EMILIO AGUINALDO COLLEGE

School of Nursing
DRUG STUDY

CLASSIFICATION INDICATION MECHANISM CONTRAINDICATION SIDE EFFECTS NURSING CONSIDERATIONS

OF DRUG OF ACTION
Generic Name: Management of May block Parkinson’s Monitor patient’s mental status daily.
A. Chemical:  manifestations postsynaptic disease, parkinsonism, Frequent: Blurred ➢ Monitor for neuroleptic malignant
Haloperidol of psychotic dopamine seizure disorders, coma; vision, constipation, syndrome (NMS) , especially in
Antipsychotic disorders and for receptors alcoholism; severe mental orthostatic those with hypertension or taking
Brand Names: control of tics in the limbic depression, CNS hypotension, dry lithium. Symptoms of NMS can
Haldol B. Therapeutic: and vocal system and depression; thyrotoxicosis. mouth, swelling or appear suddenly after initiation of
utterances of increase brain soreness of female therapy or after months or years of
Dose: First-generation Gilles de la turnover of breasts, peripheral taking neuroleptic (antipsychotic)
(typical) Tourette’s dopamine, edema. Occasional: medication. Immediately
0.5-5mg antipsychotic. syndrome; for producing an Allergic reaction, discontinue drug if NMS
treatment of antipsychotic difficulty urinating, suspected.Monitor
Frequency: b.i.d. C. Pregnancy   agitated states in effect. decreased thirst, for parkinsonismand tardivedyskin
Category:  acute and dizziness, esia . Risk of tardivedyskinesia
C chronic diminished sexual appears to be greater in women
Route: PO or IM psychoses. Used function, drowsiness, receiving high doses and in older
Preparations:   for short-term nausea, vomiting, adults. It can occur after long-term
Tablets: 0.5mg, 1rg, treatment of photosensitivity, therapy and even after therapy is
2mg, 5mg, 10mg hyperactive lethargy. discontinued.
children and for ➢ Monitor for extrapyramidal
severe behavior ADVERSE (neuromuscular) reactions that
Pharmacokinetics: problems in EFFECTS: occur frequently during first few
children of CNS:Extrapyramidal days of treatment. Symptoms are
combative, reactions: Parkinsoni usually dose related and are
Onset:  2hr
explosive hyper ansymptoms, controlled by dosage reduction or
Peak:  2-6hr excitability. dystonia,
Duration:  8-12 hr concomitant administration
akathisia, tardivedys of antiparkinsondrugs.
Half Life:   20 hrs. kinesia (after long-
➢ Be alert for behavioral changes in
term use); insomnia,
patients who are concurrently
restlessness, anxiety,
receiving antiparkinsondrugs.
euphoria, agitation,
drowsiness, mental ➢ Monitor for exacerbation of
depression, lethargy, seizure activity.
fatigue, weakness, ➢ Observe patients closely for rapid
tremor, ataxia, mood shift to depression when
headache, confusion, haloperidol is used to
vertigo; neuroleptic control mania or cyclic disorders.
malignant syndrome, Depression may represent a drug
hyperthermia, adverse effect or reversion from a
grand mal seizures, manic state.
exacerbation of
psychotic symptoms.

CV:Tachycardia,
ECG changes,
hypotension,
hypertension (with
overdosage).

Respiratory:Laryngo
-spasm,
bronchospasm,
increased depth of
respiration,
bronchopneumonia,
respiratory
depression.
 CLASSIFICATIO INDICATION MECHANISM CONTRAINDICATION SIDE EFFECTS NURSING CONSIDERATIONS
N OF DRUG OF ACTION
Generic Name: A. Chemical:  Acute and Chlorpromazi Cross-sensitivity may  having trouble  Assess mental status
Chlorpromazine Anti-psychotic chronic ne is a exist among keeping your prior to and periodically
psychoses, neuroleptic phenothiazines, and balance. during therapy.
Brand Names: B. particularly that acts by should not be used in  blank facial  Monitor BP and pulse
Thorazine Therapeutic: when blocking the narrow-angle
expression. prior to and frequently
Phenothiazine accompanied postsynaptic glaucoma and
 shuffling walk. during the period of
Dose: antipsychotic by increased dopamine in patients who have
Tablet;10-100 psychomotor receptor in the CNS depression.  restlessness. dosage adjustment. May
mg C. Pregnancy   activity, mesolimbic  agitation. cause QT interval
IV/IM;20-25mg Category:  nausea and dopaminergic  nervousness. changes on ECG.
C vomiting. system and  unusual,  Observe patient carefully
Frequency: Also used in inhibits the slowed, or when administering
PO;q4-6hr the treatment release of uncontrollable medication, to ensure
IV/IM;q4-6hr of intractable hypothalamic movements of that medication is
hiccups. and actually taken and not
any part of the
Route: hypophyseal hoarded.
PO/IM/IV hormones. It body.
 Monitor I&O ratios and
has
daily eight. Assess
Preparations:   antiemetic, ADVERSE
PO25-50mg 2- serotonin- patient for signs and
EFFECTS:
3hrs before blocking, and symptoms of
surgery weak CNS: neuroleptic dehydration.
antihistaminic malignant  Monitor for development
IM 12.5-25 mg properties and syndrome, of neuroleptic malignant
1-2 hrs before slight sedation, syndrome (fever,
surgery ganglion- extrapyramidal respiratory distress,
blocking reactions, tardive tachycardia, seizures,
Pharmacokinet activity.
 ics: dyskinesia diaphoresis,
Onset: 1-2hrs hypertension or
Peak: 15-30 CV: hypotension hypotension, pallor,
min (increased with tiredness, severe muscle
Duration: 4- IM, IV) stiffness, loss of bladder
6hrs  control. Report
Half Life:  30 Hematologic:
symptoms immediately.
hrs agranulocytosis,
May also cause
leukopenia
leukocytosis, elevated
liver function tests,
elevated CPK.
 Advise patient to take
medication as directed.
I

CLASSIFIC INDICATI MECHANIS CONTRAINDICA SIDE NURSING

ATION OF ON M OF TION EFFECTS/ CONSIDERATIONS
DRUG ACTION ADVERSE
EFFECTS

Generic A. Chemical:  Mono- Blocks Contraindicated in  CNS: Monitor patient for

Name: Anti-psychotic therapy or dopamine patients akathisia, tardive
combination and hypersensitive to somnolence, dyskinesia, which may
Risperidone B. therapy with 5-HT2 drug and occur
 dystonia,
Therapeutic: lithium or receptors in in breast-feeding after prolonged use. It
headache,
valproate the brain. women. may not
Brand Names: Second insomnia,
for 3. Use cautiously in appear until months or
generation week patients  agitation, years
antipsychotic
 (SGA) or atypical treatment of with prolonged QT anxiety, pain, later and may disappear
Risperdal, antipsychotic acute manic interval, spontaneously or persist
 Parkinsonism,
Risperdal or CV disease, neuroleptic for life,
C. mixed cerebrovascular despite stopping drug.
Consta, Pregnancy    malignant
Risperdal M- Category:  c episodes disease,
syndrome,
from bipolar dehydration, Life-
Tab suicide
disorder. hypovolemia, threateninghyperglycemia
- 12-week history of  attempt, may occur in patients
parental seizures, or dizziness, taking
Dose: fever,
therapy conditions that atypical antipsychotics.
2mg
for could affect  hallucination, Monitor
schizophren metabolism or mania, patients with diabetes
Frequency:
ia hemodynamic impaired regularly.
OD
- Irritability, responses.  concentration.
including Use cautiously in  CV: Periodically reevaluate
Route:
aggression, patients drug's
Oral tachycardia,
self- exposed to extreme risks and benefits,
injury, and heat. chest pain, especially
Pharmacokine  orthostatic
tantrums, Use caution in during prolonged use.
tics: hypotension,
associated patients at
Onset:  0.5 to 8
with an risk for aspiration  peripheral Monitor patient for weight
mg BID
autistic pneumonia. edema, gain.
Peak: 1hr
disorder. Use IM injection syncope,
Duration: 2
-Tourette cautiously  hypertension.
weeks
Syndrome in those with  ENT: rhinitis,
Half Life:
- Obsessive. hepatic or
20hours  sinusitis,
Compulsive renal impairment.
disorder.  pharyngitis,
abnormal
 vision, ear
disorder.
 Gl:
constipation,
nausea,
 vomiting,
dyspepsia,
abdominal
 pain.

CLASSIFICAT INDICATIO MECHANIS CONTRAINDICATI SIDE EFFECTS/ NURSING

ION OF DRUG N M OF ON ADVERSE CONSIDERATIONS
ACTION EFFECTS
Generic Name: A. Chemical:  Schizophreni Binds to History of bone CNS: NEUROLEPTIC Baseline assessment
Anti-psychotic a dopamine marrow disorders MALIGNANT Obtain baseline weight,
clozapine unresponsive receptors in including SYNDROME, glucose, Hgb A1c, WBC,
B. Therapeutic: to or the CNS. Also agranulocytosis, SEIZURES, dizzines absolute neutrophil count
intolerant of has circulatory collapse, s, sedation. EENT: v (ANC) before initiating
Brand Names: Second alcoholic or toxic treatment. Assess behavior,
standard anticholinergic isual
generation psychosis, drug appearance, emotional status,
Clozaril, therapy with and alpha- intoxication, disturbances. CV:M response to environment,
antipsychotic
FazaClo ODT, (SGA) other adrenergic uncontrolled epilepsy, YOCARDITIS, hypot speech pattern, thought
antipsychotic blocking severe renal, hepatic or ension, tachycardia content.
Versacloz
C. Pregnancy   s (treatment activity. cardiac disease; , ECG changes,
Category:  B refractory). Produces paralytic ileus. hypertension. GI: c
Dose: 100 mg To reduce fewer Pregnancy and onstipation, Intervention/evaluation
OD recurrent extrapyramidal lactation. abdominal Monitor B/P for
suicidal reactions and discomfort, dry hypertension/hypotension.
Frequency: OD behavior in less tardive mouth, ↑ Assess pulse for tachycardia
(common side effect).
schizophrenic dyskinesia salivation, nausea,
Route: PO Monitor CBC for blood
patients. than standard vomiting, weight
dyscrasias. Monitor ANC,
antipsychotics gain. Derm: rash, WBC count every wk for first
Pharmacokinetic
but carries sweating. Endo: hy 6 mos, then biweekly for 6
s:
Onset:  varies high risk of perglycemia. Hema mos. If CBC and ANC are
Peak: 1 - 6 hr hematologic t:AGRANULOCYTOS normal after 12 mos, then
Duration: weeks abnormalities.  IS, monthly monitoring of CBC
Half Life:  12 Therapeutic LEUKOPENIA. Neur and ANC is recommended.
hours Effects: Dimini o:extrapyramidal Supervise suicidal-risk pt
shed reactions. Misc: fev closely during early therapy
schizophrenic er. (as depression lessens, energy
level improves, increasing
behavior.
suicide potential). Assess for
Diminished
therapeutic response (interest
suicidal in surroundings, improvement
behavior. in self-care, increased ability
 to concentrate, relaxed facial
expression).

CLASSIFICAT INDICATIO MECHANIS CONTRAINDICATI SIDE EFFECTS/ NURSING

ION OF DRUG N M OF ON ADVERSE CONSIDERATIONS
ACTION EFFECTS

Generic Name: A. Chemical: 

Lurasidone is Atypical Any known Side effects Baseline assessment
Lurasidone Atypical used to treat antipsychotics hypersensitivity to Frequent (15%– Question history as listed in
Brand Names: Antipsychotic
the symptoms block both LATUDA or any 7%): Drowsiness, Precautions. Assess behavior,
of dopamine and components in the sedation, insomnia appearance, emotional status,
Latudaz B. Therapeutic: schizophrenia serotonin formulation (4). (paradoxical response to environment,
Antipsychotic (a mental Coadministration with reaction). speech pattern, thought
receptors. This
illness that a strong CYP3A4 Occasional (6%– content. Renal function, LFT
dual action
Dose: 20 mg PO C. Pregnancy   causes inhibitor (e.g.,
3%): Nausea,
should be obtained before
Category:  B disturbed or may help to ketoconazole) and therapy as dose adjustment is
alleviate some vomiting, dyspepsia,
Frequency: OD unusual inducer (e.g.,rifampin) required when initiating
thinking, loss of the fatigue, back pain, therapy.
Route: PO of interest in unpleasant akathisia, dizziness,
life, and neurological agitation, anxiety. Intervention/evaluation
Pharmacokinetic strong or effects and Rare (2%–1%): Supervise suicidal risk pt
s: inappropriate depression Restlessness, closely during early therapy
Onset: 20mg/OD emotions) associated salivary (as depression lessens, energy
hypersecretion, level improves, increasing
with the
Peak:  1-3 hours tongue spasm, suicide potential). Monitor for
typical
Duration: 10 torticollis, trismus. potential neuroleptic
antipsychotics. malignant syndrome. Assess
weeks
Adverse effects for therapeutic response
Half Life:   18 (greater interest in
Extrapyramidal
hours surroundings, improved self-
disorder (including
care, increased ability to
cogwheel rigidity, concentrate, relaxed facial
drooling, expression).
bradykinesia,
tardive dyskinesia, Patient/family teaching
tremors) occurs in • Avoid tasks that may require
5% of pts. alertness, motor skills until
Neuroleptic response to drug is
malignant syndrome established (may cause
drowsiness, dizziness).
(fever, muscle
• Avoid alcohol.
rigidity, irregular
• Report trembling in fingers,
B/P or pulse, altered altered gait, unusual
mental status, visual muscle/skeletal movements,
changes, dyspnea) palpitations, severe dizziness,
occurs rarely. fainting, visual changes, rash,
difficulty breathing. • Report
suicidal ideation, unusual
changes in behavior.