Drug

Action

Indication

Contraindication

Side-Effects/Adverse Reactions CNS: Severe extrapyramidal reactions, tardive dyskinesia, seizuressedation, drowsiness, lethargy, headache, insomnia, confusion, CV: Tachycardia, hypotension, EEG: Blurred vision GI: Dry mouth, anorexia, constipation, diarrhea, nausea, vomiting

Nursing Considerations

Haloperidol - Typical antipsychotic

Unknown. A butyrophenone probably exerts antipsychotic effects by blocking postsynaptic dopamine receptors in the brain.

Psycotic disorders Chronic psychosis requiring prolong therapy Tourette Syndrome

Patients hypersensitive to drug Patients with parkinsonism, in coma, and CNS depression Use cautiously in elderly and deliberated patients; in patients with history of seizures; severe CV disorders, allergy, glaucoma, and urine retention, and those taking anticonvulsants, antiparkinsonians, or lithium.

Warn patient to avoid activities that require alertness and good coordination until effects of the drugs are known. Educate patient that drowsiness and dizziness usually subside after a few weeks. Tell patient to relieve dry mouth with sugarless gum or hard candy.

GU: Urine retention, menstrual Warn patient to avoid irregularities, alcohol during drug therapy.

Drug Akineton - Anticholinergic - Anti parkinsonian

Action It is a weak peripheral anticholinergic agent with nicotinolytic activity. The beneficial effects in Parkinson disease and Neuroleptic-induced extrapyramidal symptoms are believed to be due to the inhibition of the striatal cholinergic receptors.

Indication Treatment for Parkinsons disease Improve the parkinsonian signs and symptoms related to antipsychotic drug therapy. Relieves muscle rigidity, reduces abnormal sweating and salivation

Contraindication Hypersensitivity to Biperiden or any component of the formulation. Narrow-angle glaucoma Bpwel obstruction, megacolon Caution in patients with obstructive diseases of the urogenital tract; patients with known history of seizures, and those with dangerous tachycardia

Side-Effects/Advese Effects Side-Effects: CNS: Drowsiness, vertigo, headache, dizziness Peripheral: Blurred vision, dry mouth, impaired sweating, abdominal discomfort, obstipation, tachycardia Eyes: Mydriasis, photophobia

Nursing Responsibilities Remind patient to use alcohol cautiously. Alcohol may increase drowsiness and dizziness. Remind client to avoid being overheated. Drug may cause decrease sweating. Educate client to take the drug with a glass of water.

Adverse-Effects:

CV: Ortho hypotension, bradycardia CNS: Drowsiness, euphoria, disorientation, agitation, sleep disorder EEG: Blurred vision GI: constipation, dry throat, nasal dryness GU: urinary retention

Take it after meal if it upsets the stomach. Remind to store at room temperature away from moisture and heat. Instruct to take special care with dental hygiene and have regular dental checkups.

Drug Chlorpromazine - Typical Antipsychotic

Action Unknown. A piperidine phenothiazine that probably blocks postsynaptic dopamine receptors in the brain.

Indication Psychosis, mania Nausea, Vomiting Tetanus

Contraindication Patients hypersensitive to drug, in those with CNS depression, and those in coma Use cautiously in elderly and deliberated patients and in patients with hepatic or renal disease, severe CV disease, respiratory disorders, hypocalcemia, Use cautiously in acutely ill, or dehydrated children.

Side-Effects/Advese Effects Side-Effects: CNS: extrapyramidal reactions, sedation, tardive dyskinesia, pseudoparkinsonism CV: orthostatic hypotension GI: dry mouth, constipation GU: urine retention Skin: mild photosensitivity reactions Adverse Effects: CNS: Seizures, NMS Hema: Leukopenia,

Nursing Responsibilities Obtain baseline BP measurements before starting the therapy and monitor regularly. Watch for orthostatic hypotension. Monitor for tardive dyskinesia. Warn to avoid activities that require alertness or good coordination until effects of drug are known. Advise not to crush, chew, or break extended release capsule form before swallowing.

agranulocytosis, thrombocytopenia, anemia

Educate to avoid alcohol while taking the drug.

Drug Diphenhydramine Antihistamine

Action Competes with histamine for H1-receptor sites. Prevents, but doesnt reverse, histamine-mediated responses, particularly those of the bronchial tubes, GI tract, uterus, and blood vessels. Structurally related to local anesthetics, drug provides local anesthesia and suppresses cough reflex

Indication Rhinitis, allergy symptoms, motion sickness, Parkinsons disease

Contraindication Contraindicated in patients hypersensitive to drug Avoid use in patients taking MAO inhibitors. Use with caution in patients with prostatic hyperplasia, asthma, COPD, increased intraocular pressure, hyperthyroidism, CV disease, and hypertension. Children younger than age 12 should use drug only as directed by prescriber.

Side-Effects/Advese Effects CNS: drowsiness, sedation, sleepiness, dizziness, seizures, confusion, insomnia, headache, vertigo, fatigue, restlessness, tremor, nervousness. CV: palpitations, hypotension, tachycardia. EENT: diplopia, blurred vision, nasal congestion, tinnitus. GI: dry mouth, nausea, epigastric distress, vomiting, diarrhea, constipation, anorexia. GU: dysuria, urine retention, urinary frequency. Hematologic: thrombocytopenia, agranulocytosis, hemolytic anemia. Skin: urticaria, photosensitivity, rash

Nursing Responsibilities Stop drug 4 days before diagnostic skin testing. Injection form is for I.V. or I.M. administration only. Dizziness, excessive sedation, syncope, toxicity, paradoxical stimulation, and hypotension are more likely to occur in elderly patients. food or milk to reduce GI distress. Warn patient to avoid alcohol and hazardous activities that require alertness until CNS effects of drug are known.