anti-cholinergic drug, block cholinergic responses in the CNS

CNS: confusion, anxiety, restlessness, irritability. Delusions, hallucinations, headache, sedation, depression, incoherence, dizziness, euphoria, tremors, memory loss CV: palpitations,

tachycardia, postural hypotension, bradycardia

EENT: blurred vision, photophobia, dilated pupils, difficulty swallowing, mydriasis, increased intraocular

5. Document indication for therapy, onset of signs and symptoms and other agents tried and outcome of therapy.

6. Assess for Parkinsonism, EPS: shuffling gait, rigidity, involuntary movements, pill rolling, muscle spasms, drooling before and during treatment.

7. Assess for mental status: affect, mood, CNS depression, worsening of mental symptoms during early therapy.

8. Assess patient response if

4. Instruct patient that doses should not be dpuble, but missed dosemay be taken up to 2hrs before next dose.

5. Tell patient not to discontinue this drug abruptly, taper off over a week to prevent withdrawal symptoms.

6. Avoid activities that require alertness, may cause dizziness, drowsiness and blurring of vision.

7. Teach patient toavid OTC coughand cold

tension, angle-closure glaucoma

GI: dryness of mouth, constipation, nausea, vomiting, abdominal distress, paralytic ileus

GU: hesitancy, retention, dysuria

Integ: rash, urticaria, dermatoses

Misc: increased temp, flushing, decreased sweating, hyperthermia, heat stroke, numbness of fingers

MS: weakness, cramping

anticholinergics are given.

9. Monitor for constipation, cramping pain in abdomen and abdominal distention. Increase fluids; add fiber to diet and exercise if these occurs.

10. Assess for tolerance over long-term therapy, dosage may have to be increased or changed.

preparations with alcohol and antihistamines, increased CNS depression may occur.

8. Caution patient to rise slowly from sitting or recumbent positions to minimize prthostatis hypotension.

2. Benadryl

DRUGS ACTION INDICATIONS SIDE /ADVERSE EFFECTS NURSING CNSIDERATION PATIENT TEACHINGSBrand name:Benadryl

Generic name:Diphenhydramide

Classification: Antimuscarinic

Acts on blood vessels, Gi, respiratory system by antagonizing the effects of histamine for H1-receptor site; decreases allergic response by bloking histamine ; causes decrease heart rate , vasodilatation, secretions; significant CNS depressant and anticholinergic properties.

Is used for its antimuscarinic properties in the control of Parkinsonism and drug-induced extrapyramidal disorders.

Orthostatic hypotension, palpitations; bradycardia; tachycardia; reflex tachycardia; extrasystoles; faintness. Drowsiness; sedation; dizziness; disturbed coordination; Epigastric distress; nausea; vomiting; diarrhea; constipation; change in bowel habits. Hemolytic anemia; thrombocytopenia; aggranulocytosis. Increases appetite, weight gain. Thickening of bronchial secretions; chest tightness; wheezing; respiratory depression.

1. Assess respiratory status: rate, rhythm, and increase in bronchial secretions, wheezing and chest tightness; provide fluids to 2L day to decrease chest secretions

2. Monitor input and ouput ratio: be alert for urinary retention, frequency, dysuria, especially elderly: drug should be discontinued if these occur.

3. Asses type of involuntary movements and evaluate response to this medication.

4. Assess movement disorder before and after administration.

5. Assess sleep patterns.

1. . Tell the patient that false-negative result,ay occur with skin testing;; these procedure should not be scheduled until 3 days after discontinuing use.

2. Caution patient to avoid hazardous activities and activities requiring alertness, since dizziness may occur,; instruct patient to request assistance with ambulation.

3. Teach all aspects of drug uses; to notify physician if confusion, sedation, hypotension occur, to avoid driving and other hazardous activity if drowsiness occurs; to avoid alcohol or other CNS depressants that may potentiate effect.

4. Inform patient that drug

Hypersensensitivity reactions; photosensitivity.

6. Assess nausea, vomiting , bowel sounds and abdominal pain.

7. Asses degree of itching, skin rashand inflammation.

may cause dry mouth: frequent oral rinses, good oral hygiene, and sugarless gum or candy may minimize the effect

ANTI CONVULSIVE DRUGS1. Carbamezipine (fegretol)

DRUG INDICATION ACTION SIDE/ADVERSE EFFECT NURSING CONSIDERATION PATIENT TEACHINGS

Generic Name: carbamazepine

Brand Name: Tegretol

Classification: Central nervous system drugs

Acute mania, maintenance for bipolar affective disorders.

Exact mechanism unknown, appears to decrease polysynaptic responses and block posttetanic potentiation.

Dizziness, ataxia, allergic skin reactions, leukopenia, vomiting and accommodation disorders.

Assess for seizures, character, location, duration, intensity, character, activity that stimulates pain.

Asses for trigeminal neuralgia: facial pain including location, duration, intensity, character, activity that stimulates pain.

Monitor liver functions test.

Check for water retention, with decreased osmolality and concentration of sodium in plasma, especially in elderly patients with cardiac disease.

Check blood levels during treatment or when

Advise patient to take medications as directed

caution patient to avoid activities that require alertness.

Teach patient to report immediately tp physician if with following reactions: chills, rash, llight-colored stools, dark urine, yellowing of skin/eyes, abdominal pain, sore throat, mouth ulcers, bruising, blurred vision, dizziness.

Advise the patient not to discontinue medication quickly after a long term

changing dose.

2. (Depakote) Divalproex sodium 

DRUG INDICATION MODE OF ACTION SIDE & ADVERSE EFFECTS

NURSING CONSIDERATION PATIENT TEACHING

Generic name: divalproex sodium

Brand name:Depakote

Classification: Anticonvulsant/mood stabilizer

For treatment and management of seizure disorders, mania, and prophylactic treatment of migraine headache

Divalproex binds to and inhibits GABA transaminase. The drug's anticonvulsant activity may be related to increased brain concentrations of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter in the CNS, by inhibiting enzymes that catabolize GABA or block the reuptake of GABA into glia and nerve endings. Divalproex may also work by suppressing repetitive neuronal firing through inhibition of voltage-sensitive sodium channels.

The most common side effects from Depakote are sedation, tiredness, and gastrointestinal symptoms, includingnausea, cramping, and diarrhea. Shifting all or most of the dosage close to bedtime may decrease daytimesedation

Give drug with food if GI upset occurs; substitution of the enteric-coated formulation also may be of benefit; have patient swallow SR tablet whole; do not cut, crush, or chew.

WARNING: Reduce dosage, discontinue, or substitute other antiepileptics gradually; abrupt discontinuation of all antiepileptics may precipitate absence seizures.

WARNING: Arrange for frequent liver function tests; discontinue drug immediately with significant hepatic dysfunction, suspected or apparent; hepatic dysfunction has progressed in spite of drug

If you miss a dose, take it as soon as possible, within 2–3 hours of the scheduled dosing. If it is close to yournext scheduled dose, skip the missed dose and continue on your regular dosing schedule, but do not takedouble doses.• Depakote, the extended-release form, is intended for once-a-day dosing. Swallow the tablets wholeand do not crush or chew them. If stomach upset occurs, take

discontinuation.WARNING: Arrange for

patient to have platelet counts, bleeding time determination before therapy, periodically during therapy, and prior to surgery. Monitor patient carefully for clotting defects (bruising, blood-tinged toothbrush). Discontinue if there is evidence of hemorrhage, bruising, or disorder of hemostasis.

Monitor ammonia levels, and discontinue if there is clinically significant elevation in level.

Monitor serum levels of valproic acid and other antiepileptic drugs given concomitantly, especially during the first few weeks of therapy. Adjust dosage on the basis of these data and clinical response.

Arrange for counseling for women of childbearing age who wish to become pregnant.

WARNING: Discontinue drug at any sign of pancreatitis.

WARNING: Evaluate for therapeutic serum levels—

Depakote after meals or with food.• Contact your physician if you have persistent abdominal symptoms, including pain, loss of appetite, nausea,vomiting, and jaundice.• Depakote may cause sedation and drowsiness, especially during initiation of therapy, and impair your alertness.Use caution when driving or performing tasks that require alertness.• Store the medication in its originally labeled, light-resistant container, away from heat and moisture. Heatand moisture may precipitate breakdown of your medication.

usually 50–100 mcg/mL.

3. Epicval

DRUG INDICATION ACTION SIDE/ADVERSE EFFECTS

NURSING CONSIDERATION

PATIENT TEACHING

Generic Name: Valproic Acid

Brand Name:Epival

Classification:Antiepileptic

Dosage/Route:250mg/Oral

Treatment of acute manic or mixed episodes associated with bipolar disorder, with or without psychotic features.

Adjunct in symptom management of schizophrenia.

Mechanism of action not understood. Antiepileptic activity may be related to the metabolism of the inhibitory neurotransmitter, GABA; divalproex sodium is a compound containing equal proportions of valproic acid and sodium valproate.

CNS: Sedation, tremor (may be dose related), emotional upset, depression, psychosis, aggression, hyperactivity, behavioral deterioration, weaknessDermatologic: Transient increases in hair loss, rash, petechiaeGI: Nausea, vomiting, indigestion, diarrhea, abdominal cramps, constipation, anorexia with weight loss, increased appetite with weight gain, life-threatening pancreatitis, hepatic failure

Nursing Consideration:- Give drug with food if GI

upset occurs; substitution of the enteric-coated formulation also may be benefit; hve patient swallow SR tablet whole; do not cut of crush, or chew.

- Black box warning Arrange for frequent LFTs; discontinue drug immediately with suspected or apparent significant hepatic impairment; continue LFTs to determine if hepatic impairment progresses in spite of drug discontinuation

- Arrange for patients to have platelet counts, bleeding time determination before therapy, periodically during therapy, and prior to surgery. Monitor patient carefully for clotting defects.

- Do not d/c this drug abruptly or change dosage, except on the advice of your health care provider.

- Have frequent check-ups, including blood tests to monitor your drug response. Keep all appointments for check-ups.

- You may experience these s/e: Drowsiness, GI upset, transient increase in hair loss.

- Report bruising, pink stain on the toothbrush, yellowing of the the skin/eyes, pale feces, preganancy, abdominal pain with N/V and anorexia.

D/c if there is evidence of hemorrhage, bruising, or disorder of hemostasis.

-ANTI-MANIC DRUGS1. Lithium carbonate

NAME OF DRUG INDICATION MODES OF ACTION SIDE/ADVERSE EFFECTS NURSING

CONSIDERATIONS PATIENT TEACHINGS

Generic name: Lithium Carbonate

Brand name: Quilonium-R

Classification: Antidepressant

Treatment of acute episodes of mania & hypomania.

Acute depressions.

Acute or chronic cluster headaches.

Prophylaxis of recurrent manic depressive illness

Endogenous depression.

Neurotransmitters: β-Adrenergic: Lithium increases the proportion of low-affinity β-receptors thereby reducing β-receptor function.

α2-Adrenergic: Lithium induces subsensitivity of α2-receptors thereby increasing the release of NE.

Serotonergic: Lithium down-regulates some serotonergic receptor subtypes and increases serotonin turnover. This reduces negative feedback, thereby increasing the release of serotonin.

Dopaminergic: Lithium blocks the up-regulation of receptors

Initial Therapy: Fine hand tremor, polyuria, thirst and nausea

Blood and Lymphatic System Disorders: Leukocytosis.

Endocrine Disorders: Euthyroid goitre, hypothyroidism, hyperthyroidism, hyperparathyroidism.

Metabolism and Nutrition Disorders: Hyperglycemia, hypercalcemia, weight gain, anorexia.

Psychiatric Disorders: Hallucinations, somnolence, memory loss.

Nervous System Disorders: Tremor, fasciculations/twitching, clonic movements of extremities, ataxia, choreoathetoid

1. Observe client for signs and symptoms of depression, mood changes, insomnia, apathy or lack of interest in activities.

2. Check for signs of lithium toxicity.

3. Monitor client for suicidal tendencies

4. Check client’s urine output and body weight.

5. Observe for and signs of side/adverse

1. Tell patient to take the drug as prescribed even if they feel better.

2. Teach patient the signs and symptoms of lithium toxicity and tell them to report it to the doctor if any of it is observed.

3. Tell the patient that there is a need for an adequate and constant salt and water intake.

4. Tell patient that they must discontinue lithium therapy and contact the physician

when given concurrently with neuroleptics and increases dopamine concentrations and turnover. This prevents the release of NE, prevents D2 dopamine receptor up-regulation and augments the effects of indirect agonists.

Secondary Messengers: Inositol Phosphate: Lithium blocks the activity of inositol polyphosphate 1-phosphate and inositol monophosphate phosphatase. This leads to the depletion of inositol and dampens the function of the phosphoinositide cycle.

Adenyl Cyclase:Lithium directly inhibits adenyl cyclase by competing with magnesium. Lithium also inhibits G-proteins. This leads to a reduction or increase in adenyl cyclase

movements, impaired nerve conduction, hyperactive deep tendon reflexes, extrapyramidal symptoms, seizures, slurred speech, dizziness, vertigo, nystagmus, stupor, coma, pseudomotor cerebri, headache, dysgeusia, myasthenia gravis.

Eye Disorders: Scotomata, blurred vision.

Cardiac Disorders: Cardiac arrhythmia, of which bradycardia due to sinus node dysfunction is most frequent, edema. ECG changes: Reversible flattening and inversion of T-waves.

Vascular Disorders: Peripheral circulatory collapse, hypotension, Raynaud's phenomena.

Gastrointestinal Disorders: Nausea, vomiting, diarrhea, excessive salivation, dry mouth.

Skin and SC Tissue Disorders: Alopecia, acne, folliculitis, pruritus, psoriasis exacerbation, angioedema, rash and other signs of skin hypersensitivity.

effects.

6. Check client’s cardiac status.

7. Monitor patient’s electrolytes.

immediately if they experience polydypsia, polyurea or such clinical signs of lithium toxicity.

5. Tell patient to take the drug with food.

function depending on the proportion of regional G-proteins.

Musculoskeletal and Connective Tissue Disorders: Arthralgia, myalgia.

Renal and Urinary Disorders: Symptoms of nephrogenic diabetes insipidus, urinary incontinence and other after long-term therapy, histological renal changes (including tubulointerstitial nephropathy) and impaired renal function.

Reproductive System and Breast Disorders: Impotence, sexual dysfunction.

MINOR TRANQUILIZERS1. Alprazolam (xapor)

DRUG INDICATION ACTION SIDE/ADVERSE EFFECT NURSING CONSIDERATION

PATIENT TEACHINGS

Generic Name:

Alprazolam

Brand Name:

• Management of anxiety disorders, short-term relief of symptoms of anxiety; anxiety

Exact mechanisms of action not understood; main sites of action may be the limbic

CNS: dizziness, drowsiness, lethargy, confusion, hangover, headache, mental depression, paradoxical

Nursing Consideration:

-• Use cautiously with impaired liver or kidney function,

- • Instruct patient to take medication exactly as directed; do not skip or double up on missed doses. If a dose is missed, take within 1 hr;

Apo-Alpraz (CAN), Novo-Alprazol (CAN), Nu-Alpraz (CAN), Xanax, Xanax TS (CAN), Xanax XR

Drug class: BenzodiazepineAnxiolytic

associated with depression.• Treatment of panic attacks with or without agoraphobia• Unlabeled uses: Social phobia, premenstrual syndrome, depression

system and reticular formation; increases the effects of gamma-aminobutyrate, an inhibitory neurotransmitter; anxiety blocking effects occur at doses well below those necessary to cause sedation, ataxia.

excitation.

EENT: blurred vision.

GI: constipation, diarrhea, nausea, vomiting, weight gain.

Derm: rashes.

Misc: physical dependence, psychological dependence, tolerance.

debilitation. otherwise, skip the dose and return to regular schedule. If medication is less effective after a few weeks, check with health care professional; do not increase dose. Abrupt withdrawal may cause sweating, vomiting, muscle cramps, tremors, and seizures

• May cause drowsiness or dizziness. Caution patient to avoid driving and other activities requiring alertness until response to the medication is known. Geri: Instruct patient and family how to reduce falls risk at home

• Advise patient to avoid drinking grapefruit juice during therapy

• Advise patient to avoid the use of alcohol or other CNS depressants concurrently with alprazolam. Instruct patient to consult health care professional before taking Rx, OTC, or herbal products concurrently with this medication

• Inform patient that

benzodiazepines are usually prescribed for short-term use and do not cure underlying problems

• Teach other methods to decrease anxiety (exercise, support group, relaxation techniques)

2. Zolpidem (adormix)

Drug Indication Action Side Effects and Adverse Reactions

Nursing Responsibilty Patient teaching

Generic Name:Zolpidem

Brand Name:Adormix

Zolpidem is approved for the short-term (usually about two to six weeks) treatment of insomnia, and it has been studied for nightly use up to six months in a single-blind

Produces CNS depression at limbic, thalamic, hypothalamic levels of CNS; may be mediated by neurotransmitter y-

headache, lethargy, drowsiness. Daytime sedation, dizziness, confusion, light-headedness, anxiety, irritability, amnesia, poor coordination,

Blood studies: Hct, Hgb, RBC, if blood dyscrasias are suspected (rare)

Hepatic studies: AST, ALT, bilirubin if hepatic damage

That dependence is possible after long-term use

To avoid driving or other activities requiring alertness until drug is

Classification:Sedative-hypnotic

Dosage and route:

1 tab, 10 mg

trial published in 1991, an open-label study lasting 180 days published in 1992 (with continued efficacy in patients who had kept taking it as of 180 days after the end of the trial), and in an open-label trial lasting 179 days published in 1993. Zolpidem has not proven effective in maintaining sleep and is more used for sleep initiation problems.

aminobutyric acid (GABA); results are sedation, hypnosis, skeletal muscle relaxant, anticonvulsant activity, anxiolytic action

complex sleep related reactions: sleep driving, sleep eating

CV: chest pain, palpitation

GI: nausea, vomiting, diarrhea, heartburn, abdominal pain, constipation

HEMA: luekopenia, granulocytopenia (rare)

SYST: severe allergic reactions

has occurred Mental status:

mood, sensorium, affect, memory (long, short)

Blood dyscrasias: fever, sore throat, bruising, rash, jaundice, epistaxis (rare)

Type of sleep problem: falling

asleep, staying asleep

stabilized To avoid alcohol

ingestion That effects may

take 2 nights for benefits to be noticed

Alternative measures to improve sleep: reading, exercise several hours before bedtime, warm bath, warm milk, TV, self hypnosis, deep breathing

3. Clorazepam

DRUG INDICATION ACTION SIDE/ADVERSE EFFECTS NURSING CONSIDERATION

PATIENT TEACHING

Brand Name:

Ritrovil

-Lennox-

Gaustatsyndrome,atypical

-Probablyfacilitates theeffects of theinhibitory

CNS: Transient mild drowsiness, depression, lethargy, apathy, fatigue, light headedness, anger, restlessness, confusion, delirium, headache

- Watch for behavioraldisturbancesespecially in

-Don’t stopdrug abruptlybecause thismay worsenseizures. Callprescriber atonce if

Generic Name:

Clorazepam

Classification:

Minor Tranquilizer

Dosage:

2mg

absenceseizures,akinetic andmycolonicseizures.-Panic disorder-Acute manicepisodes ofbipolardisorder-Adjuncttreatment forschizophrenia

neurotransmitter GABA.

CV: Bradycardia, tachycardia, CV Collapse, hypertension and hypotension, palpitation, edama

DERMATOLOGIC: Urticaria, pruritus, rash, edema

EENT: Visual and auditory disturbance, diplopia, nystagmus, depressed hearing, nasal congestion

GI: Constipation, diarrhea, dry mouth, salvation, nausea, anorexia, vomiting, difficulty swallowing

GU: Incontinence, urinary retention, changes in libido, menstrual irregularities

children.

-Assess elderlypatient’sresponseclosely.

-Monitorpatient foroversedation-Withdrawalsymptoms aresimilar tothose ofbarbiturates.

adversereactionsdevelop

INJECTABLES

1. Fluphenazine decanoate

NAME OF DRUG

INDICATION MODE OF ACTION SIDE/ADVERSE EFFECTS NURSING CONSIDERATIONS

PATIENT TEACHINGS

Generic name: Fluphenazine decanoate

Management of schizophrenia, mania & other psychoses.

Fluphenazine decanoate blocks postsynaptic dopamine D1 and D2 receptors in the mesolimbic system

Tardive dyskinesia Sedation Mental confusion Hypotension Hyperprolactinaemia

1. Check if patient has any extrapyramidal symptoms (dystonic reactions & akathisia are common). Occasionally, galactorrhea,

1. Tell patient to avoid direct sunlight exposure.

2. Tell patient to have

Brand name: Modezine

Classification: Antipsychotics

and decreases the release of hypothalamic and hypophyseal hormones. It reduces aggressiveness with disappearance of hallucinations and delusions.or increase in adenyl cyclase function depending on the proportion of regional G-proteins.

leading to galactorrhoea and amenorrhoea in women

Loss of libido Impotence and

sterility in males. Allergic reactions Cholestatic jaundice orneal and lens

deposits Skin pigmentation. Potentially Fatal:

Agranulocytosis; neuroleptic malignant syndrome.

augmentation of epilepsy, epigastric pain or jaundice. May release catecholamines, use w/ caution in pheochromocytoma.

2. Check for any history of hypersensitivity to the drug

3. Rotate injection sites

4. Check patient’s prolactin levels (which may persist after chronic admin.)

regular eye examinations if receiving long term therapy.

3. Tell patient that drug may be taken with or without food.

4. Tell patient to report any observed adverse reaction to the health care team.

2. Haloperidol

DRUG INDICATION ACTION SIDE/ADVERSE EFFECT

NURSING CONSIDERATION

PATIENT TEACHINGS

Generic Name: Haloperidol

Brand Name: Haldol

Management of Tourette disorders, control for adults. Long-term antipsychotic therapy.

Competitively blocks dopamine receptors to cause sedation and also causes alpha adrenergic and anti-cholinergic blockade.

Blurred vision; changes in menstrual period; constipation; dryness of mouth; swelling or pain in breasts (in females);

-assess patients disorder and mental status before drug therapy.-Monitor for possible adverse reactions

-Instruct patient to take drug exactly as prescribed.- advise patient to avoid hazardous activities until the

Classification: CNS drugs -management of

severe behavioural problems in children.

It depresses cerebral cortex, hypothalamus and limbic system that control activity and aggression.

unusual secretion of milk; weight gain

(severe extrapyramidal reactions).Monitor swallowing of

drug response is determined because dizziness and blurred vision are common.