NAME OF DRUG

MECHANISM OF ACTION Alters the effects of dopamine in the CNS Also has anticholinergic and alphaadrenergic blocking activity. Diminished signs and symptoms of psychoses

INDICATION

CONTRAINDICATION

ADVERSE REACTION CNS: extrapyramidal symptom such as muscle rigidity or spasm, shuffling gait, posture leaning forward, drooling, masklike facial appearance, dysphagia, akathisia, tardive dyskinesia, headache, seizures. CV: tachycardia, arrhythmias, hypertension, orthostatic hypertension. EENT: blurred vision, glaucoma GI: dry mouth, anorexia, nausea, vomiting, constipation, diarrhea, weight gain. GU: urinary frequency, urine

DRUG INTERACTION

NURSING CONSIDERATION 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. 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,

Generic Name: haloperidol

Brand name: haldol

Organic Psychoses acute psychotic symptoms Relieve hallucinations, delusions, disorganized thinking severe anxiety seizures

seizure disorder glaucoma elderly clients

Classification: Antipsychotics

Other central depressants (alcohol, tranquilizers, narcotics): actions and side-effects of these drugs (sedation, respiratory depr ession) are increased. Levodopa: decreased action of levodopa

retention, impotence, enuresis, amenorrhea, gynecomastia Hematologic: anemia, leucopenia, agranulocytosis Skin: rash, dermatitis, phtosensitivity

severe muscle stiffness, loss of bladder control. Report symptoms immediately. May also cause leukocytosis, elevated liver function tests, elevated CPK.

NAME OF DRUG

MECHANISM OF ACTION Antagonizes the effect of histamine at H1 receptor sites; does not bind or inactivate histamine

INDICATION

CONTRAINDICATION

ADVERSE REACTION CNS: headache, fatigue, anxiety, tremors, vertigo, confusion, depression, seizures, hallucinations CV: tachycardia, palpitations, orthostaic hypotension, heart failure EENT: blurred vision

DRUG INTERACTION Diphenhydrami ne hydrochloride has additive effects with alcohol and other CNS depressants (hypnotics, sedatives, tranquilizers, etc). MAO inhibitors prolong and intensify the anticholinergic (drying) effects of antihistamines.

NURSING CONSIDERATION Caution the client that the medication may cause drowsiness, creating difficulties or hazards or other activities that require alertness. Tell the client to take the medication with food to decrease GI upset. Explain to the client that arising quickly form a lying or sitting position may cause orthostatic hypotension. commonly in elderly clients. Explain to the client that use of these drugs in warm weather may increase the likelihood of heatstroke.

Generic Name: diphenhydramine

parkinsonism or drug-induced extrapyramidal effects

Brand name: Benadryl

contraindicated with allergies in penicillins, cephalosporins, or other allergens use cautiously with renal disorders, pregnancy, lactation

Classification: Antiparkinsonian drug

NAME OF DRUG

MECHANISM OF ACTION

INDICATION

CONTRAINDICATION

ADVERSE REACTION CNS: headache, tremors, confusion, restlessness, memory loss, seizures, slurred speech, muscle weakness, lack of coordination, lethargy, stupor CV: bradycardia, ECG changes, arrhythmias, hypotension, peripheral circulatory collapse EENT: blurred vision, tinnitus

DRUG INTERACTION Carbamazepi ne interacts with multiple drugs and caution should be used in combining other medicines with it. Lower levels of carbamazepin e are seen when administrated with phenobarbital, phenytoin(Dila ntin)

NURSING CONSIDERATION Administer medication with food to minimize gastric irritation. Tablets may be crushed if patient has difficulty swallowing. Do not crush or chew extended-release tablets. May cause dizziness or drowsiness. Advise patient not to take alcohol or other CNS depressant concurrently with this medication.

Generic Name:

carbamazepine

Brand name:

Tegretol, Tegretol XR , Equetro, Carbatrol

Decreases synaptic transmission in the CNS by affecting sodium channels in neurons Prevention of seizures

Reduces anxiety, irritability, elation Impulse control behavior

Hypersensitivity Kidney disease Cardiovascular disease Seizure disorder, myasthenia gravis Dehydration Hypothyroidism

NAME OF DRUG

MECHANISM OF ACTION Anticholinergic, chemically related to atropine, which blocks vagally mediated reflexes by antagonizing the action of acetylcholine. Causes bronchodilation and inhibits secretion from serous and seromucous glands lining the nasal mucosa.

INDICATION

CONTRAINDICATION

ADVERSE REACTION CNS: Nervousness, dizziness, headache, fatigue, insomnia, blurred vision GI: Nausea, GI distress, dry mouth RESPIRATORY: Dyspnea, bronchitis, bronchospasm, URI, cough, exacerbation of symptoms, hoarseness, pharyngitis

DRUG INTERACTION there is some potential for additive anticholinergic effects when administered with other anticholinergic agents.

NURSING CONSIDERATION Administer medication with food to minimize gastric irritation. Tablets may be crushed if patient has difficulty swallowing. Do not crush or chew extended-release tablets. May cause dizziness or drowsiness. Advise patient not to take alcohol or other CNS depressant concurrently with this medication.

Generic Name: Ipratropium bromide

Brand name: Apo-Ipravent, Atrovent, GenIpratropium

Classification: Anticholinergic Antimuscarinic Bronchodilator Parasympatholyt ic

bronchodilator for maintenance treatment of bronchospasm associated with COPD, chronic bronchitis, and emphysema nasal spray: symptomatic relief of rhinorrhea associated with perinneal rhinitis, common cold, seasonal allergic rhinitis.

contraindicated with hypersensitivity to atropine or its derivatives, sybean or peanut allergies use cautiously with narrow-angle glaucoma, prostatic hypertrophy, bladder neck obstruction, pregnancy, lactation

NAME OF DRUG

MECHANISM OF ACTION Antiprotozoal activity in susceptible pneumocytiscarini i pneumonia infections, mechanism of action is not fully understood, but the drug interferes with nuclear metabolism and inhibits the synthesis of DNA, RNA, phospholipids, and proteins, which lead to cell death.

INDICATION

CONTRAINDICATION

ADVERSE REACTION PARENTERAL CV: hypotension, tachycardia GI: Nausea, anorexia GU: Elevated serum creatinine, acute renal failure HEMATOLOGIC: Leukopenia, hypoglycaemia, thrombocytopeni a, hypocalcemia, elevated LFTs LOCAL: Pain, abscess at injection site INHALATION CNS: Fatigue, dizziness, headache, tremors, confusion, anxiety, memory loss, seizures CV: Tachycardia

DRUG INTERACTION Do not reconstitute with saline solutions. Do not mix with other drugs.

NURSING CONSIDERATION monitor patient closely during administration; fatalities have been reported. position patient before parenteral administration to protect patient if BP changes.

Generic Name: Pentamidineisethi onate

Brand name: Pentacarinat, Pentam 300, Nebupent

Classification: Antiprotozoal

treatment of P.carinii pneumonia, especially in patients who do not respond to therapy with the less toxic trimethoprimsulfa methaxazole combination inhalation: prevention of P.carinii pneumonia in high risk, HIVinfected patients unlabeled use (injection): treatment of trypanosomiasis, visceral leishmaniasis

contraindicated with history of anaphylaptic reaction to inhaled or parenteral pentamidineisethion ate, lactation use cautiously with hypotension, hypertension, hypoglycaemia, hyperglycemia, hypocalcemia, leukopenia, thrombocytopenia, anemia, hepatic or renal impairment, pregnancy