Zamora, Maria Karina D.

Assignment in NCM 105 MAD

BSN 301 Prof. Jocelyn C. Lauro

Name of Drug Mechanism of Action Indications Contraindications Side and Adverse Effects Nursing Responsibilities
Generic Name: Classification:  Psychosis, mania Hypersensitive to the drug; CNS: extrapyramidal  Give drug without
Thorazine Antipsychotics;  Nausea and those with CNS reactions, sedation, tardive regard to food
Phenothiazines vomiting depression; bone marrow dyskinesia,  Obtain baseline BP
Brand Name:  Acute intermittent suppression; or subcortical pseudoparkinsonism, before therapy and
Chlorpromazine Peak effect: Unknown porphyria, damage; and those in coma neuroleptic malignant monitor regularly
hydrochloride intractable hiccups syndrome, seizures,  Watch for
A piperidine phenothiazine  Tetanus Use cautiously in elderly or dizziness, drowsiness orthostatic
Route and Dosage: that may block  Behavioral debilitated patients and in CV: orthostatic hypotension,
Injection: 25 mg/mL postsynaptic dopamine disorders: patients with hepatic or hypotension, tachycardia, especially with
Tablets: 10 mg, 25 mg, 50 receptors in the brain hyperactivity renal disease; severe CV quindine-like ECG effects parenteral
mg, 100 mg, 200 mg  Surgery disease (may suddenly EENT: ocular changes, administration
increase BP), respiratory blurred vision, nasal  Monitor patient for
disorders, hypocalcemia, congestion tardive dyskinesia
glaucoma, preexisting GI: dry mouth, which may occur
WBC count, or prostatic constipation, nausea after prolonged use
hyperplasia; exposed to GU: urine retention,  Watch for evidence
extreme heat or cold menstrual irregularities, of neuroleptic
(antipyretic therapy) or inhibited ejaculation, malignant
organophosphate priapism syndrome
insectisides Hematologic: leukopenia, (extrapyramidal
agranulocytosis, aplastic effects,
Use cautiously in acutely anemia, thrombocytopenia, hyperthermia,
ill or dehydrated children eosinophilia, hemolytic autonomic
anemia disturbance)
Hepatic: jaundice  Tell patient to avoid
Skin: mild photosensitivity alcohol
reactions, pain at IM  Report signs of
injection site, allergic urine retention or
 reactions, sterile abscess, constipation
skin pigmentation changes  Use sunblock or
Other: gynecomastia, wear protective
lactation, galactorrhea clothing
Generic Name: Classification:  Psychotic disorders Hypersensitive to the drug CNS: severe  Monitor patient for
Haloperidol; haloperidol Antipsychotics;  Chronic psychosis and in those with extrapyramidal reactions, tardive dyskinesia,
decanoate; haloperidol Phenylbutyl-piperadine requiring prolonged parkinsonism, coma, or dystonia, tardive which may occur
lactate derivatives therapy CNS depression dyskinesia, neuroleptic after prolonged use
 Nonpsychotic malignant syndrome,  Watch for signs and
Brand Name: Haldol; Peak effect: behavior disorders Use cautiously in elderly seizures, sedation, symptoms of
Novo-Peridol PO: 3-6 hr  Tourette syndrome and debilitated patients, drowsiness, lethargy, neuroleptic
IM: 3-9 days or 10-20 min  Hiccups history of seizures, or EEG headache, insomnia, malignant
Route and Dosage: SC: Unknown abnormalities, prolonged confusion, vertigo, syndrome
Tablets: 0.5 mg, 1 mg, 2 QT interval and other agitation, anxiety, (extrapyramidal
mg, 5 mg, 10 mg, 20 mg A butyrophenone that severe CV disorders, depression, hallucinations, effects,
Injection: 50 mg/mL, 100 probably exerts allergies, glaucoma, or euphoria, restlessness, hyperthermia,
mg/mL, 5 mg/mL antipsychotic effects by urine retention, and in tonic clonic seizures autonomic
blocking postsynaptic those taking CV: tachycardia, disturbance) which
dopamine receptors in the anticonvulsants, hypotension, hypertension, is rare but
brain anticoagulants, prolonged QT interval and commonly fatal
antiparkinsonians, or other ECG changes,  Monitor ECG when
lithium torsades de pointes with drug is given in
high doses high doses because
EENT: blurred vision of the increased risk
GI: dry mouth, anorexia, of QT-interval
constipation, diarrhea, prolongation and
nausea, vomiting, torsades de pointes
dyspepsia  Aren’t approved for
GU: urine retention, the treatment of
menstrual irregularities dementia-related
Hematologic: leukopenia, psychotics
leukocytosis  May contain
Hepatic: jaundice tartrazine
 Metabolic: hyperglycemia,
hypoglycemia,
Skin: rash, other skin
reactions, diaphoresis
Other: gynecomastia
Generic Name: Classification:  Psychotic Hypersensitive to the CNS: extrapyramidal  Monitor patient for
Fluphenazine decanoate; Antipsychotics; disorders drug and in those with reactions, tardive tardive dyskinesia
fluphenazine Phenothiazines coma, CNS depression, dyskinesia, which may occur
hydrochloride bone marrow pseudoparkinsonism, after prolonged use
Peak effect: suppression, or other neuroleptic malignant  Watch for evidence
Brand Name: Prolixin PO: 30 min blood dyscrasia, syndrome, seizures, of neuroleptic
IM: Unknown; 90-120 min subcortical damage, or sedations, dizziness, malignant
Route and Dosage: SC: Unknown liver damage drowsiness, EEG changes syndrome
Depot injection: 25 mg/mL CV: orthostatic (extrapyramidal
Elixir: 2.5 mg/mL A piperazine phenothiazine Use cautiously in elderly hypotension, tachycardia, effects,
IM: 2.5 mg/mL that probably blocks or debilitated patients in ECG changes hyperthermia,
PO: 5 mg/mL postsynaptic dopamine those with EENT: ocular changes, autonomic
Tablets: 1 mg, 2.5 mg, 5 receptors in the brain pheochromocytoma, blurred vision, nasal disturbance
mg, 10 mg severe CV disease (may congestion  Withhold dose and
cause sudden drop in GI: dry mouth, notify prescriber if
BP), peptic ulcer, constipation, increased patient develops
respiratory disorder, appetite signs and
hypocalcemia, seizure GU: urine retention, dark symptoms of blood
disorder (may lower urine, menstrual dyscrasia
seizure threshold), severe irregularities, inhibited  Aren’t approved for
reactions to insulin or ejaculation the treatment of
electroconvulsive Hematologic: leukopenia, dementia-related
therapy, mitral agranulocytosis, aplastic psychotics
insufficiency, glaucoma, anemia, thrombocytopenia,  Tell patient to avoid
or prostatic hyperplasia eosinophilia, hemolytic alcohol
anemia  Report signs of
Neonates exposed to Hepatic: cholestatic urine retention or
antipsychotic drug jaundice constipation
 during the third trimester Metabolic: weight gain  Use sunblock or
of pregnancy are at risk wear protective
for developing clothing
extrapyramidal signs and  May discolor urine
symptoms

Use cautiously in those

exposed to extreme heat
or cold

Use parenteral if with

asthma or allergic to
sulfites
Generic Name: Classification:  Schizoprenia Hypersensitive to drug CNS: headache, anxiety,  Give drug without
Aripiprazole Antipsychotics;  Bipolar mania, insomnia, light- regard to food
Quinolinone derivatives including manic Isn’t approved for use in headedness, somnolence,  Monitor patient for
Brand Name: Abilify, and mixed children with depression akathisia, increased neuroleptic
Discmelt Peak effect: episodes, with or suicide risk, neuroleptic malignant
PO: 3-5 hr without psychotic Aren’t approved for the malignant syndrome, syndrome (stop
Route and Dosage: IM: 1-3 hr features, treatment of dementia- seizures, suicidal drug and notify
Injection: 9.75 mg/1.3 mL adjunctive therapy related psychotics thoughts, extrapyramidal prescriber)
(7.5 mg/mL) single dose Thought to exert partial with either lithium disorder (children),  Monitor for signs
vial agonist activity at or valproate for Use cautiously in patients tremor, asthenia, and symptoms of
ODTs: 10 mg, 15 mg dopamine 2 and 5-HT IA treatment of with CV disease, depression, fatigue, tardive dyskinesia
Oral solution: 1 mg/mL receptors and antagonist manic and mixed cerebrovascular disease, dizziness, nervousness,  Fatal
IM suspension: 300 mg, activity at 5-HT 2A episodes or conditions that could hostility, manic behavior, cererbrovascular
400 mg receptors associated with predispose patient to confusion, abnormal gait, adverse events may
Tablets: 2 mg, 5 mg, 10 bipolar I disorder hypotension, such as cogwheel rigidity, fever, occur in elderly
mg, 15 mg, 20 mg, 30 mg with or without dehydration or tardive dyskinesia,  Hyperglycemia
psychotic features hypovolemia restlessness, agitation may occur
 Adjunctive CV: peripheral edema,
treatment of Use cautiously in patients chest pain, hypertension,
major-depressive with history of seizures or tachycardia, orthostatic
 disorder with conditions that hypotension, bradycardia
 Agitation lower the seizure EENT: blurred vision,
associated with threshold conjunctivitis, ear pain,
schizophrenia or rhinitis, increased
bipolar I disorder, Use cautiously in patients salivation,
mixed or manic who engage in strenuous nasopharyngitis
 Irritability exercise, are exposed to GI: nausea, vomiting,
associated with extreme heat, take constipation, anorexia,
autistic disorder anticholinergics, or are dry mouth, dyspepsia,
 Tourette disorder susceptible to diarrhea, abdominal
dehydration pain, esophageal
dysmotility, increased
Use cautiously in patients appetite
with Lewy body dementia GU: urinary incontinence
or Parkinson disease Hematologic: ecchymosis,
anemia
Use cautiously in patients Metabolic: weight gain,
at risk for aspiration weight loss,
pneumonia, such as those hyperglycemia,
with Alzheimer disease hypercholesterolemia
Musculoskeletal: neck
pain, neck stiffness,
muscle cramps, myalgia,
extremity pain
Respiratory: dyspnea,
pneumonia, cough
Skin: rash, dry skin,
pruritus, sweating, ulcer
Other: flulike syndrome
Generic Name: Clozapine Classification:  Schizoprenia in Because of risk of severe CNS: drowsiness,  Drug increases the
Antipsychotics; severely ill neutropenia, which can sedation, dizziness, risk of fatal
Brand Name: Clorazil, Dibenzapine derivatives patients lead to fatal infections, vertigo, headache, myocarditis and
FazaClo ODT, Versacloz unresponsive to drug is available only seizures, syncope, tremor, cardiomyopathy,

Route and Dosage:
Oral suspension: 50
mg/mL
Tablets: 12.5 mg, 25 mg,
50 mg, 100 mg, 200 mg,
orally disintegrating: 12.5
mg, 25 mg, 200 mg, 250
mg, 200 mg
Peak effect:
PO: 2 ½ hr
Unkown; binds selectively
dopaminergic receptors in
the CNS and may interfere
with adrenergic,
cholinergic, histaminergic,
and serotonergic receptors
other therapies through the Clozapine disturbed sleep or especially during,
 To reduce risk of REMS Program nightmares, restlessness, but not limited to,
recurrent suicidal hypokinesia o akinesia, the first month of
behavior in Obtain CBC with agitation, rigidity, therapy
schizophrenia or differential before akathisia, confusion,  Myocarditis – stop
schizoaffective initiating treatment fatigue, insomnia, therapy
disorders hyperkinesia, weakness, immediately and
ANC must be at least lethargy, ataxia, slurred don’t restart
1.500/mm3; 1000/mm3 if speech, depression,  May cause
with BEN myoclonus, anxiety, fever hyperglycemia
CV: tachycardia,  Monitor patient for
Hypersensitivity to drug, hypotension, metabolic
irregular pulse, hypertension, chest pain, syndrome
fluctuating blood ECG changes, orthostatic  Seizures may occur,
pressure, tachycardia, hypotension especially in high
diaphoresis, cardiac EENT: visual doses
arrythmias, elevated disturbances  Fever may occur
creatinine phosphokinase GI: constipation,  Aren’t approved for
myglobinuria, excessive salivation, dry the treatment of
rhabdomyolysis, acute mouth, nausea, vomiting, dementia-related
renal failure heartburn, diarrhea psychotics
GU: urinary frequency or
Tardive dyskinesia urgency, urine retention,
incontinence, abnormal
ejaculation
Hematologic: leukopenia,
neutropenia, eosinophilia
Metabolic:
hyperglycemia, weight
gain,
hypercholesterolemia,
hypertriglyceridemia
Musculoskeletal: muscle
 pain or spasm, weakness
Respiratory: respiratory
arrest
Skin: rash, diaphoresis
Generic Name: Classification:  Depression Contraindicated in CNS: stroke, seizures,  May increase
Amitriptyline Antidepressants; (outpatients) patients hypersensitive to come, ataxia, tremor, suicidal thinking
hydrochloride Tricyclic antidepressants  Depression drug and in those who peripheral neuropathy, and behavior in
(hospitalized have received an MAO anxiety, insomnia, children,
Brand Name: Elavil, Peak effect: patients) inhibitor within the past restlessness, drowsiness, adolescents, and
Levate PO: 2-5 hr  Postherpetic 14 days dizziness, weakness, young adults with
neuralgia fatigue, headache, major depressive
Route and Dosage: Unkown, A TCA that  Prevention of Concomitant use with extrapyramidal reactions, disorder or other
Tablets: 10 mg, 25 mg, 50 increases the amount of chronic headache linezolid or methylene hallucinations, delusions, psychiatric disorder
mg, 75 mg, 100 mg, 150 norepinephrine, serotonin,  Prevention of blue can cause serotonin disorientation  Don’t use in
mg or both in the CNS by migraine syndrome CV: orthostatic children younger
blocking their reuptake by  Fibromyalgia hypotension, tachycardia, than age 12
the presynaptic neurons  Irritable bowel During acute recovery heart block, arrhythmias,  If linezolid or
syndrome phase of MI MI, ECG changes, methylene blue
hypertension, edema must be given,
Isn’t approved for use in EENT: blurred vision, amitriptyline must
children younger than tinnitus, mydriasis, be stopped and the
age 12 increased IOP patient should be
GI: dry mouth, nausea, monitored for
Use cautiously in patients vomiting, anorexia, serotonin toxicity
with history of seizures, epigastric pain, diarrhea,  Has anticholinergic
urine retention, angle- constipation, paralytic effects and is one of
closure glaucoma, or ileus the most sedating
increased IOP; in those GU: urine retention, TCAs; have rapid
with hyperthyroidism, altered libido, erectile onset
CV disease, diabetes, or dysfunction  Elderly patients
impaired liver function, Hematologic: have increased
and in those receiving agranulocytosis, sensitivity
thyroid drugs thrombocytopenia,  May cause
 leukopenia, eosinophilia hypertension during
Use cautiously in those Metabolic: hypoglycemia, surgery
receiving hyperglycemia  Monitor glucose
electroconvulsive therapy Skin: rash, urticaria, level
photosensitivity  Don’t withdraw
reactions, diaphoresis drug abruptly
Other: hypersensitivity
reactions
Generic Name: Classification:  Depression, Hypersensitive to the CNS: nervousness,  Use antihistamines
Fluoxetine hydrochloride Antidepressants; SSRIs obsessive- drug and within 14 days somnolence, anxiety, or topical
compulsive of stopping an MAO insomnia, headache, corticosteroids to
Brand Name: Prozac, Peak effect: disorder inhibitor intended to drowsiness, tremor, treat rashes or
Sarafem PO: 6-8 hr  Maintenance treat psychiatric dizziness, asthenia, pruritus
therapy for disorders suicidal behavior, fatigue,  Watch for weight
Route and Dosage: Thought to be linked depression in fever change during
Capsules: 90 mg, 10 mg, drug’s inhibition of CNS stabilized patients MAO inhibitors should CV: palpitations, hot therapy, particularly
20 mg, 40 mg neuronal uptake of (not for newly not be started within 5 flashes in underweight or
Oral solution: 20 mg/5 serotonin diagnosed) weeks of stopping EENT: nasal congestion, bulimic patients
mL  Short-term and fluoxetine pharyngitis, sinusitis  Record mood
Tablets: 10 mg, 15 mg, 20 long-term GI: nausea, diarrhea, dry changes
mg, 60 mg treatment of Concomitant use with mouth, anorexia,  Watch for suicidal
bulimia nervosa linezolid or methylene dyspepsia, constipation, tendencies
 Short-treatment of blue can cause serotonin abdominal pain,  Has long life:
panic disorder syndrome vomiting, flatulence, monitor patient for
with or without increased appetite adverse effects for
agoraphobia Use cautiously in patients GU: sexual dysfunction up to 2 weeks after
 Depressive at high risk for suicide Metabolic: weight loss, drug is stopped
episodes and those with history of hyponatremia  When discontinuing
associated with diabetes mellitus, Musculoskeletal: muscle drug, taper dosage
bipolar I disorder seizures, mania, or pain over 2 weeks to 1
 Premenstrual hepatic, renal, or CV Respiratory: upper month
dysphoric disorder disease respiratory tract
 Treatment- infection, cough,

Generic Name: Selegiline Classification: MAO
hydrochloride inhibitors
Brand Name: Emsam, Peak effect:
Eldepryl, Zelapar PO: 40-90 min (tablet,
capsule)
Route and Dosage: PO: 10-15 min (ODT)
Transdermal system: 6 Transdermal: Unknown
mg/24 hrs. 9 mg/24 hrs,
12 mg/24 hrs May inhibit MAO type B
Capsules: 5 mg (mainly found in the brain)
ODTs: 1.25 mg and dopamine metabolism.
Tablets: 5 mg At higher-than-
recommended, drug non-
selectively inhibits MAO,
including MAO type A
(mainly found in the
intestine). May also
directly increase
dopaminergic activity by
decreasing reuptake of
dopamine into nerve cells.
resistant respiratory distress,
depression Skin: rash, pruritus,
 Posttraumatic diaphoresis
stress disorder Other: flulike syndrome
(PTSD)
 Borderline
personality
disorder
 Irritable bowel
syndrome
 Adjunctive Hypersensitive to drug, in CNS: dizziness, agitation,  Some patients
treatment with patients with delusions, loss of balance, experience new or
levodopa- pheochromocytoma and depression, increased increased adverse
carbidopa in in those taking bradykinesia, involuntary reactions to
managing signs bupropion, movements, headache, levodopa, such as
and symptoms of carbamazepine, confusion, hallucinations, dyskinesia, when
Parkinson disease cyclobenzaprine, vivid dreams, insomnia, it’s used with
 Major depressive dextromethorphan, syncope, pain selegiline (needs
disorder duloxetine, methadone, CV: arrhythmias, 10-30% reduction)
meperidine, mirtazapine, orthostatic hypotension,  Drug may increase
MAO inhibitors, hypertension, or risk of suicidal
oxcarbazepine, SSRIs, increased angina thinking and
sympathomimetics, EENT: pharyngitis, behavior in
tramadol, TCAs, or rhinitis children,
venlafaxine GI: nausea, dry mouth, adolescents, and
abdominal pain, diarrhea young adults ages
Concomitant use with Musculoskeletal: leg 18 to 24
linezolid or methylene cramps, myalgia, back  If linezolid or
blue can cause serotonin pain methylene blue
syndrome Respiratory: dyspnea must be given, stop
Skin: rash, ecchymosis selegiline and
Don’t use oral drug with monitor patient for
transdermal system Transdermal form serotonin toxicity

Generic Name: Classification:  Obsessive-
Clomipramine Antidepressants;
hydrochloride Tricyclic antidepressants
 Panic disorder
Brand Name: Anafranil Peak effect:
PO: 2-6 hr
Route and Dosage:
Capsules: 25 mg, 50 mg, Unknown; inhibits
75 mg reuptake of serotonin and
norepinephrine at the
presynaptic neuron
CNS: headache, insomnia  Monitor patients
Don’t use at daily doses CV: chest pain, with major
exceeding 2.5 mg/day hypotension, orthostatic depressive disorder
BP for worsening of
Should not consume GI: diarrhea, dry mouth, symptoms and of
foods containing dyspepsia suicidal behavior
tyramine, because of risk Metabolic: weight loss,  Monitor patient
of hypertensive reactions weight gain carefully for
Respiratory: pharyngitis, orthostatic
sinusitis hypotension
Skin: application-site  Examine skin
reaction, rash periodically for
possible melanoma
because of drug’s
associated risk of
skin cancer
Hypersensitive to drug or CNS: somnolence,  Monitor mood and
compulsive another TCAs, in those tremor, dizziness, watch for suicidal
disorder who have taken MAO headache, insomnia, tendencies
inhibitors within previous nervousness, myoclonus,  Drug may increase
14 days, in those fatigue, seizures, EEG suicidal thinking
receiving linezolid or changes and behavior in
methylene blue IV, and in CV: orthostatic children,
patients in acute recovery hypotension, palpitations, adolescents, and
period after MI tachycardia young adults ages
EENT: pharyngitis, 18 to 24
Use cautiously in patients rhinitis, visual changes  If linezolid or
with history of seizure GI: dry mouth, methylene blue
disorders or with brain constipation, nausea, must be given, drug
damage of varying cause, dyspepsia, increased must be stopped
in patients receiving appetite, anorexia, and the patient
other seizure-threshold- abdominal pain, diarrhea should be
lowering drugs, in GU: urinary hesitancy, monitored for
 patients at risk for UTI, dysmenorrhea, serotonin toxicity
suicide, in patients with ejaculation failure,  Hypertensive
history of urine retention erectile dysfunction episodes during
or angle-closure Hematologic: purpura surgery
glaucoma, increased IOP, Metabolic: weight gain  Avoid hazardous
CV disease, impaired Musculoskeletal: myalgia activities
hepatic or renal function, Respiratory:  Avoid alcohol
or hyperthyroidism, in bronchospasm, coughing,  Advise patient to
patients with tumors of dyspnea use sunblock, wear
the adrenal medulla, in Skin: diaphoresis, rash, protective clothing,
patients receiving thyroid pruritus, dry skin and avoid
drug or electroconvulsive Other: altered libido prolonged exposure
therapy; and in those to strong sunlight
undergoing elective
surgery

Isn’t approved for use in

children except for those
with obsessive-
compulsive disorder
Generic Name: Sertraline Classification:  Depression Hypersensitive to drug CNS: fatigue, headache,  Give sertraline once
hydrochloride Antidepressants; SSRIs  Obsessive- tremor, dizziness, daily, either in
compulsive Concomitant use with insomnia, somnolence, morning or evening
Brand Name: Apo- Peak effect: 4-8 hr disorder linezolid or methylene suicidal behavior, with or without
Sertraline, Zoloft  Panic disorder blue can cause serotonin paresthesia, hypesthesia, food
Route and Dosage: Thought to be linked to  Posttraumatic syndrome nervousness, anxiety,  Make dosage
Capsules: 25 mg, 50 mg, drug’s inhibition of CNS stress disorder agitation, hypertonia, adjustments at
100 mg neuronal uptake of  Premenstrual Patients taking pimozide pain intervals of no less
Oral concentrate: 20 serotonin dysphoric disorder or MAO inhibitors or CV: palpitations, chest than 1 week
mg/mL  Social anxiety within 14 days of MAO pain, hot flashes  Record mood
Tablets: 25 mg, 50 mg, disorder inhibitor therapy GI: dry mouth, nausea, changes
100 mg, 150 mg, 200 mg  Cholestatic- diarrhea, loose stools,  Monitor patient for
related pruritus Oral concentrate is dyspepsia, vomiting, suicidal tendencies
 contraindicated with
disulfiram because it
contains alcohol
Isn’t approved for use in
children except those
with obsessive-
compulsive disorder
Use cautiously in patients
at risk for suicide and in
those with seizure
disorders, major affective
disorders, or diseases or
conditions that affect
metabolism or
hemodynamic responses
Generic Name: Classification:  Anxiety Contraindicated in patients
lorazepam Anxiolytics;  Insomnia from hypersensitive to drug,
Benzodiazepines anxiety or transient other benzodiazepines, or
Brand Nam: Ativan situational stress the vehicle used in
Peak Effect: parenteral dosage form,
Route & Dosage P.O. – 1 hour and in patients with acute
P.O. – 0.5mg, 1mg, 2mg I.V. – 60 to 90 minutes angle-closure glaucoma
Injection – 2mg/mL, I.M. – 60 to 90 minutes
4mg/mL Contraindicated for intra-
May potentiate the effects arterial administration
of GABA, depress the
CNS, and suppress the Use cautiously in patients
constipations, thirst,
flatulence, anorexia,
abdominal pain,
increased appetite
GU: male sexual
dysfunction
Musculoskeletal: myalgia
Skin: rash, pruritus,
diaphoresis
CNS: drowsiness,
sedation, amnesia,
insomnia, agitation,
dizziness, weakness,
unsteadiness,
disorientation, depression,
headache
CV: hypotension
EENT: visual
disturbances, nasal
congestion
GI: abdominal discomfort,
and allow only a
minimum supply of
drug
 Drug may increase
the risk of suicidal
thinking and
behavior in
children,
adolescents, and
young adults with
major depressive
disorder or other
psychiatric disorder
 If linezolid or
methylene blue
must be given, drug
must be stopped
and the patient
should be
monitored for
serotonin toxicity
 Monitor periodic
hepatic, renal, and
hematopoietic
function studies in
patients receiving
repeated or
prolonged therapy
 When used before
the surgery, drug
causes substance
preoperative
amnesia. Patient
 spread of seizure activities with pulmonary, hepatic,
and renal impairment, or
history of substance abuse
Use cautiously in elderly,
acutely ill, or debilitated
patients.
Generic Name: Classification: Anxiolytics  Anxiety Contraindicated in patients
alprazolam Benzodiazepines  Panic disorders hypersensitive to drug or
other benzodiazepines and
Brand Name: Xanax Peak Effect: in those with acute angle-
P.O. – 1 to 2 hours closure glaucoma
Route & Dosage:
P.O. – 0.25mg, 0.5mg, Use cautiously with
1mg, 2mg, 3mg hepatic, renal, or
pulmonary disease or
history of substance abuse
nausea, change in appetite
CNS: insomnia,
irritability, dizziness,
headache, anxiety,
confusion, drowsiness,
light-headedness, sedation,
somnolence, difficulty
speaking, impaired
coordination, memory
impairment, fatigue,
depression, suicide, mental
impairment, ataxia,
paresthesia, dyskinesia,
hypoesthesia, lethargy,
vertigo, malaise, tremor,
nervousness, restlessness,
agitation, nightmare,
syncope, akathesia, mania
CV: palpitations, chest
pain, hypotension
EENT: allergic rhinitis,
blurred vision, nasal
congestion
teaching requires
extra care to ensure
adequate recall.
Provide written
materials or inform
family member, if
possible
 Advise women to
avoid becoming
pregnant while
taking drug
 Give the smallest
effective dose to
prevent ataxia or
oversedation,
especially in elderly
or debilitated
patients
 Monitor hepatic,
renal, and
hematopoietic
function
periodically in
patients receiving
repeated or
prolonged therapy
 Closely monitor
addiction-prone
patients
 Consider giving
same total daily
dose of immediate-
release formulation
 GI: diarrhea, dry mouth, in divided doses
constipation, nausea, more frequently in
increased or decreased patients being
appetite, anorexia, treated for panic
vomiting, dyspepsia, disorder who
abdominal pain experience early
GU: dysmenorrheal, sexual morning anxiety or
dysfunction, premenstrual anxiety symptoms
syndrome, difficulty between doses
urinating
Metabolic: increased or
decreased weight
Musculoskeletal:
arthralgia, myalgia, arm or
leg pain, back pain, muscle
rigidity, muscle cramps,
muscle twitch
Respiratory: upper
respiratory tract infection,
dyspnea, hyperventilation
Skin: pruritus, increased
sweating, dermatitis
Other: influenza, injury,
emergence of anxiety
between doses,
dependence, feeling warm,
increased or decreased
libido

Generic Name: Classification: Anxiolytics  Mild to moderate Contraindicated in patients CNS: drowsiness, lethargy,  Monitor hepatic,
chlordiazepoxide Benzodiazepines anxiety hypersensitive to the drug ataxia, confusion, renal, and
hydrochloride  Severe anxiety extrapyramidal reactions, hematopoietic
Peak Effect:  Withdrawal Use cautiously in elderly minor changes in EEG function
Brand Name: P.O. – 0.5 to 4 hours
Librium
Binds to stereospecific
Route & Dosage: benzodiazepine receptors
P.O. – 5mg, 10mg, 25mg on the postsynaptic GABA
neuron at several sites
within the CNS
Generic Name: Classification: Anxiolytics
diazepam Benzodiazepines
Brand Name: Peak Effect:
Valium P.O. – 0.25 to 2.5 hours
I.V. – 1 to 5 minutes
Route & Dosage: I.M. – 1 hour
P.O. – 2mg, 5mg, 10mg
Injection – 5mg/mL A benzodiazepine probably
potentiates the effects of
GABA , depresses the
symptoms from patients with mental
acute alcoholism depression, history of
 Preoperative substance abuse, porphyria,
apprehension and or hepatic or renal disease
anxiety
 Anxiety Contraindicated in patients
 Acute alcohol hypersensitive to drug or
withdrawal soy protein; in patients
experiencing shock, coma,
or acute alcohol
intoxication (parenteral
form); and in infants
younger than 6 months
Diazepam is
contraindicated in patients
patterns
CV: edema
GI: nausea, constipation
GU: menstrual
irregularities
Hematologic:
agranulocytosis
Hepatic: jaundice
Skin: skin eruptions
Other: altered libido
CNS: drowsiness,
dysarthria, slurred speech,
tremor, transient amnesia,
fatigue, ataxia, headache,
insomnia, paradoxical
anxiety, hallucinations,
minor changes in EEG
patterns, pain, vertigo,
confusion, depression
CV: CV collapse,
bradycardia, hypotension
periodically in
patients receiving
repeated or
prolonged therapy
 Watch for
paradoxical
reaction in
psychiatric patients
and hyperactive,
aggressive children
 Warn patient that
drug may cause
psychological and
physical
dependence
 Tell patient not to
increase dose or
abruptly stop the
drug because of
withdrawal
symptoms may
occur
 Monitor periodic
hepatic, renal, and
hematopoietic
function studies in
patients receiving
repeated or
prolonged therapy
 Monitor elderly
patients for
dizziness, ataxia,
and mental status
 CNS, and suppresses the with acute angle-closure
spread of seizure activity glaucoma
Use cautiously in patients
with liver or renal
impairment, depression,
history of substance abuse,
or chronic open-angle
glaucoma.
Use cautiously in elderly
and debilitated patients
Generic Name: Classification: Anxiolytics  Anxiety disorders Contraindicated in
buspirone Azaspirodecanedione patients hypersensitive to
hydrochloride derivatives the drug within 14 days
of MAOI therapy
Brand Name: Peak Effect:
Buspar P.O. – 40 to 90 minutes Drug isn’t recommended
for patients with severe
Route & Dosage: May inhibit neuronal firing and hepatic or renal
EENT: diplopia, blurred changes. Patients
vision, nystagmus are at an increased
GI: nausea, constipation, risk for falls
diarrhea with rectal form,  Warn patient to
dry mouth avoid hazardous
GU: incontinence, urine tasks until full
retention effects of drugs are
Hematologic: neutropenia known
Hepatic: jaundice  Warn patient not to
Respiratory: respiratory abruptly stop drug
depression, apnea, hiccups because withdrawal
Skin: rash, phlebitis at symptoms may
injection site occur
Other: altered libido,  Advise female
physical or psychological patient to avoid
dependence using during
pregnancy and of
potential hazard to
fetus if drug is used
during pregnancy or
of patient becomes
pregnant while
taking drug
CNS: dizziness,  Monitor patient
drowsiness, headache, closely for adverse
nervousness, insomnia, CNS reactions. Drug
light-headedness, fatigue, is less sedating than
numbness, excitement, other anxiolytics, but
confusion, depression, CNS effects may be
anger, decreased unpredictable
concentration, paresthesia,  Teach patient to
P.O. – 5mg, 7.5mg, reduce serotonin turnover in
10mg, 15mg, 30mg cortical, amygdaloid, and
septohippocampal tissue
 
impairment. incoordination, tremor,
anger hostility
CV: tachycardia,
nonspecific chest pain
EENT: blurred vision
GI: dry mouth, nausea,
diarrhea, abdominal distress,
constipation, vomiting
Musculoskeletal: aches and
pains
Skin: rash, sweating,
clamminess
recognize and
immediately report
symptoms of
serotonin toxicity
(fever, mental status
changes, muscle
twitching, excessive
sweating, shivering
or shaking, diarrhea,
loss of coordination)
 Warn patient to
avoid hazardous
tasks until full
effects of drugs are
known
 Warn patient not to
abruptly stop
benzodiazepine
because of risk of
withdrawal
symptoms
 Advise patient to
take consistently,
that is, always with
or always without
food