DRUG

CLASSIFICATION

ACTION

SIDE EFFECTS

CONTRAINDICATIONS

NURSING INTERVENTION

BIPERIDIN HCL tab OD

Antiparkinsonian

y Anticholinergic activity in the CNS that is believed to help normalize the hypothesized imbalance of cholinergic and dopaminergic neurotransmission in the basal ganglia

y y y y y y

Disorientation Confusion Nervousness Lightheadedness Dizziness blurred vision

y Angle-closure glaucoma y pyloric or duodenal obstruction y Use cautiously with tachycardia, cardiac arrhythmias

y Take this drug exactly as prescribed y Avoid use of alcohol, sedative and OTC y Report presence of side effects

Levopromazine 100 mg OD

aliphatic phenothi azineneuroleptic d rug.

y Levomepromazine is used for the treatment of psychosis, particular those of schizophrenia, and manic phases of bipolar disorder. It should be used only with caution in the treatment of agitated depressions, as it can cause akathisia as a side effect, which could worsen the agitation.

y Dizziness, headache, nausea, anorexia, impotence

y Levomepromazi ne may increase the risk of death when used in elderly patients with dementiarelated psychosis. Because of this possible risk, levomepromazi ne should not be used in the treatment of such patients.

y 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.

Chlorpromazine 150 mg OD

FumenazolDecanoate 0.5 cc once a monrt

Antipsychotic drugs

y Acute and chronic y CNS: neuroleptic psychoses, particularly malignant syndrome, when accompanied by sedation, extrapyramidal increased reactions, tardive psychomotor activity. dyskinesia Nausea and vomiting. CV: hypotension Also used in the (increased with IM, IV) treatment of EENT: blurred vision, intractable hiccups dry eyes, lens opacities GI: constipation, dry mouth, anorexia, hepatitis, ileus GU: urinary retention Hematologic: agranulocytosis, leukopenia Skin: photosensitivity, pigment changes, rashes The exact y hypotension, mechanism of action y insomnia of flupenthixol has y headache not been y Lightheadedness established. Its y Dizziness effects resemble those of the phenothiazine, fluphenazine, in that it belongs among the antipsychotic drugs which are less likely to cause sedation and hypotension, but have greater propensity for producing extrapyramidal reactions.

Do not use in patients with known hypersensitivity to phenothiazines. Do not use in comatose states or in the presence of large amounts of central nervous system depressants (alcohol, barbiturates, narcotics, etc.). y y The maintenance therapy of chronic schizophrenic patients whose main manifestations do not include excitement, agitation or hyperactivity

Cross-sensitivity may exist among phenothiazines. Should not be used in narrowangle glaucoma. Should not be used in patients who have CNS depression.

y Flupenthixol is also contraindicated in the presence of CNS depression due to any cause, comatose states, suspected or established subcortical brain damage, blood dyscrasias, pheochromocytoma, liver damage, cerebrovascular or renal insufficiency, and severe cardiovascular disorders. It is not indicated for the management of severely agitated

Haloperidol

Antipsychotic

Completely blocks dopamine receptors to cause sedation and also causes alpha-adrenergic and anticholinergic blockade. It depresses cerebral cortex, hypothalamus and limbic system, which control activity and aggression but also cause significant extrapyramidal effects.

y Dry mouth, salivation, hypotension, drowsiness, insomnia

y Severe toxic CNS depression or comatose states from any cause; Parkinson disease. Hypersensitivity , blood dyscrasias, coma, bone marrow depression, alcohol and barbiturate withdrawal states. Angina, epilepsy, urinary retention, narrow-angle glaucoma

y y

y y

psychotic patients, psychoneurotic patients or geriatric patients with confusion and/or agitation. As with phenothiazines, flupenthixol should not be used concomitantly with large doses of hypnotics due to the possibility of potentiation. Assess patient s disorder and mental status before drug therapy and reassesses regularly Monitor for possible adverse reactions Monitor VS during initial treatment. Check for dizziness, faintness, tachycardia Assess for constipation and urinary retention daily Assess for neuroleptic malignant syndrome Assess reflexes, gait, coordination and EPS Give oral drug in form mixed in glass

y y

y y

of juice or caffeinefree cola if hoarding is suspected; do not mix caffeine drinks, tannics and pectins give with food to decrease GI upset store in tight, lightresistant container, oral solution in amber bottle advise patient to shift positions slowly because orthostatic hypotension may occur tell patient to report adverse reaction teach patient to use good oral hygiene, frequent rinsing of mouth to prevent candidiasis. Sugarless gum may be used for dry mouth

Enano, Ma. Tezza Joy H. (3nu04)