Generic Name Classification Action Indication Contraindication Drug Interaction Nsx Action

Avoid afternoon doses to prevent insomnia

Enhances action of
dopamine, norepinephrine
by blocking absorption from
the synapses
PHARMACOLOGIC CLASS:
Amphetamine Facilitates release of
Amphetamine (Schedule II) cathecolamines
THERAPEUTIC CLASS: Increases motor activity,
CNS stimulants mental alertness
Decreases drowsiness,
fatigue, and suppresses
appetite
Parenteral theophylline for acute
PHARMACOLOGIC DRUG:
Xanthine derivatives
Theophylline
bronchospasm in Px not currently
THERAPEUTIC CLASS:
Bronchodilators
Depresses sensory cortex
PHARMACOLOGIC CLASS: Decreases motor activity
Barbiturate (Schedule IV)
Phenobarbital
Alters cerebellar function
THERAPEUTIC CLASS:
Anticonvulsant ; hypnotic Induces drowsiness,
sedation, anticonvulsant
activity
Hypersensitivity to
dextroamphetamine, amphetamine, or
sympathomimetics
Px with moderate to severe
hypertension
doxepin, nortriptyline), sympathomimetics.
Narcolepsy
Px with hyperthyroidism
ADHD
Px with symptomatic CV disease
Px with glaucoma
Advanced arteriosclerosis
Px with history of drug abuse
bronchospasm in patients not
currently receiving theophylline
Oral theophylline for acute
receiving theophylline
Chronic bronchospasm using
extended-release preparations
Hypersensitivity to PHENobarbital or
other barbiturates
Porphyria
Status Epilepricus
Dyspnea or airway obstruction
Seizure Control (Maintenance)
in nephritic pxs
Severe hepatic impairment
Pxs with history of sedative/hypnotic
addiction
— take early in day
Monitor for CNS overstimulation, increase
of BP, change in pulse and respiratory rate,
May enhance effects of tricyclic
and weight loss
antidepressants (e.g., amitriptyline,
Narcolepsy: Observe/document frequency
of narcoleptic episodes
MAOIs (e.g., phenelzine, selegiline) may
prolong, intensify effects.
ADHD: observe for improved attention span
May antagonize effects of hypotensive
Teach Px to avoid alcohol and caffeine
agents.
Instruct Px to report pronounced anxiety,
dizziness, decreased appetite, dry mouth,
new or old worsening behaviors, chest pain,
or palpitations
Monitor CNS status, seizure activity,
hepatic/renal function
Monitor respiratory rate, heart rate, BP
Alcohol, other CNS depressants (e.g.,
LORazepam, morphine): may increase
Monitor for therapeutic serum level
effects.
Instruct patient to avoid alcohol and limit
May decrease effects of warfarin, oral
caffeine
contraceptives.
Do not discontinue abruptly
Valproic acid may increase concentration,
risk of toxicity
Avoid tasks that require alertness, motor
skills
HIGH ALERT DRUG

Potentiates the effects of
PHARMACOLOGIC CLASS: GABA
Benzodiazepines
Diazepam
Depress the CNS
THERAPEUTIC CLASS:
Anxiolytics Suppresses the spread of
seizure activity
Phenytoin PHARMACOLOGIC CLASS: Stabilizes neuronal
Hydantoin derivatives membranes
THERAPEUTIC CLASS: Limits seizure activity by
Anticonvulsant either increasing efflux or
decreasing influx of sodium
ions across cell membranes
in the motor cortex during
generation of nerve impulses
Anxiety
Acute alcohol withdrawal
Before endoscopic procedures
Muscle spasm
Preoperative sedation
Adjunctive treatment for seizure
disorder
Status epilepticus, severe recurrent
seizures
Px on stable regimens of
antiepileptic drugs who need
diazepam intermittently to control
bouts of increased seizure activity
Tetanus
To control tonic-clinic (grand mal)
and complex partial (temporal
lobe) seizures
To control tonic-clinic (grand mal)
and complex partial (temporal
lobe) seizures in Px requiring a
loading dose
To prevent and treat seizures
occurring during neurosurgery
Status epilepticus
Px hypersensitive to drug
Infants younger than age 6
Px with Myasthenia Gravis, severe
respiratory insufficiency, severe hepatic
insufficiency, or sleep apnea syndrome
In Px with acute angle-closure glaucoma
Px with hypersensitivity to hydantonin
Px taking delavirdine
Px with history of acute hepatoxicity
attributable to phenytoin
Parenteral phenytoin in Px with sinus
bradycardia, SA block, second or third
degree AV block, or Adam’s Stroke
Syndrome
Cimetidine, disulfiram, fluoxetine,
fluvoxamine, hormonal contraceptives,
isoniazid, metoprolol,propranolol, valproic
acid: may decrease clearance of diazepam
and increase risk of adverse effects
LOOK ALIKE-SOUND ALIKE DRUG: don’t
confuse with diazoxide or ditropan.
CNS depressants: May increase CNS
depression
Periodically monitor LFTs, CBC, and renal
function
Digoxin: May increase digoxin level and risk
of toxicity
Monitor HR, BP, and mental status changes
Diltiazem: May increase CNS depression and
Do not leave drug with patient as it may be
prolong effects of diazepam
addicting
Fluconazole, itraconazole, ketoconazole,
Warn patient to report all adverse reactions
miconazole: May increase and prolong
and to avoid activities that require alertness
diazepam level, CNS depression, and
psychomotor impairment
Levodopa: May decrease levodopa
effectiveness
Acetaminophen: May decrease the Carefully monitor cardiac status before and
therapeutic effect of acetaminophen and after administration
may increase the incidence of hepatoxicity
Asian Px who are + for allele HLA-B*1502
Amiodarone, antihistamines, have potentially increased risk for skin
chloramphenicol, cimetidine (life- reactions — monitor carefully
threatening), cycloserine, diazepam,
fluconazole (life-threatening), isoniazid (life- Stop drug if rash appears; resume once rash
threatening), metronidazole, omeprazole, clears; if rashes resurface, stop therapy
phenylbutazone, salicylates, sulfonamides
(life-threatening), ticlopidine (life- Do not abruptly stop drug— may worsen
threatening), valproate: May increase seizure
phenytoin activity and toxicity.
Monitor for adverse reactions
Atracurium, cisatracurium, pancurium,
rocurnium, vecuronium: (all rapid onset) Monitor drug level
May decrease the effects of nondepolarizing
muscle relaxant Closely monitor all Px for changes in
behavior that may indicate worsening of
Barbiturates, carbamazepine, suicidal thoughts or depression
dexmethasone, diazoxide, folic acid,
rifampin: May decrease phenytoin activity Instruct Px to report all adverse reactions
and to report if rashes develop
Carbamazepine, cardiac glycosides,
doxycycline, quinidine, theophylline, Advise Px and caretaker to immediately
valporic acid: May decrease effects of these report changes in behavior
drugs
Advise Px to avoid driving or doing other
Colesevalam: May impair phenytoin activities that require mental alertness until
absorption drug’s CNS effects are known
Corticosteroids: May decrease phenytoin No abruptly stopping of drug
level and corticosteroid effects
 Cyclosporine: life-threatening; May
decrease cyclosporine levels, risking organ
rejection

Delavirdine: May cause loss of virologic

response

Disulfiram: May increase toxic effects of

phenytoin

Efavirenz, Erlotinib: May increase phenytoin

levels and decrease drug levels
Hormonal drug level: may decrease
contraceptive effectiveness and increase
phenytoin levels
LOOK ALIKE-SOUND ALIKE DRUG: don’t
confuse with mephenytoin, fosphenytoin,
phenelzine, phentermine, or phenobarbital.

Isoniazid, Methylphenidate: May increase

phenytoin levels

Lithium: May increase toxicity of lithium

Protease inhibitors: May increase level of

both drugs

Warfarin: May increase effects of warfarin

Generic Name Classification Action Indication Contraindication Drug Interaction Nsx Action

Gabapentin            

Tensilon            
Quinine            

Carbidopa-            
Levodopa

Donepezil