Far Eastern University Institute of Nursing Louielyn V.

Paragas BSN 301 Drug Study Generic/ Brand Name: Olanzapine -Zyprexa Drug Class: Antipsychotic Dopaminergic blocker Dosage 5-10 mg BID Indication: Treatment of schizophrenia Acute mixed or manic episodes associated with bipolar 1 disorder and maintenance of bipolar 1 disorder as monotherapy or combined with lithium or valproate Agitation associated with schizophrenia and bipolar 1 mania Contraindication:
Contraindicated

with allergy to olanzapine, myeloproliferati ve disorders, severe CNS depression, comatose states, and lactation.

Adverse/Side Effects: Adverse effects: somnolence, dizziness, nervousness, headache, akathisia, personality disorders, tardive dyskinesia, neuroleptic malignant syndrome, orthostatic hypotension, peripheral edema, tachycardia, constipation, abdominal pain, cough, pharyngitis,

Nursing Responsibilities: Inspect I.M. solution for particulate matter and discoloration before administration. 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 malignant syndrome.

(injection) Side effects: Drowsiness, dizziness, sedation, seizures, increased salivation, constipation and fast heart rate.

Divalproex sodium Depakote

Antiepileptic

250 mg BID

treatment of acute manic or mixed episodes associated with bipolar disorder with or without psychotic features

Contraindicated in patients hypersensitive to drug and in those with hepatic disease or significant hepatic dysfunction, and in patients

Adverse effects: Sedation, tremor, emotional upset, depression, psychosis, aggression, hyperactivity, behavioural deterioration, weakness,

Monitor for orthostatic hypotension and provide appropriate safety measures as needed. Monitor patient regularly for signs and symptoms of diabetes mellitus; monitor lipid and triglyceride levels. Peel back foil on blister pack of disintegrating tablets; do not push through foil; use dry hands to remove tablet , place entire tablet in mouth. Obtain liver function test results, platelet count, and PT and INR before starting therapy, and monitor these values periodically. Don't give syrup

 treatment of bipolar mania prophylaxis of migraine headaches

with a urea cycle disorder (UCD).

suicidality, rash, petechiae, pancreatitis, hemorrhage, bone marrow suppression, thrombocytopeni a, hepatotoxicity, erythema multiforme, Stevens-Johnson syndrome, hypersensitivity reactions Side effects: Drowsiness, GI upset, transient increase in hair loss

to patients who need sodium restriction. Check with prescriber. Adverse reactions may not be caused by valproic acid alone because it's usually used with other anticonvulsants. Divalproex sodium has a lower risk of adverse GI reactions. Never withdraw drug suddenly because sudden withdrawal may worsen seizures. Call prescriber at once if adverse reactions develop. Notify prescriber if tremors occur; a dosage reduction may be needed. Monitor drug level. Therapeutic level is 50 to 100 mcg/ml.

Diphenhydramin e hydrochloride

Antihistamine Anti-motion sickness drug Antiparkinsoni an Cough suppressant Sedative hypnotic

50 mg PRN

Relief of symptoms associated with perennial and seasonal allergic rhinitis; vasomotor rhinitis; allergic conjunctivitis, Active and prophylactic treatment of motion sickness night time sleep aid Parkinsonism

Contraindicated with allergy to antihistamines, third trimester of pregnancy and lactation

Adverse effects: Drowsiness, dizziness, sedation, disturbed coordination, fatigue, confusion, hypotension, palpitations, bradycardia, tachycardia, epigastric distress, haemolytic anemia, hypoplastic anemia, thrombocytopeni a, leukopenia, agranulocytosis, pancytopenia, and thickening of bronchial

When converting patients from a brand-name drug to a generic drug, use caution because breakthrough seizures may occur. Administer with food if GI upset occurs Monitor patient response, and arrange for adjustments of dosage to lowest possible effective dose avoid alcohol, serious sedation could occur

secretions. Side effects: Dizziness, sedation, drowsiness, epigastric distress, diarrhea or constipation, dry mouth, and dryness of nasal mucosa.