NAME OF

DRUG

INDICATIONS

Generic Name:
Amisulpride

It is used to treat
an illness called
schizophrenia.

Brand Name:
Solian
Classification:
Antipsychotic
Dosage:
200mg BID
Route:
Oral

Schizophrenia can
make you feel, see
or
hear things which
do not exist, have
strange
and
frightening
thoughts,
change
how
you act, and make
you feel alone.
Sometimes people
with
these
symptoms
may
also
feel
tense, anxious or
depressed.
Solian works by
improving
disturbed
thoughts, feelings
and behaviour. It is
used
to
treat
schizophrenia when
it starts and
also over the long
term.

CONTRADICTIONS

Phaeochromoc
ytoma
concomitant
prolactindependent
tumours (e.g.
pituitary gland
prolactinomas
or breast
cancer).
Pre-pubertal
children
Combination w/
levodopa.

MECHANISM OF ACTIONS

SIDE EFFECTS

NURSING
RESPONSIBILITIES

Amisulpride is a substituted
benzamide atypical
antipsychotic which binds
selectively w/ a high affinity to
human dopaminergic D2 and
D3 receptor subtypes.

Insomnia, anxiety,
agitation,
drowsiness, wt
gain, acute
dystonia,
parkinsonism,
akathisia, tardive
dyskinesia, QT
prolongation,
hypotension,
bradycardia, GI
disorders (e.g.
constipation,
nausea, vomiting,
dry mouth),
hyperglycaemia;
breast pain,
erectile
dysfunction,
amenorrhoea,
gynaecomastia,
galactorrhoea.
Rarely, allergic
reactions,
abnormal LFTs,
seizures.

Take this medicine

by mouth
Swallow the
tablets whole with a
drink of
water. Do not chew
your tablets
Take before a meal
If you feel the
effect of your
medicine is
too weak or too
strong, do not
change
the dose yourself,
but ask your doctor

For elderly, your

doctor will need to
keep a close check
on you as you are
more likely to
have low blood
pressure or
sleepiness due to
this medicine
People with
kidney problems,
your doctor may
need to give you a
lower dose

NAME OF
DRUG

INDICATIONS

Generic Name:
Akidin

Symptomatic
treatment
of
parkinsonism
&
alleviation
of
extrapyramidal
syndrome by drugs
eg phenothiazines.

Brand Name:
Biperiden
Classification:
Antiparkinsonian
Drugs
Dosage:
2mg BID
Route:
Oral

CONTRADICTIONS

Prostatic
enlargement,
paralytic ileus
or pyloric
stenosis
ulcerative
colitis,
angle-closure
glaucoma
myasthenia
gravis.

MECHANISM OF ACTIONS

SIDE EFFECTS

NURSING
RESPONSIBILITIES

Biperiden binds competitively

to peripheral and central
muscarinic receptors. In vitro,
it has a higher affinity for the
M1 receptor compared to the
M2 muscarinic receptor subtype. Although the clinical
significance of this selectivity
has not been established, it
may account for lower
peripheral side effects in those
tissues where M2 receptors
predominate.

Dry mouth w/
difficulty in
swallowing &
talking, thirst,
reduced bronchial
secretions,
mydriasis,
cycloplegia &
photophobia,
flushing & dryness
of the skin,
transient
bradycardia
followed by
tachycardia w/
palpitation &
arrhythmias &
difficulty in
micturition as well
as reduction in the
tone & motility of
the GIT leading to
constipation.

Asses pt for the ff:

Diarrhea, fever,
thyrotoxicosis,
heart failure,
cardiac surgery,
acute MI & HTN.
Gradual increase
in dosage. Avoid
abrupt w/drawal.
May impair ability
to drive or operate
machinery. Childn.
Elderly.

NAME OF
DRUG

INDICATIONS

CONTRADICTIONS

MECHANISM OF ACTIONS

SIDE EFFECTS

Generic Name:
escitalopram
oxalate

Management
of
generalized anxiety
disorder,
obsessivecompulsive
disorder,
panic
disorder w/ or w/o
agoraphobia, social
phobia
&
posttraumatic
stress
disorder.

Use of MAOI w/in past

14 days.

The mechanism of
antidepressant action of
escitalopram, the Senantiomer of racemic
citalopram, is presumed to be
linked to potentiation of
serotonergic activity in the
central nervous system (CNS)
resulting from its inhibition of
CNS neuronal reuptake of
serotonin (5-HT).

Dry mouth,
anorexia, wt loss,
neurological
disorders & GI
disturbances.

Brand Name:
Feliz S
Classification:
Antidepressants
Dosage:
1 tab NN
Route:
Oral

NURSING
RESPONSIBILITIES

Special
Precautions
Increase risk of
suicidality in
childn &
adolescents w/
major depressive
disorder & other
psychiatric
disorders.
Avoid abrupt
w/drawal.
Epilepsy or history
of such disorders,
cardiac disease,
diabetes
History of bleeding
disorders.
Discontinue use if
seizures develop
or when seizure
frequency is
increased.

NAME OF
DRUG

INDICATIONS

Generic Name:
Diphenhydramin
e

Allergic conditions;
Treatment
and
prophylaxis
of
motion
sickness
25-50
mg
3-4
times/day.
Max:
300
mg/day.
Parkinsons disease
Initial: 25 mg tid,
may increase to 50
mg 4 times/day.
Short-term
management
of
insomnia 50 mg 30
min
before
bedtime.
IM/IV
Allergic conditions;
Treatment
and
prophylaxis
of
motion
sickness;
Parkinsons disease
As 1% or 5% soln:
10-50 mg, up to
100 mg. Max: 400
mg/day.
Topical
Pruritic
skin
disorders As 1% or
2%
cream/gel/soln/stic
k: Apply to affected
area up to 3-4
times/day.

Brand Name:
Classification:
Antihistamines &
Antiallergics
Dosage:
50mg PRN
Route:
Oral

CONTRADICTIONS

Asthma,
narrow angle
glaucoma,
prostatic
hypertrophy,
stenosing
peptic ulcer,
pyloroduodenal
obstruction or
bladder neck
obstruction,
porphyria.
Neonates or
premature
infants
Lactation

MECHANISM OF ACTIONS

SIDE EFFECTS

Diphenhydramine is an
antihistamine w/
anticholinergic and sedative
effects. It competes w/
histamine for H1-receptor sites
on effector cells in the GI tract,
blood vessels and resp tract.

Chest tightness,
extrasystoles,
hypotension,
palpitations,
tachycardia;
ataxia, chills,
confusion,
dizziness,
drowsiness,
euphoria,
excitement,
fatigue, headache,
insomnia,
irritability,
nervousness,
neuritis,
paraesthesia,
paradoxical
excitation,
restlessness,
sedation, seizure,
vertigo;
diaphoresis;
menstrual
disease; GI
disturbances (e.g.
anorexia,
constipation,
diarrhoea);
difficulty in
micturition,
urinary frequency,
urinary retention;
agranulocytosis,
haemolytic
anaemia,
thrombocytopenia
; anaphylactic
shock; tremor;
blurred vision,
diplopia; acute
labyrinthitis,
tinnitus;

NURSING
RESPONSIBILITIES

Special
Precautions
Patient w/
glaucoma, urinary
retention,
myasthenia
gravis, epilepsy or
seizure disorders,
bronchitis or
COPD, CV disease,
thyroid
dysfunction.
Hepatic and
moderate to
severe renal
impairment.
Pregnancy.

constriction of
pharynx, nasal
congestion,
thickening of
bronchial
secretions,
wheezing;
photosensitivity,
rash, urticaria
(topical).

NAME OF
DRUG

INDICATIONS

CONTRADICTIONS

MECHANISM OF ACTIONS

SIDE EFFECTS

NURSING
RESPONSIBILITIES

Generic Name:
Clonazepam
Brand Name:
Rivotril
Classification:
Anticonvulsants
Dosage:
2mg HS
Route:
Oral

Epilepsy
Initial: 1 mg at
night for 4 days,
gradually increased
over
2-4
wk.
Maintenance:
4-8
mg/day. Max: 20
mg/day.
Panic
disorder
Initial:
0.25
mg
bid,
increased after 3
days
up
to
1
mg/day. Max: 4
mg/day.
IV
Emergency
treatment of status
epilepticus 1 mg by
slow IV inj over at
least 2 min or by
infusion. Max: 20
mg.

acute angle
closure
glaucoma
acute
pulmonary
insufficiency,
severe resp
insufficiency,
myasthenia
gravis
sleep apnoea
syndrome.

Clonazepam reduces the

nerve transmission in the
motor cortex which
suppresses the spike and
wave discharge in absence
seizures. Its mechanism is
believed to be related to its
ability to enhance the activity
of GABA. Clinically, it improves
focal epilepsy and generalised
seizures.

Drowsiness or
sedation, fatigue,
muscular
hypotonia,
behavioural
disturbances
including
aggressiveness,
agitation,
hyperkinesis and
irritability;
coordination
disturbances,
dizziness, vertigo,
anorexia, visual
disturbances,
libido changes;
rhinorrhoea, chest
congestion and
shortness of
breath; skin rash,
hair loss,
hirsutism, and
ankle and facial
oedema;
diarrhoea,
constipation, wt
gain or loss,
abnormal thirst,
encopresis,
gastritis,
increased or
decreased
appetite,
dyspepsia,
nausea, coated
tongue, dry
mouth, sore gums;
nocturia, dysuria,
enuresis, urinary
retention. Salivary
or bronchial
hypersecretion
leading to resp
problems (childn).
Rarely, abnormal

Special
Precautions
Patient w/ open
angle glaucoma,
chronic pulmonary
insufficiency,
porphyria, spinal
or cerebellar
ataxia, history of
alcohol or drug
addiction, and
depression and/or
suicide attempts.
Increased risk of
suicidal behaviour
and ideation.
Avoid abrupt
withdrawal. Renal
and hepatic
impairment.
Elderly or
debilitated
patient. Pregnancy
and lactation.

skin pigmentation.

NAME OF
DRUG

INDICATIONS

CONTRADICTIONS

MECHANISM OF ACTIONS

SIDE EFFECTS

NURSING
RESPONSIBILITIES

Generic Name:
fluphenazine
decanoate
Brand Name:
No brands
available.
Classification:
Antipsychotic

Long-acting
treatment
of
certain mental or
mood
disorders
(eg, schizophrenia).

Dosage:
0.55 cc
Route:
IM

you are allergic

to any
ingredient in
fluphenazine
decanoate or
to other
phenothiazines
(eg,
thioridazine)
you have
certain types of
brain damage,
liver damage,
severe
drowsiness, or
blood problems
you have
recently taken
large amounts
of alcohol or
medicines that
may cause
drowsiness,
such as
barbiturates
(eg,
phenobarbital)
or narcotic pain
medicines (eg,
codeine)
you are taking
astemizole,
cabergoline,
cisapride,
metoclopramid
e, pergolide,
terfenadine, or
tramadol

Fluphenazine blocks
postsynaptic mesolimbic
dopaminergic D1 and D2
receptors in the brain;
depresses the release of
hypothalamic and
hypophyseal hormones and is
believed to depress the
reticular activating system
thus affecting basal
metabolism, body
temperature, wakefulness,
vasomotor tone, and emesis.

Agitation
Constipatio
n
Dizziness
Drowsiness
dry mouth
enlarged
pupils
headache
jitteriness
loss of
appetite
nausea
stuffy
nose.

Seek medical
attention right away
if any of these
SEVERE side effects
occur:
Severe allergic
reactions (rash;
hives; itching;
difficulty breathing;
tightness in the
chest or throat;
swelling of the
mouth, face, lips, or
tongue; unusual
hoarseness;
wheezing); chest
pain; confusion;
decreased
coordination;
drooling; fainting;
fast, slow, or
irregular heartbeat;
mask-like face;
muscle spasms of
the face, neck, or
back; muscle
weakness; new or
worsening mental or
mood problems;
numbness of an arm
or leg; prolonged or
painful erection;
restlessness;
seizures; severe or
persistent
constipation; severe
or persistent
dizziness,
drowsiness, or
headache; shuffling
walk; sleeplessness;
stiff or rigid
muscles; sudden
shortness of breath
or vomiting; swelling

of the hands,
ankles, or feet;
symptoms of
infection (eg, fever,
chills, persistent
sore throat);
symptoms of liver
problems (eg,
yellowing of the skin
or eyes; dark urine;
pale stools; severe
or persistent
nausea, stomach
pain, or loss of
appetite); tremors;
trouble urinating;
twisting or twitching
movements;
uncontrolled muscle
movements (eg,
twitching of the face
or tongue; loss of
balance;
uncontrolled
movements of arms
or legs; trouble
speaking, breathing,
or swallowing);
unusual bruising or
bleeding; unusual
eye movements or
inability to move
eyes; unusual or
excessive sweating;
unusual tiredness or
weakness; unusually
pale skin; vision
changes (eg, blurred
vision).

NAME OF
DRUG

INDICATIONS

Generic Name:
Chlorpromazine

Chlorpromazine is
used virtually in all
types of psychoses.
It can be combined
with other antipsychotics.
Chlorpromazine is
also used to control
anxiety or agitation
in
certain
patients,to relieve
a wide range of
drug or disease
induced vomiting,
and
in
severe
hiccups.
Chlorpromazine is
also used in the
treatment
of
tetanus
in
combination
with
other drugs.
Acute
and
chronic
psychoses,
particularly
when
accompanie
d
by
increased
psychomoto
r
activity.
Nausea and
vomiting.
Also used in
the
treatment of
intractable
hiccups.

Brand Name:
Thorazine
Classification:
Antipsychotic,
Antiemetics
Dosage:
50mg 2x/wk
Route:
Oral

CONTRADICTIONS

Hypersensitivity.

Cross-sensitivity
may exist among
phenothiazines.
Should not be used
in narrow-angle
glaucoma.

Should not be used

in patients who
have CNS
depression.

Coma

bone-marrow
suppression

phaeochromocyto
ma

lactation.

MECHANISM OF ACTIONS

SIDE EFFECTS

NURSING
RESPONSIBILITIES

Chlorpromazine is a
neuroleptic that acts by
blocking the postsynaptic
dopamine receptor in the
mesolimbic dopaminergic
system and inhibits the
release of hypothalamic and
hypophyseal hormones. It has
antiemetic, serotonin-blocking,
and weak antihistaminic
properties and slight ganglionblocking activity.
Onset: 15 min (IM); 30-60 min
(oral).

Blurred vision;
constipation;
dizziness;
drowsiness; dry
mouth; light
sensitivity; nasal
congestion.
Severe allergic
reactions (rash;
hives; itching;
difficulty
breathing;
tightness in the
chest or throat;
swelling of the
mouth, face,
lips, or tongue);
changes in
breasts; changes
in menstrual
period; changes
in vision; chest
pain; chills;
confusion;
difficulty
swallowing;
difficulty
urinating;
drooling;
extreme
tiredness; fever;
inability to move
eyes;
involuntary
movements of
the face, mouth,
tongue, or jaw;
jitteriness; lip
smacking or

1, Assess mental
status prior to and
periodically during
therapy. So that the
nurse can determine
major or minor
changes after drug has
been taken.
2. Monitor BP and
pulse prior to and
frequently during the
period of dosage
adjustment. May
cause QT interval
changes on ECG.
R: to observe for any
changes relevant.
3. The drug may be
taken with or without
food.
R: May be taken w/
meals to reduce GI
discomfort.
4. Observe patient
carefully when
administering
medication.
R: to ensure that
medication is actually
taken and not
hoarded.
5. Monitor I&O ratios
and daily weight.
R: Assess patient for
signs and symptoms
of dehydration.
6. 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.

Absorption: Readily but

sometimes erratically
absorbed from the GI tract
(oral); peak plasma
concentrations after 2-4 hr.
Distribution: Widely
distributed; crosses the bloodbrain barrier and placenta;
enters breast milk.
Metabolism: Extensively
hepatic by hydroxylation and
conjugation with glucuronic
acid, N-oxidation, oxidation of
a sulfur atom and dealkylation.
Excretion: Urine and faeces
(as active and inactive
metabolites); 30 hr
(elimination half-life).

Block dopamine
receptors in the brain;
also alter dopamine
release and turnover.
Prevention of seizures

puckering;
mask-like face;
muscle spasms
of the face,
neck, or back;
prolonged or
painful erection;
puffing of
cheeks; rigid
muscles;
seizures;
shuffling walk;
skin
discoloration;
sleeplessness;
sore throat; stiff
arms or legs;
tremors of
hands; twitching
or twisting
movements;
weakness of
arms or legs;
yellowing of the
skin or eyes

Report symptoms
immediately. May also
cause leukocytosis,
elevated liver function
tests, elevated CPK.
R: to be able to watch
out for any changes,
and report to
physician these
changes
7. Advise patient to
take medication as
directed. Take missed
doses as soon as
remembered, with
remaining doses
evenly spaced through
out the day.
R: Missed doses may
require several weeks
to obtain desired
effects.
8. Do not increase
dose or discontinue
medication without
consulting health care
professional.
R: Abrupt withdrawal
may cause dizziness,
nausea, vomiting, GI
upset, trembling, or
uncontrolled
movements of mouth,
tongue or jaw.
9. Instruct patient to
report significant
changes in
neurological status,
such as seizures,
extreme lethargy,
slurred speech,
disorientation or
ataxia.
R: To report to the
physician and to be
able to do some
precautions.
10. Monitor kidney and
liver function of the
patient.
R: Observe for signs of

hepatic toxicity.
Monitor laboratory
blood work such as
platelets, PT, PTT, and
liver enzymes
11. Monitor
cardiovascular status
of the patient.
R: To be able to
observe for
hypertensive crisis
and signs of
impending stroke or
M.I.: severe headache,
dizziness,
paresthesias,
bradycardia,
tachycardia,
nausea/vomiting,
diaphoresis.
12. Watch out for
somnolence, coma,
hypotension and
extrapyramidal
symptoms, agitation
and restlessness,
convulsions, fever,
autonomic reactions
such as dry mouth and
ileus, EKG changes
and cardiac
arrhythmias.
R: These are signs of
over dosage of
Chlorpromazine.
Treatment is
symptomatic and
supportive. Early
gastric lavage may be
helpful. Observe
patient and maintain
an open airway.
13. Store
Intramuscular
injections of
Chlorpromazine at 1530C and oral dosages
at 15-30C.
R: To maintain potency
and effectivity of
Chlorpromazine.

14. Take special

precautions with
patients with
Parkinson's disease,
CV disease, renal or
hepatic impairment,
cerebrovascular and
respiratory disease,
jaundice, DM,
hypothyroidism;
paralytic ileus.
Prostatic hyperplasia
or urinary retention;
epilepsy or history of
seizures; myasthenia
gravis; pregnancy;
elderly (especially with
dementia),and
debilitated patients.
Instruct the patients to
avoid direct sunlight.
R: Side and adverse
effects of
Chlorpromazine occur
severely with these
patients. Sunlight can
cause an allergic
reaction to the patient.