Name of the Drug Vitamin B

Dose/Frequency

Mechanism of Indication Action A coenzyme Pernicious that anemia stimulate metabolic function and is needed for cell replication, hematopoiesis, and nucleoprotein and myelin synthesis.

Contraindication hypersensitive to vitamin B12 or cobalt. early Lebers disease

Side Effects CV: peripheral vascular thrombosis, heart failure. GI:transient diarrhea. Respi: pulmonary edema. Skin:it ching, transitory exanthema, urticaria. Other: anaphylaxis, anaphylactoid reactions with parenteral administration , pain or burning at injection site.

Nursing Responsibilities BEFORE: Determine reticulocyte count, hct, Vit.B12, iron, folate levels before beginning therapy. Obtain a sensitivity test history before administration Avoid I.V. administration because faster systemic elimination will reduce effectiveness of vitamin. DURING: Dont give large doses ofvitaminB12 routinely; drug is lost through excretion.

 Dont mix parenteral preparation in same syringe with other drugs. AFTER: Protect Vit.B12 from light. Dont refrigerate or freeze. Monitor patient for hypokalemia for first 48 hours, as anemia correct itself. Give potassium supplements, as needed

Name of the Drug Olanzapine (Zydis)

Dose/ Frequency 10 mg

Mechanism of Action The exact mechanism of action of olanzapine is not known. It may work by blocking receptors for several neurotransmitter s (chemicals that nerves use to communicate with each other) in the brain. It binds to alpha-1, dopamine, histamine H-1, muscarinic, and serotonin type 2 (5-HT2) receptors.

Indication Olanzapine is used for treating schizophrenia and acute mixed or manic episodes associated with bipolar disorder. It also is used as maintenance therapy for bipolar disorder and treating agitation due to schizophrenia or bipolar disorder. Olanzapine also is used in combination with fluoxetine (Prozac) for treatment of resistant depre ssion and

Contraindication -Contraindicated with allergy to olanzapine, myelo proliferative disorder s, severe CNS depression, comatose states, lactation. -Use cautiously in elderly or debilitated patients, or with CV or cerebrovascular disease, dehydration, seizure disorders, Alzheimer's disease, prostate enlargement, narrow-angle glaucoma, history of paralytic ileus or breast cancer, pregnancy. .

Side Effects Drowsiness dizziness sedation seizures increased salivation constipatio n fast heart rate

Nursing Responsibilities Do not dispense more than 1-wk supply at a time. Peel back foil on blister pack of disintegrating tablets; do not push through foil; use dry hands to remove tablet and place in mouth. Prepare solution for IM injection using 2.1 mL sterile water for injection. Resulting solution contains 5 mg/mL. Solution should be clear yellow. Use within 1 hr of reconstitution. Discard any unused portion. Monitor for the many possible drug interactions before beginning therapy. WARNING: Monitor elderly patients for dehydration and institute remedial measures promptly; sedation and decreased sensation of

treatment of depression associated with bipolar disorder.

thirst related to CNS effects of drug can lead to dehydration. Encourage patient to void before taking the drug to help decrease anticholinergic effects of urinary retention. Monitor for elevations of temperature and differentiate between infection and neuroleptic malignan t syndrome. Monitor for orthostatic hypotension and provide appropriate safety measures as needed.

Name of the Drug

Dose/ Frequency Chlorpromazine 100 mg

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

Indication
Acute and chronic psychoses, particularly when accompanied by increased psychomotor activity. Nausea and vomiting. Also used in the treatment of intractable hiccups.

Contraindication - 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.

Side Effects
CNS: neuroleptic malignant syndrome, sedation, extrapyramidal reactions, tardive dyskinesia CV: hypotension (increased with IM, IV) EENT: blurred vision, dry eyes, lens opacities GI: constipation, dry mouth, anorexia, hepatitis, ileus GU: urinary retention Hematologic: agranulocytosis, leukopenia Skin: photosensitivity, pigment changes, rashes

Nursing Responsibilities Assess mental status prior to and periodically during therapy. Monitor BP and pulse prior to and frequently during the period of dosage adjustment. May cause QT interval 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 eight. Assess patient for signs and symptoms of dehydration. 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. Advise patient to take medication as directed. Take missed doses as soon as remembered, witih remaining

doses evenly spaced throughout the day. May require several weeks to obtain desired effects. Do not increase dose or discontinue medication without consulting health care professional. Abrupt withdrawal may cause dizziness, nausea, vomiting, GI upset, trembling, or uncontrolled movements of mouth, tongue or jaw.

Name of the Drug Diphenhydra mine

Dose/ Frequency Capsules: 25 and 50 mg. Tablets: 12.5, 25, and 50 mg. Strips: 12.5 and 25 mg. Elixir, oral solution, liquid: 12.5 mg per teaspoon (5 mL). Suspensio n: 25 mg per 5 ml. Injection: 50 mg per ml

Mechanism of Indication Action -Diphenhydramine Histamine is is used for the relief released by of nasal and nonthe body nasal symptoms of during several various allergic types of conditions. It is also allergic used to alleviate reactions and-- cold symptoms and chronic urticaria(hiv to a lesser es). extent. When Diphenhydramine histamine also is used for binds to its allergic reactions receptors on involving the eyes cells, it (allergic stimulates conjunctivitis) changes - to prevent or treat active motion within the sickness, and for cells that lead mild cases to sneezing, itchi of Parkinsonism, including drugng, and induced increased Parkinsonism. mucus production. Antihistamine s compete with histamine

Contraindication cardiac disease or hypertension glaucoma gastric or duodenal ulcers

Side Effects Sedation tiredness sleepiness dizziness disturbed coordinatio n drying and thickening of oral and other respiratory secretions stomach distress

Nursing Responsibilities Give without regards to meals. Scored tablets may be crushed. Do not crush capsules or film-coated tablets. If patient is having acute allergic reactions, obtain history of recently ingested food, drugs, environmental exposure, and recent emotional stress. Monitor rate, depth, rhythm, and type of respiration. Monitor rate, depth, rhythm, and quality or rate of pulse. Assess lung sounds for rhonchi, wheezing, rales. Monitor blood pressure especially in elderly. Monitor children closely for paradoxical reaction.

for cell receptors; however, when they bind to the receptors they do not stimulate the cells.

Name of the Drug Quetiapine (Seroquel)

Dose/ Frequency 100mg BID

Mechanism of Action Quetiapine is an oral antipsychotic drug used for treating schiz ophrenia and bipolar disorder. Although the mechanism of action of quetiapine is unknown, like other antipsychotics, it inhibits communicatio n between nerves of the brain. It does this by blocking receptors on the nerves for

Indication

Contraindication

Side Effects

Nursing Responsibilities

Quetiapine is used alone or in combination with other drugs to treat schizophrenia and bipolar disorder.

-Contraindicated in patients with a known hypersensitivity to this medication or any of its ingredients.

Drowsiness dizziness pain in the joints, back, neck, or ears weakness dry mouth indigestion constipation gas stomach pain or swelling increased appetite excessive weight gain

Advise patient of risk of orthostatic hypotension. Risk is greatest during 3to 5-day period of initial dose titration, when reinitiating treatment, or when increasing dosages. Tell patient to avoid becoming overheated or dehydrated during therapy. Warn patient to avoid activities that require mental alertness such as driving a car or operating hazardous machinery until CNS effects of drug are known. Remind patient to have initial eye examination before starting drug therapy and every 6 months during therapy to monitor for possibility of cataract formation. Tell patient to notify

several neurotransmit ters, the chemicals that nerves use to communicate with each other. It is thought that its beneficial effect is due to blocking of the dopamine type 2 (D2) and serotonin type 2 (5-HT2) receptors.

doctor of other medications (prescription or OTC) he is taking or plans to take.

Tell female patient to notify doctor if she becomes pregnant or intends to become pregnant during drug therapy. Advise her not to breast-feed during therapy. Advise patient to avoid alcohol during therapy.

Name of the Drug Vitamin C Ascorbic Acid

Dose/ Frequency 500mg OD

Mechanism of Action Assists in collagen formation, tissue repair; involved in oxidation reduction reactions, other metabolic reactions. Vitamin C is involved in metabolism; carbohydrate utilization; synthesis of lipids, proteins, carnitine. It also preserves blood vessel integrity.

Indication Vitamin C is used for prevention and treatment of scurvy, acidification of urine, dietary supplement, prevention of and reduction in the severity of colds.

Contraindication -Hypersensitivity to drug/class/compon ents -Use cautiously in client with renal impairment

Side Effects

Nursing Responsibilities

Abdominal May give without regard to cramps food. Nausea Assess for clinical Vomiting improvement (improved Diarrhea sense of well-being and Increased sleep patterns). Flushing,H Observe for reversal of eadache deficiency symptoms Dizziness,S (gingivitis, bleeding gums, leepiness poor wound healing, digestive difficulties, joint pain). Abrupt vitamin C withdrawal may produce rebound deficiency.