DRUG NAME CLASSIFICATION MECHANISM OF INDICATION CONTRAINDICATIO ADVERSE REACTION NURSING

ACTION N RESPONSIBILITIES
GENERIC Anti-alzheimer’s/ Reversibly inhibits Donepezil is 1. CNS: Abnormal gait, Before
NAME Cholinergics acetylcholinesteras primarily indicated *Hypersensitivity*: agitation, anxiety, Administration:*
donepezil e and improves for the treatment Donepezil should asthenia, depression, 1. *Assessment*:
acetylcholine’s of symptoms not be used in dizziness, dream Before giving any
TRADE NAMES concentration at associated with individuals who disturbances, fatigue, medication, the
Aricept cholinergic Alzheimer's have a known fever, headache, hostility, nurse should
synapses. Raising disease, which is a hypersensitivity or insomnia, nervousness, assess the
NORMAL the acetylcholine progressive allergic reaction to seizures, somnolence, patient's current
DOSAGE level in the cerebral neurodegenerativ the medication or syncope, tremor condition,
RANGE cortex may improve e disorder that any of its CV: Abnormal ECG, including cognitive
(ALSOINCLUDE cognition. affects memory, components. 2. bradycardia, chest status, medical
ROUTE AND Donepezil becomes cognition, and *Severe Liver pain, edema, heart failure, history, allergies,
FREQUENCY) less effective as daily functioning. Dysfunction*: Since hypertension, and any potential
Initial: 5 mg at Alzheimer’s disease The medication is Donepezil is hypotension contraindications
bedtime. After progresses and the used to improve metabolized in the EENT: Pharyngitis to the medication.
4 to 6wk, number of intact cognitive function liver, individuals ENDO: Hyperglycemia 2. *Patient
dosage cholinergic neurons and slow down with severe liver GI: Abdominal Education*: The
increased to declines. the decline in impairment should pain, anorexia, nurse should
10 cognitive abilities not use the constipation, diarrhea, educate the
mg at bedtim in individuals with medication. It can dyspepsia, gastroenteritis, patient and their
e, as Alzheimer's potentially worsen fecal incontinence, nausea caregivers about
indicated. disease. It is liver function or , vomiting the purpose of
Maximum: available in lead to adverse GU: Cystitis, glycosuria, Donepezil, its
10mg daily. different strengths effects. 3. *Allergic hematuria, urinary potential benefits,
CLIENT: 10 mg and is usually Reactions*: People frequency possible side
tab PO Daily taken once daily who have or incontinence, UTI effects, and the
experienced HEME: Anemia, importance of
hypersensitivity hemorrhage adherence to the
reactions or allergic MS: Arthralgia, back pain, medication
responses to other elevated creatine kinase regimen. This
acetylcholinesteras level, muscle spasms education helps
e inhibitors, which RESP: Bronchitis, the patient and
are medications in increased cough, caregivers make
the same class as pneumonia informed
Donepezil, should SKIN: Ecchymosis, eczema, decisions. 3.
avoid using pruritus, rash, ulceration *Verify
Donepezil. 4. Other: Angioedema, Prescription*:
*History of dehydration, elevated Ensure that the
Bradycardia or alkaline phosphatase or medication order
Sickness lactate dehydrogenase is accurate, and
Syndrome*: level, flu syndrome, that the dosage
Donepezil can have weight loss and
effects on heart administration
rate and route match the
conduction. prescription.
Individuals with a 4. *Review
history of Medical History*:
bradycardia (slow Check for any
heart rate) or sick history of adverse
sinus syndrome (a reactions,
heart rhythm allergies, or
disorder) should interactions with
avoid using other medications
Donepezil due to the patient might
the potential risk of be taking.
exacerbating these *During
conditions. 5. Administration:*
*Peptic Ulcer 1. *Proper
Disease or Active Identification*:
Gastric Bleeding*: Confirm the
Donepezil can patient's identity
increase stomach using at least two
acid production. patient identifiers
Individuals with a (e.g., name and
history of peptic date of birth) to
ulcer disease or ensure the right
active gastric patient receives
bleeding should use the right
Donepezil with medication.
caution, as it might 2. *Medication
worsen these Preparation*:
conditions. 6. Prepare the
*Seizure appropriate
Disorders*: dosage of
Donepezil should be Donepezil
used cautiously in according to the
individuals with a prescription.
history of seizures, Donepezil is
as it can potentially commonly
lower the seizure available in tablet
threshold and form, with
increase the risk of different
seizures. 7. strengths. Follow
*Respiratory proper aseptic
Conditions*: techniques when
Individuals with handling the
asthma or chronic medication.
obstructive 3.
pulmonary disease *Administration*:
(COPD) might Administer the
experience medication orally
worsened as prescribed.
symptoms due to Ensure that the
the cholinergic patient is in an
effects of Donepezil upright position
on airway tone. 8. and has the ability
*Pregnancy and to swallow. If the
Breastfeeding*: patient has
Donepezil should be difficulty
avoided during swallowing,
pregnancy and consult the
breastfeeding, as its healthcare
effects on fetal provider for
development and alternative
infant health are options, such as
not well crushed tablets or
established. liquid
formulations.
*After
Administration:*
1. *Monitoring*:
Keep a close
watch on the
patient for any
immediate
adverse reactions,
such as allergic
responses or signs
of gastrointestinal
distress.
2. *Patient
Comfort and
Safety*: Ensure
the patient's
comfort after
administration.
Provide water if
needed, and offer
assistance with
any discomfort
the patient may
experience.
3.
*Documentation*
: Record the
administration of
Donepezil in the
patient's medical
record. Include
the time, date,
dosage, route of
administration,
any observed
reactions, and the
patient's response
to the medication.
4. *Follow-Up*:
As the nurse, you
may need to
communicate with
the patient's
primary
healthcare
provider about
the patient's
response to the
medication and
any observed
 effects or
concerns. 5.
*Patient and
Family
Education*:
Reinforce any
educational
information
provided earlier,
especially about
potential side
effects, expected
benefits, and the
importance of
adhering to the
medication
schedule.
Encourage
patients and
caregivers to
report any
adverse effects
promptly.

Drug name Classification Mechanism of Indications Contraindications Adverse Reaction Nursing

Actions Responsibilities
Generic Name Ther. Class. Rivastigmine works Rivastigmine is CNS: Before
Rivastigmine anti-Alzheimers's ag by inhibiting the primarily indicated weakness Administration:* 1.
ents activity of an for the treatment of , dizziness, *Assessment*:
Brand Name Pharm. Class. enzyme called mild to moderate drowsiness, Before
EXELON cholinergics acetylcholinesterase. dementia headache, sedation administering
(cholinesterase Acetylcholinesterase associated with (unusual) Rivastigmine, the
Actual Dosage inhibitors) is responsible for Alzheimer's disease CV: nurse should assess
breaking down and Parkinson's edema, heart the patient's
acetylcholine in the disease-related failure, hypotension medical history,
synaptic cleft (the dementia. It is used GI: current
small gap between to improve anorexia medications,
nerve cells where cognitive function, , dyspepsia, allergies, and any
neurotransmitters memory, and daily nausea contraindications to
transmit signals). By functioning in , the medication. This
inhibiting this individuals with vomiting assessment helps
enzyme, these conditions. , abdominal pain, determine whether
Rivastigmine Rivastigmine is diarrhea the patient is an
increases the levels available in ,flatulence, weight appropriate
of acetylcholine in different forms, gain (unusual) candidate for
the brain's synapses, including oral Derm: Rivastigmine.
enhancing capsules and a allergic contact 2. *Patient
cholinergic transdermal patch, dermatitis Education*:
neurotransmission. to provide flexibility Neuro: Educate the patient
This increased in dosing. tremor and their caregivers
acetylcholine Misc: about the purpose
availability helps to fever, weight loss, of Rivastigmine, its
compensate for the application potential benefits,
reduced cholinergic reactions (for possible side
function in transdermal patch effects, and the
Alzheimer's disease. only) importance of
adherence to the
medication
regimen. Address
any questions or
concerns they might
have.
3. *Review
Medication Order*:
Ensure that the
medication order is
accurate, and that
the dosage and
administration
route match the
prescription.
4. *Verify Patient
Identity*: Confirm
the patient's
identity using at
least two patient
identifiers (e.g.,
name and date of
birth) to ensure that
the right patient
receives the right
medication.
*During
Administration:*
1. *Medication
Preparation*:
Prepare the
appropriate dosage
of Rivastigmine
according to the
prescription. If using
an oral capsule,
ensure the patient
is able to swallow
and provide water if
needed. If using a
transdermal patch,
follow proper
aseptic techniques
when applying the
patch and rotate
the application site.
2.
*Administration*:
Administer the
medication as
prescribed. Ensure
the patient is
comfortable and in
an appropriate
position for
administration (e.g.,
upright for oral
administration,
suitable skin area
for patch
application).
*After
Administration:*
1. *Monitoring*:
Keep an eye on the
patient for any
immediate adverse
reactions or side
effects, especially
during the initial
administration.
Monitor for changes
in heart rate, blood
pressure, and signs
of gastrointestinal
distress.
2. *Patient Comfort
and Safety*: Ensure
the patient's
comfort after
administration.
Offer water if
needed and provide
any necessary
assistance.
3.
*Documentation*:
Record the
administration of
Rivastigmine in the
patient's medical
record. Include
details such as the
time, date, dosage,
route of
administration, site
of application (if
using a patch), and
any observed
reactions or the
patient's response
to the medication.
4. *Patient and
Family Education*:
Reinforce the
importance of
adhering to the
medication
schedule and any
specific instructions
related to
administration.
Provide information
on potential side
effects and when to
seek medical
attention if needed.
5. *Follow-Up*:
Communicate with
the patient's
primary healthcare
provider about the
patient's response
to the medication
and any observed
effects or concerns.
Regular follow-up
appointments may
be scheduled to
monitor the
patient's progress
and adjust the
medication regimen
if necessary.
6. *Patch
Handling*: If using a
transdermal patch,
provide clear
instructions on
proper patch
application, rotation
of application sites,
and disposal of used
patches.
Nursing Responsibilities

Before Administration:*

1. *Assessment*: Prior to administering Memantine Hydrochloride, assess the patient's medical history, current medications, allergies, and any contraindications
to the medication. Ensure that Memantine is appropriate for the patient's condition.

2. *Patient Education*: Educate the patient and their caregivers about the purpose of Memantine, its potential benefits, possible side effects, and the
importance of adhering to the medication regimen. Address any questions or concerns they might have.

3. *Review Medication Order*: Verify that the medication order is accurate, and that the dosage and administration route match the prescription.

4. *Patient Identification*: Confirm the patient's identity using at least two patient identifiers (e.g., name and date of birth) to ensure the right patient receives
the correct medication.

*During Administration:*

1. *Medication Preparation*: Prepare the appropriate dosage of Memantine according to the prescription. This may involve measuring a specific amount of
liquid solution or dispensing the appropriate tablet strength.

2. *Administration*: Administer the medication as directed. If Memantine is available in tablet form, make sure the patient is able to swallow the tablet. If it's a
liquid solution, measure the correct dose using a calibrated device.
3. *Patient Monitoring and Interaction*: While administering Memantine, closely monitor the patient's response to the medication. Use this opportunity to
engage with the patient, ensuring they are comfortable and well-informed about the process. Address any concerns they might have and provide reassurance.
This interaction not only enhances patient-centered care but also allows you to promptly identify any immediate adverse reactions and provide support if
needed.

*After Administration:*

1. *Monitoring*: Observe the patient for any immediate adverse reactions or side effects following administration. Pay attention to any changes in heart rate,
blood pressure, and overall well-being.

2. *Documentation*: Record the administration of Memantine in the patient's medical record. Include details such as the time, date, dosage, administration
route, and any observed reactions or the patient's response to the medication.

3. *Patient Comfort and Safety*: Ensure the patient is comfortable after administration. Offer water if needed and provide any necessary assistance.

4. *Patient and Family Education*: Reiterate the importance of adhering to the medication schedule and provide information on potential side effects.
Encourage patients and caregivers to report any adverse effects or concerns.

5. *Follow-Up*: Communicate with the patient's primary healthcare provider about the patient's response to Memantine and any observed effects or concerns.
Regular follow-up appointments may be scheduled to monitor the patient's progress and adjust the medication regimen if necessary.

6. *Storage and Handling*: If applicable, provide guidance on proper storage and handling of the medication, including protecting it from light, moisture, and
temperature extremes.