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VIII.

DRUG STUDY

NAME OF THE MECHANISM OF INDICATION CONTRAINDICATION ADVERSE EFFECTS/SIDE NURSING


DRUG/ ACTION/ EFFECTS RESPONSIBILITIES
CLASSIFICATION DOSAGE, ROUTE
AND FREQUENCY
GENERIC NAME: ACTON: Treatment of  Pregnancy  The most frequent  Monitor blood studies:
Divalproex Increases level of primary generalized category D. adverse effects are Hct, Hgh, RBC, serum
gamma aminobutyric seizures, and  Patients with gastro-intestinal folate, platelets, Pro-
BRAND NAME: acid (GABA) in the notably absence and known disturbances, time, vit. D if long
Depakote brain, which myoclonic seizures, hypersensitivity to particularly on the term therapy
decreases seizure and also for partial the drug initiation of the  Monitor liver function
CLASSIFICATION: activity. seizures. Also used  Patients with pre- therapy studies: AST, ALT,
Antidepressant to treat acute manic existing liver  Less common: bilirubin, creatinine,
DOSAGE, ROUTE phase of bipolar disease or a family Increased appetite and failure
AND disorder (manic history of severe weight gain, edema,  Monitor blood levels:
FREQUENCY: depression) and for hepatic headache, reversible therapeutic level 50-
250 mg, 2 tab OD the prophylaxis of dysfunction prolongation of 100 mcg/mL
migraine.  Patients with bleeding time and  Assess mental status:
known urea cycle thrombocytopenia mood, sensorium,
disorders.  Neurologic: affect, memory
Ataxia, tremor, (long,short)
sedation, lethargy,  Assess respiratory
confusion and more dysfunction:
rarely encephalopathy respiratory depression,
and coma character, rate, rhythm;
• Aggression, hold drug if
hyperactivity, respirations are <
behavioural 12/min or if pupils are
disturbances, transient dilated
hair loss, sometimes  Warn patient not to
with regrowth of curly stop the drug abruptly
hair, amenorrhea,  Instruct patient to
gynecomatia, hepatic avoid driving or
failure and pancreatitis activities that require
alertness
 Advise patient to
report visual
disturbance,rash,
diarrhea, light colored
stools, jaundice,
protracted vomiting to
physician

NAME OF THE MECHANISM OF INDICATION CONTRAINDICATION ADVERSE NURSING


DRUG/ ACTION/ EFFECTS/SIDE RESPONSIBILITIES
CLASSIFICATION DOSAGE, ROUTE EFFECTS
AND FREQUENCY

GENERIC NAME: ACTION: •Organic Psychoses • seizure disorder ADVERSE EFFECTS: • Assess mental status prior to
haloperidol • Alters the • acute psychotic • glaucoma and periodically during
effects of symptoms • elderly clients •CNS: extrapyramidal therapy.
BRAND NAME: dopamine in • Relieve symptom such as muscle • Monitor BP and pulse prior
Haldol the CNS hallucinations, rigidity or spasm, shuffling to and frequently during the
• Also has delusions, gait, posture leaning period of dosage adjustment.
CLASSIFICATION: anticholinergi disorganized thinking forward, drooling, masklike May cause QT interval
Antipsychotics c and alpha- • severe anxiety facial appearance, changes on ECG.
adrenergic • seizures dysphagia, akathisia, tardive • Observe patient carefully
blocking dyskinesia, headache, when administering
activity seizures. medication, to ensure that
• Diminished •CV: tachycardia, medication is actually taken
signs and arrhythmias, hypertension, and not hoarded.
symptoms of orthostatic hypertension. •Monitor I&O ratios and daily
psychoses eight. Assess patient for signs
•EENT: blurred vision, and symptoms of dehydration.
glaucoma • Monitor for development of
Haloperidol interferes • GI: dry mouth, anorexia, neuroleptic malignant
with the effects of nausea, vomiting, syndrome Report symptoms
neurotransmitter in constipation, diarrhea, immediately.
the brain which are weight gain. • Advise patient to take
the chemical • GU: urinary frequency, medication as directed. Do not
messengers that urine retention, impotence, increase dose or discontinue
nerves manufacture enuresis, amenorrhea, medication without consulting
and release to gynecomastia health care professional.
communicate with • Hematologic: anemia, Abrupt withdrawal may cause
one another. It blocks leucopenia, agranulocytosis dizziness, nausea, vomiting,
receptors for the • Skin: rash, dermatitis, GI upset, trembling, or
neurotransmitters phtosensitivity uncontrolled movements of
(specifically the mouth, tongue or jaw.
dopamine and
serotonin type 2
receptors) on the
nerves. As a result,
the nerves are not
“activated” by the
neurotransmitters
released by the other
nerves. Specifically, it
can bind to dopamine
D1 and D2, 5-HT2,
histamine H1 and A2
adrenergic receptors
in the brain. The
efficacy of
neuroleptics is
thought to be due to
antagonism of
dopamine receptors in
the mesolimbic and
mesofrontal systems.

DOSAGE, ROUTE
AND
FREQUENCY:
5 mg, ½ tab OD

NAME OF THE MECHANISM OF INDICATION CONTRAINDICATION ADVERSE NURSING


DRUG/ ACTION/ EFFECTS/SIDE RESPONSIBILITIES
CLASSIFICATION DOSAGE, ROUTE EFFECTS
AND FREQUENCY
GENERIC NAME: ACTON: •Acute and chronic •Hypersensitivity. ADVERSE EFFECTS: • Assess mental status prior to
chlorpromazine psychoses, •Cross-sensitivity may and periodically during
• Block dopamine particularly when exist among •CNS: neuroleptic malignant therapy.
BRAND NAME: receptors in the brain; accompanied by phenothiazines. Should syndrome, sedation, • Monitor BP and pulse prior
Thorazine also alter dopamine increased not be used in narrow- extrapyramidal reactions, to and frequently during the
release and turnover. psychomotor angle glaucoma. tardive dyskinesia period of dosage adjustment.
CLASSIFICATION: activity. Nausea and •Should not be used in •CV: hypotension (increased May cause QT interval
Antipsychotics • Prevention of vomiting. patients who have CNS with IM, IV) changes on ECG.
seizures • Also used in the depression. •EENT: blurred vision, dry • Observe patient carefully
treatment of eyes, lens opacities when administering
Chlorpromazine is a intractable hiccups. • GI: constipation, dry medication, to ensure that
neuroleptic that acts mouth, anorexia, hepatitis, medication is actually taken
and not hoarded.
by blocking the ileus •Monitor I&O ratios and daily
postsynaptic • GU: urinary retention eight. Assess patient for signs
dopamine receptor in • Hematologic: and symptoms of dehydration.
the mesolimbic agranulocytosis, leukopenia • Monitor for development of
dopaminergic system • Skin: photosensitivity, neuroleptic malignant
and inhibits the pigment changes, rashes syndrome Report symptoms
release of immediately.
hypothalamic and • Advise patient to take
hypophyseal medication as directed. Do not
hormones. It has increase dose or discontinue
antiemetic, serotonin- medication without consulting
blocking and weak health care professional.
antihistaminic Abrupt withdrawal may cause
properties and slight dizziness, nausea, vomiting,
ganglion-blocking GI upset, trembling, or
activity. uncontrolled movements of
mouth, tongue or jaw.
DOSAGE, ROUTE
AND
FREQUENCY:
50 mg, ½ tab @ H.S
NAME OF THE MECHANISM OF INDICATION CONTRAINDICATION ADVERSE NURSING
DRUG/ ACTION/ EFFECTS/SIDE EFFECTS RESPONSIBILITIES
CLASSIFICATION DOSAGE, ROUTE
AND FREQUENCY
GENERIC NAME: ACTON: Parkinsonian Untreated narrow angle CNS and peripheral effects, • Assess for
biperiden Synthetic syndrome especially glaucoma, intestinal skin rashes, dyskinesia, Parkinsonism, EPS
anticholinergic, to counteract stenosis or obstruction, ataxia, twitching, impaired • Assess for mental
BRAND NAME: blocks cholinergic
muscular rigidity ,mega colon, prostatic speech, micturition status
Akineton responses in the CNS
and tremor; hypertrophy, life difficulties. Fatigue, • Assess patient response
extrapyramidal threatening tachycardia dizziness, at higher if anticholinergic are
CLASSIFICATION: DOSAGE, ROUTE symptoms doses,restlessness, agitation, given
Anticholinergic drug AND anxiety, confusion • Assess for tolerance
FREQUENCY: over long term therapy,
2 mg, ½ tab OD dosage may have to be
increased or changed
• Avoid activities that
require alertness, may
cause dizziness,
drowsiness and
blurring of vision
NAME OF THE MECHANISM OF INDICATION CONTRAINDICATION ADVERSE NURSING
DRUG/ ACTION/ EFFECTS/SIDE EFFECTS RESPONSIBILITIES
CLASSIFICATION DOSAGE, ROUTE
AND FREQUENCY
GENERIC NAME: ACTON: • Urinary tract • Sensivity to • CNS: Dizziness, • Assess patient for
cefuroxime Inhibits bacterial wall infections, cephalosporins headache, fatigue, signs and symptoms of
synthesis, rendering otitis media paresthesia, fever, infection
BRAND NAME: cell wall osmotically • Severe chills, confusion • Assess for
unstable, leading to infections • GI: Diarrhea, nausea, anaphylaxis: rash,
CLASSIFICATION: cell death by binding vomting, anorexia, urticaria, chills, fever,
Antibiotic to cell wall glossitis, bleeding, dyspnea
membrane. increased AST, ALT, • Monitor Intake and
bilirubin, LDH, Output
alkaline phosphotase, • Assess bowel pattern
DOSAGE, ROUTE abdominal pain, loose daily
AND stools, flatulence, • Monitor for bleeding
FREQUENCY: heartburn, stomach
500 mg/tab, 1 tab cramps, colitis,
BID (P.O) jaundice
• GU: vaginitis,
pruritus, candidiais,
increased BUN,
nephrotoxicity, renal
failure, pyuria,
dysuria,reversible
interstitial nephritis
NAME OF THE MECHANISM OF INDICATION CONTRAINDICATION ADVERSE NURSING
DRUG/ ACTION/ EFFECTS/SIDE RESPONSIBILITIES
CLASSIFICATION DOSAGE, ROUTE EFFECTS
AND FREQUENCY
GENERIC NAME: ACTON: • It is used for • Hypersensitivity to Dizziness: disturbed • Be alert for urinary
diphenhydramine Acts on blood antiemetic antihistamines; coordination; nausea; retention, frequency
vessels, GI, properties in history of sleep vomiting; diarrhea; dysuria especially
BRAND NAME: respiratory system by the treatment apnea; use in constipation; change in elderly. Drug should
Benadryl antagonizing the of nausea newborn or bowel habits. Chest be discontinued if
effects of histamine and premature infants tightness; wheezing; these occur.
CLASSIFICATION: for H1 receptor site; vomiting, and in nursing Hypersensitivity reactions • Assess type of
Antihistamine decrease allergic particularly women involuntary
response by blocking in the movements and
histamine; causes prevention evaluate response to
increased heart rate, and this medication.
vasodilation, treatment of • Assess movement
secretions; significant motion disorder before and
CNS depressant and sickness after administration.
anticholinergic when it • Assess sleep pattern,
properties should be nausea, vomiting,
given at least bowel sounds and
DOSAGE, ROUTE 30 mins. abdominal pain.
AND FREQUENCY: before
50 mg, amp travelling