FIVE CLASSIFICATION OF PSYCHIATRIC DRUGS

1. Antidepressants

DRUG STUDY

NAME OF DRUG MODE OF ACTION INDICATIONS/ SIDE/ADVERSE EFFECTS NURSING CONSIDERATION

CONTRAINDICATIONS

GENERIC NAME: Selectively inhibits INDICATIONS: ● CNS: Headache, ● Monitor patient especially an elderly patient
reuptake of the nervousness, insomnia, for hypoosmolarity of serum and urine and for
fluoxetine neurotransmitter ● Treatment of depression;
drowsiness, anxiety, tremor, hyponatremia
serotonin by CNS most effective in patients with
dizziness, light-headedness,
major depressive disorder ● Arrange for lower or less frequent doses in
neurons and increases agitation, sedation, abnormal
BRAND NAME: the amount of serotonin gait, seizures elderly patients and patients with hepatic
● Treatment of depressive
available in nerve impairment.
Prozac episodes associated with
synapses. An elevated ● CV: Hot flashes,
bipolar I disorder in ● Administer drug in the morning.
serotonin level may palpitations
combination with olanzapine ● Monitor patient for response to therapy for
result in elevated mood
● Dermatologic: Sweating, up to 4 wk before increasing dose.
CLASSIFICATION: and, consequently, ● Short-term treatment of
rash, pruritus,acne, alopecia,
reduced depression. treatment-resistant depression
Antidepressant contact dermatitis
with olanzapine
SSRI ● GI: Nausea, vomiting,
● Treatment of OCD TEACHING POINTS:
diarrhea, drymouth, anorexia,
● Treatment of bulimia dyspepsia, constipation, taste ● Do not stop taking this drug without
DOSAGE: changes, flatulence, consulting your health care provider.
● Treatment of PMDD gastroenteritis, dysphagia,
10 mg (Sarafem) ● Do not take this drug during pregnancy
gingivitis
● Treatment of panic disorder ● Do not use St. John’s Wort while taking this
● GU: Painful menstruation,
sexual dysfunction, frequency,
FREQUENCY: with or without agoraphobia cystitis, impotence, urgency, drug
vaginitis
Once a day ● Urge family or caregiver to watch patient
closely for suicidal tendencies, especially
CONTRAINDICATIONS:
when therapy starts or dosage changes, and
ROUTE: ● Contraindicated with particularly if patient is a child, teenager, or
hypersensitivity to fluoxetine, young adult.
Oral
pregnancy.

● Use cautiously with

impaired hepatic or renal
function, diabetes mellitus,
lactation, seizures; history of
suicide attempts
 DRUG STUDY

NAME OF DRUG MODE OF ACTION INDICATIONS/ SIDE/ADVERSE EFFECTS NURSING CONSIDERATIONS

CONTRAINDICATIONS

GENERIC NAME: Exerts antidepressant, INDICATIONS: ● CNS: Somnolence, ● Administer once a day in the morning.
antiobsessional, dizziness, insomnia, tremor, ● Shake suspension well before using.
paroxetine ● Treatment of major
and antipanic effects by nervousness, headache, ● Ensure that patient swallows CR tablets
depressive disorder
potentiating serotonin anxiety, paresthesia, blurred whole; do not cut, crush, or chew.
● Treatment of OCD
activity in CNS and vision
BRAND NAME: inhibiting serotonin ● CV: Palpitations, ● Monitor patient closely for evidence of GI
● Treatment of panic
reuptake at presynaptic vasodilation, orthostatic bleeding, especially if patient also takes a drug
Paxil disorders
neuronal membrane. known to cause GI bleeding, such as aspirin,
● Treatment of social anxiety hypotension, hypertension
Blocked serotonin ● Dermatologic: Sweating, an NSAID, or warfarin
disorder (social phobia)
reuptake increases levels rash, redness
CLASSIFICATION: ● Treatment of generalized ● Don’t give enteric-coated form with antacids.
and prolongs activity of
anxiety disorder ● GI: Nausea, dry mouth, ● Limit amount of drug given to potentially
Antidepressant serotonin at synaptic
constipation, suicidal patients.
receptor sites.
● Treatment of PTSD diarrhea,anorexia, flatulence,
SSRI ● Abruptly discontinuing the drug may result
● Treatment of PMDD vomiting ● GU: Ejaculatory
in discontinuation symptoms (agitation,
disorders, male genital
palpitations); consider tapering
DOSAGE: disorders, urinary
frequency ● Respiratory:
CONTRAINDICATIONS:
20 mg Yawns, pharyngitis, cough ●
TEACHING POINTS:
● Contraindicated with use of Other: Asthenia
MAOI, thioridazine, ● Suggest that patient avoid hazardous
FREQUENCY: pimozide, linezolid, activities until drug’s CNS effects are known.
methylene blue.
Once a day ● Report severe nausea, vomiting; palpitations;
 ● Use cautiously in the blurred vision; excessive sweating; thoughts of
elderly; with renal or hepatic suicide
ROUTE:
impairment, pregnancy,
Oral lactation, suicidal patients.
2. Anti-anxiety medications

DRUG STUDY

NAME OF DRUG MODE OF ACTION INDICATIONS/ SIDE/ADVERSE NURSING CONSIDERATIONS

CONTRAINDICATIONS EFFECTS

GENERIC NAME: Exact mechanisms of INDICATIONS: ● CNS: Transient, mild ● Arrange to taper dosage gradually after
action not understood; drowsiness initially; sedation, long-term therapy, especially in epileptic
alprazolam ● Management of anxiety
main sites of action may depression, lethargy, apathy, patients.
be the limbic system and disorders, short-term relief of fatigue, light-headedness
reticular formation; symptoms of anxiety; ● Do not administer with grapefruit juice or
BRAND NAME: increases the effects of anxiety associated with ● CV: Bradycardia, within 48 hr of grapefruit juice.
GABA, an inhibitory depression tachycardia, CV collapse,
Xanax hypertension, hypotension, ● Taper drug slowly, decrease by no more
neurotransmitter; anxiety ● Treatment of panic attacks palpitations,edema than 0.5 mg every 3 days.
blocking effects occur at with or without agoraphobia
doses well below those (Niravam, Xanax, Xanax ● Dermatologic: Urticaria,
CLASSIFICATION: necessary to cause XR) pruritus, rash, dermatitis TEACHING POINTS:
sedation, ataxia. ● EENT: Visual and auditory
Anxiolytic
Benzodiazepine disturbances, diplopia, ● Take this drug exactly as prescribed
CONTRAINDICATIONS: nystagmus, depressed hearing,
● Do not drink grapefruit juice while on this
nasal congestion
● Contraindicated with drug.
DOSAGE: ● GI: Constipation, diarrhea,
hypersensitivity to ● Do not stop taking drug (in long-term
0.25-0.50 mg benzodiazepines, psychoses, dry mouth, salivation, therapy) without consulting health care
acute narrow-angle nausea,anorexia, vomiting,
provider
glaucoma, shock, coma, difficulty in swallowing,
acute alcoholic intoxication gastric disorders, hepatic ● Avoid alcohol, sleep-inducing, or over-the-
FREQUENCY: impairment
with depression of vital counter drugs.
TID signs, pregnancy (crosses the
placenta; risk of congenital
malformations, neonatal
ROUTE: withdrawal syndrome), labor
and delivery (“floppy infant”
Oral syndrome), lactation
(secreted in breast milk;
infants become lethargic and
lose weight).
● Use cautiously with
impaired liver or renal
function, debilitation.
● GU: Incontinence, changes ● Report severe dizziness, weakness,
in libido, urine retention, drowsiness that persists, rash or skin lesions,
menstrual irregularities difficulty voiding, palpitations, swelling in the
extremities.
● Hematologic: Elevations of
liver enzymes—LDH,
alkaline phosphatase, AST,
ALT; blood dyscrasias—
agranulocytosis, leukopenia

NAME OF DRUG MODE OF ACTION
GENERIC NAME: Exact mechanisms are
not understood; acts
lorazepam mainly at subcortical
levels of the CNS,
binding to
BRAND NAME: benzodiazepine receptors
on postsynaptic GABA
Ativan
neurons in the CNS,
leaving the cortex
relatively unaffected.
CLASSIFICATION: Main sites of action may
be the limbic system and
Anxiolytic
reticular formation;
Benzodiazepine benzodiazepines
potentiate the effects of
Sedative-hypnotic GABA, an inhibitory
neurotransmitter;
anxiolytic effects occur at
DOSAGE: doses well below those
needed to cause sedation
2-6 mg
and ataxia.
FREQUENCY:
DRUG STUDY
INDICATIONS/
CONTRAINDICATIONS
INDICATIONS:
● Oral: Management of
anxiety disorders or for
short-term relief of
symptoms of anxiety or
anxiety associated with
depression; insomnia due to
anxiety or transient
situational stress
● Parenteral: Preanesthetic
medication in adults to
produce sedation, relieve
anxiety, and decrease recall
of events related to surgery;
treatment of status
epilepticus
CONTRAINDICATIONS:
● Contraindicated with ● GU: Incontinence, urinary
hypersensitivity to retention, libido changes,
benzodiazepines,propyleneg
SIDE/ADVERSE
EFFECTS
● CNS: Transient, mild
drowsiness initially; sedation,
depression, lethargy, apathy
● CV: Bradycardia,
tachycardia, CV collapse,
hypertension and hypotension,
palpitations, edema
● Dermatologic: Urticaria,
pruritus, rash, dermatitis
● EENT: Visual and auditory
disturbances, diplopia,
nystagmus, depressed hearing,
nasal congestion
● GI: Constipation, diarrhea,
dry mouth, salivation, nausea,
anorexia, vomiting, difficulty
in swallowing, gastric
disorders, hepatic impairment
NURSING CONSIDERATIONS
● Do not administer intra-arterially;
arteriospasm or gangrene may result.
● Give IM injections of undiluted drug deep
into muscle mass, monitor injection sites.
● Do not use solutions that are discolored or
contain a precipitate. Protect drug from light,
and refrigerate oral solution.
● Oral solution may be mixed with water,
juice, soda, applesauce, or pudding.
TEACHING POINTS:
● Take drug exactly as prescribed; do not stop
taking drug (in long-term therapy) without
consulting your health care provider.
● Report severe dizziness, weakness,
drowsiness that persists, rash or skin lesions,
palpitations, edema of the extremities; visual
changes; difficulty voiding.
Once a day lycol,polyethylenegly menstrual irregularities
colorbenzylalcohol(parenter
al lorazepam); psychoses;
ROUTE: acute narrow-angle
glaucoma; acute alcoholic
Oral intoxication with depression
of vital signs; pregnancy
(crosses placenta; labor and
delivery (“floppy
infant”syndrome)

● Use cautiously with

impaired hepatic or renal
function.
3. Stimulants

DRUG STUDY

NAME OF DRUG MODE OF ACTION INDICATIONS/ SIDE/ADVERSE NURSING

CONTRAINDICATIONS EFFECTS CONSIDERATIONS

GENERIC NAME: Acts in the CNS to INDICATIONS: ● CNS: Overstimulation, ● Monitor growth of children on long-term
release norepinephrine restlessness, dizziness, amphetamine therapy.
dextroamphetamine ● Narcolepsy
from nerve terminals; in insomnia,dyskinesia, euphoria,
higher doses also dysphoria, tremor, headache, ● Dispense the lowest feasible dose to
● Adjunct therapy for minimize risk of overdosage; drug should be
releases dopamine; abnormal behavioral psychotic episodes
BRAND NAME: suppresses appetite; stored in a light-resistant container.
syndrome in children and
increases alertness, ● CV: Palpitations,
Dexedrine adults (ADHD, hyperkinetic tachycardia, hypertension ● Ensure that patient swallows ER capsules
elevates mood; often syndrome) that includes whole; do not cut, crush, or allow patient to
improves physical psychological, social, ● Dermatologic: Urticaria chew them.
performance, especially educational measures ● Endocrine: Reversible
CLASSIFICATION: when fatigue and sleep elevations in serum thyroxine ● Give drug early in the day to prevent
deprivation have caused ● Unlabeled uses: Cocaine- with heavy use insomnia.
Amphetamine
impairment; efficacy in dependence treatment,
● Monitor BP frequently early in therapy.
CNS stimulant hyperkinetic syndrome, autism, traumatic brain ● GI: Dry mouth, unpleasant
ADHD in children injury taste, diarrhea,constipation,
appears paradoxical and anorexia and weight loss
is not understood TEACHING POINTS:
DOSAGE: ● GU: Impotence, changes in
CONTRAINDICATIONS: libido ● Other: Tolerance, ● Take this drug exactly as prescribed.
5 mg
● Contraindicated with psychological dependence,
● Do not crush or chew extended-release or
hypersensitivity to social disability with abuse
long-acting capsules.
sympathomimetic amines,
FREQUENCY:
tartrazine (DextroStat); ● Take drug (especially sustained-release
Once or twice a day advanced arteriosclerosis, forms) early in the day to avoid insomnia
symptomatic CV disease,
moderate to severe ● Report nervousness, insomnia, dizziness,
palpitations, anorexia, GI disturbances.
ROUTE: hypertension,
hyperthyroidism, glaucoma,
Oral agitated states.

● Use cautiously with

history of drug abuse;
pregnancy; lactation.

NAME OF DRUG MODE OF ACTION
GENERIC NAME: Thought to block
reuptake of
lisdexamfetamine norepinephrine and
dopamine in the
presynaptic neuron and
BRAND NAME: increase release of these
monamines into the
Vyvanse
extraneuronal space,
stimulating CNS activity
and leading to
CLASSIFICATION: suppressed appetite,
increased alertness,
Amphetamine
elevated mood, improved
CNS stimulant physical performance
when fatigue and sleep
deprivation have caused
DOSAGE: impairment; mode of
action in attention deficit
30 mg hyperactivity disorder
(ADHD) is not
understood.
FREQUENCY:
Once a day
DRUG STUDY
INDICATIONS/ SIDE/ADVERSE NURSING
CONTRAINDICATIONS EFFECTS CONSIDERATIONS
INDICATIONS: ● CNS: Headache, dizziness, ● Monitor growth of children on long-term
somnolence, insomnia, tics, therapy; failure to grow may indicate need to
● Treatment of ADHD in irritability, aggression, mania, stop drug.
patients 6 yr and older as
affect lability, seizures, visual ● Dispense the lowest feasible dose to
part of an integrated disturbances minimize risk of overdosage
treatment plan ● CV: Serious cardiac events,
● Administer drug early in the day to help
sudden death, hypertension,
prevent insomnia.
tachycardia
CONTRAINDICATIONS: ● Provide small, frequent meals if GI upset is
● GI: Abdominal pain,
● Contraindicated with diarrhea, nausea, vomiting, dry a problem.
hypersensitivity to any mouth, decreased appetite ● ● Monitor BP periodically.
component of the drug, Other: Fever, weight loss,
advanced arteriosclerosis, rash, drug dependence, slowed
symptomatic CV disease, growth
TEACHING POINTS:
moderate to severe
hypertension, ● Store this drug at room temperature in a dry
hyperthyroidism, place
hypersensitivity or
idiosyncratic reaction to ● Report aggression, vision changes, manic
sympathetic amines, symptoms, marked weight loss, seizures.
glaucoma, agitated states,
history of drug abuse,
during or within 14 days
 following treatment with an
MAOI, lactation.
ROUTE:
● Use cautiously with
Oral history of seizures,
preexisting psychosis or
bipolar disorder, pregnancy
4. Antipsychotics

DRUG STUDY

NAME OF DRUG MODE OF ACTION INDICATIONS/ SIDE/ADVERSE NURSING

CONTRAINDICATIONS EFFECT CONSIDERATIONS

GENERIC NAME: Mechanism not fully INDICATIONS: ● Autonomic: Dry mouth, ● Do not give children IM injections.
understood; salivation, nasal congestion,
haloperidol ● Management of ● Do not use haloperidol for IV injections.
antipsychotics block nausea, vomiting, anorexia,
postsynaptic dopamine manifestations of psychotic fever, pallor, facial flushing,
disorders ● Consult physician regarding appropriate
receptors in the brain, sweating warning of patient or patient’s guardian about
BRAND NAME: depress the RAS, ● Control of tics and
including those parts of ● CNS: Drowsiness, insomnia, tardive dyskinesias.
Haldol vocalizations in Tourette vertigo, headache, weakness,
the brain involved with syndrome in adults and ● Consult physician about reducing dosage
tremor, ataxia and using anticholinergic antiparkinsonians
wakefulness and emesis; children
chemically resembles (controversial) if extrapyramidal effects
● CV: Hypotension,
CLASSIFICATION: the phenothiazines ● Behavioral problems in orthostatic hypotension, occur.
children with combative, hypertension
Antipsychotic
explosive hyperexcitability ● Dilute oral solution with a beverage, such as
cola or orange, apple, or tomato juice.
Dopaminergic blocker that cannot be attributed to ● Endocrine: Lactation, breast
immediate provocation engorgement in females, ● Monitor CBC, especially if patient has a
● Short-term treatment of galactorrhea low WBC count or history of drug-induced
hyperactive children with leukopenia or neutropenia, often during the
DOSAGE: ● Hematologic: Eosinophilia,
excessive motor activity, first few months of therapy.
mood lability leukopenia, leukocytosis,
0.5 - 2 mg
anemia; aplastic anemia;
hemolytic anemia;
thrombocytopenic or TEACHING POINTS:
FREQUENCY: CONTRAINDICATIONS: nonthrombocytopenic purpura;
BID or TID ● Contraindicated with
hypersensitivity to typical
antipsychotics, coma or
ROUTE: severe CNS depression,
bone marrow depression,
Oral blood dyscrasia, circulatory
collapse, subcortical brain
damage, Parkinson disease,
liver damage, cerebral
arteriosclerosis, coronary
disease, severe hypotension
or hypertension
pancytopenia
● Hypersensitivity: Jaundice,
urticaria, angioneurotic edema,
laryngeal edema,
photosensitivity, eczema,
asthma, anaphylactoid
reactions, exfoliative
dermatitis
● Respiratory: Bronchospasm,
laryngospasm, dyspnea;
suppression of cough reflex
and potential for aspiration
● Take this drug exactly as prescribed.
● Maintain fluid intake, and use precautions
against heatstroke in hot weather.
● Caution patient to avoid skin contact with
oral solution because it may cause a rash.
● Advise patient to take tablets with food or
full glass of milk or water to reduce GI
distress
● Urge patient not to drink alcohol during
therapy.
● Report sore throat, fever, unusual bleeding
or bruising, rash, weakness, tremors, impaired
vision
 DRUG STUDY

NAME OF DRUG MODE OF ACTION INDICATIONS/ SIDE/ADVERSE NURSING

CONTRAINDICATIONS EFFECT CONSIDERATIONS

GENERIC NAME: May treat psychotic INDICATIONS: ● Autonomic: Dry mouth, ● Monitor elderly patients for dehydration;
disorders by blocking salivation, nasal congestion, institute remedial measures promptly;
loxapine dopamine at ● Treatment of nausea, vomiting, anorexia,
schizophrenia ● Assess for signs of tardive dyskinesia,
postsynaptic receptors in fever, pallor, facial flushing,
the brain. With sweating, constipation including involuntary protrusion of tongue and
● To treat acute chewing movements.
BRAND NAME: prolonged use, loxapine exacerbations of psychotic ● CNS: Drowsiness,
enhances antipsychotic disorders ● Observe for extrapyramidal reactions or
Loxitane insomnia, vertigo, headache,
effects by causing parkinsonian symptoms, such as excessive
depolarization blockade weakness, tremor, ataxia,
slurring salivation, masklike facies, rigidity, and
of dopamine tracts, tremor, especially in first few days of
CLASSIFICATION: CONTRAINDICATIONS:
resulting in decreased ● CV: Hypotension, treatment
Antipsychotic
dopamine ● Contraindicated with orthostatic hypotension,
neurotransmission. coma or severe CNS hypertension, tachycardia, TEACHING POINTS:
Dopaminergic blocker depression; bone marrow bradycardia ● Take drug exactly as prescribed.
depression; blood
dyscrasia; circulatory ● Endocrine: Lactation, breast ● Tell patient not to take antacids and
collapse; subcortical brain engorgement, galactorrhea antidiarrheals within 2 hours of loxapine.
DOSAGE:
damage; Parkinson disease;
● Hematologic: Eosinophilia, ● Avoid driving or engaging in dangerous
10 mg liver disease; cerebral leukopenia, leukocytosis, activities if dizziness or vision changes occur.
arteriosclerosis; coronary anemia; aplastic anemia;
disease; severe hypotension ● Avoid prolonged exposure to sun or use a
hemolytic anemia;
FREQUENCY: or hypertension; known thrombocytopenic or non- sunscreen or covering garments.
hypersensitivity to thrombocytopenia purpura;
BID-QID ● Advise patient to change position slowly to
 dibenzoxazepines. pancytopenia minimize orthostatic hypotension.

ROUTE: ● Use cautiously with ● Hypersensitivity: Jaundice, ● Maintain fluid intake, and use precautions
respiratory disorders urticaria, angioneurotic against heatstroke in hot weather.
Oral (“silent pneumonia”); edema, laryngeal edema,
glaucoma, prostatic photosensitivity, eczema, ● Urge patient to have periodic eye
hypertrophy asthma, anaphylactoid examinations during therapy.
reactions, exfoliative
dermatitis

● Respiratory: Bronchospasm,
laryngospasm, dyspnea
5. Mood stabilizers
NAME OF DRUG MODE OF ACTION
GENERIC NAME: May decrease seizure
activity by blocking
valproic acid
reuptake of gamma-
aminobutyric acid
(GABA), the most
BRAND NAME: common inhibitory
neurotransmitter in the
Depakene
brain. GABA suppresses
the rapid firing of neurons
by inhibiting voltage-
CLASSIFICATION: sensitive sodium
channels.
Anticonvulsant
Mood stabilizer
DOSAGE:
10-15 mg/kg
FREQUENCY:
DRUG STUDY
INDICATIONS/
CONTRAINDICATIONS
INDICATIONS:
- Sole and adjunctive
therapy in simple (petit
mal) and complex absence
seizures; acute treatment of
manic episodes associated
with bipolar disorder;
prophylaxis of migraine
headaches; adjunctive
therapy for multiple seizure
disorders
CONTRAINDICATIONS:
● Contraindicated with
hypersensitivity to valproic
acid, hepatic disease, or
significant hepatic
impairment.
● Use cautiously with
SIDE/ADVERSE
EFFECT
● CNS: Sedation, tremor (may
be dose-related), emotional
upset, depression, psychosis,
aggression, hyperactivity,
behavioral deterration,
weakness, suicidality
● Dermatologic: Transient
increases in hair loss, rash,
petechiae
● GI: Nausea, vomiting,
indigestion,diarrhea,
abdominal cramps,
constipation, anorexia with
weight loss, increased appetite
with weight gain, life-
threatening pancreatitis,
hepatic failure; elevated liver
enzyme, serum bilirubin
● GU: Irregular menses,
secondary amenorrhea
NURSING
CONSIDERATIONS
● Monitor ammonia levels, and discontinue if
there is clinically significant elevation in level.
● Monitor serum levels of valproic acid and
other antiepileptics given concomitantly,
especially during the first few weeks of
therapy.
● Give oral valproic acid or divalproex with
food to minimize GI irritation, if needed.
● Administer drug at least 2 hours before or 6
hours after cholestyramine.
● Don’t break or let patient chew delayed-
● Watch for evidence of decreased hepatic
function, including anorexia, facial edema,
jaundice, lethargy, loss of seizure control,
malaise, vomiting, and weakness.release
tablets.
TEACHING POINTS:
Once a day children younger than 18
mo; children younger than
2 yr, especially with
ROUTE: multiple antiepileptics,
congenital metabolic
Oral disorders, severe seizures
accompanied by severe
mental retardation, organic
brain disorders
● Hematologic: Altered
bleeding time;
thrombocytopenia; bruising;
hematoma formation;
● Take this drug exactly as prescribed. Do not
chew tablets or capsules before swallowing
them
Advise patient to avoid hazardous activities
during therapy
● Urge woman to notify prescriber at once
about suspected or known pregnancy.
● Advise patient to notify prescriber if tremor
develops during therapy; it may be dose-
related
● Urge family or caregiver to watch patient
closely for suicidal tendencies, especially
when therapy starts or dosage changes.
● Do not discontinue this drug abruptly or
change dosage, except on the advice of your
health care provider.
● Avoid alcohol and sleep-inducing and over-
the-counter drugs. These could cause
dangerous effects.
● Have frequent checkups, including blood
tests, to monitor your drug response. Keep all
appointments for checkups.
● Use contraceptive techniques at all times. If
you want to become pregnant, consult your
health care provider.

NAME OF DRUG MODE OF ACTION
GENERIC NAME: Normally, sodium moves
into a neuronal cell by
carbamazepine passing through a gated
sodium channel in the cell
membrane.
BRAND NAME: Carbamazepine may
prevent or halt seizures by
Epitol
closing or blocking
sodium channels, as
shown here, thus
CLASSIFICATION: preventing sodium from
entering the cell. Keeping
Antiepileptic
sodium out of the cell
may slow nerve impulse
Mood stabilizer
transmission, thus
slowing the rate at which
DOSAGE: neurons fire.
400 mg
FREQUENCY:
Once a day
DRUG STUDY
INDICATIONS/
CONTRAINDICATIONS
INDICATIONS:
● Refractory seizure
disorders: Partial seizures
with complex symptoms
(psychomotor, temporal
lobe epilepsy), generalized
tonic-clonic (grand mal)
seizures, mixed seizure
patterns or other partial or
generalized seizures.
Reserve for patients
unresponsive to other
agents with seizures
difficult to control or who
are experiencing marked
side effects, such as
excessive sedation
● Trigeminal neuralgia (tic
douloureux): Treatment of
pain associated with true
trigeminal neuralgia; also
beneficial in
SIDE/ADVERSE
EFFECT
● CNS: Dizziness, drowsiness,
unsteadiness, disturbance of
coordination, confusion,
headache, fatigue,
● CV: Heart failure, increased
hypertension, hypotension,
syncope and collapse
● Dermatologic: Pruritic and
erythematous rashes, urticaria,
Stevens-Johnson syndrome,
photosensitivity reaction
● Hematologic: Hematologic
disorders(severe bone marrow
suppression)
● Respiratory: Pulmonary
hypersensitivity characterized
by fever, dyspnea,
pneumonitis or pneumonia
NURSING
CONSIDERATIONS
● Use only for classifications listed. Do not
use as a general analgesic. Use only for
epileptic seizures that are refractory to other
safer agents.
•Monitor patient’s electrolytes, especially
sodium level, as ordered
● Give drug with food to prevent GI upset.
● Do not mix suspension with other
medications or elements—precipitation may
occur.
● Arrange for frequent eye examinations,
urinalysis, and BUN determinations.
● Arrange for frequent monitoring of serum
levels of carbamazepine and other
antiepileptics given concomitantly
•Monitor patient closely for evidence of
suicidal thinking or behavior, especially
when therapy starts or dosage changes.
 glossopharyngeal neuralgia TEACHING POINTS:

ROUTE: ● Treatment of acute manic ● Take drug with food as prescribed.

and mixed episodes
Oral associated with bipolar 1
disorder (Equetro)
Swallow extended-release tablets whole; do
not cut, crush, or chew them.
•Warn patient about possible dizziness,
blurred vision, and unsteadiness.

CONTRAINDICATIONS: •Urge patient to wear sunscreen and protec-

tive clothing to reduce photosensitivity
● Contraindicated with
hypersensitivity to ● Report bruising, unusual bleeding,
carbamazepine or TCAs, abdominal pain, yellowing of the skin or
history of bone marrow eyes, pale feces
depression, concomitant
use of MAOIs, lactation,
pregnancy.

● Use cautiously with

history of adverse
hematologic reaction to
any drug (increased risk of
severe hematologic
toxicity)