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MANONGSONG, ANTWERP TED R.

BSN124

PSYCHIATRIC DRUG STUDY

Generic/ Dosage Classification Indication Contraindication Side Effects Nursing


Trade Name / Responsibilities
Freque
ncy

ESKALITH 450mg Bipolar Disorder; Lithium carbonate Patients with severe Neuromuscular: >Patients
BID Depression; is indicated in the cardiovascular or tremor, muscle receiving such
Lithium Mania treatment of manic renal disease and hyperirritability,hyperto combined therapy
Carbonate episodes of manic- those with evidence nicity, ataxia, choreo- should have
depressive illness. of severe athetotic movements, serum lithium
Maintenance debilitation or hyperactive deep levels monitored
therapy prevents or dehydration, sodium tendon reflex, closely and the
diminishes the depletion, brain extrapyramidal lithium dosage
intensity of damage. Conditions symptoms including adjusted if
subsequent requiring low acute dystonia, necessary.
episodes in those sodium intake. cogwheel rigidity,
manic-depressive blackout spells, >It is essential for
patients with a epileptiform seizures, the patient to
history of mania. slurred speech, maintain a normal
dizziness, vertigo, diet, including
downbeat nystagmus, salt, and an
incontinence of urine or adequate fluid
feces, somnolence, intake (2500-3000
psychomotor ml.) at least
retardation, during the initial
restlessness, confusion, stabilization
stupor, coma, tongue period.
movements, tics,
tinnitus, hallucinations, >Avoid large
poor memory, slowed amounts of
intellectual functioning, caffeine-
startled response, containing foods
worsening of organic and beverages,
brain syndromes such as coffee,
tea, cocoa, cola
Cardiovascular: cardia drinks, and
c arrhythmia, chocolate. Avoid
hypotension, peripheral excessive
circulatory collapse, sweating caused
bradycardia, sinus node by hot weather,
dysfunction with severe hot baths, saunas,
bradycardia (which may or exercising.
result in syncope)

Gastrointestinal: anor
exia, nausea, vomiting,
diarrhea, gastritis,
salivary gland swelling,
abdominal pain,
excessive salivation,
flatulence, indigestion

Genitourinary: glycos
uria, decreased
creatinine clearance,
albuminuria, oliguria,
and symptoms of
nephrogenic diabetes
insipidus including
polyuria, thirst, and
polydipsia

Dermatologic: drying
and thinning of hair,
alopecia, anesthesia of
skin, acne, chronic
folliculitis, xerosis cutis,
psoriasis or its
exacerbation,
generalized pruritus
with of without rash,
cutaneous ulcers,
angioedema

Autonomic: blurred
vision, dry mouth,
impotence/sexual
dysfunction
THORAZIN 200mg Antipsychotic - The management Comatose or Automatic Nervous >Inform physician
Antiemetic of psychotic depressed states System: if antihistamines;
Chlorpromazi disorders including due to CNS dry mouth, blurred lithium (Eskalith,
ne manifestations of depressants; blood vision, constipation, Lithobid);
manic depressive dyscrasias; bone ileus, nasal stuffiness, medications for
illness, manic marrow depression; photophobia. Syncope depression,
phase and severe liver damage. and impaired Parkinson's
behavioral Hypersensitivity to temperature regulation disease, seizures,
problems in chlorpromazine. have also occurred. hay fever,
children; nausea Cross allergenicity allergies, or colds;
and vomiting due with other Cardiovascular: muscle relaxants;
to stimulation of phenothiazines may Its effects on the ECG narcotics (pain
the chemoreceptor occur. include prolongation of medication);
trigger zone. the PR and QT intervals, sedatives;
Should be avoided blunting of the T wave sleeping pills; and
in children or and depression of the S- vitamins.
adolescents with T segment. Ventricular
signs or symptoms arrythmia and sudden >You should know
suggestive of Reye's death have occurred that this drug
Syndrome. Its rarely. may make you
antiemetic effect drowsy. Do not
may mask the signs Orthostatic drive a car or
and its CNS effect hypotension,tachycardi operate
may be confused a, fainting and dizziness machinery until
with the signs of have also occurred. you know how
Reye's Syndrome or Hypotension can also this drug affects
other occur after oral you.
encephalopathies. administration.
>Remember that
CNS: alcohol can add to
Extrapyramidal the drowsiness
reactions, including caused by this
pseudoparkinsonism drug.
(with motor retardation,
rigidity, mask like >Plan to avoid
facies, pill rolling and unnecessary or
other tremors, drooling, prolonged
shuffling gait, etc.); exposure to
dystonic reactions sunlight and to
(including periroral wear protective
spasms, trismus, tics, clothing,
torticollis, oculogyric sunglasses, and
crises, protrusion of the sunscreen.
tongue, difficulty Chlorpromazine
swallowing, carpopedal may make your
spasm, opisthotonos of skin sensitive to
the back muscles); and sunlight.
akathisia,tardive
dyskinesia

Dermatologic:
Itching, rash,
hypertrophic papillae of
the tongue,
angioneurotic edema,
erythema, allergic
purpura, exfoliative
dermatitis,
photosensitivity.

Endocrine:
Increased prolactin
secretion;
gynecomastia,
galactorrhea,
mastalgia, altered
libido, menstrual
irregularities, weight
gain, alterations in
glucose tolerance and
false positive
pregnancy tests have
occurred.

Gastrointestinal:
Nausea, vomiting,
increase or decrease in
appetite, gastric
irritation, constipation,
paralytic ileus, rarely
diarrhea. Dry mouth.

Genitourinary:
Urinary retention,
priapism, inhibition of
ejaculation.

Hematologic:
Agranulocytosis,
leukopenia,
granulocytopenia,
eosinophilia,
thrombocytopenia,
anemia, aplastic
anemia, pancytopenia,
agranulocytosis

Neuroleptic
Malignant Syndrome

NOZINAN 1 tab Antipsychotics, A Treatment of Hypotension, >The change


nalgesics (Non- schizophrenia, orthostatic hypotension, seats injection
Levomeprom Opioid) & depression and Comatose state, due to the
tachycardia, QT
azine Antipyretics other mental severe CNS potential for local
prolongation;
illnesses depression, photosensitivity, rash; tissue reaction.
phaeochromocytom gynaecomastia, wt
Management and a, blood dyscrasia. >A systematic
gain, irregular
control of pain analysis of the
menstruation, changes
blood and monitor
in libido;
To intensify the liver function.
extrapyramidal effects,
effects of
dizziness, seizure,
anesthetics >To prevent
headache, drowsiness, collapse within 30
Treatment of neuroleptic malignant minutes after the
nausea and syndrome, interference injection to the
vomiting with temperature horizontal
regulation; constipation, position.
Treatment of nausea, vomiting, ileus;
insomnia urinary retention, > Patients
ejaculatory disorders, receiving
incontinence, polyuria, levomepromazin
priapism; blood should refrain
dyscrasias; jaundice, from the use of
hepatotoxicity. alcohol and
Potentially potentially
Fatal: Arrhythmias. dangerous
Severe orthostatic activities (driving,
hypotension machinery).

CLOZARIL 25mg 1 Antipsychotic Treatment- Hypersensitivity to Agranulocytosis:


tab BID refractory clozapine or any Therapy should not be
Clozapine Atypical schizophrenia; to component of the initiated in patients with >Use exactly as
Antipsychotic reduce risk of formulation; history WBC <3500 directed; do not
recurrent suicidal of agranulocytosis cells/mm3 or ANC increase dose or
Second- behavior in or granulocytopenia <2000 cells/mm3 or frequency.
Generation
Antipsychotic schizophrenia or with clozapine; history of >Do not
schizoaffective uncontrolled myeloproliferative discontinue this
disorder epilepsy, severe disorder. Eosinophilia medication
central nervous has been reported to without consulting
system depression occur with clozapine prescriber.
or comatose state; and may require
paralytic ileus; temporary or > Avoid alcohol or
myeloproliferative permanent interruption caffeine and other
disorders or use of therapy. prescription or
with other agents OTC medications
which have a well- Anticholinergic not approved by
known risk of effects: constipation, prescriber.
agranulocytosis or xerostomia, blurred
bone marrow vision, urinary >Maintain
suppression retention; use with adequate
caution in patients with hydration unless
decreased instructed to
gastrointestinal restrict fluid
motility, paralytic ileus, intake.
urinary retention, BPH,
xerostomia, or visual >If you have
problems. diabetes, monitor
blood glucose
Cardiovascular levels frequently.
events: Myocarditis,
pericarditis, pericardial >You may
effusion, experience
cardiomyopathy, and headache, excess
HF have also been drowsiness,
associated with dizziness, or
clozapine. Myocarditis blurred vision
or cardiomyopathy (use caution
should be considered in driving or when
patients who present engaging in tasks
with signs/symptoms of requiring
heart failure (dyspnea, alertness until
fatigue, orthopnea, response to drug
paroxysmal nocturnal is known);
dyspnea, peripheral
> You may be
edema), chest pain,
palpitations, new prone to
infections; report
electrocardiographic
abnormalities fever, sore throat
or other possible
(arrhythmias, ST-T
wave abnormalities), or signs of infection.
unexplained fever. >Report
Extrapyramidal persistent CNS
symptoms (EPS): May effects (insomnia,
cause extrapyramidal depression,
symptoms, including altered
pseudoparkinsonism, consciousness);
acute dystonic palpitations, rapid
reactions, akathisia, heartbeat, severe
and tardive dyskinesia dizziness; vision
(risk of these reactions changes;
is generally much lower
relative to >Breast-feeding
typical/conventional precaution: Breast
antipsychotics). Risk of -feeding is not
dystonia (and probably recommended.
other EPS) may be
greater with increased
doses, use of
conventional
antipsychotics, males,
and younger patients.

Hyperglycemia: may
be extreme and
associated with
ketoacidosis,
hyperosmolar coma, or
death. Use with caution
in patients with
diabetes or other
disorders of glucose
regulation; monitor for
worsening of glucose
control.

Neuroleptic
malignant syndrome
(NMS): monitor for
mental status changes,
fever, muscle rigidity
and/or autonomic
instability.

• Orthostatic
hypotension:
hypotensive episodes
(cerebrovascular
disease, cardiovascular
disease, hypovolemia,
or concurrent
medication use which
may predispose to
hypotension/bradycardi
a).

Sedation: CNS
depression is a feature;
patients must be
cautioned about
performing tasks which
require mental
alertness (eg, operating
machinery or driving).
Use with caution in
patients receiving
general anesthesia.

Seizures: use with


caution in patients at
risk of seizures,
including those with a
history of seizures,
head trauma, brain
damage, alcoholism, or
concurrent therapy with
medications which may
lower seizure threshold.
Elderly patients may be
at increased risk of
seizures due to an
increased prevalence of
predisposing factors.

Suicidal ideation: The


possibility of a suicide
attempt is inherent in
psychotic illness or
bipolar disorder

Temperature
regulation: Impaired
core body temperature
regulation may occur;
caution with strenuous
exercise, heat
exposure, dehydration

Thromboembolism:
Rare cases of
thromboembolism,
including pulmonary
embolism and stroke
resulting in fatalities,
have been associated
with clozapine in
patients with
cardiovascular disease.

Weight gain:
Significant weight gain
has been observed with
antipsychotic therapy;
incidence varies with
product. Monitor waist
circumference and BMI.