ANTIPSYCHOTICS

CHLORPROMAZINE
DOSAGE ACTION INDICATION CONTRA- SIDE NURSING
INDICATION EFFECTS CONSIDERATION
 Adult: PO 10- Depresses cerebral Management of  Hypersensitivity, Respiratory: Assess for hypersensitivity,
50 mg 4th cortex, manifestations of  Circulatory collapse, Laryngospasm,Dysp comatose or severely depressed
hourly hypothalamus , psychotic conditions.  Liver damage, cerebral noea, respiratory states.
initially , then limbic system Control of manic phase arteriosclerosis, depression Dilute the oral concentrate just
increase up which control of manic depressive  Coronary disease, CNS: Extra-pyramidal before the administration in 60
2000mg/day if activity - illness ,  Severe hypertension, symptoms, dystonia, ml or more of fruit juice or in
necessary. aggression Schizophrenia, hypotension, tardive dyskinesia, semi-solid fluids.
 Adult : IM 10- Blocks Relief of pre-operative  Blood dyscrasias, coma, seizures, head ache. Protect oral concentrate from light
50 mg 4th neurotransmissi restlessness &  Child below 2 years Blood: Anaemia, Do not allow the patient to crush
hourly. on produced by apprehension.  Brain damage, leukopenia, or chew the sustained release
 Child: PO dopamine at Severe behavioural leukocytosis, capsules.
 Bone marrow depression,
0.25mg/lb 6th synapse exhibits problems in children. agranulocytosis. Do not give by SC injection; give
 Alcohol & barbiturates
hourly or 0.5 a strong alpha- Therapy for Integumentary: Rash, slowly by deep IM injection
depressive states.
mg /kg adrenergic combativeness, photosensitivity, Keep recumbent for half an hour
Precautions:
 Child : IM blocking action; hyperactivity. dermatitis. after injection to avoid
mechanism for Pregnancy seizure disorder,
0.25 mg/lb Possibly effective in the GI: Dry mouth, nausea, orthostatic hypotension
antipsychotic Lactation,
treatment of non- vomiting, anorexia, Monitor renal function tests &
action is unclear Hypertension,
psychotic anxiety (not constipation, CBC; any abnormal values
Hepatic disease, diarrhoea, jaundice,
a drug of choice). discontinue the drug
Cardiac disease. weight gain.
Acute intermittent Monitor patients for dehydration
porphyria therapy. Genito-urinary: Urinary & withdraw drug gradually after
retention, frequency high dose therapy.
in micturition, Avoid OTC drugs & alcohol.
enuresis, impotence, Assess the client for side effects
amenorrhoea, specially heat stroke during hot
Gynaecomastia. weather.
CV: orthostatic Advice client not to get oral
hypotension, cardiac concentrate on the skin or
arrest, hypertension,
 ECG changes, clothes ; contact dermatitis can
tachycardia, occur
EENT: blurred vision,
Glaucoma
TRIFLUPROMAZINE
Adult : PO 0.5 –  Mechanism of  Management of  Hypersensitivity  Blurred vision Assess for swallowing of PO
2 mg/kg/day in action not fully manifestations of  Comatose or severely  Dry mouth medication. Check for boarding
three divided understood. psychotic disorders depressed states  Urinary retention/ or giving of medication to other
doses. IM 0.2-  Blocks post  Schizophrenia,  Bone marrow depression hesitancy patients
0.25 mg/kg synaptic  Acute agitation  CVS collapse  Constipation Intake &output ratio: Palpate
 Child: PO 10- dopamine  Subcortical brain  Orthostatic bladder if low urine output
50 mg bid/tid. receptors in the damage hypotension occurs
IM – 60mg, not brain  Parkinson’s disease  Allergic rash Assess for hypo/hyperglycemias,
exceeding  Depresses the  Liver damage  Akathesia Appetite patterns
150mg/day parts of the brain  Respiratory disorders  Dystonia Administer IM injection in to large
involved with  Glaucoma  Muscle weakness muscle mass
wakefulness & Avoid contact with skin
 Epilepsy  Anorexia
emesis, Provide decreased stimulus by
 Peptic ulcers  Insomnia
anticholenergic, dimming lights, avoid loud
antihistamine voices.
(H1) & alpha
adrenergic
blocking
FLUPHENAZINE
Adult: PO 2.5- Depresses cerebral  Psychotic disorders  Hypersensitivity  CNS: Neuroleptic  Use of aral concentrate for those
10 mg 8th cortex,  Schizophrenia  Circulatory collapse malignant syndrome , unable or not willing to swallow
hourly not to hypothalamus ,  Mania  Liver damage sezures tablets
exceed 20 limbic system  Aggressive behaviour  Cerebral arterioscleriosis  CV: Tachycardia,  Dilute the oral concentrate only
mg. IM 2.5-10 which control  Hallucination  Coronary disease cardiac arrest in water , saline, seven-up,
mg 8 hourly
th
activity -  Seizure threshold  Severe hypertension  EENT: Blurred vision, carbonated orange beverage,
Child: PO 0.25- aggression  Hypotension dry eyes pine apple.
3.5 mg in  Blocks  Blood dyscrasias  GI: Paralytic ileus,  Do not mix beverages containing
divided doses neurotransmissio Hepatitis, Dry mouth caffeine with oral concentrate.
 Children below 12 years
 6th hourly n produced by  Bone marrow depression  GU: Urinary retension.  Any alteration in BUN & WBC
maximum dopamine at  Alcohol & barbituarate Impotence, Enuresis, count discontinue the drug
10mg/qid synapse exhibits withdrawal Gynaecomastia  Monitor patient for dehydration
a strong alpha-  Pregnancy  HEMA: Leukopenia, & extra-pyramidal symptoms.
adrenergic  Hepatic disease leukocytosis,  Use pre-caution against heat
blocking action;  Lactation agranulocytosis. stroke.
 Mechanism for  RESP: Laryngospasm,  Avoid driving or engaging in
antipsychotic respiratory depression activities if CNS or vision
action is unclear changes occur

THIORIDAZINE
 Adults:  Mechanism of  Management of  Severe bone marrow Respiratory:  Ensure that patient is not
Ranges from action not fully schizophrenic patients depression Laryngospasm, responding to other
200-800 mg understood. who fails to respond  Blood dyscrasias respiratory antipsychotics
divided in to  Blocks post adequately for other  Parkinson’s disease depression  Arrange for ophthalmologic
two-four doses synaptic antipsychotic  Circulatory collapse CNS: Pseudo examination before & during
per day dopamine medication.  Cerebral atherosclerosis parkinsonism, drug therapy.
 Child: 2-12 receptors in the  Psychotic disorders  Severe hypotension dystonia, tardive  Avoid skin contact.
years . 0.5-3 mg brain,  Behavioural problems  Prolonged QT interval dyskinesia, seizures,  Avoid driving or engaging in
/kg per day per  But this may not in children  Hypokalemia head ache. other dangerous activities if CNS
oral. be sufficient for  Alcohol withdrawal Blood: Anaemia, or vision changes occur.
 Silent pneumonia
antipsychotic  Anxiety, leucopoenia,  Avoid prolonged exposure to
 Glaucoma
activity  Major depressive leukocytosis, sun, Use a sunscreen
 Epilepsy
 Depresses RAS disorders agranulocytosis.  Maintain fluid intake
 Decreased renal function
including the  Organic brain Integumentary: Rash,  Any changes in renal function
parts of the brain  Pregnancy photosensitivity,
syndrome. test /CBC , discontinue the drug.
involved with  Lactation dermatitis.  Do not change the brand name
wakefulness &  Children below 12 years GI: Dry mouth, nausea,
of age  Bio-availability differs from one
emesis, vomiting, anorexia, to another.
anticholenergic, constipation, weight
antihistamine
 (H1) & alpha gain.
adrenergic Genito-urinary: Urinary
blocking retention, , enuresis,
Gynaecomastia.
CV: orthostatic
hypotension, cardiac
arrest, hypertension,
ECG changes,
tachycardia,
EENT: blurred vision,
TRIFLUPERAZINE
Adult: 2-5 mg Depresses cerebral  Psychotic disorders,  Hypersensitivity Respiratory: 
bid, 15-20 cortex,  Non psychotic  Cardiovascular disease, Laryngospasm,
mg/day . IM 1- hypothalamus , anxiety (not a drug of Blood dyscrasias respiratory
2mg 6 hourly
th
limbic system choice)  Coma depression
Child: PO which control  Schizophrenia  Severe hepatic disease. CNS: Extra-pyramidal
1mg/bid Im is activity -  Child below 6 years symproms dystonia,
contraindicated. aggression  Breat cancer tardive dyskinesia,
Non psychotic  Blocks  Seizure disorder seizures, head ache.
anxiety : neurotransmissio  Pregnancy Blood: Anaemia, ,
Adult: PO 1-2 n produced by agranulocytosis.
 Lactation
mg bid , not dopamine at Integumentary: Rash,
more than 5 mg synapse exhibits photosensitivity,
& do not exceed a strong alpha- dermatitis.
after 12 weeks adrenergic GI: Dry mouth, nausea,
blocking action; vomiting, anorexia,
 Mechanism for constipation, weight
antipsychotic gain.
action is unclear Genito-urinary: Urinary
retention, , enuresis,
Gynaecomastia.
CV: orthostatic
hypotension, ,
hypertension, ECG
 changes,
tachycardia,
EENT: blurred vision,
HALOPERDOL
 Adult: PO 0.5-  Potent  Psychotic disorders  Hypersensitivity  CNS: Seizures , EPS,  Do not give children IM
5 mg bid/tid antagonist at  Control of tics  Blood dyscrasias Neuroleptic malignant injections
max 100 central and  Vocal Utterances in  Coma syndrome, Akathesia  Do not use Haloperidol
mg /day. peripheral Gillesde La  Child under 13 yrs  CV: Orthostatic deaconate for IV injections
 Geriatric: dopamine  Tourette’s syndrome  Brain damage hypertension, ECG  Gradually withdraw drug when
PO/IM 0.25-5 receptors and  Short term treatment  Bone marrow depression changes, tachy cardia patient has maintenance therapy
mg daily. selective for D2 of hyperactive  Alcohol & barbiturate  EENT: Dry eyes, to avoid withdrawal emergent
 Child: 3-12 receptors, children showing withdrawal states glaucoma, blurred dyskinesias.
yrs PO/Im  Blocks excessive motor  Parkinson’s disease vision  Maintain fluid therapy, monitor
0.05- 0.15 neurotransmissio activity  GI: Dry mouth , ileus, for dehydration, tardive
 Angina
mg/kg/day n produced by  Prilonged parenteral Hepatitis, weight gain dyskinesia
 Epilepsy
dopamine at therapy in  GU: Enuresis,  Any alteration In BUN, WBC
synapse exhibits  Narrow angle glaucoma
Schizophrenia impotence, dysuria count , discontinue the drug
strong alpha-  Pregnancy,
 Control of severe  INTEG:  Monitor for EPS & if occurs
adrenergic  Lactation,
Nausea & vomiting Photosensitivity, then use anticholenergic ,
anticholenergic  Seizure disorders
 Organic mental dermatitis, rash, antiparkinsonism drugs
action.  Hypertension
syndrome with  RESP: laryngospasm,
 Mechanism for psychotic features respiratory depression
antipsychotic
action is unclear
ROXAPINE
 Adults: PO 10 A  Psychotic behaviour,  Hypersensitivity  CNS: Seizures , EPS,  Assess for any contra-indications
mg bd-qid dibenzoxazepine  Depression  Blood dyscrasias Neuroleptic malignant  Mix the oral concentrate with
IM-12.5-50 antagonizes ,  Anxiety  Coma syndrome, Akathesia, grape or orange fruit shortly
mg 6th hourly central  Child under 16 yrs pseudo parkinsonism, before admission
dopamanergic  Brain damage Akathesia, Dystonia.  Do not give Loxitane IM intra-
action by  Bone marrow depression  CV: Orthostatic venously
blocking post  Alcohol & barbiturate hypertension.  Any alteration in BUN & WBC
synaptic withdrawal states  EENT: glaucoma, count , discontinue the drug
 mesolimbic D1  Prostatic hypertrophy blurred vision  Monitor elderly patient for
& D2 receptors  Pregnancy,  GI: Dry mouth , dehydration
in the brain . It  Lactation, Vomitting, anorexia  Warn the patient for tardive
also has  Seizure disorders  GU: Enuresis, dyskinesias.
serotonin 5-HT2  GI obstruction impotence, dysuria  Monitor for EPS & if occurs use
inhibiting  INTEG: Dermatitis, anticholenergic antiparkinsonism
activity rash, drugs
 RESP: laryngospasm,  Avoid prolonged exposure to
respiratory depression. sun, Use precaution against heat
 HEMA: Anemia , stroke.
Leukopenia
CLOZAPINE
 Adult: PO 25  Interfeeres with  Management of  Hypersensitivity  Sedation  Monitor Intake & output chart.
mg qid/ bid dopamine psychotic symptoms  Myeloproliferative  Salivation  Swalowing of PO medication
may increase receptor binding in Schizophrenia disorders  Dizziness  Check for hoarding or giving
by 25-50 with lack of patients for whom  Severe granulocytopenia  Headache medication to others.
mg/day not to EPS, also acts as other antipsychotics  CNS depression,  Tremors  Check for LFT, blood count
exceed 900 an adrenergic have failed  Coma  Sleep disturbances mental status examination
mg/day cholinergic ,  Narrow angle glaucoma  Akinesia  Regular monitoring of vital signs
serotonergic  Check for EPS if yes give
 Seizures
antagonist antiparkinsonism drugs.
 Sweating
 Drooling  Decrease noise input
 Excessive salivation  Increase fluids for constipation
 Norepine Costipation  Monitor & teach family to take
 Weakness care of the patient for orthostatic
 Pain in back hypotension
 ECG changes
 Dyspnoea
 Nasal congestion
 Leukopenia
 ANTIDEPRESSANTS
AMITRYPLINE
 Adult: per oral  Major  Blocks reuptake of  Hypersensitivity to  CNS: Dizziness, EPS,  Always administer medications
50-100 mg hs, depression norepinephrine, tricyclics, increased psychiatric with the food or milk.
may be  Chronic pain serotonin into nerve  Recovery phase of MI, symptoms, seizures.  Asses the general condition of
increased up management endings,  Suicidal patients,  CV: Tachycardia, the client.
to 200 mg qd  Prevention of  Increasing action of  Schizophrenia, ECG changes,  Medications are crushed if
IM-20-30 mg cluster/migraine norepinephrine,  Psychosis , dysarrhthmias. patient is unable to swallow.
qid. headaches, serotonin in nerve  Severe depression ,  EENT: blurred vision ,  Gum; hard , sugarless candy; or
 Fibromyalgia. cells.  Electro shock therapy mydriasis , tinnitus , frequent sips of water for dry
 Elective surgery ,  GI: paralytic ileus , mouth.
 Lactation , hepatitis , stomatitis  Provide safety measures,
 Pregnancy  GU: urinary retention. including side rails primarily in
 Geriatric  HEMA: elderly.
agranulocytosis,  Assist with ambulation during
eosinophilia, beginning therapy, since
leucopoenia. drowsiness/ dizziness occurs.
 INTE: rash, urticaria  To avoid alcohol ingestion.
sweating, pruritis, Other CNS depressants.
photosensitivity.
CLOMIPRAMINE:
 Adult : per  Clear action is  Depression  Hypersensitivity  HEMA:  Monitor the vital signs
oral 25 mg not known .  Euphoria  Seizures Agranulocytosis,  Check regularly for blood
and increased  It is a potent  Phobias  Suicidal patients neutropenia, studies, hepatic studies, * Mental
up to 75-300 inhibitor of  Anxiety  Elderly pancytopenia status , withdrawal symptoms
mg/day in seroronin uptake  Agoraphobia  Pregnancy  CV: Hypotension,  Increase fluids , bulk in diet for
divided doses  Increases  Obsessive &  Lactation tachycardia, cardiac elderly
 Child: 10-18 dopamine compulsive disorder arrest.  Store the drug in a tight
yrs PO 25-50 metabolism  CNS: Seizures , container at room temperature .
mg/day dizziness Do not freeze.
 Depression:  ENDO: Galactorrheoa,  Not to break , crush or chew the
Adult: PO 50- hyperbilirubinemia. tablets
150 mg/day  META: Hyponatremia  Not to discontinue medication
 Anxiety  GI: Constipation, Dry quickly after long term use : may
Adult: PO 25- mouth. cause nausea , headache,
75 mg/day  GU: Delayed malaise.
ejaculation.  To wear sunscreen, to prevent
 INTEG: Diaphoresis, photosensitivity
photosensitivity
 NORTRIPTYLINE
 Adult: PO 25  Blocks reuptake  Major depression.  Hypersensitivity to  HEMA:  Use only when the BP is
mg tid or qid of  Chronic pain trycyclic Agranulocytosis, normal.
may increase norepinephrine, management antidepressants. thrombocytopenia,  Any abnormal change even drop
up to serotonin in to  Recovery phase of MI Leucopoenia, of 20 mm of Hg may lead to
150mg/day nerve endings  Convulsive disorders. eosinophilia. problem.
may give  Increasing action  Prostatic hypertrophy  CV: orthostatic  Note that withdrawal symptoms
daily dose hs. of hypotension, ECG headache, nausea, vomiting,
norepinephrine , changes, hypertension. muscle pain, weakness: do not
serotonin in  CNS: Drowsiness, usually occur unless drug was
nerve cells increased anxiety, discontinued abruptly .
psychiatric symptoms,  Dosage hs for oversedation
dizziness.. during day: may take entire dose
 GI: Paralytic ileus, at night elderly may not
epigastric pain,  Assistance with ambulation
cramps, hepatitis. during beginning therapy since
 GU: Retention, acute drowsiness/dizziness occurs
renal failure.
 EENT: blurred vision ,
mydriasis , tinnitus
 BUPROPION
 Adult: PO 100  Inhibits  Depression  Hypersensitivity.  CNS: headache,  Assess liver function tests before
mg initially reuptake of  Smoking cessation  Eating disorders agitation, seizures, during therapy
then increase norepinephrine,  Seizure disorders Akathesia, tremors  Teach therapeutic effects may
after 3 days to serotonin &  Renal & hepatic disease.  CV: Dysarrythmias , take 2-4 wks.
100mg tid if dopamine  Recent MI hypertension,  To avoid alcohol ingestion, other
needed.  Cranial trauma palpitation CNS depressants
 Pregnancy  GI: Nausea, dry mouth  Not to discontinue the
 Lactation constipation, medication quickly after long
 Children  GU: Impotence, term use;
frequency.  May cause nausea, headache,
 INTEG: Rash, pruritis, malaise
sweating  Administer increased fluids ,
 EENT: Blurred vision, bulk in diet if constipation
Auditory disturbance occurs. Provide safety measures
including side rails in elderly.
 MIRTAZIPINE:
 Adult : per  Blocks reuptake  Depression ,  Hypersensitivity to  HEMA:  Monitor the vital signs.
oral 15m/ Day of  Dysthymic disorder , trycyclic agranulocytosis  Assess the general condition of
at norepinephrine ,  Bipolar disorder , antidepressants, thrombocytopenia, the client.
hs .maintenan serotonin in to  Depressed agitated  Recovery phase of MI eosinophilia,  Assess for the side effects of the
ce to continue nerve endings , depression.  Convulsive disorders. leucopoenia. drug.
for 6 months  Increasing action  Prostatic hypertrophy.  CNS: dizziness,  Teach the patient and family that
of  Suicidal patients. headache, anxiety , therapeutic effects may take 2-
norepinephrine  Severe depression. EPS. 3weeks.
serotonin in  Increased IOP.  GI: diarrhoea, dry  Advice the client to wear the sun
nerve cells.  Hypo / hyperthyroidism mouth, paralytic ileus, screen or large hat since
 Pregnancy , hepatitis. photosensitivity occurs.
 Lactation.  GU: retention, ARF.  Concentrate with fruit juice
 INTEG: urticaria, rash, water or milk to disguise taste.
photosensitivity.  Safety measures inclusive the
 CV: orthostatic side rails for elderly patients
hypotension,
hypertension. ECG
changes.
 EENT: blurred vision,
tinnitus, and
mydriasis.
 VENTAFAXINE
 Adult: PO 75  Potent inhibitor  Depression  Hypersensitivity  CNS: Emotional  Assess the mental status for
mg/day in 2 or of neuronal  Second generation  Mania lability, vertigo, mood, sensorium, affect, suicidal
3 divided serotonin & antidepressant  Pregnancy apathy, hallucinations, tendencies, psychosis, panic.
doses norepinephrine  Lactation hypo/hypertonic,  Always dispense in small
increased up uptake.  Children psychosis, hostility. amounts because of suicide
to 150 mg/day  Weak inhibitor  Elderly  CV: Migraine, Angina potential, especially in the
of dopamine no  Hypertension pectoris, Extra systoles beginning of the therapy.
muscarinic;  Seizure disorder  EENT: Abnormal  Checking to see PO medication
histaminergic or vision, ear pain , Otitis swallowed.
alpha- media  To wear sunscreen to prevent
adrenergic  GI: Dysphagia, Colitis, photosensitivity
receptors in vitro  GU: Anorgesmia,  Administer medication always
metorrhagia, vaginitis. with food or milk.
 INTEG: Ecchymosis  Give gum, hard candy or
 META: Peripheral frequent sips of water for dry
oedema. mouth.
 MS: Arthritis.
 RESP: Bronchitis.
 SYST: Accidental
injury
 MOOD STABILISING DRUGS
CARBAMAZEPINE
 Tablet 200 mg  Mechanism of  Refractory seizure  Hypersensitivity  Dizziness, drowsiness,  Give drug with food to prevent
chewable action not disorders  History of Bone marrow unsteadiness, GI upset
tablets. 100 understood.  Trigeminal neuralgia depression  Disturbance of co-  Does not mix the suspension
mg ER tablets Antiepileptic  Unlabelled use  Use of MAOI ordination, with other medication,
100,200, 400 activity may be neurogenic diabetes  Lactation  Visual hallucination, precipitation may occur.
mg , ER related to its insipidus,  Pregnancy  Speech disturbances,  Reduce dosage, discontinue or
capsules 200, ability.  Certain psychiatric  Use cautiously with  Abnormal involuntary substitute other antiepileptic
300 mg  Inhibit disorders including history of adverse movements. medication gradually.
polysynaptic BPAD, reactions.  Paralysis,  Abrupt discontinuation of all
responses. Schizoaffective  Tinnitus medication may lead to status
 Blocks post illness  Blurred vision epilepticus
synaptic  Paraesthesia.  Arrange for frequent LFT.
potentialisation  Arrange the patient to have a
 CHF, oedema, pain,
syncope, primary complete blood count including
thrombophlebitis , platelet & RBC
Aggravation of CAD
LITHIUM
 Capsules:  Mechanism is  Treatment of manic  Hypersensitivity to  CNS: Headache,  Assess for any hypersensitivity
150,300, 600 not known. episodes of manic- tartrazine drowsiness, tremors, reactions.
mg.  Alters sodium depressive illness  Significant renal or CV dizziness, ataxia,  Assess the weight, skin colour,
 Tablets: 300 transport in  Maintenance therapy disease slurred speech, baseline ECG, vital signs, affect,
mg. nerve & muscle to prvent or diminish  Severe debilitation restlessness, reflexes, renal function etc.
 SR tablets: cells. frequency & intensity dehydration confusion, stupor,  Give with caution & daily
300 mg.  Inhibits release of subsequent manic  Sodium depletion memory loss, clonic monitor serum lithium levels to
 Syrup: of episodes patients on diuretics movements. patients with renal or CV
300mg/ml norepinephrine  Unlabeled use: (decreases sodium  GI system: Dry mouth, disease.
 Route: oral. & dopamine but Improvement of reabsorption & Anorexia, nausea  Give drug with food or milk..
 Metabolism: not serotonin neutrophil counts in Hyponatremia increases vomiting, diarrhoea,  Monitor the therapeutic serum
Liver from stimulated patients with cancer lithium retention0 incontinence, lithium level of 0.6-1.2 mEq/l.
 Excretion: neurons chemotherapy –  Pregnancy, Lactation abdominal pain.  Advice the client to take
induced neutrophilia &  GU system: Polyuria,
 Urine  Slightly in children with Gycosuria, Proteinuia, adequate fluids 2-3l/day to
increases schizophrenia (doses  Use cautiously with Urinary incontinence, prevent dehydration during
intraneuronal of 300-1000 mg/d. protracted sweating & edema, albumineuria, initial treatment, 1-2l/day during
stores of Serum levels of 0.5 & diarrhoea , suicidal or polydipsia. maintenance..
catecholamine’s 1 mEq/l) . impulsive patients ;  CV: Hypotension,  Monitor specific gravity of urine.
 Decreases  Prophylaxis of cluster infection with fever. ECG changes,  Advice the client not to operate
intraneuronal headache & cyclic dysarrhthmias, any machinery until lithium level
content of migraine headache circulatory collapse. is stable.
second 600-900 mg/d)  Integumentary: Drying  Advice the client not to take
messengers &  of hair , rash, alopecia, drug during pregnancy.
may thereby pruritis  Ensure that patient maintains
selectively  Blood: leukocytosis adequate intake of salt, food &
modulate the  ENT: Tinnitus, blurred fluids ( 2,500-3,000 ,l/day)
responsiveness vision.  Teach patient about minor
of hyperactive  MS: Muscle weakness. toxicity symptoms like vomiting
neurons that  Endo: diarrhoea, poor concentration,
might contribute Hypothyroidism, fine motor tremors, weakness,
to the manic and lassitude. Etc.
state

ANTICONVULSANTS
SODIUM VALPORATE
 Mania: PO  Increase levels  Simple( Petitmal)  Hypersensitivity,  Thrombocytopenia.  Blood studies hb%, RBC serum
750 mg/bd. of gama amino-  Complex( Petitmal),  Pregnancy  Leucopoenia folate, Hepatic studies, SGOT,
Available 125, butyric acid seizure.  Precaution during  Sedation, SGPT, bilirubin, creatinine has
250, 500 mg. (GABA) in brain  Manic episodes lactation.  Drowsiness, to be checked.
 Syrup: 250 which decreases associated with  Inco-ordination  Blood levels 50-100mg/ml
mg/ 5 ml seizure activity, BPAD  Headache,  MSE- mood, sensorium, affect
 Injection: 5 ml  Migraine  Tremors, memory.
 Agitation,  Check for
 Nausea, vomiting, respiratorydysfunction.
 Constipation,  During administration, r=break,
 Rashes, crush 0r chew,
 Do not dilute with carbonated
  Alopecia, beverages.
 Bruising,  Give with food to reduce GI
 Enuresis, irritation
 Irregular menses
PHENOBARBITOL
 Cap: 16 mg ,  Decreases  All forms of epilepsy,  Hypersensitivity to  Paradoxic excitement  Mental status, respiratory
15, 20mg/5 ml impulse status epilepticus, barbiturates,  Drowsiness depression, blood dyscrasias,
 Tab: 8, 15, 16, transmission, febrile seizures in  Porphyria  Lethargy convulsion activity, blood
32, 30, 60, 65, increases seizure children, sedation,  Hepatic disease  Hangover headache studies, therapeutic blood level
100 mg. threshold at insomnia  Respiratory disease  Nausea, vomiting (15-40 mg/ml) has to be
 Injection: 30, cerebral cortex  Nephritis.  Rash, urticaria assesses.
60, 65, 130 level.  Hyperthyroidism  Stevens Johnson  Slow IV after diluted with atleast
mg/ml  Diabetes mellitus. syndrome 10 ml sterile water for injection,
 Elderly  Angio-edema. regardless of dose is given.
 Pregnancy  Local pain  Teaches to use the drug exactly
as ordered
 Swelling
 To avoid CNS depressants
 Necrosis
including alcohol
 Thrombophlebitis
 Never to withdraw drug abruptly
 Anti-dot- Calcium gluconate IV
ANTI-ANXIETY DRUGS
CLONAZEPAM
Mild anxiety:  Potentiates the  Short term  Hypersensitivity to  CNS: dizziness,  Administer by 5 ml IV with
 Adult: PO 5- action of GABA management of benzodiazepines drowsiness, headache, NS/100mg powder: agitate
10 mg tid-qid especially in the anxiety.  Narrow angle glaucoma anxiety, confusion, ampoule gently: Give through Y-
 Child >6 yr: 5 limbic system,  Acute alcohol  Psychosis tremors, stimulation, tube or three-way stopcock: Give
mg bid-qid reticular withdrawal  Pregnancy fatigue, depression, 100 mg or less, greater than or
not to exceed formation.  Preoperatively for the  Lactation insomnia, equal to 1 min: do not use IVM
10 mg bid-tid. relaxation  Child < 18 yrs hallucination. diluents for IV use. With food or
Alcohol  GI: Constipation, dry milk for GI symptoms
withdrawal: mouth, nausea,  Gushed, if patient is not able to
 Adult: vomiting, anorexia swallow medication whole
PO/IM/IV 50-  INTEG: Rash, itching,  Sugarless gum, hard candy,
 100 mg , not Dermatitis. frequent sips of water for dry
to exceed 300  CV: Orthostatic mouth
mg /day hypotension, ECG  Assistance with ambulation
changes, tachycardia, during beginning therapy. Since
 EENT: Blurred drowsiness / dizziness occurs
vision , tinnitus,
mydriasis.
 GI : Constipation, Dry
mouth, nausea,
vomiting, Anorexia.
 INTEG: Rash,
dermatitis, itching.
DIAZEPAM
Anxiety:  Potentiates the  Anxiety  Hypersensitivity to  CNS: dizziness,  Teach patient that drug may be
 Adult: PO, 2- actions of  Acute alcohol benzodiazepines drowsiness, headache, taken with food
10 mg bid-qid. GABA, withdrawal  Narrow angle glaucoma anxiety, confusion,  Not to be used for everyday .
 Child >6 mo: especially in  Adjunct in seizure  Psychosis tremors, stimulation,  Stressor used longer than 4 mo
PO1-2.5 mg limbic system, disorders  Pregnancy fatigue, depression, unless directed by prescriber
tid –qid. reticular  Preoperatively as  Lactation insomnia, no more than prescribed amount
Tetanic muscle formation. relaxant  Elderly, hallucination. may be habit forming
spasm:  Enhances pre-  Skeletal muscle  Debilitated hepatic  GI: Constipation, dry  To avoid OTC preparations,
 Child < 5 yrs: sympathetic relaxation disease mouth, nausea, unless approved by the
IM/IV 5-10 inhibition.  Rectally for acute  Renal disease vomiting, anorexia prescribed.
mg q3-4h prn.  Inhibits spinal repetitive seizures  INTEG: Rash, itching,  To avoid diving activities that
 Infant >30 polysynaptic Dermatitis. require alertness : drowsiness
days : IM/IV afferent paths  CV: Orthostatic may occur
1-2mg q3-4h hypotension, ECG  To avoid alcohol, other
prn changes, tachycardia, psychotropic medication unless
 EENT: Blurred directed by prescriber.
vision , tinnitus,  Not to discontinue medication
mydriasis abruptly after a long term use.
 ALPROZOLAM
 Adult: PO  Produces CNS  Insomnia  Hypersensitivity  HEMA: Leucopoenia,  Assess the general condition of
0.125-0.5 mg depression at  Sedation  Narrow angle granulocytopenia patient
hs limbic , thalamic  Hypnosis glaucoma  CNS: Headache,  Administer drug after removal of
 Elderly: PO hypothalamic  Convulsions  Psychosis lethargy, drowsiness, any source of fire.
0.125-0.25mg levels of CNS  Pregnancy day time sedation,  Administer only after trying
hs  May be  Lactation dizziness, conservative measure for
mediated by  Elderly.  GI: Nausea, vomiting, insomnia
neurotransmitter  Intermittent porphyria heart burn, abdominal  Administer half-one hour before
GABA:  Anaemia pain. night for sleeplessness
 Results are  Hepatic disease  CV: Chest pain, pulse  Administer on empty stomach
sedation, changes for fast onset. But may be taken
 Renal disease
hypnosis, with food if GI symptoms occur.
 Suicidal individuals
skeletal muscle
relaxation , anti-  Drug abuse
convulsant  Seizure disorder
activity,  Child < 15 yrs
anxiolytic action
OXAZEPAM
Anxiety:  Potentiates the  Anxiety  Hypersensitivity  CNS: dizziness,  Assess for vital signs
 Adult: PO 10- actions of  Alcohol withdrawal to drowsiness, headache,  Assess the blood studies for blood
30 mg tid-qid GABA, benzodiazepines anxiety, confusion, dyscrasias
Alcohol especially in  Narrow angle tremors,  Assess the hepatic studies
withdrawal limbic system & glaucoma  GI: Nausea, vomiting,  Assess the physical dependency
 Adult : PO 15- reticular  Psychosis anorexia. withdrawal symptoms like headache,
30 mg tid-qid formation.  Pregnancy  INTEG: Rash, itching, nausea, vomiting, muscle pain,
 Lactation dermatitis. weakness, tremors, convulsions (long
 Child < 12 yrs  CV: Orthostatic term use)
 Elderly, hypotension, ECG  Assess for suicidal tendencies
 Debilitated hepatic changes, tachycardia,  Administer with food , milk for GI
disease  ENT: tinnitus, symptoms
 Renal disease mydriasis.  Administer sugarless gum, hard candy,
 EYES: Blurred vision frequent sips of water for dry mouth
 CEREBRAL STIMULANTS
DISULFIRAM
 Adult: PO  Blocks alcohol  Chronic alcoholism  Hypersensitivity  Headache, drowsiness,  Liver function studies every two
250-500 mg X at acetaldehyde as adjunct therapy  Alcohol intoxication restlessness, weeks during therapy AST &
1-2 weak then stage.  Psychosis dizziness, fatigue, ALT
125-500 mg  Accumulation of  CV disease tremors, psychosis,  Mental status: affect, mood, drug
until fully acetaldehyde  Nephritis neuritis, sweating, history, ability to follow
socially produces the  Cerebral damage. convulsions , death treatment abstain from alcohol
recovered disulfiram ,  Nausea , vomiting ,  Assess for signs of
 Tab 250 mg, alcohol reaction anorexia, severe hepatotoxicity.
500 mg thirst , hepatotoxicity,  Administer only with patient’s
available. metallic garlic like knowledge
after taste  Do not give to intoxicated client
 Rash dermatitis,  Once per day if drowsiness
urticaria. occurs.
 Disulfiram reaction,  Tabs may be crushed or mixed
 Alcohol reaction: with water.
Flushing, throbbing  Teach patient & family: Effect of
headache , respiratory drug if alcohol is taken; written
difficulty, nausea, consent for disulfiram has to be
vomiting , sweating, obtained.
thirst, chest pain,  Shaving lotions, creams , cough
palpitations, dyspnoea, preparations, skin products has
hyperventilation, tachy to be avoided since they produce
cardia, NI, CHF, reaction.
Convulsions , death  To avoid driving, hazardous
tasks if drowsiness occurs.
 To carry ID listing disulfiram
therapy.
 Treatment of overdose- IV Vit
C, Ephidrine sulphate,
antihistamines O2
 ANTICHOLENERGICS
ATROPINE
 Inj – 0.o5, 0.1,  Block acetyl-  Brady cardia  Hypersensitivity  GU: retention,  Maintain intake/output chart
0.3, 0.4, 0.5, choline at  Bradydysarrythmias  Angle closure glaucoma impotence, hesitancy,  Check for urinary retention.
0.8, 1mg/ml parasympathetic  Anticholenestrase  GI obstruction dysuria  Monitor ECG for ectopic
2mg/0.7 ml. neuroeffector blocking cardiac  Myasthenia gravis  CNS: Headache, ventricular beats, tachycardia
 Tab- 0.4, 0.6 sites vagal reflex  Ulcerative colitis, drowsiness,  Monitor for bowel sounds, check
mg  Increase cardiac  Decreasing secretions  Prostatic hypertrophy restlessness, for constipation.
output, heart rate  Before surgery  Tachy cardia dizziness, fatigue,  Check for increased IOP, eye
by blocking antispasmodics with  Asthma tremors, psychosis, pain, vomiting, blurred vision.
vagal GI neuritis, sweating,  Check cardiac rhythm, character
stimulation in  Biliary surgery,  GI: dry mouth, & BP continuously
heart, dries  Bronchodilation vomiting , paralytic  Increase water if constipation
secretions by ileus, abdominal occurs, IV diluted or undiluted
blocking vagus distension with 10 ml sterile water, Give at
 CVS: Tachycardia, 0.6 mg/dl.
ectopic ventricular  Given through three way stop
beats, hypertension cock
 Do not add to IV solution
SUCCINYL CHOLINE
 Inj 20,50 Inhibits  Facilitation of  Hypersensitivity  CV: Bradycardia,  Assess thee electrolyte imbalance
100mg/mg transmission of endotracheal  Malignant hyperthermia tachycardia, because it increases action of drug
 Inj 100,500 nerve impulses by intubation  Decreased plasma increased BP, sinus  Vital signs are monitored
mg/vial, 1g binding with  Skeletal muscle pseudocholinestrase arrest.  Intake & output chart is maintained
vial cholinergic relaxation  Penetrating eye injuries  RESP: Prolonged  Deep IM preferably high in deltoid
receptor sites  During orthopaedic  Acute narrow angle apnoea, muscle.
antagonising manipulation glaucoma bronchospasm,  IV dilute in 1-2 mg/ml in D5
action of acetyl  ECT cyanosis, respiratory isotonic saline solution.
choline causing depression  Give 5-10 mg/minute titrate to
release of  ENT: Increased response may be directly given over
histamine secretions , Increased per minute
IOP
ANTI PARKINSONIAN DRUGS
ECT DRUGS
PACITANE
 Tab 2 mg It acts by  Treat extrapyramidal  Patient with history of  Dry mouth  Assess the order of confirmation
increasing the symptoms closed angle glaucoma.  Flushed dry skin of diagnosis
release of  Urinary or intestinal  Blurred vision  Observe the patient for side
dopamine from obstruction.  Photophobia effect
pre-synaptic  Hypersensitivity  Increased heart rate  Maintain intake & output chart.
vesicles,  Prostatic hypertrophy  Constipation  Encourage adequate intake of
blocking their  Tachycardia fluids & roughage in the diet
 Urinary retention
uptake of Precautions taken  Record vital signs
 Mental confusion
dopamine in to  Myasthenia gravis  Advice the patient not to get up
presynaptic nerve  Excitement
 Atherosclerosis quickly from a lying down
terminal or by position to sitting position
 Chronic respiratory
exerting an
problems  Educate patient not to use
agonistic effect on
hazardous machineries
presynaptic
 Encourage the patient to have
dopamine
routine eye check up
receptors
 Advice frequent rinsing of
mouth
 THIOPENTANE SODIUM
 Adult: IV210-  Acts in reticular  Short , General  Hypersensitivity  Respiratory  V5- q3- % min during IV
280 mg or 3-5 activating anaesthesia before  Status asthmaticus depression, administration
ml/kg system to other substances  Hepatic intermittent  Bronchospasm.  Extravasation if it occurs, use
 Sedation: 12- produce  Increased ICP porphyrias  Retrograde amnesia nitropruside or Chloroprolaine to
20 mg /Lb anaesthesia.  Prolonged decrease pain, increase
 Available:  Raises , seizure Somnolescence circulation
Powder for Inj threshold  Tachycardia dysarrythmias or myocardial
2%, 2.5%`  Hypotension depression.
 Myocardial depression  Administer IV after diluting 500
 Sneezing mg/ 20 ml sterile water for Inj
 Coughing give each 25 mg or less/min
titrate to response.
 Chills
 Only with rash cart, resuscitate
 Shivering
equipment nearby
 Necrosis
 Pain at injection site
 Muscle irritability