Drug

Classific
ation

Indications

Mechanism
of Action

Adverse
Reaction

Drug Interaction

Generic
name:
Olanzapin
e

Antipsyc
hotic

Treatment
of
schizophreni
a

Mechanism of
action not fully
understood;
blocks
dopamine
receptors in
the brain,
depresses the
RAS; blocks
serotonin
receptor
sites; anticholi
nergic,
antihistaminic
(H1), and
alphaadrenergic
blocking
activity may
contribute to
some of its
therapeutic
(and adverse)
actions;
produces
fewer extrapyr
amidal effects
than

CNS:
Somnolence,
dizziness,
nervousness,
headache, akat
hisia,
personality
disorders, tardiv
e dyskinesia, ne
uroleptic
malignant
syndrome
CV: Orthostatic
hypotension,
peripheral
edema,
tachycardia
GI:
Constipation,
abdominal pain
Respiratory:
Cough, pharyng
itis
Other: Fever,
weight gain,
joint pain,
development of
diabetes

Increased risk of
10mg tab
orthostatic
1 tab
hypotension
@hs
with antihypertensi
ves, alcohol,
benzodiazepines;
avoid use of
alcohol and use
caution
with antihypertensi
ves
Increased risk of
seizures
with anticholinergic
s, CNS drugs
May decrease
effectiveness
of levodopa,
dopamine agonists
Decreased
effectiveness
with rifampin, ome
prazole, carbamaz
epine, smoking
Increased risk of
toxicity
with fluvoxamine

Brand
Name:
Zyprexa

Dopamin
ergic bloc
ker

Treatment
of acute
mixed or
manic
episodes
associated
with bipolar
1 disorder
and
maintenanc
e of bipolar
1 disorder
as
monotherap
y, or
combined
with lithium
or valproate
Treatment
of agitation
associated
with

Route/Fr
equency

Nursing Consideration

Encourage patient to void before

taking the drug to help
decrease anticholinergic effects of
urinary retention.
Monitor for elevations of temperature
and differentiate between infection
and neuroleptic malignant syndrome.
Monitor for orthostatic hypotension
and provide appropriate safety
measures as needed.
Monitor patient regularly for signs and
symptoms of diabetes mellitus.
Take this drug exactly as prescribed;
do not change dose without consulting
your health care provider.
Peel back foil on blister pack of
disintegrating tablets; do not push
through foil; use dry hands to remove
tablet, place entire tablet in mouth.
This drug cannot be taken during
pregnancy. If you think you are
pregnant or wish to become pregnant,
contact your health care provider.

Report lethargy, weakness,

fever, sore throat, malaise,
mouth ulcers,
and flulike symptoms.

schizophreni mostantipsych mellitus

a and
otics.
bipolar 1
mania
(injection)

Drug

Classificati
on

celeco nonsteroidal
antixib
inflammatory
drug
(NSAID)

Indications

Mechanism of Action Adverse

Reaction

used to treat
pain or
inflammation
caused by many
conditions such
as arthritis,
ankylosing
spondylitis, and
menstrual pain.
Celecoxib is
also used in the
treatment of
hereditary
polyps in the
colon

Prostaglandins are
chemicals that are
important contributors
to the inflammation of
arthritis that causes
pain, fever, swelling
and tenderness.
Celecoxib blocks the
enzyme that makes
prostaglandins
(cyclooxygenase 2),
resulting in lower
concentrations of
prostaglandins. As a
consequence,
inflammation and its
accompanying pain,
fever, swelling and
tenderness are
reduced. Celecoxib
differs from other
NSAIDs in that it
causes less
inflammation and
ulceration of the
stomach and intestine
(at least with shortterm use) and does
not interfere with the
clotting of blood.

Body as a
Whole:
Back pain,
peripheral
edema.
Increased
risk of
cardiovascul
ar events.
GI:
Abdominal
pain,
diarrhea,
dyspepsia,
flatulence,
nausea.
CNS:
Dizziness,
headache,
insomnia.
Respiratory:
Pharyngitis,
rhinitis,
sinusitis,
URI. Skin:
Rash.

Drug
Interaction

Route/Fre
quency

Some products 200mg

that may
cap bid
interact with this
drug include:
aliskiren, ACE
inhibitors (such
as captopril,
lisinopril),
angiotensin II
receptor
blockers (such
as valsartan,
losartan),
cidofovir,
lithium, "water
pills" (diuretics
such as
furosemide).

Nursing Consideration
Assessment & Drug Effects
Therapeutic effectiveness is
indicated by relief of joint pain.
Lab tests: Periodically monitor Hct
and Hgb, liver functions, BUN and
creatinine, and serum electrolytes.
Monitor closely lithium levels when
the two drugs are given concurrently.
Monitor closely PT/INR when used
concurrently with warfarin.
Monitor for fluid retention and edema
especially in those with a history of
hypertension or CHF.
Patient & Family Education
Avoid using celecoxib during the
third trimester of pregnancy.
Promptly report any of the following:
unexplained weight gain, edema, skin
rash.
Stop taking celecoxib and promptly
report to physician if any of the
following occurs: S&S of liver
dysfunction including nausea, fatigue,
lethargy, itching, jaundice, abdominal
pain, and flulike symptoms; S&S of GI
ulceration including black, tarry stools
and upper GI distress

Drug

Classificatio Indications
n

Mechanism
of Action

Adverse
Reaction

daflon

venotonic (it
- Treatment of the
increases
symptoms and signs
venous tone)
of organic and
and a
idiopathic,
vasculoprotec
functional, chronic
tor
venous insufficiency of the lower
limbs, such as
heavy legs, pain,
heat sensation,
edema, functional
impair- ment,
nocturnal cramps
and in adjunction
with con- ventional
treatment in venous
leg ulcers.
- Treatment of the
symptoms of acute

Daflon has
the ability to
suppress
damage to
the valves
structures in
situation of
acute hyperpression.

Possible side none

effects
include
routine
gastric
disorders and
neurovegetati
ve disorders.

Drug
Interaction

Route/Fre Nursing
quency
Consideration
1 Tab tie

advise pt to
take meds with
water
advise to report
any signs of
symptoms

drug

clas
sific
atio
n

indication

mechani
sm of
action

adverse reaction

drug interaction

sodium
valproat
e+valpro
ic acid

Anti
con
vuls
ant
Diva
lpro
ex
Sodi
um

Monotherapy
and adjunctive
therapy in
treating patients
with complex
partial seizures
that occur
either in
isolation or in
association with
other types of
seizures; sole
and adjunctive
therapy in
treating simple
and complex
absence
seizures and
adjunctively in
patients with
multiple seizure
types that
include
absence
seizures.

Believed
to work
by
increasin
g brain
levels of
GABA.

Cardiovascular
Arrythmia, hypertension,
hypotension, palpitation,
postural hypotension,
tachycardia, vasodilation (more
than 1% and less than 5%);
bradycardia (postmarketing).
CNS
Tremor (57%); headache
(31%); somnolence (30%);
asthenia (27%); dizziness
(25%); insomnia (15%);
depression (5%); a
Respiratory
Flu-like syndrome (12%);
bronchitis, dyspnea, rhinitis
(5%); hiccup, increased cough,
pneumonia, sinusitis (more
than 1% and less than 5%).
Musculoskeletal
Back pain (8%); neck pain,
neck rigidity (1% or more);
arthralgia, leg cramps, myalgia,
myasthenia, twitching (more
than 1% and less than 5%);
bone pain, weakness
(postmarketing).

Carbamazepine
500mg 1tab
Carbamazepine plasma
bid
levels may be decreased
while carbamazepine-10,11epoxide levels may be
increased; decreased valproic
acid levels.
Carbapenem antibiotics
(eg, ertapenem, imipenem,
meropenem), charcoal,
cholestyramine, rifampin
May decrease valproic acid
levels.
Chlorpromazine,
erythromycin, felbamate,
fluoxetine, salicylates
May increase valproic acid
levels.
Clonazepam
Absence status may be
induced in patients with a
history of absence-type
seizures.
Hormonal contraceptives

route/freque nursing
ncy
consideration

Divalproex ER
tablets and
valproic acid
delayed-release
capsules: must
be swallowed
whole; do not
break, crush, or
chew
Divalproex
sprinkle
capsules: May be
swallowed whole
or sprinkled on a
teaspoonful of
soft food (eg,
applesauce,
pudding) and
swallowed
immediately
without chewing.
Patients who
experience GI
irritation may
benefit from
taking the
medication with

EENT
Diplopia (16%); amblyopia,
blurred vision (12%);
nystagmus, pharyngitis (8%);
tinnitus

Valproic acid plasma

concentrations may be
reduced, decreasing the
efficacy.

food or by slowly
increasing the
dose from the
initial dose.