Cebu Normal University

College of Nursing

PSYCHOTROPIC DRUG STUDY IN

PSYCHIATRY AS A NURSING SPECIALTY

DRUG DATA CLASSIFICATION MECHANISM OF ACTION INDICATIONS CONTRAINDICATIONS SIDE EFFECT/ NURSING RESPONSIBILITIES
ADVERSE
REACTIONS
GENERIC NAME: PHARMACOLOGIC: Increases level of gamma- GENERAL CONTRAINDICA- BEFORE:
Valproic Acid Carboxylic acid aminobutyric acid in brain, INDICATIONS: TIONS: CNS: confusion, 1. Take vital signs prior to
derivative reducing seizure activity - Complex partial - Hypersensitivity to dizziness, administration.
seizures drug or tartazine (some headache, 2. Confirm medication on medication
TRADE NAME: - Simple or complex products) sedation, ataxia, ticket, medication sheet, and doctor’s
Aleptiz, Depacon, THERAPEUTIC: PHARMACOKINETICS: absence seizures - Hepatic impairment paresthesia, orders.
Depakene, Epival, Anticonvulsant, mood A: Rapid absorption from - Mania associated - Urea cycle disorders asthenia, tremor, 3. Physical: Weight; skin color,
Depkote, Depakote ER stabilizer, antimigraine gastrointestinal tract. with bipolar - Pregnanacy drowsiness, lesions; orientation, affect, reflexes;
agent M: metabolized almost disorder emotional bowel sounds, normal output; CBC
entirely by the liver - To prevent PRECAUTIONS: liability, and differential, bleeding time tests,
PATIENT’S DOSE: E: Less than 3% of an migraine Use cautiously in: abnormal LFTs, serum ammonia level, exocrine
PREGNANCY administered dose is excreted - bleeding disorders, thinking, pancreatic function tests, EEG
CATEGORY: unchanged in urine organic brain disease, amnesia 4. History: Hypersensitivity to valproic
D Half-life: 9-16 hours bone marrow EENT: acid; hepatic impairment; pregnancy,
MINIMUM DOSE: Protein binding: 90% PATIENT’S depression, renal amblyopia, lactation
250 mg/day protein bound ACTUAL impairment blurred vision, 5. Perform handwashing prior to
INDICATIONS: - posttraumatic seizures nystagmus, administration.
ROUTE: PO (capsules) caused by head injury tinnitus,
MAXIMUM DOSE: ONSET: Rapid (use not recommended) pharyngitis DURING:
1 g/day PEAK: 1-4 hours - history of hepatic GI: Nausea, 1. Give drug with food if GI upset
DURATION: 6-24 hours disease vomiting, occurs
- breastfeeding patients diarrhea, 2. Greet pt. and SO, verify client
CONTENTS: ROUTE: PO (syrup) - children abdominal pain, identity (verbal, pt. tags, bed number).
dipropylacetic acid, ONSET: Rapid dyspepsia, Assess baseline v/s
corn oil, FD&C Yellow PEAK: 15-120 hours DRUG anorexia, 3.  Don’t give syrup in carbonated
No. 6, gelatin, glycerin, DURATION: 6-24 hours INTERACTIONS: pancreatitis beverages (may cause mouth and
iron oxide, Hematologic: throat irritation)
methylparaben, ROUTE: PO (delayed, DRUG TO DRUG leucopenia, 4. Give IV only when oral therapy
propylparaben, and extended) - Activated charcoal, thrombocytopeni isn’t feasible.
titanium dioxide. ONSET: Unknown cholestyramine: a 5. For IV use, dilute valproate sodium
PEAK: Unknown decreased valproate Hepatic: in at least 50 ml of dextrose 5% in
AVAILABILITY & DURATION: Unknown absorption hepatotoxicity water, lactated Ringer’s solution, or
COLOR: - Antiplatelet agents Musculoskeletal: normal saline solution. Infuse over 1
Capsules (liquid- ROUTE: I.V. (including abciximab, back pain hour at a rate slower than 20
filled): 250 mg ONSET: Rapid aspirin and other Respiratory: mg/minute.
Injection: 100 mg/ml in PEAK: End of 1 hour nonsteroidal anti- dyspnea
5-ml vial infusion inflammatory drugs, Skin: rash, AFTER:
Syrup: 25o mg/5 ml DURATION: Unknown eptifibatide, tirofiban), alopecia, brusing 1. Closely monitor neurologic status.
Capsules (containing cefamandole, Other: abnormal Watch for seizures.
coated particles or cefoperazone, cefotetan, taste, increased 2. Evaluate GI status. Stay alert for
sprinkles): 125 mg heparin, thrombolytics, appetite, weoght signs and symptoms of pancreatitis.
Tablets (enteric-coated, THERAPEUTIC warfarin: increased risk gain, flulike 3. Advise patient to immediately report
delayed-release): 125 LEVELS: of bleeding symptoms, malaise, weakness, lethargy, appetite
mg, 250 mg, 500 mg 50 – 200 mcg/ml - Barbiturates, infection, loss, vomiting or yellowing of skin or
Tablets (extended- primidone: decreased infusion site eyes
release): 250 mg, 500 metabolism and greater pain and 4. DOCUMENT hour, amount,
mg risk of toxicity of these reaction medication and drug reaction (if any)
drugs, decreased 5. Caution patient not to stop therapy
ROUTE/S OF valproate efficacy abruptly.
ADMINISTRATION: - Carbamazepine:
P. O., I.V. increased carbamazepine
blood level, decreased
valproate blood level,
poor seizure control
- Chlorpromazine:
decreased valproate
clearance and increased
trough level
- Cimetidine: decreased
valproate clearance
- Clonazepam: absence
seizures in patients with
history of these seizures
- CNS depressants (such
as antihistamines and
antidepressants, MAO
inhibitors, opioid
analgesics, sedative-
hypnotics): additive
CNS depression
- Diazepam:
displacement of
diazepam from binding
 site, inhibited diazepam
metabolism
- Erythromycin,
felbamate: increased
valproate blood level,
greater risk of toxicity
- Ethosuximide:
inhibited ethosuximide
metabolism
- Lamotrigine: decreased
valproate blood level,
increased lamotrigine
blood level
- Phenytoin: increased
phenytoin effects and
risk of toxicity,
decreased valproate
effects
- Salicylates (large doses
in children): increased
valproate effects
- Tricyclic
antidepressants:
increased blood levels of
these drugs, greater risk
of adverse reactions
- Zidovudine: decreased
zidovudine clearance in
patients with human
immunodeficiency virus

FOOD TO DRUG
- None

Source: Schull, P. D. Source: Schull, P. D. Source: Schull, P. D. (2010). Source: Schull, P. Source: Schull, P. D. Source: Source: Schull, P. D. (2010).
(2010). Nursing (2010). Nursing Nursing Spectrum Drug D. (2010). Nursing (2010). Nursing Schull, P. Nursing Spectrum Drug Handbook.
Spectrum Drug Spectrum Drug Handbook. New York, NY: Spectrum Drug Spectrum Drug D. (2010). New York, NY: McGraw Hill. (pp
Handbook. New Handbook. New York, McGraw Hill. (pp 1216- Handbook. New Handbook. New York, Nursing 1216-1219)
York, NY: McGraw NY: McGraw Hill. (pp 1219) York, NY: McGraw NY: McGraw Hill. (pp Spectrum
Hill. (pp 1216-1219) 1216-1219) Hill. (pp 1216- 1216-1219) Drug
http://www.drugbank.ca/dru 1219) Handbook.
gs/DB00313 New York,
NY:
McGraw
Hill. (pp
1216-1219)