DRUG STUDY

Name of Drug Dosage/ Mechanism of Action Indication Contraindication Adverse Effect Nursing Responsibilities
Frequency/ And Special
Timing/ Route Precautions

Generic Name: Dosage: 10 mg. ● Olanzapine ● Treatment of ● Contraindicated CNS: Somnolence, ● Check the name of the
Zyprexa 1 ½ Tab activity is schizophrenia in patients insomnia, patient.
achieved by the ● Short-term hypersensitive to parkinsonism, ● Check the name of the
antagonism of drugs. medication, brand
Brand Name: Frequency: OD treatment of dizziness, NMS,
many neuronal ● Opioids should names, expiry dates,
acute manic suicide attempt,
Olanzapine receptors only be and check the
episodes linked prescribed with abnormal gait, prescription.
Timing: 8:00 including the
to bipolar I asthenia,
dopamine benzodiazepines ● Confirm the
Classification: AM disorder. or other CNS personality appropriateness of the
receptors D1,
Antipsychotics D2, D3, and D4 ● Short-term depressants to disorder, akathisia, dose.
Route: Oral in the brain. This treatment, with patients for headache, tremor, ● Check the order and
route is also the case lithium or whom alternative articulation appropriateness of the
for serotonin valproate, of treatment options impairment, route prescribed.
receptors, the are inadequate. ● Confirm that the
acute mixed or tardive dyskinesia,
adrenergic ● Use cautiously in patient can take or
manic episodes patients with a fever, receive the medication
receptor, and
linked to current diagnosis extrapyramidal by the ordered route.
histamine
receptors. bipolar I or history of events (IM). ● Check the frequency
● Olanzapine also disorder. urine retention, of the prescribed
acts in the ● Long-term clinically CV: orthostatic medication.
serotonin treatment for significant hypotension, ● Double-check that the
receptors in the bipolar I prostatic tachycardia, chest nurses are giving the
frontal cortex in disorder. hypertrophy, pain, HTN, prescribed medicine at
a similar manner constipation, or the correct time.
● Treatment of history of
ecchymosis, ● Check if the patient
that the reported agitation peripheral edema,
dopamine D2 paralytic ileus or understands what the
receptors. This
caused by related hypotension (IM). medication is for.
allows for a schizophrenia conditions. Make them aware they
decrease in and bipolar I ● Use cautiously in EENT: amblyopia, should contact a
adverse effects. mania. patients with conjunctivitis, healthcare professional
● Treatment for heart disease, rhinitis, if they experienced
depressive cerebrovascular pharyngitis. side-effects reactions.
disease, and ● Ensure that you have
episodes
conditions that signed up for the
associated with predispose GI: constipation, medication after it has
bipolar I patients to dry mouth, been administered.
disorder. dyspepsia,
● Treatment- hypotension, a increased appetite, ● Check for
resistant history of salivation, contraindications.
depression. seizures or vomiting, and ● Assess the patient’s
conditions that Vital signs.
thirst.
might lower the ● Assess for the allergy
seizure threshold, history of Olanzapine
and hepatic GU: Hematuria, ● Watch for evidence of
impairment. metrorrhagia, NMS (hyperpyrexia,
● Use cautiously in urinary muscle rigidity, altered
elderly patients, incontinence, UTI, mental status,
those with a amenorrhea, autonomic instability),
history of vaginitis. which is rare but
paralytic ileus, commonly fatal. Stop
and those a risk the drug immediately;
Hematologic:
for aspiration monitor and treat the
pneumonia, leukopenia. patient as needed.
prostatic ● Monitor the patient for
hyperplasia, or Metabolic: symptoms of
angle-closure hyperglycemia, metabolic syndrome
glaucoma. weight gain. (significant weight
● Use cautiously gain and increased
during initiation Musculoskeletal: BMI, HTN,
of therapy in Joint pain, hyperglycemia,
patients at high hypercholesterolemia,
risk for suicide.
extremity pain, and
● Impaired core back pain, neck hypertriglyceridemia).
body temperature rigidity, twitching, ● Monitor the patient for
may occur. hypertonia. abnormal temperature
Patients should regulation, especially
use caution with Respiratory: if the patient exercises,
strenuous increased cough, is exposed to extreme
exercise, heat dyspnea. heat, takes
exposure, and anticholinergics, or is
dehydration. dehydrated.
● Black box Skin: sweating, ● Obtain baseline and
warning: Drugs ecchymosis. periodic LFT results.
may increase the ● Monitor patient for
risk of CV or Others: flulike weight gain.
infection-related syndrome, injury. ● Monitor patient for
death in elderly mental status changes,
patients with sedation, coma, or
dementia. delirium.
Olanzapine isn’t
approved to treat
patients with PATIENT TEACHING
dementia-related ● Caution Patient or
psychosis. caregiver of the patient
taking an opioid with
venzodiazepine, CNS
depressants, or alcohol
is to seek immediate
medical attention for
dizziness, light-
headedness, extreme
sleepiness, slowed or
difficult breathing, or
unresponsiveness.
● Inform the patient of
potential weight gain.
● Advise the patient to
avoid alcohol.
● Tell the patient to rise
slowly to avoid
dizziness upon
standing up quickly.
 Name of Drug Dosage/ Mechanism of Action Indication Contraindication Adverse Effect Nursing Responsibilities
Frequency/ And Special
Timing/ Route Precautions

Generic Name: Dosage: 500 mg Divalproex sodium ● Treatment of ● Contraindicated CNS: Asthenia, ● Check the name of the
Depakote 1 tab dissociates to the valproate acute mania in patients dizziness, patient.
ion in the gastrointestinal associated with hypersensitive to drowsiness, ● Check the name of the
tract. The mechanisms by bipolar disorder drugs in those headache, insomnia, medication, brand
Brand Name: Frequency: which valproate exerts its with or without with hepatic nervousness, names, expiry dates,
Divalproex TID therapeutic effects have psychotic dysfunction, and somnolence, tremor, and check the
Sodium not been established. It has features. in patients with abnormal thinking, prescription.
been suggested that its ● For migraine urea cycle amnesia, ataxia, ● Confirm the
Timing: 6:00 activity in epilepsy is prophylaxis. disorder (UCD). depression, appropriateness of the
Classification: AM, 8:00 AM, related to increased brain ● Treatment for ● Black box emotional upset, dose.
Anticonvulsant and 1:00 PM concentrations of gamma- partial seizure. warning: fever, abnormal ● Check the order and
aminobutyric acid ● Treatment for Patients with dreams. appropriateness of the
Route: Oral (GABA). mania hereditary route prescribed.
neurometabolic CV: Chest pain, ● Confirm that the
route syndromes edema, HTN, patient can take or
caused by DNA hypotension, receive the medication
mutations of the tachycardia, by the ordered route.
mitochondrial palpitations. ● Check the frequency
DNA polymerase of the prescribed
gamma EENT: blurred medication.
(POLGA) gene vision, diplopia, ● Double-check that the
such as Alphers- nystagmus, nurses are giving the
Hutten- locher phrayngitis, rhinitis, prescribed medicine at
syndrome are at tinnitus. the correct time.
high risk for ● Check if the patient
acute liver failure GI: abdominal pain, understands what the
and fatalities. anorexia, diarrhea, medication is for.
Drugs are dyspepsia, nausea, Make them aware they
contraindicated vomiting, should contact a
in patients pancreatitis, healthcare professional
known to have constipation, if they experienced
mitochondrial increased appetite. side-effects reactions.
disorders caused ● Ensure that you have
by POLGA Hematologic: bone signed for the
mutations and marrow suppression, medication after it has
children younger hemorrhage, been administered.
 than age 2 who thrombocytopenia, ● Check for
are uspected of bruising, petache. contraindications.
having the Hepatic: ● Assess the patient’s
mitochondrial hepatoxicity. Vital signs.
disorder. ● Assess for the allergy
● Black Box Metabolic: history of Divalproex
Warning: Cases hyperammonemia, Sodium.
of life weight gain or loss. ● Closely monitor all
threatening patients taking or
pancreatitis have Musculoskeletal: starting antiepileptic
been reported in back and neck pain, drugs for changes in
children and arthralgia. behavior indicating
adults receiving worsening or suicidal
valproate shortly Respiratory: thoughts or behavior
after initial use bronchitis, dyspnea. or depression.
as well as after Symptoms such as
several years of Skin: alopecia, anxiety, agitation,
use. erythema multi- hostility, mania, and
● Drug is forme, hypomania may be
associated with a hypersensitivity precursors to emerging
rare but serious reactions, SJS, rash, suicidality.
reaction known photosensitivity ● Monitor CBC, platelet
as DRESS reactions, pruritus. count, PT, and INR
syndrome. before starting therapy
Immediately Other: flulike and at frequent
discontinue the syndrome, infection, intervals. Decrease the
drug if DRESS chills. dose or discontinue the
syndrome is drug if hemorrhage,
suspected. bruising, or
● Black Box coagulation disorder
Warning: Avoid occurs.
use in women ● Monitor the patient
who may become immediately and
pregnant as it report symptoms of
can cause neural DRESS syndrome.
tube defects and Discontinue the drug if
other organ DRESS syndrome is
system suspected.
malformation. ● Never withdraw drugs
● Drug is suddenly, because
contraindicated sudden withdrawal
for use in may worsen seizure.
pregnancy for the Call prescribers at
prevention of once adverse reactions
migraine. develop.
● Notify the prescriber if
tremors occur; dosage
reduction may be
needed.
● Monitor drug level.

PATIENT TEACHING
● Tell patient and
caregivers that drug
may increase the risk
of suicidal thoughts
and behavior and to
immediately report the
emergence or
worsening of
depression, unusual
changes in mood, or
the emergence of
suicidal thoughts or
self-harm.
● Tell the patient to take
the drug with food and
milk to reduce adverse
GI effects.
● Advise patient not to
chew capsules.
● Warn patients and
caregivers not to stop
drug therapy abruptly.
● Tell the patient to
immediately report
rash, fever, swollen
lymph nodes, mouth
ulcers, or skin
shedding.
● Warn patients and
caregivers that
abdominal pain,
nausea, vomiting, and
anorexia can be
symptoms of
pancreatitis that
 require prompt
medical evaluation.
● Instruct patient or
caregivers to call
prescriber if malaise,
weakness, lethargy,
facial swelling, loss of
appetite, or vomiting
occur.
● Tell the female patient
to call the prescriber if
she becomes pregnant
or plans to become
pregnant during the
therapy.
 Name of Drug Dosage/ Mechanism of Action Indication Contraindication Adverse Effect Nursing Responsibilities
Frequency/ And Special
Timing/ Route Precautions

Generic Name: Dosage: 2 mg. 2 Block dopamine, 5-HT2, ● Treatment for ● Contraindicated CNS: Somnolence, ● Check the name of the
Risperdal Tab alpha1 and alpha2 schizophrenia. in patients insomnia, patient.
adrenergic, and H1 ● Parenteral hypersensitive to parkinsonism, ● Check the name of the
histaminergic receptors in drugs. medication, brand
Brand Name: Frequency: maintenance dystonia,
the brain. ● Opioids should names, expiry dates,
therapy for akathisia,
Risperidone BID only be and check the
schizophrenia prescribed with headache, prescription.
or bipolar I benzodiazepines agitation, anxiety, ● Confirm the
Classification: Route: Oral disorder (as or other CNS pain, NMS, appropriateness of the
Antipsychotics route monotherapy depressants to dizziness, fever, dose.
or as a patients for hallucination, ● Check the order and
combination whom alternative mania, impaired appropriateness of the
therapy with treatment options concentration, route prescribed.
are inadequate. ● Confirm that the
are lithium or abnormal thinking,
● Use cautiously in patient can take or
valproate) patients with and dreaming, receive the medication
● Monotherapy prolonged QT tremor, by the ordered route.
or combination interval, CV hypoesthesia, ● Check the frequency
therapy with disease, fatigue, depression, of the prescribed
lithium or cerebrovascular and nervousness. medication.
valproate for disease, ● Double-check that the
the 3-week hypovolemia, CV: tachycardia, nurses are giving the
treatment of history of chest pain, prescribed medicine at
seizures, or the correct time.
acute manic or conditions that
orthostatic ● Check if the patient
mixed episodes could affect hypotension, understands what the
from bipolar I metabolism or peripheral edema, medication is for.
disorder. hemodynamic syncope, HTN. Make them aware they
responses. should contact a
● Use cautiously in EENT: abnormal healthcare professional
patients exposed vision, rhinitis, if they experienced
to extreme heat. sinusitis, side-effects reactions.
● Use cautiously in ● Ensure that you have
pharyngitis.
patient risk for signed up for the
aspiration medication after it has
pneumonia. GI: nausea, been administered.
● Somnolence, constipation, ● Check for
orthostatic vomiting, contraindications.
 hypotension, and dyspepsia, ● Obtain baseline BP
motor and abdominal pain, measurements before
sensory anorexia, dry starting therapy, an
instability have monitor BP regularly.
mouth, increased
been reported, Watch for orthostatic
which may lead
saliva, and hypotension,
to fall or fall- diarrhea. especially during the
related injury. first dosage
● Drug may cause GU: urinary adjustment.
hyper- incontinence, ● Monitor the patient for
prolactinemia, increased tardive dyskinesia,
which may urination, which may occur after
decrease abnormal orgasm, prolonged use.
reproductive ● Watch for evidence of
decreased libido,
function in both NMS, which is rare
men and women. vaginal dryness, but can be fatal.
amenorrhea. ● Life-threatening
hyperglycemia, may
Metabolic: occur in patients
hyperglycemia, taking atypical
weight gain or loss, antipsychotics.
gynecomastia. ● Monitor symptoms for
metabolic syndrome.
● Periodically reevaluate
Musculoskeletal: the drug’s risks and
Arthralgia, back benefits, especially
pain, leg pain, during prolonged use.
myalgia. ● Monitor patient for
weight gain.
Respiratory:
coughing, dyspnea,
URI. PATIENT TEACHING
● Warn the patient to
avoid activities that
Skin: rash, dry require alertness until
skin, the effects of drugs are
photosensitivity known.
reactions, acne. ● Caution Patient or
caregiver of the patient
Others: toothache, taking an opioid with
injury. venzodiazepine, CNS
depressants, or alcohol
is to seek immediate
medical attention for
 dizziness, light-
headedness, extreme
sleepiness, slowed or
difficult breathing, or
unresponsiveness.
● Warn the patient to
rise slowly, and use
other precautions to
avoid fainting when
starting therapy.
● Advise patient to use
caution in hot weather
to prevent heatstroke.
● Instruct the patient to
keep the ODT in the
blister pack until just
before taking it. After
opening the pack, the
patient should dissolve
the tablet on the
tongue without cutting
or chewing. Tell the
patient to use dry
hands to peel apart the
foil to expose the
tablet. The patient
shouldn’t attempt to
push the tablet through
the foil.