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Facundo, Christel Margaret P.

Drug
Thorazine

Classification and
Indication
Classification:
Neuroleptic

Indication:
Management of
psychotic
disorders, manic
depressive illness
(manic phase). To
control nausea
and vomiting,
acute intermittent
porphyria. Relief
of intractable
hiccups,
restlessness &
apprehension,
before surgery.
Treatment of
several
behavioral
problems in
children

Dose, Route,
& Frequency
Adult psychotic
disorders 10
mg TID or 25
ng BID-TID

Mechanism of
Nursing Responsibilities
Contraindication
Side Effects
Action
Chlorpromazine is Do not use in
Shuffling walk,
a neuroleptic that
Establish baseline BP (in
patients with known
restlessness,
acts by blocking the
hypersensitivity to
agitation, or
standing and recumbent
postsynaptic
phenothiazines. Do
confusion,
positions), and pulse, before
dopamine receptor
not use in comatose
drowsiness, blank
initiating treatment.
in the mesolimbic
states or in the
facial expression,
dopaminergic
presence of large
nervousness,
Monitor BP frequently.
system and inhibits
amounts of central
difficulty falling
Hypotensive reactions,
the release of
nervous system
asleep or staying
dizziness, and sedation are
hypothalamic and
depressants
asleep, weight gain,
common during early
hypophyseal
(alcohol,
constipation or
therapy, particularly in
hormones. It has
barbiturates,
stomach pain,
patients on high doses and
antiemetic,
narcotics, etc.).
nausea, increased
in the older adult receiving
serotonin-blocking,
appetite, breast
parenteral doses.
and weak
milk production or
antihistaminic
breast
Be alert to complaints of
properties and
enlargement,
diminished visual acuity,
slight ganglionmissed menstrual
reduced night vision,
blocking activity.
periods, decreased
photophobia, and a
sexual ability
perceived brownish
(trouble having an
discoloration of objects.
orgasm),
Patient may be more
uncontrollable or
comfortable with dark
unusual
glasses.
movements of any
body part, dry
Do not alter dosing regimen,
mouth, stuffy nose,
and do not give the drug to
changes in skin
another person.
color, difficulty
urinating, widening Avoid driving a car or
or narrowing of the
undertaking activities
pupils in the eye

Facundo, Christel Margaret P.

requiring precision and


mental alertness until drug
response is known.

Drug
Prozac

Classification and
Indication
Classification:
Antidepressant

Indication:
Acute and
maintenance
treatment of Major
Depressive Disorder,
acute and
maintenance
treatment of
obsessions and
compulsions in
patients with
Obsessive
Compulsive Disorder
(OCD), acute and
maintenance
treatment of bingeeating and vomiting
behaviors in patients
with moderate to

Dose, Route,
& Frequency
PROZAC 20
mg/day orally
in the morning

Mechanism of
Contraindication
Side Effects
Action
Metabolized to
Epileptic seizure,
Suicidal Thoughts and
norfluoxetine,

Closed angle
Behaviors in
fluoxetine is a
glaucoma, Recent
Children,
selective serotoninheart attack, very
Adolescents, and
reuptake inhibitor
rapid heartbeat Young Adults,
(SSRI), it blocks
Torsades de
Serotonin

the reuptake of
Pointes, slow
Syndrome, Allergic
serotonin at the
heartbeat, hardenin
Reactions and Rash,
serotonin reuptake
g of the liver, liver
Screening Patients
pump of the
problems, bleeding
for Bipolar
neuronal
from stomach,
Disorder and
membrane,
esophagus or
Monitoring for
enhancing the
duodenum, loss of
Mania/Hypomania,
actions of serotonin
appetite, diabetes,
Seizures, Altered

on 5HT1A auto
Syndrome of
Appetite and Weight,
receptors. SSRIs
Inappropriate
Abnormal Bleeding,
bind with
Antidiuretic
Angle-Closure
significantly less
Hormone Secretion,
Glaucoma,
affinity to
low amount of
Hyponatremia,
histamine,
magnesium in the
Anxiety and
acetylcholine, and
blood, low amount
Insomnia, QT

norepinephrine
of sodium in the
Prolongation,
receptors than
blood, low amount
Potential

Nursing Responsibilities

Use with caution in anorexic


patient, since weight loss is a
possible side effect.
Monitor for S&S of
anaphylactoid reaction
Lab tests: Periodic
serum electrolytes; monitor
closely plasma glucose in
diabetes.
Monitor serum sodium
level for development of
hyponatremia, especially in
patients who are taking
diuretics or are otherwise
hypovolemic.
Observe for and
promptly report rash or

Facundo, Christel Margaret P.


severe Bulimia
Nervosa, acute
treatment of Panic
Disorder, with or
without agoraphobia

tricyclic
antidepressant
drugs.

of potassium in the
blood, increased
risk of bleeding,
behaving with
excessive
cheerfulness and
activity, mild degree
of mania, ManicDepression

for Cognitive and


Motor Impairment,
Discontinuation
Adverse Reactions

urticaria and S&S of fever,


leukocytosis, arthralgias,
carpal tunnel syndrome,
edema, respiratory distress,
and proteinuria. Drug may
have to be discontinued or
adjunctive therapy instituted
with steroids or
antihistamines.

Drug
Ritalin

Classification and
Indication
Classification:
Anxiolytic

Indication:
Ritalin is indicated
as an integral part of
a total treatment
program which
typically includes
other remedial

Dose, Route,
& Frequency
20 to 30 mg,
BID-TID, 30
to 45 minutes
before meals

Mechanism of
Contraindication
Side Effects
Action
Activates the brain Marked anxiety,
Stomach pain,
stem arousal
tension, and
nausea, vomiting,
system and cortex.
agitation are
loss of appetite,
Structurally,
contraindications to
vision problems,
methylphenidate
Ritalin, since the
dizziness, mild
acts as a dopamine
drug may aggravate
headache,
and norepinephrine
these symptoms.
sweating, mild skin
reuptake inhibitor,
Ritalin is
rash, numbness,
resulting in a
contraindicated also
tingling, or cold
prolongation of
in patients known to
feeling in your
dopamine receptor
be hypersensitive to
hands or feet,

Do not drive or engage


in potentially hazardous
activities until response to
drug is known; especially if
dizziness noted

Nursing Responsibilities

Monitor BP and pulse at


appropriate intervals.

Lab tests: Obtain


periodic CBC with
differential and platelet
counts during prolonged
therapy.

Facundo, Christel Margaret P.


measures
(psychological,
educational, social)
for a stabilizing
effect in children
with a behavioral
syndrome
characterized by the
following group of
developmentally
inappropriate
symptoms:
moderate-to-severe
distractibility, short
attention span,
hyperactivity,
emotional lability,
and impulsivity.

Drug
Eskalith

Classification and
Indication
Classification:
Mood Stablizer

Indication:
Indicated in the

effects.

Dose, Route,
& Frequency
450 mg BID,
oral

Mechanism of
Action
The moodstabilizing effect
has been
postulated to relate
to a reduction of
catecholamine

the drug, in patients


with glaucoma, and
in patients with
motor tics or with a
family history or
diagnosis of
Tourette's
syndrome.

Contraindication

nervous feeling,
sleep problems
(insomnia),or
weight loss,
dangerously high
blood pressure
(severe headache,
blurred vision,
buzzing in your
ears, anxiety,
confusion, chest
pain, shortness of
breath, uneven
heartbeats,
seizure).

Side Effects

Hypersensitivity to Extreme thirst,


lithium, patients with
urinating more or
renal disease,
less than usual,
cardiovascular
weakness, fever,
disease, untreated
feeling restless or
hypothyroidism,
confused, eye pain

Check weight at least 2


or 3 times weekly and
report weight loss.
Check height and
weight in children;
failure to gain in either
should be reported to
physician.

Supervise drug
withdrawal carefully
following prolonged use.
Abrupt withdrawal may
result in severe
depression and
psychotic behavior.

Administer drug 30 to
45 minutes before
meals

Nursing Responsibilities

Lab test: Periodic lithium


levels (draw blood sample
prior to next dose or 812 h
after last dose); periodic
thyroid function tests.

Facundo, Christel Margaret P.


treatment of manic
episodes of manicdepressive
illness. Maintenan
ce
therapy prevents
or diminishes the
intensity of
subsequent
episodes in those
manic-depressive
patients with a
history of mania.

neurotransmitter
concentration,
possibly mediated
by lithium ion (Li +)
effect on Na +K +
adenosine
triphosphatase (Na
+K +ATPase) to
produce improved
transneuronal
membrane
transport of sodium
ion. An alternate
postulate is that
lithium may
decrease cyclic
adenosine
monophosphate
(cyclic AMP)
concentrations ,
which would result
in decreased
sensitivity of
hormonal-sensitive
adenylcyclase
receptors.

sodium imbalance
resulting from
dehydration,
Addisons disease,
reduced dietary salt
intake, pregnancy
and lactation

and vision
problems, restless
muscle movements
in your eyes,
tongue, jaw, or
neck, pain, cold
feeling, or
discoloration in
your fingers or toes,
feeling lightheaded, fainting,
slow heart rate,
hallucinations,
seizure (blackout or
convulsions), fever
with muscle
stiffness, sweating,
fast or uneven
heartbeats, early
signs of lithium
toxicity, such as
nausea, vomiting,
diarrhea,
drowsiness, muscle
weakness, tremor,
lack of
coordination,
blurred vision, or
ringing in your ears

Monitor for S&S of lithium


toxicity (e.g., vomiting,
diarrhea, lack of
coordination, drowsiness,
muscular weakness, slurred
speech when level is 1.52.0
mEq/L; ataxia, blurred vision,
giddiness, tinnitus, muscle
twitching, coarse tremors,
polyuria when >2.0 mEq/L).
Withhold one dose and call
physician. Drug should not
be stopped abruptly
Drink plenty of liquids (23
L/d) during stabilization
period and at least 11 L/d
during ongoing therapy.
Avoid self-prescribed low-salt
regimen, self-dosing with
antacids containing sodium,
and high-sodium foods (e.g.,
prepared meats and diet
soda).
Do not drive or engage in
other potentially hazardous
activities until response to
drug is known.