CONSTANTINO, Jesus Martin Miguel G.

BSN 4B8

Drug Ana:
Patient: J. D.

Risperidone
Drug Class: Antipsychotic; Benzisoxazole
Therapeutic Action: Mechanism of action not fully understood: Blocks dopamine
and serotonin receptors in the brain, depresses the RAS; anticholinergic,
antihistaminic, and alpha-adrenergic blocking activity may contribute to some of its
therapeutic and adverse actions.
Indication: Acute manic or mixed episodes associated with bipolar disorder;
Schizophrenia
Contraindication: Hypersensitivity, Pregnancy & Lactation, CV Disease, Renal or
Hepatic Impairment, Hypotension
Side Effects: Insomnia, Anxiety, Agitation, Headache, Dizziness, N/V, Constipation,
Dry mouth, Photosensitivity
Adverse Effects: Arrhythmias, Rashes, Aggression, Neuroleptic Malignant
Syndrome, Faintness
Nursing Interventions:
1. Assess for allergy.
2. Maintain seizure precautions.
3. Mix/Take with water, orange, milk. Do not mix with cola or tea.
4. Monitor for S/Sx of complications or A/E.
5. Assist in position change: slow movement and assistance at times.
6. Tell to avoid ROH, driving, sleep-inducing OTC.

Divalproex Na
Therapeutic Action: Mechanism of action not fully understood. Anti-epileptic
activity maybe related to the metabolism of the inhibitory neurotransmitter, GABA.
Indication: Acute mania, Bipolar disorder, Adjunct in symptom management of
schizophrenia, treatment of aggressive outburst.
Contraindication: Hypersensitivity, pregnancy & lactation, CV disease, renal or
hepatic impairment, hypotension
Side Effects: N/V, Indigestion, Diarrhea, Abdominal cramps, Constipation,
Sedation, Drowsiness, Transient Increase in Hair Loss
Adverse Effects: Life-Threatening Pancreatitis, Hepatic failure, Irregular Menses,
Elevation of Liver Enzymes, Staining of Teeth, Rash
Nursing Interventions:
1. Assess for allergy.
2. Maintain seizure precautions.
3. Give drug with food to avoid GI upset.
4. Do not cut, crush, chew drug.
5. Monitor for S/Sx of complications or A/E.
6. Assist in position change: slow movement and assistance at times.
7. Tell to avoid ROH, driving, sleep-inducing OTC.
DEMDAM, Ma. Eliza Jeneil B.
IV-B8

Drug Analysis:Patient E.E

OLANZAPINE zyprexa, zyprexa zydis,

Drug Class: Antipsychotics
Indications: Bipolar disorder, schizophrenia.
Therapeutic Effects: Improved control of psychiatric disorder. Affects dopaminergic, serotogenic,
muscarinic and adrenergic activities.
Dosage: PO: Adults: Schizophrenia: 5-10 mg/d initially; may increase at weekly intervals by 5 mg/d (not
to exceed 20 mg/d). Bipolar mania: 10-15 mg/d initially; may increase every 24 hr by 5 mg/d (not to
exceed 20 mg/d).
Administration: PO: May be administered without regard to meals. For orally disintegrating tablets, peel
back foil on blister, do not push tablet through foil. Using dry hands remove from foil and place entire
tablet in mouth. Tablet will disintegrate with or without liquid.
Side effects: agitation, tremor, dizziness, headache, restlessness, sedation, weakness, insomnia, mood
changes, tardive dyskinesia, orthostatic hypotension, tachycardia, constipation, dry mouth, weight gain
Adverse effects: neuroleptic malignant syndrome, seizures
Contraindication: Hypersensitivity, Lactation, Orally disintegrating tablets ccontain aspartame-
contraindicated for phenylketonurics
Nursing intervention:
a. Assess potential for interactions with other prescriptions, OTC medications or herbal products
patient may be taking.
b. Initiate at lower doses. Taper dosage slowly when discontinuing.
c. Instruct patients with diabetes to monitor blood glucose levels closely (hyperglycemia)
d. Monitor therapeutic effevtiveness, and adverse reactions at beginning of therapy and periodically
with long term use.
e. Monitor weight prior to initiating therapy and at least monthly.
f. Teach patient appropriate administration, interventions to reduce side effects, and adverse
symptoms to report.

DIVALPROEX Na
Drug Class: Anticonvulsant, Anti-epileptic drug
Indications: Therapy in the treatment of patients with generalized seizures and partial seizures.
Therapeutic Effects: Effective for patients with a rapid cycling variant of bipolar disorder and for those
with mania secondary to a general medical condition. Causes increased availability of gamma-
aminobutyric acid (GABA), an inhibitory neurotransmitter, to brain neurons or may enhance the action of
GABA or mimic its action at postsynaptic receptor sites
Dosage: 1000-1500 mg
Administration; PO: Swallow whole, do not crush or chew. Take with large amount of water or food to
decrease GI disturbance. Do not mix with carbonated beverage.
Side Effects: N/V, sedation, weight gain, hair loss
Adverse Effects: Life-Threatening Pancreatitis, Hepatic failure, Irregular Menses, Elevation of Liver
Enzymes, Staining of Teeth, Rash
Contraindication: Hypersensitivity to valproic acid, derivatives, or any component of the formulation;
hepatic disease or significant impairment; urea cycle disorders
Nursing intervention:
a. Assess potential for interactions with other prescriptions, OTC medications or herbal products
patient may be taking.
b. Keep patient under observation, observe safety/seizure precautions, and monitor therapeutic
effectiveness (type of seizure activity, force, and duration).
c. Monitor vital signs; neurological, cardiac, and respiratory status. Monitor for signs and symptoms
of hepatic failure (malaise, weakness, facial edema, anorexia, jaundice, and vomiting), especially
when used in children <2 years of age. Monitor for signs and symptoms of pancreatitis
(abdominal pain, nausea, vomiting, and/or anorexia).