I

I
I
I
PHARMACOLOGY
I
I
I
I
I
I
I
: :.
',.
. 1
BASIC MEDICATION CONCEPTS
I
I
I
I
I
..
,
Ii
"'
I
I
I
'-----'
I I.
I
I
I
I
I
JI.
I
I
III.
I
I
,
IV.
L ..
I
V.
I
!---..
I
,
VI.
,
1
I
I
TABLE OF CONTENTS
I Training 9blectives
Pharmacology: Basic Medication Concepts
AntipsYchotic Medications ..........................................
a. Medication Names
b.
Intended Effects ...........................' ..................
c.
Side Effects .................... '............................
d. ,Side effects !hat should be
e.
Positive vs. Negative symptoms of Schizophrenia,
f.
C{ozarif - Special considerations ................................
-
g. How is Clozaril different
h. Tarvide
i.
Neurolptic Malignant Syndrome
j.
Extrapyramidal Reactions
Anti8hoI!nergic Medications - medications used to !reat .side effects of other
medIcations ....................... '.' . . . . . . . .....................
a.
Medication Names ...........'. : .....
Artane - Cogentin special considerations (Note} :'. .
b.
lntended Effects ........................................... ; .
c.
Side Effects .............................. '. . . . . . . . ..........
d. Special Considerations
Anti-Anxiety Medications - medications used to treat disorders.......
a. Medication Names
b.
Intended Effects .............. .............................
c.
Side Effects. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .......
d.
Central nervous System Depressants
a.Special Considerations
Anti-Manic
Medications - medications used to treat mood disorders ......' ...
a. Medication Names
b.
Intended Effects ............................ " ................
c.
Side Effects . . . . . ... ............... '. . . . . . . . . . . . . . . . . . . .....
d. SpeCial considerations
Mood stabilizers! Anti-Consultants - medications used to treat mood disorders!
seizure disorders. . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
- .
a. MedicC!tion Names
b.
Intended Effects .................................... : ........
c.
Side Effects ................................................
d.
Side effects that should be reported immediately
e.
Special considerations
Antidepressant Medication - Medication used to treat depression
a. Medication Names
b.
Intended Effects .............................................
c.
Side Effects . '. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .......
d. SpeCial considerations
p. 1

1-3
p.4-7
p.4
p.4-5
'
p. 5
p. 5
p. 5
-
p.6
p.6-7
p. 7
p. 7
p. 7
'
Pp.8-9
p. 8
p. 8
. p. 8
,p.8
p.8-9
p.9-12
p.9

p. 9
,p. 10
p.10
p. 10-11
p. 11-12
p. 11
P. 12
p. 12
,
p. 12

p. 13-14
p. 13
p. 13
p. 14
p. 14
p.13-14
p.15-16
p. 15
p. 15
p. 15
p.16
I
stimulants - medication used to treat attention deficit/hyperactivity
p. 17
I
Disorder ADDfADHD
Medications - A listing of generic and brand name including "use" ..........
p. 18-19
...
I
I
Pharmacology Vocabulary ................ , ........................
p.20-23
. . .
Examples of control substances
p.24
I
Psychotropic Medications: Acting on the brain/mind
I
I
I
I
I
I
,
,

I
,



I
I OBJECTIVES: At the completion of this training you will be able to:
1. Explain to the consumer, their family members and/or significant others (S.O.) some of the
I
basic medication concepts, using this hand out as a tool.
I
2. You will be able to name 3 Antipsychotic Medications.
I
3. You will be able to name 2 Medications used to treat side effects of antipsychotic
medications.
4.
You will be able to state the difference between administering medication and monitoring sell
administration of medication.
I
5. You will be able to explain what is meant by ''Tardive Dvskinesia".
I
6. You will be able to give examples of medication side effects to watch for in consumers who
take medications and how you may help the consumer to cope with these effects.
I
I
PHARMACOLOGY: BASIC MEDICATION CONCEPTS
I
Before a consumer begins taking any medication, it is important for the staff to know
the following information about the consumer.
I
1. Allergies to any medications or food.
2. If the consumer is pregnant or intends to become pregnant while using the medication. If the
I
intent is not to get pregnant be careful some medications interact with birth control
medication.
I
3. If the consumer is breast-feeding.
4. If the consumer is taking any other medication. This includes prescription, over-the-counter
I
medication and herbal tablets and drinks
5. If the consumer has any other medical problems or any past history of medical problems ie:
I
diabetes, high blood pressure, TB, hepatitis, prior surgery, etc., etc.
,
B. Helpful Information that you can tell your consumers:
1. Do not stop taking the medication without first checking with their doctor.
I 2. Do not change the dose or time medication is taken, without first checking with their doctor.
I 1
I
i
I
3.
Mediation will add to the effects of alcohol and other eNS depressants (medications that sloVl
down the Central Nervous System).
4. Do not wait until Friday afternoon to check if you have enough medicine for the week end
I
(staff should ask tool)
i
5. Do not share your medicine with friends or family who seem to have the same symptoms.
6. Keep a list of all current medications and your doctor's name in your purse or wallet.
f 7. Consumers will be monitored for the development of abnormal involuntary movements,
particularly tardive dyskinesia. MR consumers will be monitored every 3 months, MH
consumers in residential units every 3 months, and MH consumers in outpatient clinics every
I 6 months, children and adolescents will be monitored every 3 months in residential wnits and
every 6 months in outpatient clinics.
I
C. PHARMACOLOGY: OTHER MEDICATION CONCEPTS
1..
Intended Effect: When a drug does what it is prescribed to do, this is called the intended
i
I
effect. Example: is given to a consumer with a psychotic disorder with audit.ory
hallucinations. (Reducing the auditory hallucinations is the intended effect) This is also,
given to children to control behavioral problems. (Intend.ed effect is to stabilize behavior.)
...
.. i? ...."
Side Effect: When a drug causes an undesired effect leading to uncomfortable or more
severe symptoms, this: is cafled side effect or "adverse effect." The term I'adverse effect" is
i
used when symptoms are more troublesome, but often people use both terms
interchangeably. Side effects can be a rash, dermatitis, blurred vision, etc. See each
classification.
-
3. AIMS: Abnormal involuntary movement scale. A tool the doctor or.nurse uses to measure
-
the involuntary movements that consumers on psychotrqpic medications may develop.
4. Tardive Dyskinesia: Tardive =late onset, Dyskinesia =Movement Disorder ,
I
Tardive Dyskinesia is a central nervous system disorder characterized by twitching of face,
-
tongue, and other muscle movements; generally results from prolonged use of some
neuroleptic drugs (although TD may develop quickly in some consumers) and sometimes as
a result of poorly monitored AIMS (Abnormal InvoluntarY Movement Scale.)
5. Therapeutic Drug Levels: Lab tests which measure the amount of a drug circulating in a
I
person's blood tells the doctor that the amount of drug needed to produce the intended effect
is or is not in the consumer's blood. Example: Lithium level and Tegretollevel.
I
6. Placebo: Medication with no real healing agent,one's own belief thatthe medication will
work causes effect.
I
IJ
2
lIil
I
7.
Akathisia: A =Not, Kathisia ::: sitting. <Inability to sit down because the thought of doing se
I
I
causes severe anxiety. Patient has a feeling of restlessness and an urgent need of
movement and complains of a feeling of muscle quivering. This symptom can .be a
complication of antipsychotic therapy.
-""'\ ,
I
8.
",'"
}
Controlled Su bstance: Medications with potential for addiction, kept under lock and key,
and carefully accounted (signed) for. Examples: Benzodiazepines, such as Valium, Librium,
Xanax, Ativan and also stimulants such as Ritalin and Dexedrine.
Note: Not aU anti-anxiety medications are controlled drugs.
'1/".,.
I ! 9.
Drug Interaction: One drug affecting the way another drug acts. Some may have serious
adverse effects.
I 10.
Extral}!{Jamidal Symptoms: (EPS). Symptoms that resemble Parkinson'.s diseasR
Shuffling walk, drooling, shakiness, mask-like facial expression, "pill-rolling", tremor.
I
Example: the expression "the Thorazine shuffle".
I
11.
Administer Medications: Only licensed nursing staff will administer consumer's ora1.
medication.
I
12.
Certified medical assistance: May administer medication under the of an
EPMHMR physiCian. . <
Supervision of s.elf-adJ.llinistration of medications - staff/providers,oversee thE;it
I
consumers take their medications as prescribed;
I,
PDR: {Physician's Desk Reference}: An annually published compilation of information. on
drugs approved by the FDA for.marketing. Lists the folfowing about drugs: Indications (for
I
usage), effects, dosages, routes (of administration), methods, frequency, and duration of
administration and any relevant warnings, hazards, contraindications, side effects, and.
precautions. Drugs are listed under their brand and geperic names. Every unit should have
an updated issue of the PDR. -: '
'1 15. Prescription medicines: Medication prescribed by a physician
16. Over-the-counter medicines: (OTe) need no prescription, have a low potential for abuse,
I
fewer side effects and are purchased as desired by individuals.
,
Brand Name: The manufacturers name for the product. Example: Tylenol.
..
Generic: The chemical name of the drug. Example: Acetaminophen.
,
I
19. The 5 R's of monitoring medication: The right consumer. the right medication, the right
dose, the right time, the right route.
20. Factors that influence theeffects of medications: Weight, age, gender, other medication
that a patient may also be taking, including OTe meds, alcoholic beverages, medical
conditions especially kidney and liver function.
.'
I]
3
I
I
Antipsychotic Medication: Medications used to treat Psychotic conditions
r\. Medications Names:
I
I
Brand Name
Haldol
I
Loxitane
Mellaril
Moban
I
Navane
-
Prolixin
Serentil
Stelazine
Thorazine
I
Trilafon
Atypical antipsychotics/New Generation
Meds (NGM)
I
Clozaril*
I
G,eodon
Resperdal
I
'Seroquel
Zyprexa
. "ecanoates: Injectables
,adol Decanoate
I Prolixin Decanoate
I
"
Generic Name
Haloperidol
Loxapine
Thioridazine
MoJindone
Thiothixene
Fluphenazine
Mesoridazine
Trifuloperazine
Chlorpromazine
Perphenazine
Clozapine!'*:
Ziprusadone
Risperidone
I' Quetiaipine
Olanzapine
Haloperidol
Fluphenzine
**This mediCation requires. a strict program of monitoring blood levels on a weekly basis.
Clozaril can cause a potentially fatal blood disorder in which white blood cell count drops to
anextremely low level., (AgranuQcytosis) This disorder is reversible if caught early. That is
I why it must be monitored every week without exception Jor the first six months. After that, at
the doctor's discretion, the consumer can come in every two weeks 'for blood work.
B.lntended Effects of Antipsychotics:
I
The intended effects of antipsychotics are to stop or reduce hallucinations, reduce delusions
and strange ideas, and allow the individual to function more effectively and appropriately.
These medications are used for psychotic states, such as schizophrenia, or other psychotic
conditions.
2. These medications reduce paranoid or persecutory delusions, decrease aggressive or self
I
abusive behavior, improve concentration and reasoning, increase social interaction, and alse
relieve anxiety and agitation.
I!
Antipsychotic drugs are the best treatment available now, but they do not "cure"
3.
schizophrenia or ensure that there will be no further psychotic episodes.
I:
4
I
4. Antipsychotic medications have also been called Major tranquilizers, Neuroleptic Drugs
I
and Psychotherapeutic Drugs.
I rG:) Side Effects: Common:
\,-.,..,/ Constipation
Decreased sweating
Drowsiness Dry Mouth
I
Light-headed Dizziness
Restlessness (Akathisia)
Muscle Stiffness or Rigidity
Low Blood Pressure (Orthostatic Hypotension)
Increased sensitivity to sun
I
Weight gain (from about 23 Ibs)
(6) Side Effects that should be reported immediately to the doctor:
I
../'
'"
1. Convulsions (Seizures)
2. Lip smacking or puckering
3. Tic-like, twitching or twisting movements
4. Uncontrolled chewing and tongue or mouth movements
5. Mask-like facial expression or muscle stiffness
I
6. Shuffling walk or stiff arms and legs (EPS)
7. Trembling of hands
8. Inability to move eyes
I
9. Uncontrolled movements or weakness of arms or legs
10. Fainting or dizzy spells
II
11. Painful, inappropriate penile erection (continuing)
12. Fast or irregular heartbeat
13. Extreme restlessness and inability to sit sUII" (Akathisia)
I
E. Positive versus Negative Symptoms of SchizoRhrenia: ..
,
1. Positive Symptoms include hallucinations, delusions,' marked positive formal thought
disorder (manifested by markedincoherenoo, derailment, tangentiality, or ilfogicality), and
bizarre or disorganized behavior.
,
II
2. Negative Symptoms include marked poverty of speech or poverty of cohtent of speech,
affective flattening, and inability to experience pleasure, few social contacts, emotional
withdrawal and lack of concern with self-care.' .
F. With all Antipsychotics:
Ii

a. Increased fluid intake may help the side effects of dry mouth, nasal stuffiness, and
constipation. Frequent rinsing of the mouth, hard candy and sugarless gum will also
help.
-
b. Increased f1.uid and high fiber will help relieve constipation,
,r
'i
5
I
c. Advise consumers that care should be taken not to get up too suddenly. Getting up
I
suddenly can cause dizziness in someone who does not take medications, so you cal
imagine what kind of dizziness it can cause with our consumers. Advise the consumE
to sit on the side of the bed in the morning when they wake up and dangle their feet f(
I
a minute or two before they get up.
I
d. Wear sunscreen, protective clothing; hats and sunglasses; especially in the summer.
Do not become overheated during exercise or hot weather, since overheating may
result in heat stroke.
I e. Antipsychotic drugs do not control a person's thoughts; instead, they often help the
consumer- to tell the difference between psychotic symptoms and the "real world."
I G. Clozaril Special Considerations:
I
a.
Increased constipation can be a major problem. Encourage diet with lots of fruits,
vegetables, and whole grains. Encourage fluids. Ask doctor about use of fiber
additivesie: Metamud!.
I
I b.
Nocturnal Salivation (nighttime drooling}, happens in almost everyone on Clozari!. It
can last a long time, but it usually goes away by Itself after 8 to 12 months on the
medication. It can reoccur if the dose is increased, but will again eventually go away.
c. Orthostatic Hypotension or Postural Hypotension, (low blood pressure) happens in
about 50% of consumers on this medication. It usually disappears in about 2 to 4
I
weeks. Caution consumer to get up especially from lying down, slowly and in steps:
rise up on elbow, sit (slowly) at edge, then rise to standing slowly. Move slowly at firs1
I
d. it may cause temporary drowsiness or blurred Vision. (AVOid driving if this should
occur.)
I
H.
How is ClozarH different from other antipsychotic medication?
I
a. Clozaril therapy offers new hope for many patients because it often works when other
antipsychotics have not. It has helped some seriously ill patients improve enough to
I
be able to return to normal family life, school or work.
b.
Clozaril differs from other antipsychotics in terms of side effects. It has fewer nerve
I
and muscle-related side effects common to mostantipsychotics, such as feelings or
restlessness, stiffness, shaking and muscle cramps.
Ii
I:
c.
Tardive Dyskinesia, movements such asgrimacing,sucking, and smacking of the lips
and spastic movements of the arms, legs, head and neck, over which the consumer
has no control have not been proven to occur as a result of Clozaril therapy. In fact,
Clozaril has even improved the symptoms of tardive dyskinesia in some patients who
developed this side effect while taking other
6

1
I
d. About one or two people out of every 100 who take Clozaril will develop
I
I
agranulocytosis. With this condition, the body's ability to make white blood cells can
severely reduce the body's ability to fight infection. If there is a decrease, even
something as minor as a sore throat can rapidly become a life-threatening situation.
Therefore, weekly bl.ood tests are essential for ttie first six months. After six months,
the doctor can authorize the consumer to come every two weeks after.
I
Tarvide Dvskinesia:
I
I 1. A central nervous system disorder characterized by involuntary movements most often
affecting the mouth, lips, and tongue, and sometimes the trunk or other parts of the body. It
generally occurs in about 15 to 20% of consumers who, have been receiving antipsychotic
I
drugs for many years, but TO can occur in consumers who have been treated with these
drugs for shorter periods of time. In most cases, the symptoms of TO are mild, and the
consumer may be unaware of the movements. Often these will disappear if the medication
can be stopped.
I
2. Tardive means "late onset". Dyskinesia means "movement disorder".
3. Remember, AIMS (Abnormal Involuntary Movement Scale) needs to be done routinely by thl
II
doctor or nurse to assess the consumer for abnormal involuntary movements. Anytime you
,\
observe abnormal involuntary movements in our consumers, document what you obselVe
and report your observations to the unit nurse or the doctor.
I
J. Neuroleptic Malignant Syndrome:
I;
1. A rare and potentially fatal syndrome, also called NMS.. Ifs clinical manifestations are great!
increased muscle tone (muscle rigidity), decreased leVEn of consciousness, hyperpyrexia
(increase in body temperature to over 101F). altered mental status, irregular pulse and blooe
I
pressure, tachycardia, (abnormally rapid heart rate), profuse sweating .
: . '1
2. This condition is very hard for the physiCian to diagnose because it is easily confused with,
I
other serious medication conditions.
3. Should the consumer have any of the above signs and symptoms, you should call the
I
doctor immediately!
4. 60% of affected patients are men.
I
I. Extrapyramidal Reactions:
,
The extrapyramidal system is the portion of the central nervous system responsible for
coordinating and integrating various aspects of motor or body movements.
'J
1. Extrapyramidal syndrome is a variety of signs and symptoms, including muscular rigidity,
tremors, drooling, shuffling gait (parkinsonism); restlessness (akathisia); peculiar involuntary
postures (dystonia); motor inertia (akinesia) and many other neurologic disturbances.
II
z
.1
I'
I
2.
Oculogyric Crisis may occur, where the eyes are elevated and "locked" in this position.
These reactions are TERRI FYI NG to the consumer who has no prior experience with these
problems or knowledge of this type of side effect.. Administration of an anticholinergic drug i
I
necessary at this point and provides rapid treatment of this acute dystonic reaction.
3.
Parkinsonian Syndrome has many features of Parkinson's Disease, such as: diminished
I
I
range of facial expression (masked facial features), cogwheel rigidity, slowed movements,
drooling, small handwriting and "pillrolling" tremor. The onset of this side effect is gradual,
and may not a p p e a ~ for weeks after the meds have been administered.
I'
)1
Antichofinergics: Medications used to treat side effects of Antjpsychotics:
Medication names:
t" , I
f' A\
Brand Name
Generic Name
I Akineton Biperiden
Artane* Trihexphenidyl
Benadryl Diphenhydramine
II
Cogentin Benztropine
SymmetreJ Amantidine
It
Note* Artane, is potentially abused. It is known to create a feeling of a "high" or well
being in some .people, so if you have a consumer who is always "running out" 'or
II
"losing" or "missing" their Artane, you may want.to talk to the doctor and monitor this
more closely. Cogentin has also been abuse in this way.
Ii
- ~ ~ -
"
B. Intended Effect:
II
The intended effect of this medication class is to reduce or eliminate the side effects that the
consumer may get from taking antipsychotic drugs.
Examples of the side effects this medication class helps to alleviate include:
,
a. Restlessness
b, Involuntary movements
c. Muscle rigidity or stiffness
d. Twitching
I
e. Tongue or mouth movements
I
c. Side Effects:
1. Like all other medications, these medicines can also cause unwanted side effects.
,
2. Some side effects you will see with these drugs are:
a. Drowsiness
,
b. Dry mouth
c. Constipation
d. Urinary retention
e. Decreased or possibly increased sweating

8
I
I
,
D. Special Considerations:
,
Remember, this medication is given to relieve or diminish the side effects of antipsychotic
drugs which already cause dry mouth. Taking anticholinergics increases dry mouth.
Frequent rinsing, sugarless gum, hard candy can help. Encourage the person to drinks lots
of fluids, especially water. Good oral hygiene also help's - frequent tooth brushing.
,
2.
This medication can cause increased sleepiness, constipation, and low blood pressure. If
these problems already exist, you should be even more diligent in monitoring the consumer.
,
'::!
v. This medication decreases sweating. This can be a real problem in the EI Paso climate.
Sweating is the body's way of cooling the body. Talk to consumer about avoiding spending
too much time in the sun and avoiding overheating. Always encourage plenty of fluids.'
4. This medication can cause urinal}' retention which can lead to frequent urinary tract
II
--
infections. Urinary retention means that the bladder does not quite empty when you urinate
some urine stays in the bladder. This leads (or may lead to) bacterial contamination and
infection.
v. Consumers should be aware of symptoms of urinary tr(:lct infection., These include:
&I
a. frequent urination, and the feeling that you still need to urinate just after urinating.
b. Burning, itching or painful urination .
c. You should also watch for dark. concentrated, foul sme.iling urine.
Educate your consumers about the need forgocid personal hygiene and daily


(For the female front to back cleaning when using the toilet.)
Contact the doctor or nurse as soon as possible;, should consumers have any of the
above symptoms. '

ilL Medications: Anxiolytics: Medications; used to treat anxiety " .
.', Some' anti-anxiety medications.are' "controlled" drugs. Benzodiazepinesare controlled drug
1. They must be kept under lock and key.
II
2.: They must be accounted for carefully, which may' include "signing out" on an inventor
sheet.
II
Medication Names:
Benzod iazepines:
II
II
Brand Name
Generic Name
Ativan Lorazepam
Doral Quazepam
Halcion Triazolam
II
Librium Chlordiazepoxide
Serax Oxazepam
Tranxene Chlorazepate
-
Valium Diazepam
.:
II
Xanax Alprazolam
9
i
2. Non-Benzodiazepines - Anti-Anxiety Medications - NOT CONTROLLED DRUGS
I
Brand Name
Generic Name
Atarax Hydroxyzine
j
Buspirone
Prochlorperzine
ICompazine
I
Vistaril Hydroxyzine Pamoate
...
:8. I ntended Effect:
j
1. Reduction of tension
2. Relief of anxiety or agitation
I
3. Relief of symptoms associated with alcohol withdrawal
4. Relief of insomnia

/ )
Side Effects -Common:
j

,
1. Difficulty concentrating, confusion, forgetfulness.
2. Sedation, unusual tiredness or severe weakness.
3. Hypotension (low blood pressure). Dizziness or light-headedness.
,
4. Muscle weakness, slurred speech.
5. Unusual excitement, nervousness or irritability, difficulty sleeping
6. Seizures
7. Clumsiness or unsteadiness.
I
o. Central Nervous System
BENZODIAZEPINES belong to the group of medicines called central Rervous, system
I- 1..
depressants (eNS). These are medici nes that "slow down" the nervous system.
2. Some benzodiazepines are used to relieve nervousness or tension, others are used regularlJ
I
for insomnia. (They usually are not effective for more than a few weeks for insomnia).
Note: Benzodiazepines should not be used for nervousness or tension caused by the stress of everyday life.
I
E. Side Effects - Rare: Report to Doctor:
1. Blurred vision or other changes in vision.
I
2. Changes in sexual drive or performance.
3. False sense of well being.
I
4. Fast or pounding heart.
5. Headache, increased sensitivity to light.
6. Nausea or vomiting.
I
7. Trembling, tingling, burning or prickly sensations.
F. Special Considerations:
I
The presence of other medical problems may affect the use of benzodiazpines. Make sure
that the doctor knows if the consumer has any other medical problems, especially:
I
10
II
a. Alcohol abuse (or history of)
11 b. Drug abuse or dependence
c. Brain disease. CNS depression and other side effects of benzodiazepines may
develop. .
11
d. Let the doctor know if consumer has difficulty swallowing, especially if the consumer i:
a child or adolescent.
I
e. Emphysema, asthma, bronchitis, or other chronic lung disease.
f. Glaucoma
g. Sleep apnea-(benzodiazepines may make this worse.}
h. Epilepsy-or history of seizure. Although Clonazepam and Diazepam are used in
I
treating seizures, starting or suddenly stopping these medications may increase
seizures.
I
i. Consumers with kidney or liver disease may have higher blood levels, which would
increase the side effects.
I
2. These drugs will add to the DEPRESSANT EFFECT OF ALCOHOL and other medications
such as cold remedies and over-the-counter sleep medicines. . .
I
3. Some consumers have the tendency to want to increase the dose of their medication if they
I.
feel it is not working properly. Remind them to consult Vvith the doctor about any changes ..
Never make changes without checking with the doctor."
I
4. For consumers taking this medication for insomnia: When their schedule does not permit
them to get a full night's (7 to 8 hours), they may continue to feel drowsy and may experiencE
I
memory problems because the effects of the medicine has not had time to wear off. If this is
a continuing problem, encourage them to discuss this with their doctor.
I
5. If a consumer will be taking this medicine in large doses or for a long time, it is important that
,
they not stop taking it without first checking with the doctor. The doctor may want to
gradually reduce the amount they are taking and not stop suddenly. Suddenly discontinuing
this medicine may cause withdrawal side effects.
,
~
6. OVERDOSE: If an overdose occurs, seek emergency help at once.. Taking an overdose of
Benzodiazepines and alcohol or other CNS depressants may lead to unconsciousness and
possibly death.
,
7. Chordiazepoxide and Di(3zepam have been reported tq increase the chance of birth defects
when used during the first 3 months of pregnancy. Too much of these drugs during
,
pregnancy may cause the baby to become dependent on the medication. Use of these
medications may cause drowsiness, slow heartbeat, shortness of breath, or troubled
breathing in the newborn infant. These medications can also pass into the breast milk.
,
11

I
I
8.
Use in children: Most of the side effects of these medications are likely to occur in children:
especially in the very young. These patients are usually more sensitive than adults to the
effects of benzodiazepines. When Clonazepam is used for long periods of time in chHdren,
may cause unwanted effects in physical and mental growth. These effects may not be
I:
noticed until many years later.
9.
Use in older adults: Most of the side effects of these mediCines are more likely to occur in t
I
I
elderly, who are usually more sensitive to all medicines. Taking these meds for trouble
sleeping may cause more daytime drowsiness in the elderly. In addition, falls and related
injuries may be more likely to occur in elderly consumers taking benzodiazepines.
--,
rlV>
Lithium: Medication/Drug Used to Treat Mood Disorders:
I
',A.' MediCLilJion Names:
Brand Name
Generic Name
'"'
I
Eskalith Lithium Carbonate
, Eskalith CR (slow release) Lithium Carbonate CR
B. Intended Effect:
I
The reduction of symptoms of mania, such as hyperactivity, loss of inhibitions, restlessness
exaggeration,grandiose thinking. Mood disorders are also known as Manic-Depressive
I
illness or Bipolar Disorders.
I
....
,
Side Effects that shoutdbe reported immediately to your doctor= ,
1. Nausea and vomiting or diarrhea
I
2. Shakiness or bothersome tremor
3. Swelling of hands and feet
4. Mental confusion, slurred speech
I
5. Lack of coordination
6. Increased drowsiness or weakness
7. Slurred speech, confusion, ringing in the ears, or involuntary movements
I
D. Side Effects: Common:
I
1. Increased thirst
2. Increased urination
I
3. Dry mouth
4. Skin rash is less common, but tell the doctor if this occurs.
I
E. Special Considerations:
1. It is best to take lithium with meals to reduce upset stomach.
I May experience muscle weakness, fatigue or shaking. These effects are temporary and
should go away after 2 or3 weeks, but should be reported to the doctor.
I
12
-
I
3. It is important to maintain proper water and salt intake when taking lithium. 6 to 8 glasses of
,
water should be consumed every day and table salt should be added to food especially if
there is profuse diaphoresis or diarrhea.
I
4. Lithium may not work as well as it should if large amounts of caffeine are present: coffee,
teas and colas should be avoided.
f 5. Never double up on medicine if a dose is missed.
6.
Lithium blood levels may be monitored on a regular basis, usually every 3 months. The
f
doctor will schedule. It is important to know if the correct amount of the drug is circulating in
the blood and that possible side effects are avoided by levels not being too high. "
I
7.
Extra care must be taken in hot weather and during activities that cause one to sweat heavily,
such as hot baths, saunas or exercising. The loss of too much water and salt from the body
could lead to serious side effects.
Mood Stablizers/Anticonvulsants: Drugs used to treat /mood/seizure disorders:
Medication Names
.Brand Name
Cerebyx (IMinjectables)
I
Depakene
Depakote
I
Dilantin
Felbatol*
Lamictal
I
Luminal
I
Neurotin (not proven to work as mood)
Primidone
TegretoI
Topamax
I
Zarontin
Generic Name
Fosphenvtoin
ValproicAcid
Divalproex Sodium
Phenytoin
Felbamate*
LamotriQine
Phenobarbital
Gabapentin
Myosin
Carbamazepine
Topiramate
-
Ethosuximide
*Used in special cases of consumers with chronic Epilepsy
4
I
B. Intended Effects:
This medication is used to treat seizure disorders.
I
c. Side Effects:
Drowsiness
Blurred vision
I
Itching
'. <""
Nausea
Headache
I
Vomiting
Muscle twitching
I
Change in color of urine
......
Dizziness
Slurred speech
Skin rash
loss of or increase in appetite
Sleep disorders
. Constipation
Sore gums, enlargement of gums
Excessive hair growth or loss
13
,
I
D.
I
,
2.
I
I
3.
4.
, 5.
6.
II
7.
II
II
...
,
9.
10.
11.
-
. ~
12.
13.
-
I
14.
II
15.
II
-
I
Special Considerations:
Inform the doctor if consumer has liver disease, bleeding disorder, kidney disease,'glaucom
lung disease or breathing disorders or any allergies.
Inform the doctor if consumer is taking any of the following:
a. Medications for depression
b. Medications for colds, allergies; insomnia; muscle re.laxants; pain medicine or sedatives.
Limit or eliminate alcohol consumption. Alcohol can add to the sedation caused by this
medication.
Advise any health care provider that consumer takes this medicine before having any health
care procedure. .
Vallproic acid can cause false results for ketones in urine tests.
Inform doctor if consumer is pregnant or becomes pregnant after this medication has been
initiated.
Inform the doctor of all meds the consumer is taking, to include over-the-counter meds
especially blood thinners, Coumadin, Tagamet, Antabuse, Theophyliine, etc.
It is recommended that consumer wear or carry medication identification indicating that they
take anticonvulsants.
Store this medication out of reach of children, away from moisture and sunlight. Do not ston
in the bathroom.
Do not crush this medication. It must be swallowed whole.
."
Take this medication as prescribed. Do not suddenly stop this drug without consulting the
doctor as seizures may occur. If there is a history of seizure disorders .
It is important to take this medication on time to keep the level of medication in the blood
constant.
Clonazepam may also be used in the treatment of panic attacks and movement disorders.
Maintain good oral hygiene with regular brushing, flossing and massaging of the gums,
especially those who take Dilantin as it can cause hyperplasia in long term use.
For information on enrollment in Med Alert - call: Medic Alert 1-800-854-1166.
14
--
--
---
--
f
'-,
f
/r"
Antidepressants: Medications used to treat depression:
. ... - Medication Names:
I Brand Name
Anafranil
Asendin
I
I
Desyrel
Effexor
Elavil
Lexapro
Limbitrol
I
Ludiomil
Luvox
NardiJ
I
I
Norpramin
Pamelor
Parnate
Paxil
Prozac
I
Remeron
I
Serzone
Sinequan
Vivactil
Wellbutrin
Zoloft
I (_0
7
<
t B. Intended Effect:
Generic Name
Clomipramine
Amoxapine
Trazodone
Venlafaxine HCL
Amitriptyline
Escitaloparmoxalate
Chlordiazepoxide & Amitriptyline
Maprotiline .
Fluvoxamine Maleate
Phenelzine Sulfate
Desipramine
Nortriptyline
Tranylcypromine Sulfate
Paroxetine .
Fluoxetine
Mirtazapine-
Nefazodone
Doxepin
Protriptyline
'-
Bupropion
Sertraline
-
..
Relief of symptoms of depression such as sleep disorders, lack of concentration, ,lack of ,
I
interest in surroundings, anxiety, inability to experience pleasure, significant change in
appetite and/or weight gain, fatigue or loss of energy, feelings of worthlessness or
inappropriate guilt, lack ofconcentration or inability to make decisions, and thoughts of death
I
and suicide. .
I:
1. Antidepressants can help reduce or alleviate symptoms such as tearfulness, bouts of
crying, problems sleeping, feeling of helplessness and hopelessness.
II
2. Antidepressants can also be used to treat children with ADHD (Attention-Deficit
Hyperactivity Disorder), Treatment of Narcolepsy (Uncontrollable d.esire for s l ~ e p or
sudden attacks of deep sleep) and Bulimia Nervosa.
Ii
3. They can also be used to prevent anxiety-related panic attack and in the treatment of
cocaine addicts who are undergoing withdrawal.
4. Antidepressants are also used in the treatmentof chronic pain.
c.
Side Effects - Common:
II
Constipation
Increased appetite for sweets
11
Dizziness
Nausea
Dry mouth
Urinary retention
15
I

Side Effects - Common (cont.):
r
Unpleasant taste Headache
Weight gain or loss
Decreased perspiration
'I Drowsiness, tiredness or weakness
... - ' ~ - .
( D ~ ) Side Effects: that should be re[!orted to the doctor immediately:
1. Blurred vision
I
2. Problems urinating
3. Seizures
4. Irregular heartbeat (cardiac effects)
5. Confusion, somnolence (sleepiness)
I
6. Fainting
7. Skin rash and itching
8. Taking Warfarin (Coumadin) when taking antidepressants such as: Paxil, may cause
I
bleeding problems. Paxil can also lower the seizure threshold.
9. Effexor is also associated with sustained increased in blood pressure: It is therefore
. recommended that consumers receiving effexor have regular monitoring of their B/P.
I
Of course this medication is contraindicated in people who have high blood pressure.
I
E. Special Considerations:
I
As- with all medications, advise the consumer not to stop taking or reduce this medication
without first talking with their doctor. It may take four or six weeks before an improvement in
the consumers condition takes place with this type of medication.
I
2. High-Risk groups: Certain groups of consumers are at a higherrisk for depression. These
include alcohol and drug abusers, consumers undergoing drug withdrawal, consumers with.
frequent psychosomatic complaints, and consumers with chronic persistent pain from
'I
concurrent disease andlor chronic illness. Also included in this category are consumers with
family members who may also be physically or mentally ill. '
I
3. Stressors or predisposing factors for the development of depression include major losses,
such as the death of a loved one, divorce, loss or change of a job; family or marital problems;
financial problems; moving (coming and going from different institutions), life transitions, suet
I
as adolescence or parenthood, etc. etc.
4. Consumers must be taught that depression is a treatable disease, and not a weakness of
I
character.
5. Consumers should avoid .alcohol and substances with potential for abuse while taking
I
antidepressant medications.
II
6. Common side effects of Prozac: Nausea, anxiety, nervousness, insomnia, tend to cause
weight gain, fewer tricyclic-like side effects. Notify doctor immediately if rash appears.
16
I
.1
Il
I
If
I
I
I
I
Ii
I
I,:,
I
I
I
I
I
I
I
I
81
7. Wellbutrin (Bupropion) incidence of seizures may exceed other antidepressants; avoid use in
consumers with increased risk of seizures. May cause insomnia (advice consumer not to
take last daily dose later than 8:00 p.m. or doctor prescribed time.) .
VII. Psycho stimulants: Drugs used to treat ADHD
A. Medication Names
Brand Name
Adderall
Adderall XR
Concerta
Cylert
Desoxyn
Dexedrine
Dextrostate
Focalin
Metadate
Metadate CD
Ritalin
~ ..
Ritalin SR
Ritalin LA
-
These are used to treat:
(ADD) Attention Deficit Disorder
Generic Name
Dextroamphetamine
Dextroamphetamine
Methilphenidate XR
Pemoline
Dextroame.hetamine
Dextroamphetamine
Dextroamphetamine
Methilphenidate
,.
Methilphenidate
Methilphenidate
Methilphenidate
Methilphenidate
' .
. Methilphenidate
(ADHD) Attention Deficit Hyperactivity Disorder
a. Parkinson's Disease
Narcolepsy
Augmentation off cyclic antidepressants
Obessional Disorder
\, B. Intended Effects:
Increase attention span
Increase concentration
Decrease hyperactivity
Decrease impulsivity
Decrease emotional
/ ' ~ ~ Side Effects:
Anorexia
Insomnia
Irritability
Clinging Behavior
Sadness
17
I
D. Side Effects: that should be reported to the doctor immediately:
I
Marked anxiety
Tension agitation
I
Tics/twitching of muscles
Rash
I
18
I
I
I
I
I
I
I
I
1\
11
I
II
II
II
.,
I
I Medications
Brand Name
Generic Name ' Classification
Akineton
Biperiden Anticholinergic
I
I Ambien
Zolpidem tartrate Hypnotic (for sleep) .
Anafranil
Clomipramine Anti-obsessional
Antabuse
Disulfiram Management of selected chror
I
Alcoholism
Asendin
Amoxapine

Antidepressant
AricepL
Donepezil HCL I tx Alzheimers
Artane
Trihexvphen idyl Anticholinergic
1-------,.
Atarax
Hydroxyzine Anti anxiety
I
Ativan
Lorazepam Anti-anxiety
."W"W
Aventyl, Pamelor
Nortriptylin e Antidepressant
Benadryl
Diphenhydramine ! Anticholinergic, Antihistamin
I
Buspar
-,
Buspirone Anti anxiety
.-
Catapres
Clonidine .. Anti-hypertensive
Centrax
Prazepam Anti anxiety
I
Clozaril
Clozaoine 1 Antipsychotic
Cogentin
Benztropine .1 Anticholinergic
j Colace
Docusate Sodium Stodl softener
'I
ICompazine Prochorperazine Anti-emetic, antipsychoficand
Antidepressant
Pemoline Management of attention de
,;1
I
!Ualmane
;Iert
Flurazepam
De akene
Va/proic Acid Mood Stabilizer/Anticonvuls;
JJepakote
Divalproex Mood Stabilizer/AnticonvulSi
Desyrel
"
Trazodone . Antidepressant
Dexedrine
Dextroamphetamine Management of ADD
I
Dj/antin
Phyenvtoin Mood Stabilizer/Anticonvulsi
Doral
Quazepam Hypnotic
Effexor
Vel afaxi ne Antidepressant
I
I
Elavil, endep
Amitriptyline Antidepressant
Eskaith
Lithium Carbonate Tx off manic-depressive dis(
Felbamate
Felbatol Antiepileptic
I
Gabapetin
Neurotine Mood StabilizerlAnticonvuls;
Halcion
Triazolam Hypnotic, Sedative
Haldol
Haloperidol Antipsychotic
Inderal
Propanodo/ Antihypertnesive, anti-anxie'
Klonopin
Clonazepam Mood Stabilizerl Anticonvulsan
panic attack, Sedative
I Lithane
Lithium Carbonate Tx off manic-depressive dis(
"-"--".
Lithobid
Lithium Carbonate Tx off manic-depressive disc
Lithium
Lithium Carhbonate Controlled release Lithium
.
I
I
Lithium Citrate Sugar free Lithium
,(honate
Lithium Carbonate Tx off manic-depressive disc
fLibrium Chlordiazepoxide Anti-anxiety
_ Loxitane
Loxapine Anti-psychotic
If

Luvox
If
1iomil
I- "
I Lummal
I
j
I
Mellaril
Moban
I
Nardil
1 Navane
f-----
Noctec
Norpramine
I
I
I
Orap
I

I
Aventy'
I
Parlodel
I 1---
II
i Paxil
Paxipam
Phenergan
I
i
Prozac
Prolixin
Restoril

I
. [alin
Serax
Serentil
Stelazine
Surmontil
Synthroid
I
Symmetrel
Sineguan
I

Tegretol
Thorazine
I
Tofranil
I
Tranxene
Trernin
Triavil
Trihexane
I
Trihexy-5
Trilafon
Valium
I
Vistaril
'Vactil
# "ellbutrin
Xanax
I
Zyprexa
FluvDxamine Maleate
Maprotiline
Phenobarbital
Thioridazine
Molindone
Phenelzine Sulfate
Thiothixene
hloral Hydrate
Desipramine
Pimozide
Nortriptyline
Bromocriptine
Paroxetine
Halazepam
Promethazine
Fluoxetine
Flupenazine
Temazepam
Risperidone
Methylphenidate
Oxazepam
. Mesoridazine
Trifuloperazine

Levothyroxine
Amantadine
Doxepin
Nefazodone
Carbamazepine
Chlorpromazine
Imipramine

Benztropine
Anitriptyline &
Trihexphenidyl
Trihexphenidyl
Perphenazine
Diazepam
Hydroxyzine Pamoate
Protriptyline Hydrochloride
Buropion Hydrochloride
Alprazolam
Olanzapine
OCD
Antidepressant, tx manic depre
i Disorder
Mood Stabilizer/Anticonvulse

Antfgsychotic
._---..-
Antipsychotic
MAO Inhibitor,
Antipsychotic
Sedative-Hypnotic

Suppression of Motor & phonic
Tourette's
Antidepressant
Anti-Parkinsonian, tx of withdra
Phenothiazine, anti-emetic, anti


Anti anxiety
Anti-emetic, sedative, Anticholir
Tx motion sickness
Antidepressant
Antipsychotic
HYPflotic, Sedative
Antipsychotic
Ps),chostim" tx of ADD
Anti-anxiety
Antipsychotic

"
Antidepressant
Thyroid replacement, sometime
used In treatment of depressior
Anticholinergic
Antidepressant Movement diso
Antidepressant
Mood Stabilizer/Anticonvulse

.J
Antidepressant
Anti::.anxiety
.Anticholinergic
Antidel?ressant
Antichol i nergic
Antichol inerg ic
Antipsy_chotic
Anti-anxiety
Anti-anxiety
Antidepressant
Antidem-9ssant
IAnti-anxiety
. Antipsychotic.
J:
I
I,
ABSORBED
I, ADDICTION
Ii
ADVERSE
AFFECTIVE
Ii
AFFECT
,I
AGITATION
11
AGRANULOCYTOSIS
:1
AIMS
I
AKINESIA
I
AKATHISIA
I
I
ANAPHYLACTIC SHOCK
I
ANXIETY
I
ATAXIA
I
CARDIOVASCULAR
I
, )NTROLLED SUBSTANCE
I
-
PHARMACOLOGY VOCABULARY
Taken into the body via cells, blood, digestion
Physical dependence on a drug
Unfavorable, undesirable
Pertaining to emotions or mental state
The emotional reactions associated with an experience
Disturbance, troubled thoughts or feelings
An acute disease in which the white blood cell count drops
to an extremely low level. Characterized by high fever,
prostration, Neurotic ulcerations of the mouth, rectum, and
vagina.
Abnormal Involuntary Movement Scale. A tool used to
Measure the involuntary movements that consumers on
Psychotropic medications may develop.
-
Slowing of movement, lack of facial expression, lack of
spontaneity.
Inability to sit down because thought of doing so causes
Severe anxiety. Patient has a feeling of restlessness and
an urgent need of movement and complaints of a feeling oi
, muscle quivering. This symptom can be a complication of
antipsychotic therapy. A =not KATHISIS =sitting.
Severe allergic reacti9n with breathing distress.
Apprehension, fear, uneasiness of mind.
Failure or irregularity of muscle coordination, especially the
manifested when 'voluntary muscular movements are
attempted. Walking will be uneven, hand movements will
be uneven.
Involving the heart and blood vessels.
Medications with potential for addiction,kept under lock
and key, and Signed for.
21
U
11
~
~
11
IJ
i
I
}-
ill1

II

nELUSION
uRUG INTERACTION
DYSTONIA
EXTRAPYRAMIDAL SYMPTOMS
(EPS)
GENERIC
AABITUATION
HALF-LIFE
HALLUCINATIONS
INFLAMMATION
tNTRAMUSCULAR
LETHARGY
LEUKOCYTOSIS
.a:
NEUROLEPTIC
METABOLIZE
MOTOR
NEUTROPENIA
NKA
Fa/se belief held in spite of evidence.
One drug affects the way another drug acts.
Muscle stiffness.
Symptoms that resemble Parkinson's disease. Shuffling
walk,
drooling, shakiness, mask-like facial expressing, "pill
rolling" tremor.
Chemical class a drug belongs to.
Psychological dependence on a drug.
Time needed for amount of drug to decrease by 50%.
Seeing or hearing something that is not there.
: Reaction of body tissue to injury, marked by redness, hes
pain and swelling. '
Entering the body by way of muscle.
Drowsiness, sluggishness, lack of energy
Increase in number of leukocytes (white blood cells) abov,
10,000 per cubic millimeter in the blood, generally caused
by presence of infection and is usually transient.
One category'of psychotropic drugs. Neuro/eptics have
antipsychotic and sEidative effects; many of them also h8\
neurologic effects. Like all psychotropics, neuroleptics
have an effect on psychic function, behavior or experienci
To breakdown drugs or food substances into smaller
particles so that they can then be transported to the site II
the body where they produce their result. Most drugs tak
by mouth are metabolized in the liver .
Referring to muscle 'movement.
Abnormally small number of neutrophil cells in the blood.
Neutrophils ingest bacteria and small particles. They are
important in both defensive and repair functions of the
body.
NO KNOWN ALLERGIES.
22
: ~ -
I
NOTHING BY MOUTH,
I
NPO
Having the opposite effect.
PARADOXICAL
I
I
I
I
I
,.'
"
I
I
I
I
I
.'
I
I
I
I
I
I
23
idU

--
I
I EXAMPLES OF CONTROLSUBSTANCES
(NOT ALL INCLUSIVE)
I
I
BRAND
ANTI-ANXIETY
Ativan
I
Centrax
I
Klonopin
Librium
I
Paxipam
Serax
Tranxene
I
Valium
Xanax
I
SEDATIVES
Ambient
Doral
. Halcian
I
ILuminal
"
Rest()ril
Seconal
I
NARCOTICS/OPIOIDANALGESICS
I
Darvacet
Darvan
Demerol
Ogcontin
Talwin
I
Tylenol with Codeine
PSYCHOSTINULANTS
I
Addera"
t
_...
Concerta
Cylert
Dexedrine
..
Focalin

f Ritalin
I
GENERIC
Lorazepam
Prazepam
Clonazepam

Halazepam

Chlorazepae
Diazepam
AI prazolam
Zolpidem Tartrate

-
Triazolam
.
Phenobarbital
Temaze2am
Secobarbital Sodium
Prapoxyphene Napsylate
Propoxyphene Hydrochloride
Meperdine Hydrochloride
Oxycodone
Pentazocine Lactate
Acetaminephen with Codeine
Dextroamphetamine
Methylphenidate
Pemoline
Dextroamphetamine
Methylphenidate
Methylphenidate
Methy/ph enidate
24