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DRUG

MECHANISM OF
ACTION


INDICATION

NURSING
RESPONSIBILITIES

GENERIC
NAME:
Biperiden


BRAND NAME:

Biperiden
Hdrochloride

CLASSIFICATI
ON:
Antiparkinsonia
n

FREQUENCY:
Once a day
(A.m.)


DOSAGE:
2 milligram


ROUTE:
PO


Blocks acetylcholine
action at cholinergic
receptor sites. This
action restores the
brains normal
dopamine and
acetylcholine balance,
which relaxes muscle
movement and
decreases rigidity and
tremors.

Indicated for
Parkinsonian syndrome
especially to counteract
muscular rigidity and
tremor; extrapyramidal
symptoms.


Observe for the ten
rights:
1. Assess for clients
History
2. Right patient
3. Right medication
4. Right dosage
5. Right route
6. Right time
7. Right documentation
8. Right client education
9. Drug- to- drug
interaction
10. Assess for allergy

Assess
for Parkinsonism, EPS.

Assess for mental
status.

Assess patient
response
if anticholinergics are
given.

Assess for tolerance
over long term therapy,
dosage may have to be
increased or changed.

Avoid activities that
require alertness, may
cause dizziness,
drowsiness and blurring
of vision.
ADVERSE EFFECTS CONTRAINDICATION

CNS and peripheral
effects, skin rashes,
dyskinesia, ataxia,
twitching, impaired
speech. Fatigue,
dizziness, at
higher doses,
restlessness, agitation,
anxiety, confusion.

Bladder neck
obstruction,
hypersensitivity to
biperiden, untreated
narrow angle
glaucoma, intestinal
stenosis or
obstruction, mega
colon, prostatic
hypertrophy, life
threatening
tachycardia.



DRUG MECHANISM OF
ACTION
INDICATION NURSING
RESPONSIBILITIES

GENERIC NAME:
Haloperidol



BRAND NAME:
Haldol



CLASSIFICATION:
Typical
Antipsychotics



FREQUENCY:
BID



DOSAGE:
20 mg tab


ROUTE:
PO (Oral)

Haloperidol
produces its
effects by
blocking
dopamine
(specifically, D
2
),
alpha, and
serotonin
receptors. It has
minimal blocking
effects at
cholinergic and
histamine
receptors.

Management of
manifestations of
psychotic disorders.
Prolonged parenteral
therapy of chronic
schizophrenia.
Observe for the ten
rights:
1. Assess for clients
History
2. Right patient
3. Right medication
4. Right dosage
5. Right route
6. Right time
7. Right documentation
8. Right client
education
9. Drug- to- drug
interaction
10. Assess for allergy

Assess mental status
prior to and periodically
during therapy.

Monitor Blood
pressure and pulse
prior to and frequently
during the period of
dosage adjustment.
May cause QT and
changes on ECG

Observe patient
carefully when
administering
medication, to ensure
that medication is
actually taken and not
hoarded.

Monitor I&O ratios and
daily weight. Assess
patient for signs and
symptoms of
dehydration.

Monitor for
exacerbation of seizure
ADVERSE
EFFECTS
CONTRAINDICATION

CNS: Extra
pyramidal
symptoms such
muscle rigidity or
spasm, shuffling
gait, posture
leaning forward,
drooling ,
drowsiness,
sedation,
lethargy, and
dysphoria (a
decline in mood)
CV: Tachycardia,
arrhythmias,
hypertension
EENT: Blurred
vision
GI: Dr mouth,
nausea and
vomiting,
anorexia


Haloperidol is
contraindicated if the
patient has
hypersensitivity to any
of the drugs
components. It is also
contraindicated in
Parkinson disease
because cholinergic
stimulation in that
disorder is already
excessive.
activity.

Monitor for
development of
neuroleptic malignant
syndrome (fever,
respiratory distress,
tachycardia, seizures,
diaphoresis,
hypertension or
hypotension, pallor,
tiredness, severe
muscle stiffness, loss
of bladder control.
Report symptoms
immediately. May also
cause leukocytosis,
elevated liver function
tests, elevated CPK.

Do not increase dose
or discontinue
medication without
consulting health care
professional. Abrupt
withdrawal may cause
dizziness, nausea, and
vomiting, GI upset,
trembling, or
uncontrolled
movements of mouth,
tongue or jaw.
DRUG MECHANISM OF
ACTION
INDICATION NURSING
RESPONSIBILITIES

GENERIC NAME:
Risperidone


BRAND NAME:
Risperdal


CLASSIFICATION:
Atypical
Antipsychotic








FREQUENCY:
OD ( Once a day)


Mechanism may
be due to a
combination of
antagonism of
dopamine (D
2
)
and serotonin (5-
HT
2
) receptors.
Also has high
affinity for the
alpha
1
-, alpha
2
-,
and histamine
1

receptors.








To manage symptoms
of psychosis including
schizophrenia.


Observe for the ten
rights:
1. Assess for clients
History
2. Right patient
3. Right medication
4. Right dosage
5. Right route
6. Right time
7. Right documentation
8. Right client
education
9. Drug- to- drug
interaction
10. Assess for allergy




Maintain seizure
precautions, especially
when initiating therapy

ADVERSE
EFFECTS

CONTRAINDICATION

DOSAGE:
2 mg


ROUTE:
PO


Agitation, anxiety,
extrapyramidal
symptoms,
headache,
insomnia,
constipation,
dyspepsia,
weight gain,
rhinitis, dry
mouth, sexual
dysfunction,
orthostatic
hypotension.

Hypersensitivity,
lactation, dysrhythmias,
blood dyscrasias, liver
damage.
and increasing dosage.

Open blister units of
orally disintegrating
tablets individually; do
not push tablet through
the foil. Use dry hands
to remove tablet,
immediately place on
tongue. Do not allow
patient to chew tablet.

Monitor patient
regularly for signs and
symptoms of diabetes
mellitus.

Monitor temperature. If
fever occurs, rule out
underlying infection,
and consult physician
for appropriate comfort
measures.

Follow guidelines for
discontinuation or
reinstitution of the drug
carefully.

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