Drug Name Dosage Action Indication Contradiction Side Effects Nursing Responsibilities

Generic Name: PO (adults): Alters the effect Second-line Hypersensitivity: CNS: neuroleptic Assess mental status
Psychoses – of dopamine in treatment for hypersensitivity to malignant syndrome, (orientation, mood,
CHLORPROMAZIN 10-25mg 2-4 the CNS. Has schizophrenia and sulphites sedation, behavior) prior to and
E times daily; significant psychosis after (injectable) or extrapyramidal periodically during therapy
may increase anticholinergic / failure with benzyl alcohol reactions, tardive
Brand Name: every 3-4 days alpha-adrenergic atypical (sustained-release dyskinesia. Assess weight and BMI
LARGACTIL (usual dose is blocking antipsychotics. capsules); cross- initially and throughout
200 mg/day; activity. sensitivity with EENT: blurred therapy
Classification: up to 1 g’ Hyper excitable, other vision, dry eyes, lens
combative phenothiazines opacities. Assess fasting blood glucose
Therapeutic: behavior in may occur; angle- and cholesterol levels
antiemetics, children. closure glaucoma; CV: hypotension, initially and periodically
antipsychotics bone marrow tachycardia throughout therapy. Refer as
Nausea and depression; severe appropriate for nutritional /
Pharmacologic: vomiting. liver/cardiovascular GI: constipation, dry weight and medical
phenothiazines Intractable disease; concurrent mouth, anorexia, management
hiccups. pimozide use. hepatitis, ileus,
PREGNANCY Preoperative priapism. Assess positive
CATEGORY: C sedation. Acute (hallucinations, delusions,
intermittent GU: urinary agitation) and negative
porphyria. retention. (social withdrawal)
symptoms of schizophrenia
DERM:
photosensitivity, Monitor blood pressure
leukopenia (sitting, standing, lying),
pulse, and respiratory rate
METAB: prior to and frequently
hyperthermia during the period of dose
adjustment
MISC: Allergic
reaction Observe patient carefully
when administering
medication to ensure
medication is actually taken
and not hoarded.

Assess fluid intake and

bowel function. Increased
bulk and fluids in the diet
may help minimize
constipation

Monitor patient for onset of

akathisia (restlessness or
desire to keep moving) and
extrapyramidal side effects
(parkinsonian- difficulty
speaking and swallowing,
loss of balance control, pill
rolling of hands, mask-like
face, shuffling gait, rigidity,
tremors; and dystonic –
muscle spasm, twisting
motion, twitching, inability
to move eyes, weakness of
arms or legs)

Monitor for development of

neuroleptic malignant
syndrome (fever, respiratory
distress, tachycardia,
convulsions, diaphoresis,
hypertension or hypotension,
pallor, tiredness, severe
muscle stiffness, loss of
bladder control), report these
symptoms immediately.
 DRUG STUDY
Drug Name Dosage Action Indication Contraindication Side Effects Nursing Responsibilities
Generic Name: PO (Adults): Alters the Acute and chronic Hypersensitivity; CNS: seizures, Assess mental status
Moderate effects of psychotic angle closure extrapyramidal (orientation, mood
HALOPERIDOL disease, 0.5-2 dopamine in the disorders glaucoma; bone reactions, confusion, behavior) prior to and
mg q8-12hr CNS. Also has including marrow depression; drowsiness, periodically during therapy.
Brand Name:
SERENACE initially anticholinergic schizophrenia, CNS depression; restlessness, tardive
and alpha- manic states, severe liver or dyskenia Assess positive
Classification: Severe disease, adrenergic drug-induced cardiovascular (hallucinations, delusions,
Therapeutic: 3-5 mg q8- blocking psychoses. disease (Q-T EENT: blurred agitation) and negative
antipsychotics (social withdrawal)
12hr initially; activity. Schizophrenia interval prolonging vision, dry eyes
Pharmacologic: symptoms of schizophrenia
not to exceed patients who conditions); some
Butyrophenones
30 mg/day require long-term products contain RESP: respiratory Monitor blood pressure
PREGNANCY parenteral (IM) tartrazine, sesame depression (sitting, standing, lying),
CATEGORY C IM decanoate antipsychotic oil, or benzyl pulse, and respiratory rate
(depot) therapy. Also alcohol and should CV: hypotension, prior to and frequently
useful in be avoided in tachycardia during the period of dose
adjustment
Initial: IM managing patients with
dose 10-20 aggressive or known intolerance GI: constipation, dry Observe patient carefully
times daily PO agitated patients. or hypersensitivity. mouth, anorexia, when administering
dose drug-induced medication to ensure
administered hepatitis ileus, medication is taken and not
monthly; not to weight gain. hoarded.
exceed 100
mg; if GU: urinary Monitor intake and output
conversion retention ratios and daily weight.
requires initial Assess patient for signs and
dose >100 mg, DERM: diaphoresis, symptoms of dehydration
administer in 2 photosensitivity, (decreased thirst, lethargy,
injections (eg, rashes hemoconcentration),
100 mg especially in geriatric
initially, then patient.
remainder in 3- ENDO: galactorrhea,
7 days) amenorrhea Assess fluid intake and
bowel function. Increased
Maintenance: HEMAT: anemia, bulk and fluids in the diet
may help minimize
Monthly dose leukopenia
constipation
10-15 times
daily PO dose METAN: Monitor patient for onset of
hyperpyrexia akathisia (restlessness or
desire to keep moving) and
MISC: neuroleptic extrapyramidal side effects
malignant syndrome, (parkinsonian- difficulty
speaking and swallowing,
hypersensitivity
loss of balance control, pill
reactions. rolling of hands, mask-like
face, shuffling gait, rigidity,
tremors; and dystonic –
muscle spasm, twisting
motion, twitching, inability
to move eyes, weakness of
arms or legs)

Monitor for development of

neuroleptic malignant
syndrome (fever,
respiratory distress,
tachycardia, convulsions,
diaphoresis, hypertension
or hypotension, pallor,
tiredness, severe muscle
stiffness, loss of bladder
control), report these
symptoms immediately.
 DRUG STUDY
Drug Name Dosage Action Indication Contraindication Side Effects Nursing Responsibilities
Generic Name: PO (Adults): Binds to Schizophrenia Hypersensitivity; CNS: neuroleptic Monitor patient’s mental
25mg 1-2 dopamine unresponsive to bone marrow malignant syndrome, status (orientation, mood,
CLOZAPINE times daily receptor in the or intolerant of depression; severe seizures, dizziness, behaviour) before and
initially; CNS. Also has standard therapy CNS depression / sedation. periodically during therapy.
Brand Name:
CLORAZIL increase by 25- anticholinergic with other come; uncontrolled
50 mg / day and alpha- antipsychotics epilepsy; EENT: visual Monitor blood pressure
Classification: over a period adrenergic (treatment granulocytopenia. disturbances (sitting, standing, lying)
Therapeutic: of 2 wk up to blocking refractory). To and pulse rate before and
antipsychotics target dose of acitivity. reduce recurrent Lactation: CV: myocarditis, frequently during initial
300-450 Produces fewer suicidal behaviour discontinue drug or hypotension, dose titration
PREGNANCY
mg/day. extrapyramidal in schizophrenia bottle-feed. tachycardia, ECG
CATEGORY B
reactions and patients. changes, Assess weight and BMI
less tardive hypertension initially and throughout
dyskinesia than therapy.
standard GI: constipation,
antipsychotics abdominal Assess fasting blood
but carries high discomfort, dry glucose and cholesterol
risk of mouth, increased levels initially and
hematologic salivation, nausea, throughout therapy. Refer
abnormalities vomiting, weight as appropriate for
gain. nutritional / weight
management and medical
DERM: rash, management
sweating
Observe patient carefully
ENDO: when administering
hyperglycemia medication to ensure that
medication is actually taken
and not hoarded or
checked.
HEMAT:
agranulocytosis, Monitor patient for onset of
leukopenia akathisia (restlessness or
desire to keep moving) and
extrapyramidal side effects
NEURO:
(parkinsonian- difficulty
extrapyramidal speaking and swallowing,
reactions loss of balance control, pill
rolling of hands, mask-like
MISC: fever face, shuffling gait, rigidity,
tremors; and dystonic –
muscle spasm, twisting
motion, twitching, inability
to move eyes, weakness of
arms or legs)

Monitor frequency and

consistency of bowel
movements. Increasing
bulk and fluids in the diet
may help to minimize
constipation.

Clozapine lowers the

seizure threshold. Institute
seizure precautions for
patient with history of
seizure disorder.
 DRUG STUDY
Drug Name Dosage Action Indication Contraindication Side Effects Nursing Responsibilities
Generic Name: PO (Adults – Antagonizes Psychotic Hypersensitivity CNS: neuroleptic Assess mental status
most patients): dopamine and disorders: acute Lactation: malignant syndrome, (orientation, mood,
OLANZAPINE Schizophrenia serotonin type 2 manic episodes discontinue drug or seizures, agitation, behaviour) prior to and
periodically during therapy
– 5-10 mg / in the CNS. associated with bottle feed; Orally dizziness,
Brand Name:
ZYPREXA, Zydis day initially; Also has bipolar disorder disintegrating restlessness, Assess weight and BMI
may increase anticholinergic, (may be used with tablets only: sedation, weakness, initially and throughout
Classification: at weekly antihistaminic, lithium or phenylketonuria dystonia, insomnia, therapy
Therapeutic: intervals by 5 and anti-alpha. – valproate), long- (orally mood changes,
antipsychotics, mood mg/day (not to adrenergic term maintenance disintegrating personality disorder, Assess fasting blood
stabilizers exceed 20 affects. therapy of bipolar tablets contain speech impairment, glucose and cholesterol
Pharmacologic: levels initially and
mg/day). disorder, long- aspartame) increased dyskinesia
thienobenzodiazepines
term treatment / periodically throughout
PREGNANCY maintenance of EENT: amblyopia, therapy.
CATEGORY C schizophrenia, rhinitis, increased
agitation to salvation, Monitor blood pressure
schizophrenia or pharyngitis (sitting, standing, lying),
pulse, and respiratory rate
mania (IM).
prior to and frequently
CV: orthostatic during the period of dose
hypotension, adjustment
tachycardia, chest
pain Observe patient carefully
when administering
RESP: cough, medication to ensure
medication is actually taken
dyspnea
and not hoarded.

GI: constipation, dry Assess fluid intake and

mouth, abdominal bowel function. Increased
pain, increased thirst bulk and fluids in the diet
may help minimize
constipation
GU: decreased Monitor patient for onset of
libido, urinary akathisia (restlessness or
incontinence. desire to keep moving) and
extrapyramidal side effects
(parkinsonian- difficulty
DERM: speaking and swallowing,
photosensitivity loss of balance control, pill
rolling of hands, mask-like
ENDO: face, shuffling gait, rigidity,
hyperglycemia, tremors; and dystonic –
goiter muscle spasm, twisting
motion, twitching, inability
to move eyes, weakness of
METAB: arms or legs)
dyslipidemia
Monitor for development of
MS: hypertonia, neuroleptic malignant
joint pain syndrome (fever,
respiratory distress,
tachycardia, convulsions,
NEURO: tremor
diaphoresis, hypertension
or hypotension, pallor,
MISC: fever, flu-like tiredness, severe muscle
syndrome stiffness, loss of bladder
control), report these
symptoms immediately.
 DRUG STUDY
Drug Name Dosage Action Indication Contraindication Side Effects Nursing Responsibilities
Generic Name: PO (Adults): Probably acts by Schizophrenia. Hypersensitivity; CNS: neuroleptic Assess mental status
schizophrenia serving as an Depressive Lactation: malignant syndrome, (orientation, mood,
QUETIAPINE – 25 mg twice antagonist of episodes with discontinue drug or seizures, dizziness, behaviour) prior to and
periodically during therapy
daily initially; dopamine and bipolar disorder. bottle feed cognitive
Brand Name:
SEROQUEL increased by serotonin. Also Bipolar mania impairment, Assess for suicidal
25-50mg 2-3 antagonizes associated with extrapyramidal tendencies, especially
Classification: times daily histamine. H1 Bipolar as symptoms, sedation, during early therapy.
Therapeutic: over 3 days, up receptors and monotherapy or tardive dyskinesia Restrict amount of drug
antipsychotics, mood to 300-400mg / alpha, - with lithium or available to patient
stabilizers day in 2-3 adrenergic divalproex EENT: ear pain,
Assess weight and BMI
divided doses receptors. rhinitis, pharyngitis
PREGNANCY initially and throughout
CATEGORY C by the 4th day therapy
RESP: cough,
dyspnea Monitor blood pressure
(sitting, standing, lying),
CV: palpitations, pulse, and respiratory rate
peripheral edema, prior to and frequently
during the period of dose
postural hypotension
adjustment

GI: Anorexia, Observe patient carefully

constipation, dry when administering
mouth, dyspepsia medication to ensure
medication is actually taken
and not hoarded.
DERM: sweating
Monitor patient for onset of
HEMAT: leukopenia akathisia (restlessness or
desire to keep moving) and
METAB: weight extrapyramidal side effects
gain (parkinsonian- difficulty
speaking and swallowing,
loss of balance control, pill
MISC: flu-like rolling of hands, mask-like
syndrome face, shuffling gait, rigidity,
tremors; and dystonic –
muscle spasm, twisting
motion, twitching, inability
to move eyes, weakness of
arms or legs)

Monitor for development of

neuroleptic malignant
syndrome (fever,
respiratory distress,
tachycardia, convulsions,
diaphoresis, hypertension
or hypotension, pallor,
tiredness, severe muscle
stiffness, loss of bladder
control), report these
symptoms immediately.
 DRUG STUDY
Drug Name Dosage Action Indication Contraindication Side Effects Nursing Responsibilities
Generic Name: PO (Adults): May act by Schizophrenia in Hypersensitivity; CNS: neuroleptic malignant Monitor patient’s mental
1 mg twice antagonizing adults and Lactation: syndrome, dizziness, status (orientation, mood,
RISPERIDONE daily, dopamine and adolescents aged discontinue drug aggressive behavior, behavior) before and
increased by serotonin in the 13-17 years. or bottle feed. extrapyramidal reactions, periodically during
Brand Name:
RISPERDAL 1-2 mg/day CNS Bipolar mania headache, increased therapy
no more (oral only) in dreams, increased sleep
Classification: frequently adults and duration, insomnia, Assess weight and BMI
Therapeutic: than every children 10-17 sedation, fatigue, impaired initially and throughout
antipsychotics, mood 24hrs to 4-8 years; can be dyskinesia therapy. Obtain fasting
stabilizers mg daily. used with lithium blood glucose and
Pharmacologic:
or valproate EENT: pharyngitis, rhinitis, cholesterol levels
benzisoxazoles
(adults only). visual disturbances initially and throughout
PREGNANCY Treatment of therapy.
CATEGORY C irritability RESP: cough, dyspnea
associated with Monitor mood changes.
austic disorder in CV: arrhythmias, Assess for suicidal
children aged 5- orthostatic hypotension, tendencies, especially
16yrs. tachycardia during early therapy.
Restrict amount of drug
GI: constipation, diarrhea, available to the patient
dry mouth, nausea,
abdominal pain, anorexia, Monitor blood pressure
dyspepsia, increased (sitting, standing, lying),
salivation, vomiting, weight pulse, and respiratory
rate prior to and
gain, weight loss,
frequently during the
polydipsia period of dose
adjustment
GU: decreased libido,
dysmenorrhea/menorrhagia, Observe patient carefully
when administering
medication to ensure
difficulty urinating, medication is taken and
polyuria not hoarded.
Monitor patient for onset
of akathisia (restlessness
DERM: itching/skin rash,
or desire to keep moving)
dry skin, increased and extrapyramidal side
pigmentation, increased effects (parkinsonian-
sweating, photosensitivity, difficulty speaking and
seborrhea swallowing, loss of
balance control, pill
ENDO: galactorrhea, rolling of hands, mask-
like face, shuffling gait,
hyperglycemia
rigidity, tremors; and
dystonic – muscle spasm,
MS: arthralgia, back pain twisting motion,
twitching, inability to
move eyes, weakness of
arms or legs)

Monitor for development

of neuroleptic malignant
syndrome (fever,
respiratory distress,
tachycardia, convulsions,
diaphoresis, hypertension
or hypotension, pallor,
tiredness, severe muscle
stiffness, loss of bladder
control), report these
symptoms immediately.
 DRUG STUDY
Drug Name Dosage Action Indication Contraindication Side Effects Nursing Responsibilities
Generic Name: Adult (PO) Inhibits the Adjunct in the Hypersensitivity CNS: dizziness, Assess neurological status
Initial: 1 mg action of management of nervousness, (e.g., orientation, affect,
BENZHEXOL PO first day, acetylcholine, parkinsonian Angle-closure confusion, reflexes) to evaluate any
then increase resulting in syndrome of glaucoma drowsiness, CNS effects.
Brand Name:
ARTANE by 2 mg q3- Decreased many causes, headache, psychoses,
5days until sweating and including drug- weakness. Assess abdomen (e.g.,
Classification: reach 6-10 salivation, induced bowel sounds, bowel and
Therapeutic: mg/days Mydriasis parkinsonism. EENT: blurred bladder patterns, urinary
antiparkinson agents (pupillary vision, mydriasis. output) to evaluate for GI
Maintenance: dilation), CV: orthostatic and GU adverse effects.
Pharmacologic:
5-15 mg/day Increased heart hypotension,
anticholinergics
PO divided q6- rate. Also has tachycardia. Monitor laboratory test
PREGNANCY 8hr spasmolytic results to determine need
CATEGORY: C action on GI: dry mouth, for possible dose
Geriatric (PO) smooth muscle. nausea, constipation, adjustments and to identify
5-15 mg/day Inhibits cerebral vomiting. potential toxicity.
PO divided q6- motor centers
GU: urinary
8hr and blocks Ensure proper
hesitancy, urinary
efferent administration of the drug
retention.
impulses. to ensure effective use and
Derm: decreased decrease the risk of adverse
Therapeutic sweating. effects.
Effects:
Diminished Monitor patient response
signs and (e.g., blood pressure, ECG,
symptoms of urine output) for changes
parkinsonian that may indicate need to
syndrome adjust dose.
(tremors,
rigidity).
Provide comfort measures
(e.g., sugarless lozenges,
lighting control, small and
frequent meals) to help
patient cope with drug
effects.

Provide patient education

about drug effects and
warning signs to report to
enhance knowledge about
drug therapy and promote
compliance.
 DRUG STUDY
Drug Name Dosage Action Indication Contraindication Side Effects Nursing Responsibilities
Generic Name: PO (Adults): Blocks Adjunctive Hypersensitivity; CNS: confusion, Assess parkinsonian and
1-2 mg / day in cholinergic treatment of all children <3 yrs, depression, extrapyramidal symptoms
BENZTROPINE 1-2 divided activity in the forms of angle cross-closure dizziness, (restlessness or desire to
doses (range CNS, which is Parkinson’s glaucoma; tardive hallucinations, keep moving, rigidity,
Brand Name:
BENZTROP, 0.5-6mg/day) partially disease. Including dyskinesia headache, sedation, tremors, pill rolling, mask
CONGENTIN responsible for drug-induced weakness like face, shuffling gait,
the symptoms of extrapyramidal muscle spasms, twisting
Classification: Parkinson’s effects and acute EENT: blurred motions, difficulty
Therapeutic: disease. Restores dystonic reactions vision, dry eyes, speaking or swallowing,
antiparkinson agents the natural mydriasis loss of balance control)
Pharmacologic:
balance or before and throughout
anticholionergics
neurotransmitters CV: arrhythmias, therapy
PREGNANCY in the CNS. hypotension,
CATEGORY C palpitations, Assess bowel function
tachycardia daily. Monitor for
constipation, abdominal
GI: constipation, dry pain, distention, or absence
mouth, ileus, nausea of bowel sounds

GU: hesitancy, Monitor intake and output

urinary retention ratios and assess patient for
urinary retention (dysuria,
MISC: decreased distended abdomen,
sweating infrequent voiding of small
amounts, overflow
incontinence)

Patients with mental illness

are at risk of developing
exaggerated symptoms of
their disorder during early
therapy with benztropine.
Withhold drug and notify
physician or other health
care professional if
significant behavioural
changes occur.

IM/IV: monitor pulse and

blood pressure closely and
maintain bed rest for 1 hr
after administration. Advise
patient to change positions
slowly to minimize
orthostatic hypotension
 DRUG STUDY
Drug Name Dosage Action Indication Contraindication Side Effects Nursing Responsibilities
Generic Name: PO (Adults) Alters the Acute and chronic Hypersensitivity: CNS: Neuroleptic Assess patient’s mental
0.5 – 10 mg / effects of psychoses cross-sensitivity malignant syndrome, status (orientation,
FLUPHENAZINE day in divided dopamine in the with other extrapyramidal behaviour, mood) before
doses q 6-8hrs CNS. Has phenothiazines reactions, sedation, and periodically during
Brand Name:
MODECATE (maximum anticholinergic may exist; tardive dyskinesia therapy
dose = 40 and alpha- subcortical brain
Classification: mg/day) adrenergic damage; severe EENT: blurred Monitor blood pressure
Therapeutic: blocking activity CNS depression; vision, dry eyes (sitting, standing, lying),
antipsychotics IM (Adults): Coma; Bone ECG, pulse, and respiratory
Pharmacologic: 12.5 – 25 mg marrow depression; CV: hypertension, rate before and frequently
phenothiazine
initially; may Liver disease; hypotension, during trhe period of odse
PREGNANCY be repeated q 3 Hypersensitivity to tachycardia adjustment. May cause q-
CATEGORY C wk. dosage sesame oil wave and T-wave changes
may be closely (deaconate salt); GI: anorexia, in ECG
increased as some products constipation, drug-
needed (not to contain alcohol or induced hepatitis, Observe patient carefully
exceed 100 tartrazine and dry mouth, ileus, when administering oral
mg/dose) should be avoided nausea, weight gain medication to ensure that
in patients with medication is actually taken
known intolerance; GU: urinary and not hoarded
concurrent use of retention
drugs that prolong Assess fluid intake and
the QT interval; DERM: bowel function. Increased
Pedi: Safety not photosensitivity, bulk and fluids in the diet
established in pigment changes, help minimize constipation
children <6 months rashes
Monitor patient for onset of
ENDO: galactorrhea akathisia (restlessness or
desire to keep moving) and
extrapyramidal side effects
(parkinsonian- difficulty
HEMAT: speaking and swallowing,
agranulocytosis, loss of balance control, pill
leukopenia, rolling of hands, mask-like
face, shuffling gait, rigidity,
thrombocytopenia
tremors; and dystonic –
muscle spasm, twisting
MISC: Allergic motion, twitching, inability
reactions to move eyes, weakness of
arms or legs)

Monitor tardive dyskinesia

(uncontrolled rhythmic
movement of mouth, face
and extremities; lip
smacking or puckering;
puffing of cheeks;
uncontrolled chewing;
rapid or worm-like
movements of tongue).
Report immediately; may
be irreversible

Monitor for development of

neuroleptic malignant
syndrome (fever,
respiratory distress,
tachycardia, convulsions,
diaphoresis, hypertension
or hypotension, pallor,
tiredness, severe muscle
stiffness, loss of bladder
control), report these
symptoms immediately.
 DRUG STUDY
Drug Name Dosage Action Indication Contraindication Side Effects Nursing Responsibilities
Generic Name: PO (Adults): Potentiates the Depression Angle-closure CNS: lethargy, Obtain weight and BMI
75 mg/day in effect of glaucoma; known sedation initially and periodically
AMITRIPTYLINE divided doses; serotonin and history of QTc throughout treatment
may be norepinephrine prolongation, EENT: blurred
Brand Name:
TRYPTANOL, ENDEP increased up to in the CNS. Has recent MI, heart vision, dry eyes, dry Assess fasting glucose and
150 mg/day or significant failure mouth cholesterol levels in
Classification: 50-100mg at anticholinergic overweight/obese
Therapeutic: bedtime, may properties CV: arrhythmias, individuals
antidepressants increase by 25- hypotension, ECD
Pharmacologic: 50 mg up to changes Monitor blood pressure and
tricyclic antidepressants
150 mg pulse before during initial
PREGNANCY GI: Constipation, therapy.
CATEGORY: C hepatitis, paralytic
ileus, increased Depression: monitor mental
appetite, weight gain status (orientation, mood,
behaviour) frequently.
GU: urinary Assess for suicidal
retention, decreased tendencies, especially
libido during early therapy.

DERM: Pain: assess intensity,

photosensitivity quality, and location of pain
periodically during therapy,
ENDO: changes in may require several weeks
blood glucose, for effects to be seen. Use
gynecomastia pain scale to monitor
effectiveness of medication.
HEMAT: Blood
dyscrasias.
 DRUG STUDY
Drug Name Dosage Action Indication Contraindication Side Effects Nursing Responsibilities
Generic Name: PO (Adults): Potentiates the Various forms of Hypersensitivity: CNS: drowsiness, Monitor blood pressure and
25-50mg 3-4 effect of depression. cross-sensitivity fatigue, agitation, pulse rate prior to and
IMIPRAMINE times daily (no serotonin and Enuresis in with other confusion, during initial therapy
to exceed norepinephrine. children antidepressants hallucinations,
Brand Name:
TOFRANIL, 300mg/day); Has significant may occur; angle- insomnia Monitor plasma levels in
MELIPRAMINE total daily dose anticholinergic closure glaucoma; treatment-resistant patients
may be given properties hypersensitivity to EENT: blurred
Classification: at bedtime tartrazine or vision, dry eyes Monitor weight and BMI
Therapeutic: sulphites; Recent initially and periodically
antidepressants MI, known history CV: Arrhythmias, throughout therapy
Pharmacologic:
of QTC hypotension, ECG
tricyclic antidepressants
prolongation heart changes For overweight/obese
PREGNANCY failure individuals, obtain FBS and
CATEGORY: C GI: constipation, dry cholesterol levels Refer as
mouth, nausea, appropriate for
paralytic ileus, nutrition/weight
weight gain management and medical
management
GU: urinary
retention, decreased Obtain weight and BMI
libido initially and regularly
throughout therapy
DERM:
photosensitivity Assess for sexual
dysfunction (decreased
ENDO: libido, erectile dysfunction)
gynecomastia
Pedi, Geri; monitor
HEMAT: blood baseline and periodic ECGs
dsycrasias in elderly patients or
patients with heart disease
and before increasing dose
with children treated for
enuresis. May causes
prolonged PR and QT
intervals and may flatten T
waves

Depression: assess mental

status (orientation, mood,
behavior) frequently.
Confusion, agitation, and
hallucinations may occur
during initiation of therapy
and may require dosage
reduction. Assess for
suicidal tendencies,
especially during early
therapy. Restrict amount of
drug available to a patient

Enuresis: assess frequency

of bedwetting during
therapy. Ask patient or
caretaker to maintain diary.
 DRUG STUDY
Drug Name Dosage Action Indication Contraindication Side Effects Nursing Responsibilities
Generic Name: PO (Adults) Inhibits the Treatment of should not be used CNS: SEIZURES, Monitor vital signs,
20-30 mg / day enzyme neurotic or in patients who are dizziness, especially pulse
PHENELZINE in divided monoamine atypical hypersensitive to drowsiness, fatigue, and blood pressure.
doses q8hrs oxidase, resulting depression the drug or its headache, (Phenelzine may
Brand Name:
NARDIL (maximum in an (usually reserved ingredients, with hyperreflexia, cause orthostatic
dose = 30 accumulation of for patients who pheochromocytoma, insomnia, tremor, hypotension.)
Classification: mg/day) various do not tolerate or congestive heart twitching, weakness,
Therapeutic: neurotransmitters respond to other failure, severe renal euphoria, Monitor cardiovascular
antidepressants (dopamine, modes of therapy impairment paresthesia, status.
epinephrine, [e.g., tricyclic or renal disease, a restlessness.
Pharmacologic:
norepinephrine, antidepressants, history of liver Monitor neurological
monoamine oxidase
(MAO) inhibitors and serotonin) in SSRIs, SSNRIs, disease, or EENT: blurred status.
the body. or abnormal liver vision, glaucoma,
PREGNANCY electroconvulsive function tests. nystagmus. Monitor mental and
CATEGORY: C Therapeutic therapy]). emotional status.
Effects: CV:
Improved mood HYPERTENSIVE Monitor kidney and liver
in depressed CRISIS, edema, function.
patients. orthostatic
hypotension. Ensure patient safety.
(Dizziness
GI: constipation, dry caused by postural
mouth, abdominal hypotension
pain, liver function increases the risk of fall
test elevation, injuries.)
nausea, vomiting.
Raise bed rails. Place call
GU: sexual bell within
dysfunction, urinary patient's reach.
retention.
Derm: pruritus,
rashes.

F and E:
hypernatremia.

Endo: weight gain.

 DRUG STUDY
Drug Name Dosage Action Indication Contraindication Side Effects Nursing Responsibilities
Generic Name: PO (Adults): Selectively Various forms of Hypersensitivity: CNS: seizures, Monitor mood changes.
Depression, inhibits the depression. OCD. concurrent use or anxiety, drowsiness, Inform health care
FLUOXETINE OCD – 20 reuptake of Bulimia nervosa. use within 14 days headache, insomnia, professional if patient
mg/day in the serotonin in the Panic disorder of discontinuing nervousness, demonstrates significant
Brand Name:
PROZAC-20, LOVAN, morning. After CNS MAO inhibitors abnormal dreams, increase in anxiety,
EROCAP, ZACTIN several week, (fluoxetine should dizziness, fatigue, nervousness, or insomnia
may increase be discontinued 5 hypomania, mania,
Classification: by 20 mg/day weeks before MAO weakness Assess for suicidal
Therapeutic: at weekly therapy is initiated) tendencies, especially
antidepressants intervals. EENT: stuffy nose, during early therapy.
Pharmacologic:
Doses greater visual disturbances Restrict amount of drug
selective serotonin
reuptake inhibitors than 20 available to patient
(SSRIs) mg/day should RESP: cough
be given in 2 Monitor appetite and
PREGNANCY divided doses, CV: chest pain, nutritional intake. Weight
CATEGORY B in the morning palpitations weekly. Notify health care
and at noon. professional of continued
GI: diarrhea, weight loss. Adjust diet as
abdominal pain, tolerated to support
abdominal taste, nutritional status
anorexia,
constipation, dry Assess patient for
mouth, dyspepsia, sensitivity reaction
nausea, vomiting, (urticarial, fever, arthralgia,
weight loss edema, carpal tunnel
syndrome, rash, hives,
GU: sexual lymphadenopathy,
dysfunction, urinary respiratory distress) and
frequency notify health care
professional if present;
DERM: excessive symptoms usually resolve
sweating pruritus, by stopping fluoxetine but
erythema nodusum, may require administration
flushing, rashes of antihistamines or
corticosteroids
ENDO:
dysmenorrhea Assess for sexual side
effects (erectile
MS: arthralgia, back dysfunction, decreased
pain, myalgia libido)

NEURO: tremor OCD: assess patient for

frequency of obsessive-
MISC: allergic compulsive behaviours,
reactions, fever, flu note degree to which these
like syndrome, hot thoughts and behaviours
flashes, sensitivity interfere with daily
reactions functioning
 DRUG STUDY
Drug Name Dosage Action Indication Contraindication Side Effects Nursing Responsibilities
Generic Name: PO (Adults): Inhibits neural Major depressive Hypersensitivity; CNS: anxiety, Monitor appetite and
20 mg as a reuptake of disorder, panic Concurrent MAO dizziness, nutritional intake. Weight
PAROXETINE single dose in serotonin in the disorder. inhibitor, drowsiness, weekly. Notify health care
the morning; CNS, thus Obsessive thioridazine or headache, insomnia, professional of continued
Brand Name:
AROPAX, PAXTINE, may be potentiating the compulsive pimozide therapy weakness, agitation, weight loss. Adjust diet as
OXTINE increased by activity of disorder (OCD) amnesia, confusion, tolerated to support
10 mg/day at serotonin; has generalized emotional lability, nutritional status
Classification: weekly little effect on anxiety disorder hangover, impaired
Therapeutic: intervals (not norepinephrine (GAD). Social concentration, Depression: monitor mental
antianxiety agents, to exceed or dopamine. anxiety disorder. malaise, mental status (orientation, mood,
antidepressants
50mg/day) Post-traumatic depression, suicidal behavior). Inform health
Pharmacologic: stress disorder behavior, syncope care professional if patient
selective serotonin (PTSD). demonstrates significant
reuptake inhibitors Premenstrual EENT: blurred increase in anxiety,
(SSRIs) dysphoric vision, rhinitis nervousness, or insomnia
disorder (PMDD)
PREGNANCY RESP: cough, Assess for suicidal
CATEGORY D
pharyngitis, tendencies, especially
respiratory disorders, during early therapy.
yawning Restrict amount of drug
available to patient.
CV: chest pain,
edema, hypertension, OCD: assess patient for
palpitations, postural frequency of obsessive-
hypotension, compulsive behaviours.
tachycardia, Noted degree to which
vasodilation these thoughts and
behaviours interfere with
GI: constipation, daily functioning
diarrhea, dry mouth,
nausea, abdominal Panic Attacks: assess
pain, decreased frequency and severity of
appetite, taste panic attacks
disturbances,
vomiting Social Anxiety disorders:
Assess frequency and
GU: ejaculatory severity of episodes of
disturbance, anxiety
decreased libido,
genital disorders, Post-traumatic stress
urinary disorders, disorder: assess
urinary frequency manifestations of post-
traumatic stress disorder
DERM: sweating, periodically during therapy
photosensitivity,
pruritus, rash Premenstrual dysphoria:
assess symptoms of
METAB: weight premenstrual distress prior
gain, weight loss to and during therapy

MS: back pain,

myalgia, myopathy

NEURO:
paresthesia, tremor

MISC: chills, fever

 DRUG STUDY
Drug Name Dosage Action Indication Contraindication Side Effects Nursing Responsibilities
Generic Name: PO (Adults): Inhibits Major depressive Hypersensitivity: CNS: dizziness, Monitor appetite and
50 mg/day as a neuronal uptake disorder. Panic concurrent MAO drowsiness, fatigue, nutritional intake weight
SERTRALINE signle dose in of serotonin in disorder. inhibitor therapy headache, insomnia, weekly. Notify health care
the morning or the CNS, thus Obsessive- (may result in agitation, anxiety, professional of continued
Brand Name:
ZOLOFT, XYDEM evening potentiating the compulsive serious, potentially confusion, emotional weight loss. Adjust diet as
initially; after activity of disorder (OCD). fatal reactions); lability, impaired tolerated to support
Classification: several weeks serotonin. Has Post-traumatic concurrent concentration, manic nutritional status
Therapeutic: may be little effect on stress disorder pimozide; oral reaction,
antidepressants increased at norepinephrine (PTSD). Social concentrate nervousness, Depression: monitor mood
Pharmacologic: weekly or dopamine. anxiety disorder contains alcohol weakness, yawning changes. Inform physician
selective serotonin
intervals up to (social phobia). and should be or other health care
reuptake inhibitors
(SSRIs) 200 mg/day, Premenstrual avoided in patients EENT: pharyngitis, professional if patient
depending on dysphoric with known rhinitis, tinnitus, demonstrates significant
PREGNANCY response. disorder intolerance. visual abnormalities increase in anxiety,
CATEGORY C (PMDD). nervousness, or insomnia
CV: chest pain,
palpitations Assess for suicidal
tendencies, especially
GI: diarrhea, dry during early therapy.
mouth, nausea, Restrict amount of drug
abdominal pain, available to patient
altered taste,
anorexia, OCD: assess patient for
constipation, frequency of obsessive-
dyspepsia, compulsive behaviours.
flatulence, increased Note degree to which these
appetite, vomiting thoughts and behaviours
interfere with daily
GU: sexual functioning
dysfunction,
menstrual disorders, Panic attacks: assess
urinary disorders, frequency and severity of
urinary frequency panic attacks

DERM: increased PTSD: assess patient for

sweating, hot feelings of fear,
flashes, rash helplessness, and horror.
Determine effect on social
MS: back pain, and occupational
myalgia functioning.

NEURO: tremor, Social Anxiety Disorder:

hypertonia, assess patient for symptoms
hypoesthesia, of social anxiety disorder
paresthesia, (blushing, sweating,
twitching trembling, tachycardia
during interactions with
MISC: fever, thirst new people, people in
authority or groups)
periodically during therapy
 DRUG STUDY
Drug Name Dosage Action Indication Contraindication Side Effects Nursing Responsibilities
Generic Name: PO (Adults Alters action Manic episodes Hypersensitivity; CNS: seizures, Assess mental status
and children) transport in nerve of manic- severe fatigue, headache, (orientation, mood,
LITHIUM 300-600 mg 3 and muscle. May depressive illness cardiovascular or impaired memory, behaviour) initially and
CARBONATE
times daily also influence (treatment, renal disease; ataxia, sedation, periodically. Assess manic
Brand Name: initially; usual reuptake of maintenance, dehydrated or confusion, dizziness, symptoms with Young
LITHICARB, maintenance neurotransmitters. prophylaxis) debilitated patients drowsiness, Mania Rating Scale
QUILONUM SR dose is 300 mg should be used psychomotor (YMRS) at baseline and
3-4 times only where retardation, periodically through
Classification: daily. therapy, including restlessness, stupor treatment in patients with
Therapeutic: mood blood levels, may mania. Initiate suicide
stabilizers
be closely EENT: aphasia, precautions in indicated.
PREGNANCY monitored; some blurred vision,
CATEGORY D products contain dysarthria, tinnitus Monitor intake and output
alcohol or ratios. Report significant
tartrazine and CV: arrhythmias, changes in totals. Unless
should be avoided ECG changes, contraindicated, fluid
in patients with edema, hypotension intake of at least 2000-
known 3000 ml/day should be
hypersensitivity or GI: abdominal pain, maintained. Weight should
intolerance anorexia, bloating, also be monitored at least
diarrhea, nausea, every 3 months.
drymouth, metallic
taste

GU: polyuria,
glycosuria,
nephrogenic diabetes
insipidly, renal
toxicity.
DERM: acneform
eruption, follicuilitis,
alopecia, diminished
sensation, pruritus

ENDO:
hypothyroidism,
goiter,
hyperglycemia,
hyperthyroidism

F and E:
hyponatremia

HEMAT:
leucocytosis

METAB: weight
gain

MS: muscle
weakness,
hyperirritability,
rigidity

NEURO: tremors
 DRUG STUDY
Drug Name Dosage Action Indication Contraindication Side Effects Nursing Responsibilities
Generic Name: (TEGRETOL-XR) Normally, To treat epilepsy History of bone CNS: Chills, Patients must take their
sodium moves marrow depression confusion, dizziness, meds exactly as prescribed.
CARBAMAZEPINE Adults and into a neuronal To relieve pain in drowsiness, fatigue, It is crucial to keep in mind
children aged 12 cell by passing trigeminal hypersensitivity to fever, headache, that anti-manic medications
Brand Name:
TEGRETOL, TERIL and over. through a gated neuralgia carbamazepine suicidal ideation, can cause dizziness and
sodium channel syncope, sleepiness. Furthermore,
Classification: Initial: 200 mg in the cell To treat acute tricyclic talkativeness, patients with low sodium
Therapeutic: b.i.d. Increased membrane. manic and mixed compounds, or unsteadiness, visual levels may be more
Analgesic, weekly by 200 mg Carbamazepine episodes in their components hallucinations susceptible to harm.
anticonvulsant daily, if needed. may prevent or bipolar disorder Patients should also be
halt seizures by MAO inhibitor CV: Arrhythmias, informed that they may
PREGNANCY
CATEGORY: C Maximum: closing or including AV block; gain weight. (NOTE: If
1,600 mg daily in blocking sodium nefazodone therapy edema; heart failure; you want short statement,
adults, 1,200 mg channels, as hypertension; you can use this, if not,
daily in children shown below, hypotension; follow the statements
aged 16 and over, thus preventing thromboembolism; below and delete this part
and 1,000 mg daily sodium from thrombophlebitis; instead )
in children ages 12 entering the cell. worsened coronary
to 16. Keeping sodium artery disease •Avoid using
out of the cell carbamazepine in patients
Children aged 6 to may slow nerve EENT: Blurred with a history of hepatic
12. impulse vision, porphyria because it may
Initial: 100 mg transmission, conjunctivitis, dry prompt an acute attack.
b.i.d. thus slowing the mouth, glossitis,
•WARNING: If patient has
rate at which nystagmus,
Asian ancestry, make sure
Increased weekly neurons fire. oculomotor
he has been evaluated for
by 100 mg daily, if disturbances,
the genetic allelic variant
needed. stomatitis, tinnitus,
HLA-B 1502 before
Maximum: 1,000 transient diplopia
starting carbamazepine
mg daily.
therapy. Patients positive
 ENDO: Syndrome for HLA-B 1502 shouldn’t
ORAL of inappropriate take carbamazepine
SUSPENSION ADH secretion, because the risk of serious,
water intoxication sometimes fatal,
Adults and GI: Abdominal pain, dermatologic reactions is
children age 12 anorexia, ten times higher than in
and over. constipation, patients without this
diarrhea, dyspepsia, variant.
Initial: 100 mg elevated liver
q.i.d. Increased function test results, •Use carbamazepine
weekly by 200 mg hepatitis, nausea, cautiously in patients with
daily, if needed, pancreatitis, impaired hepatic function
given in divided vomiting because it’s mainly
Doses t.i.d or q.i.d. metabolized in the liver.
Maximum: 1,600 GU: Acute urine Monitor liver function
mg daily in adults, retention, tests, as directed.
1,200 mg daily in albuminuria, •Monitor patient closely for
children age 16 azotemia, adverse reactions because
and over, and glycosuria, many are serious.
1,000 mg daily in impotence, oliguria,
children ages 12 to renal failure, urinary •Periodically monitor
16. frequency blood carbamazepine level
to assess for therapeutic
Children ages 6 to HEME: Acute and toxic levels; a blood
12. Initial: 50 mg intermittent level of 6 to 12 mcg/ml is
q.i.d. porphyria, optimal for anticonvulsant
agranulocytosis, effects. WARNING
Increased weekly aplastic anemia, Monitor WBC and platelet
by 100 mg daily, if bone marrow counts monthly for first 2
needed, given in depression, months. Decreased counts
divided doses t.i.d eosinophilia, may indicate bone marrow
or q.i.d. leukocytosis, depression.
 leukopenia, •Monitor patient closely for
Maximum: 1,000 pancytopenia, evidence of suicidal
mg daily. thrombocytopenia thinking or behavior,
especially when therapy
Children up to age MS: Arthralgia, leg starts or dosage changes.
6. Initial: 10 to 20 cramps, myalgia
mg/ kg/day in •Withdraw carbamazepine
divided doses q.i.d. RESP: Pulmonary gradually to minimize risk
Maximum: 35 hypersensitivity of seizures.
mg/kg daily (dyspnea, fever, PATIENT TEACHING
pneumonia, or
pneumonitis) •Tell patient to take
carbamazepine with food
SKIN: Aggravation (except the oral suspension
of disseminated form, which shouldn’t be
lupus erythematosus, taken with other liquid
alopecia, altered skin drugs or diluents).
pigmentation,
•Warn patient about
diaphoresis,
possible dizziness, blurred
erythema
vision, and unsteadiness.
multiforme,
erythema nodosum, •Inform patient that coating
exfoliative of E.R. tablets isn’t
dermatitis, jaundice, absorbed and may appear
Lyell’s syndrome, in stool.
photosensitivity
reactions, pruritic •Advise patient not to
and erythematous crush or chew E.R.
rash, purpura, capsules or tablets. If he
Stevens-Johnson can’t swallow capsules
syndrome, urticaria whole, have him open them
Other: Adenopathy, and sprinkle contents on
lymphadenopathy food.

•Urge patient to wear

sunscreen and protective
clothing to reduce
photosensitivity.

•Tell patient to report

unusual bleeding or
bruising, fever, rash, or
mouth ulcers.

•Tell woman that drug

decreases oral
contraceptive effectiveness
and urge her to use
different contraception.
Because drug may cause
fetal harm, tell her to notify
prescriber about possible
pregnancy.

•If she becomes pregnant

during therapy, urge her to
enroll in the antiepileptic
drug pregnancy registry by
calling 1-888-233- 2334.
Explain that the registry is
collecting information
about the safety of
antiepileptic drugs during
pregnancy.
•Instruct caregivers to
watch patient closely for
evidence of suicidal
tendencies, especially
when therapy starts or
dosage changes, and to
report such tendencies to
prescriber immediately.
 DRUG STUDY
Drug Name Dosage Action Indication Contraindication Side Effects Nursing Responsibilities
Generic Name: The usual Increase levels Monotherapy and Contraindicated CNS: SUICIDAL Monitor for therapeutic
dose for of gamma- adjunctive with THOUGHTS, agitation, effectiveness achieved
SODIUM treating aminobutyric therapy for hypersensitivity dizziness, headache, with serum levels of
VALPROATE
epilepsy in: acid (GABA), simple and to valproic acid, insomnia, sedation, valproic acid at 50–100
Brand Name: an inhibitory complex absence hepatic disease, or confusion, depression. mcg/mL.
EPILIM, VALPRO adults and neurotransmitter seizures. significant hepatic
older children in the CNS. Monotherapy and dysfunction. CV: peripheral edema. Monitor patient alertness
Classification: (aged 12 years Therapeutic adjunctive especially with multiple
Therapeutic: and over) – Effects: therapy for EENT: visual drug therapy for seizure
anticonvulsants, 600mg to Suppression of complex partial disturbances. control. Evaluate plasma
vascular headache
2,000mg a seizure activity; seizures. levels of the adjunctive
suppressants
day, as 1 dose ↓ manic Adjunctive GI: anticonvulsants
PREGNANCY or split into 2 episodes; ↓ therapy for HEPATOTOXICITY, periodically as indicators
CATEGORY: D doses. Some frequency of patients with PANCREATITIS, for possible neurologic
people take a migraine multiple seizure abdominal pain, toxicity.
higher dose of headaches. types, including anorexia, diarrhea,
2,500mg a day absence seizures. indigestion, nausea, Monitor patient carefully
Divalproex vomiting, constipation, during dose adjustments
younger sodium only: increased appetite. and promptly report
children (aged Manic episodes presence of adverse
1 month to 11 associated with Derm: alopecia, rashes. effects. Increased dosage
years) – the bipolar disorder, Endo: weight gain. is associated with
doctor will use Prevention of frequency of adverse
your child's migraine Hemat: leukopenia, effects.
weight to headache. thrombocytopenia.
work out the Lab tests: Perform
right dose for Metab: baseline platelet counts,
them HYPERAMMONEMIA. bleeding time, and serum
ammonia, then repeat at
least q2mo, especially
The usual Neuro: during the first 6 mo of
dose for HYPOTHERMIA, therapy.
treating tremor, ataxia.
bipolar Multiple drugs for seizure
disorder in: control increase the risk of
hyperammonemia, marked
adults – by lethargy, anorexia,
750mg to asterixis, increased seizure
2,000mg a frequency, and vomiting.
day, as 1 dose Report such symptoms
or split into 2 promptly to physician. If
doses they persist with decreased
dosage, the drug will be
children – the discontinued.
doctor will
work out the
right dose for
your child

The usual
dose for
preventing
migraine in:

adults – daily
doses vary
from a single
dose of 400mg
to 1,500mg
split into 2
doses
 DRUG STUDY
Drug Name Dosage Action Indication Contraindication Side Effects Nursing Responsibilities
Generic Name: PO (Adults and Stabilizes Adjunct treatment Hypersensitivity; CNS: ataxia, Assess patient for skin rash
children > 12 neuronal of partial seizures Lactation. dizziness, headache, frequently during therapy.
LAMOTRIGINE yr): patients membranes by in adults with behaviour changes, Discontinue lamotrigine as
taking inhibiting epilepsy. depression, first sign of rash; may be
Brand Name:
LAMICTAL carbamazepine, sodium transport drowsiness, life threatening. Stevens-
phenonarbital, insomnia, tremor Johnson syndrome or toxic
Classification: phenytoin, or epidermal necrolysis may
Therapeutic: primidone – EENT: blurred develop. Rash usually
anticonsulvants 50mg daily as vision, double occurs during the initila 2-
a single dose vision, rhinitis 8wks of therapy and is
PREGNANCY
for first 2 wk, more frequent in patients
CATEGORY C
then 50 mg GI: nausea, taking multiple
twic daily for vomiting antiepileptic agents,
next 2wk; then especially valproic acid,
increase by GU: vaginitis. and much more frequent in
100 mg/day on patients <16yr
a weekly basis DERM:
to maintenance photosensitivity, Monitor for
dose of 150- rash (higher hypersensitivity reations
250 mg twice incidence in (fever, lymphadenopathy
daily. children, patient with or without rash) if
taking VPA, high cause cannot be
initial doses, or rapid determined, discontinue
dose increases) lamotrigine immediately

Seizures: assess location,

MS: arthralgia duration and
characterisitics of seizure
MISC: allergic or activity
hypersensitivity
reactions including
Stevens-Johnson Bipolar disorders: assess
syndrome mood, ideation, and
behaviours frequently.
Initiate suicide precautions
if indicated.
 DRUG STUDY
Drug Name Dosage Action Indication Contraindication Side Effects Nursing Responsibilities
Generic Name: PO (Adults): It increases Management of Hypersensitivity- CNS: Transient, Discuss risk of fetal
2-10 mg 2-4 neuronal anxiety, Pre-existing CNS mild drowsiness abnormalities with patients
DIAZEPAM times daily membrane Sleepwalking, depression or initially; sedation, desiring to become
permeability to Night terrors, coma- Respiratory depression, lethargy, pregnant.
Brand Name:
ANTENEX, DUCENE, chloride ions by Premedication depression- Acute apathy, fatigue,
binding to stereo before anesthesia- pulmonary disorientation, Instruct about side effects
VALIUM
specific Adjunct in the insufficiency or restlessness, of drug: Drowsiness,
Classification: benzodiazepine management sleep apnea, Severe confusion, delirium, dizziness, GI upset, dreams,
Therapeutic: receptors on the of seizures, hepatic headache, slurred difficulty concentrating,
antianxiety agents, postsynaptic Muscle spasms, impairment- Acute speech, dysarthria, fatigue, nervousness,
anticonvulsants, crying.
GABA neuron narrow angle stupor, rigidity,
sedative/hypnotics,
skeletal muscle within the CNS glaucoma- tremor, mild Assess for hypersensitivity.
relaxants and enhancing Children < 6 paradoxical Reduce dose of opioid
Pharmacologic: the GABA months- Pregnancy excitatory reactions, analgesics with IV
benzodiazepines inhibitory and lactation. extrapyramidal diazepam; dose should be
effects resulting symptoms, visual reduced by at least one-
PREGNANCY in and auditory third or eliminated.
CATEGORY D hyperpolarizatio disturbances
n and Instruct not to stop taking
stabilization. CV: Bradycardia, the drug without consulting
tachycardia, CV the health care provider.
collapse,
hypertension and Observe the 15 rights of
hypotension, edema drug administration.

DERM: Urticaria, Do not administer

pruritus, skin rash, arterially; may produce
dermatitis arteriospasm, gangrene.

GI: Constipation,
diarrhea, dry mouth,
salivation, nausea, Carefully monitor P. BP,
anorexia, vomiting, respiration during IV
difficulty in administration.
swallowing,
elevation in blood Change from IV therapy to
enzymes, hepatic oral therapy as soon as
impairment possible.

GU: Incontinence, Do not use small veins for

urinary retention, IV injection.
changes in libido, Instruct to take drug exactly
menstrual as prescribed.
irregularities
Maintain patients receiving
HEMAT: Decreased parenteral benzodiazepines
Hct, blood in bed for 3 hours.
dyscrasias
Do not permit ambulatory
patients to operate a vehicle
following an injection.

Instruct patient to report

adverse reactions.

Monitor EEG in patients

treated for status
epilepticus, seizures may
recur after initial control.

Monitor liver and renal

function, CBC during long
term therapy.
Taper dosage gradually
after long-term therapy.

Document that drug has

been given
 DRUG STUDY
Drug Name Dosage Action Indication Contraindication Side Effects Nursing Responsibilities
Generic Name: PO (Adults): Depresses the Anxiety disorder Contraindicated in: CNS: dizziness, Tablet may also be given
Anxiety – 1-3 CNS, probably (oral). Hypersensitivity; drowsiness, lethargy, sublingually (unlabeled) for
LORAZEPAM mg 2-3 times by potentiating Preoperative Cross-sensitivity hangover, headache, more rapid onset. Take
ataxia, slurred
daily (up to GABA, an sedation with other concentrated liquid solution
Brand Name: speech,
ATIVAN 10mg/day). `12 inhibitory (injection). benzodiazepines forgetfulness, with water, soda, pudding,
neurotransmitter. Decreases may exist; confusion, mental or applesauce.
Classification: preoperative Comatose patients depression, rhythmic
Therapeutic: anesthetic anxiety and or those with pre- myoclonic jerking in Instruct patient to take the
adjuncts, antianxiety provides amnesia. existing CNS preterm infants, medication exactly as
agents, depression; paradoxical directed.
sedative/hypnotics excitation.
Uncontrolled Advise patient that
Pharmacologic:
benzodiazepines severe pain; Angle- EENT: blurred lorazepam is usually
closure glaucoma; vision. prescribed for short-term
PREGNANCY Severe use and does not cure the
CATEGORY D hypotension; Sleep Resp: respiratory underlying problem.
apnea; OB, depression.
Lactation: Use in Advise patient to decrease
CV: rapid IV use lorazepam dose gradually
pregnancy and
only—APNEA,
lactation may cause to minimize withdrawal
CARDIAC
CNS depression, ARREST, symptoms; abrupt
flaccidity, feeding bradycardia, withdrawal may cause
difficulties, hypotension. tremors, nausea, vomiting,
hypothermia,
seizures, and GI: constipation,
respiratory diarrhea, nausea,
problems in vomiting, weight
neonate; gain (unusual).
discontinued
bottle-feed. Derma: rashes.
Misc.: physical and
psychological
dependence,
tolerance.