MEDICATIONS (DRUG STUDY)

Table 4.1. Drug Study on Haloperidol

Dosage/
Drug Name
Route/ Time Mechanism of Side effects/ Nursing
and Drug Indications Contraindications
and Action Adverse effects responsibilities
Classification
Frequency
Generic Name: 5 mg; IM Left -Alters the effects -Acute and -Hypersensitivity; -Central nrevous -Assess mental
Haloperidol Deltoid every of dopamine in the chronic psychotic Angle-closure system: status
8 hours CNS. Also has disorder including glaucoma; Bone seizures, (orientation,
Brand Name: anti-cholinergic schizophrenia, marrow extrapyramidal mood, behavior)
Haldol and alpha- manic states, drug depression; Central reactions, prior to and
adrenergic induce psychosis. nervous system confusion, periodically
Drug blocking activity. -Patients with depression, drowsiness, during therapy.
Classification: Therapeutic schizophrenia Parkinsonism; restless, tardive -Assess positive
Antipsychotics effects: who require long Severe liver or dyskinesia. (hallucination,
Date Ordered: Diminished signs term parenteral cardiovascular -EENT: Blurred delusions) and
06/27/2023 and symptoms of (IM) disease (QT vision, dry eyes negative (social
psychosis. antipsychotic Interval prolonging -Respiratory: isolation)
Pharmacokinetics: therapy. conditions) Respiratory symptoms of
Absorption: Well -Useful in depression schizophrenia.
absorbed managing Cardiovascular: -Assess weight
following PO/IM aggressive or Hypotension, and BMI initially
administration, agitated patient. tachycardia, and throughout
Decanoate salt is -Tourette’s ECG changes therapy. Refer as
slowly absorbed syndrome (QT appropriate for
and has a long - Considered prolongation, nutritional/weight
duration of action. second-line torsade de and medical
Distribution: treatment after pointes), management.
Concentrates in failure with ventricular -Observe patient
liver. Crosses atypical arrhythmias. carefully when
placenta, enters antipsychotic. - administering
breast milk. Gastrointestinal: medication, to
Protein binding: Constipation, ensure that
92%. dry mouth, medication is
Metabolism and anorexia, drug- actually taken not
Excretion: Mostly induced horded.
metabolized in hepatitis, ileus, -Inform patient of
liver. weight gain possibility of
Half-life: 21-24 extrapyramidal
hours. symptoms,
tardive
dyskinesia, and
neuroleptic
malignant
syndrome.

Reference:
DAVIS’S DRUG
GUIDE for
NURSES 17th
EDITION (2020)
Table 4.2. Drug Study on Zuclopenthixol Acetate

Dosage/
Drug Name
Route/ Time Mechanism of Contraindications Side effects/ Nursing
and Drug Indications
and Action Adverse effects responsibilities
Classification
Frequency
Generic Name: 5 mg/1 mL; IM -Has high affinity -Management of Treatment of Central nervous Assessment
Zuclopenthixol Right Deltoid for dopamine D1 schizophrenia ; dementia; Narrow system: -Assess mental
Acetate after And D2 receptors, oral iitial and angle glaucoma Neuroleptic status (orienation,
haloperidol a1 adrenergic and maintenance malignant mood,
Brand Name: 5-HT2 receptors. management. syndrome, behavior)before
Clopixol Dopaminergic -IM (acuphase)- dizziness, and periodically
blockade produces initial treatment extrapyramidal during therapy.
Drug neuroleptic of acute psychotic symptoms, Observe carefully
Classification: activity. episodes or fatigue, when
Antipsychotics Therapeutic exacerbation of sedation, tardive administering
effects: Decreases psychosis due to dyskinesia, oral medication
Date Ordered: psychosis due to schizophrenia weakness, to ensure that
07/01/2023 schizophreni. syncope, EENT: medication is
Pharmacokinetics: abnormal cision actually taken
Absorption: PO- accommodation. and not hoarded.
well absorbed Cardiovascular: -Assess weight
following oral Thromboemboli and BMI initially
administration; sm, arrhythmias, and throughout
IM- depot and hypotension, therapy.
acuphase)- tachycardia. -assess fluid
slowlyabsorbed Gastrointestinal: intake and bowel
from IM sites. constipation, dry function.
Distribution: mouth, diarrhea, Increased bulk
Enters breastmilk thirst, vomiting and fluids in the
Metabolism and Derm: diet help
Excretion: Mostly photosensitivity minimizes
metabolized reaction, constipation.
(partially by the increased -Monitor for
CVP2D6 enzyme sweating onset of
system), Endocrine: akathisia.
metabolitesdo not hyperprolactine -Monitor for
have antipsychotic mia, tardive
activity; hyprrglycemia dyskinesia.
minimalamounts Genitourinary: Patient teaching:
excreted decreased libido, -Instruct patient
unchanged in abnormal to take as
urine. urination. directed. If a dose
Half-life: PO- 20 Hemat: anemia, is missed, omit
hrs. granulocytipenia and take next
Metabolism: dose as
weight changes scheduled.
MS: myalgia Discontinue
should be
gradual.
-Inform patient of
possibility of
extrapyramidal
symptoms and
tardive
dyskinesia.
-Advise patient to
change positions
slowly to
minimize
orthostatic
hypotension.
Table 4.3. Drug Study on Esictalopram

Dosage/
Drug Name Side effects/
Route/ Time Mechanism of Contraindications Nursing
and Drug Indications Adverse
and Action responsibilities
Classification effects
Frequency

Generic Name: 10 g 1 tab a -Selectively Indications: -Hypersensitivity; - Central - Monitor mood

Escitalopram day inhibits the -For the acute and Concurrent nervous changes and level of
reuptake of maintenance pimozide; system: anxiety during
Brand Name: serotonin in the treatment of major Concurrent use of Neuroleptic therapy.
Cipralex CNS. depressive disorder MAO inhibitors or malignant - Assess for suicidal
Therapeutic (MDD) in adults MAO llike drugs syndrome, tendencies, especially
Drug effects: Anti and for the acute (linezolid or suicidal during early therapy.
Classification: depressant treatment of mythelene blue); thoughts, - Asess for sexual
Antidepressants action. generalized anxiety Concurrent use of insomnia, dysfunction
Pharmacokinetic disorder (GAD). It citalopram, Angle dizziness, -PO: Administer as
Date Ordered: s: is additionally closure glaucoma. fatigue. single dose in the
06/27/2023 Absorption: 80% indicated for Derm: morning or evening
absorbed symptomatic relief sweating without regards to
following oral of obsessive- Endocrine: meals (dependent)
administration. compulsive syndrome on -Instruct patient to
Distribution: disorder (OCD). inappropriat take escitalopram as
Enters breastmilk e secretion directed.
Metabolism and of May cause dizziness,
Excretion: antidiuretic caution patient to
Mostly hormone( SI avoid driving or other
metabolized by ADNH). activities, requiring
the liver F and E: alertnness until
(primarily hyponatremi response to
CYP3A4 and a. medication is known.
CYP2CI9 Gastrointesti
isoenzymes); 7% nal: Reference:
excreted anorgasmia, DAVIS’S DRUG
unchange by decreased GUIDE for NURSES
kidneys. libido, 17th EDITION
Half-life: ejaculatory (2020)
increased in delay,
elderly and erectile
patients with dysfunction
hepatic Metabolism:
impairment. increased
appetite
Misc:
serotonin
syndrome
Table 4.4. Drug Study on Olanzapine

Dosage/
Drug Name Side effects/
Route/ Time Mechanism of Contraindications Nursing
and Drug Indications Adverse
and Action responsibilities
Classification effects
Frequency
Generic Name: 10 g 1 tab BID -Antagonizes -Schizophrenia -Hypersensitivity, Central -Assess mental
Olanzapine dopamine and Adults: Initially, 5 Phenylketonuria nervous status
serotonin type 2 to 19 mg PO once (orally system: (orientation,
Brand Name: in the CNS. daily with the goal disintegrating Neuroleptic mood, behavior)
Zyprexa Also, has anti- to be at 10 mg daily tablets contain Malignant before and
cholinergic, within several days aspartame) ssyndrome, periodically
Drug antihistaminic, of starting therapy. Lactation: seizures, during therapy.
Classification: and anti-alpha, Most patients Lactation suicidal -Monitor blood
Antipsychotics adrenergic respond to 10 to 15 thoughts, glucose prior to
affects. mg PO daily. agitation, and periodically
Date Ordered: Therapeutic -Agitation caused delirium, during therapy.
07/01/2023 effects: by schizophrenia dizziness, -Monitor
Decreased and bipolar 1 mania headache, BP,ECG,pulse,
manifesation of Adults: 10 mg IM restless, and respiratory
psychosis. (short acting) sedation, rate before and
Pharmacokinetic (range, 2.5 to 10 weakness, frequently
s: mg) dystonia, during dose
-Absorption: insomnia, adjustment.
well absorbed mood -Assess weight
but rapidly changes, and BMI
metabolized by personality initially and
first-pass effect, disorder, throughout
resulting 60% speech therapy.
bioavailability. impairment, -Observe patient
Conventional tardive carefully when
tablets (Zydis) dyskinesia administering
are Cardiovascu medication to
bioequivalent. lar: ensure that
IM orthostatic medication is
administration hypotension, taken and not
results in bradycardia, hoarded or
significantly chesrt pain, checked.
higher blood tachycardia -Assess fluid
levels (5 times Derm: Drug intake and
that of oral. reaction with bowel function.
Distribution: Eosinophilia -Monitor patient
extensively and systemic for onset of
distributed symptoms akathisia
Protein binding: (DRESS), -Monitor for
93% photosensiti tardive
Metabolism and vity dyskinesia
Excretion: highly EENT: -Advise patient
metabolized ambyopia, to take
(mostly by the rhinitis, medication as
hepatic P450 increased directed and not
CYP 1A2 salivation to skip doses.
system); 7% pharyngitis. -Inform patient
excreted Endocrine: possibility of
unchanged in amenorrhea, extrapyramidal
urine. galactorrhea, symptoms and
Half-life: 21- goiter, tardive
54hr gynecomasti dyskinesia
a, -Advise patient
hyperglycem to change
ia positions slowly
Gastrointesti to minimize
nal: orthostatic
constipation, hypotension.
dry mouth, Protect from
increased falls.
liver -Medication
enzymes, may cause
weight loss drowsiness.
or gain, Caution patient
abdominal to avoid driving
pain,
increase Reference:
appetite, DAVIS’S
nausea, DRUG GUIDE
increased for NURSES
thirst. 17th EDITION
Genitourinar (2020)
y:
impotence,
decrease
libido,
urinary
incontinence
.
Hemat:
Agranulocyt
osis,
leukopenia,
joint pain,
Neuro:
tremor
Respiratory:
cough,
dyspnea
Misc: fever,
flu-like
syndrome