DRUG NAME RISPERDAL (RISPERIDONE)

ACTION AN ATYPICAL ANTIPSYCHOTIC DRUG THAT IS USED FOR TREATING SCHIZOPHRENIA, BIPOLAR MANIA AND AUTISM. THE EXACT MECHANISM OF ACTION OF RISPERIDONE IS NOT KNOWN, BUT, LIKE OTHER ANTI-PSYCHOTICS, IT IS BELIEVED THAT RISPERIDONE AFFECTS THE WAY THE BRAIN WORKS BY INTERFERING WITH COMMUNICATION AMONG THE BRAIN'S NERVES.

SIDE EFFECTS ABDOMINAL PAIN, VOMITING, CONSTIPATION, DIARRHEA, DRY MOUTH, ABNORMAL WALK, AGITATION, AGGRESSION, ANXIETY, CHEST PAIN, COUGHING, INVOLUNTARY MOVEMENTS, NASAL INFLAMMATION, DECREASED ACTIVITY, , DIZZINESS, DRY SKIN, DIFFICULTY URINATING, HEAVY MENSTRUATION, TREMOR, WEIGHT GAIN, JOIN PAIN, TREMOR

y y y

NURSING RESPONSIBILITIES ALLERGY TO RISPERIDONE, LACTATION, CV DISEASE, PREGNANCY, RENAL OR HEPATIC IMPAIRMENT, HYPOTENSION. MAINTAIN SEIZURE PRECAUTIONS, ESPECIALLY WHEN INITIATING THERAPY AND INCREASING DOSAGE. MONITOR PATIENT REGULARLY FOR SIGNS AND SYMPTOMS OF DIABETES MELLITUS. MIX ORAL SOLUTION WITH 3 4 OZ OF WATER, COFFEE, ORANGE JUICE, OR LOW-FAT MILK. DO NOT MIX WITH COLA OR TEA. MONITOR BLOOD STUDIES IF ON LONG TERM THERAPY (HCT, HGH, RBC, SERUM FOLATE ETC.) MONITOR LIVER FUNCTIONS STUDIES MONITOR BLOOD LEVELS (50-100MCG/ML) ASSESS RESPIRATORY DYSFUNCTION: IF 22 IS <12/MIN, HOLD THE MEDICATION GIVE WITH FOOD TO DECREASE GI UPSET ADMINISTER MEDICATION WITH FOOD TO MINIMIZE GASTRIC IRRITATION. ADVISE PATIENT NOT TO TAKE ALCOHOL OR OTHER CNS DEPRESSANT CONCURRENTLY WITH THIS MEDICATION. CAUTION PATIENTS TO USE SUNSCREEN AND PROTECTING CLOTHING TO PREVENT PHOTOSENSITIVITY REACTIONS. PHENOTHIAZINES HYPOTENSION, ORTHOSTATIC, MAY OCCUR ESPECIALLY IN ELDERLY AND IN ALCOHOLIC PATIENTS. CAUTION IN PATIENTS WITH CARDIOVASCULAR DISEASE. WITH CAUTION IN PATIENTS WHO HAVE IMPAIRED LIVER FUNCTION OR ALCOHOLIC LIVER DISEASE. CNS DEPRESSION MAY BE POTENTIATED. USE CHLORPROMAZINE CAUTIOUSLY IN PATIENTS WITH A HISTORY OF SEIZURES. ASSESS MENTAL STATUS PRIOR TO 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 I&O RATIOS AND DAILY WEIGHT FOR SIGNS OF DEHYDRATION. TAKE DRUG EXACTLY AS PRESCRIBED; DO NOT STOP TAKING DRUG (LONG-TERM THERAPY) WITHOUT CONSULTING HEALTH CARE PROVIDER. KEEP PATIENTS WHO HAVE RECEIVED PARENTERAL DOSES UNDER CLOSE OBSERVATION, PREFERABLY IN BED, UP TO 3 HR. DO NOT PERMIT AMBULATORY PATIENTS TO DRIVE FOLLOWING AN INJECTION. DO NOT USE SOLUTIONS THAT ARE DISCOLORED OR CONTAIN A PRECIPITATE.

DEPAKOTE (DIVALPROEX)

DRUGS THAT ARE USED FOR THE TREATMENT OF CONVULSIONS, MIGRAINES AND BIPOLAR DISORDER. THE THEORY IS THAT VALPROIC ACID EXERTS ITS EFFECTS BY INCREASING THE CONCENTRATION OF GAMMA-AMINOBUTYRIC ACID (GABA) IN THE BRAIN. GAMMA-AMINOBUTYRIC ACID IS A NEUROTRANSMITTER, A CHEMICAL THAT NERVES USE TO COMMUNICATE WITH ONE ANOTHER. FREQUENCY-, USE- AND VOLTAGE-DEPENDENT NEURONAL SODIUM CHANNELS, AND THEREFORE LIMITS REPETITIVE FIRING OF ACTION POTENTIALS. IT ALSO AFFECTS CALCIUM CHANNELS, GABA RECEPTORS, AND ADENOSINE RECEPTORS, AND INCREASES CONCENTRATIONS OF SEROTONIN AND OTHER NEUROTRANSMITTERS. WHETHER THESE EFFECTS CONTRIBUTE TO ITS ANTICONVULSANT ACTIVITY IS NOT CLEAR. CHLORPROMAZINE IS AN ALIPHATIC PHENOTHIAZINE. PHENOTHIAZINES ARE THOUGHT TO ELICIT THEIR ANTIPSYCHOTIC AND ANTIEMETIC EFFECTS VIA INTERFERENCE WITH CENTRAL DOPAMINERGIC PATHWAYS IN THE MESOLIMBIC AND MEDULLARY CHEMORECEPTOR TRIGGER ZONE AREAS OF THE BRAIN, RESPECTIVELY. OFTEN TERMED DOPAMINE BLOCKERS, THE EXACT MECHANISM OF DOPAMINERGIC INTERFERENCE RESPONSIBLE FOR THE DRUGS ANTIPSYCHOTIC ACTIVITY HAS NOT BEEN DETERMINED. HALOPERIDOL IS A BUTYROPHENONE DERIVATIVE WITH ANTIPSYCHOTIC PROPERTIES THAT HAS BEEN CONSIDERED PARTICULARLY EFFECTIVE IN THE MANAGEMENT OF HYPERACTIVITY, AGITATION, AND MANIA. HALOPERIDOL IS AN EFFECTIVE NEUROLEPTIC AND ALSO POSSESSES ANTIEMETIC PROPERTIES; IT HAS A MARKED TENDENCY TO PROVOKE EXTRAPYRAMIDAL EFFECTS AND HAS RELATIVELY WEAK ALPHAADRENOLYTIC PROPERTIES. IT HAS ANXIOLYTIC, SEDATIVE AND HYPNOTIC PROPERTIES. IT APPEARS TO WORK THROUGH SEVERAL MECHANISMS. BENZODIAZEPINES PRESUMABLY EXERT THEIR EFFECTS BY BINDING TO SPECIFIC RECEPTORS AT SEVERAL SITES WITHIN THE CENTRAL NERVOUS SYSTEM, THEREBY POTENTIATING THE EFFECTS OF SYNAPTIC OR PRESYNAPTIC INHIBITION MEDIATED BY GAMMAAMINOBUTYRIC ACID OR DIRECTLY AFFECTING THE ACTION POTENTIAL GENERATING MECHANISMS.

SHAKINESS, NAUSEA, DROWSINESS, AND HEADACHES ARE AMONG THE MOST COMMON SIDE EFFECTS REPORTED WITH DEPAKOTE. SIDE EFFECTS THAT ARE LESS FREQUENT BUT POTENTIALLY SERIOUS CAN INCLUDE UNEXPLAINED BRUISING OR BLEEDING, DEPRESSION, AND WORSENING OF SEIZURES. FEELING DIZZY, DROWSY, OR UNSTEADY; VOMITING, DIARRHEA, CONSTIPATION, STOMACH PAIN; CONFUSION, HEADACHE, BLURRED VISION; RINGING IN YOUR EARS; DRY MOUTH, SWOLLEN TONGUE; OR JOINT OR MUSCLE PAIN, LEG CRAMPS.

y y y y y y y

TEGRETOL (CARBAMAZEPINE)

CHLORPROMAZINE (THORAZINE)

BLURRED VISION; CONSTIPATION; DIZZINESS; DROWSINESS; DRY MOUTH; LIGHT SENSITIVITY; NASAL CONGESTION.

y BLURRED VISION; CHANGES IN MENSTRUAL PERIOD; CONSTIPATION; DRYNESS OF MOUTH; SWELLING OR PAIN IN BREASTS (IN FEMALES); UNUSUAL SECRETION OF MILK; WEIGHT GAIN, BLURRED VISION; CHANGES IN MENSTRUAL PERIOD; CONSTIPATION; DRYNESS OF MOUTH; SWELLING OR PAIN IN BREASTS (IN FEMALES); UNUSUAL SECRETION OF MILK; WEIGHT GAIN CONFUSION, DEPRESSED MOOD, THOUGHTS OF SUICIDE OR HURTING YOURSELF; HYPERACTIVITY, AGITATION, HOSTILITY; HALLUCINATIONS; OR FEELING LIGHT-HEADED, FAINTING. y y y

HALOPERIDOL (HALDOL)

y y

ATIVAN (LORAZEPAM)