CLASSIFICATION/ MECHANISM OF CONTRAINDICATION SIDE/ADVERSE REACTIONS NURSING REPONSIBILITY

NAMES ACTION
 Antipsychotic block postsynaptic Hypersensitivity to drug, CNS: sedation, drowsiness, extrapyramidal  Monitor blood pressure closely
 Anxiolytic dopamine receptors in other phenothiazine, reactions, tardive dyskinesia, during I.V. infusion.
 Antiemetic brain sulfites (injection), benzyl pseudoparkinsonism, neuroleptic  Stay alert for signs and
and depress areas alcohol (sustained-release malignant syndrome, seizures symptoms of neuroleptic
*chlorpromazine involved in wakefulness capsules) CV: tachycardia, hypotension (especially malignant syndrome
hydrochloride and emesis Angle-closure glaucoma with I.M. or I.V. use) (hyperpyrexia, muscle rigidity,
Bone marrow depression EENT: blurred vision, dry eyes, lens altered mental status, irregular
anticholinergic, Severe hepatic or opacities, nasal congestion pulse or blood pressure,
antihistaminic, and cardiovascular GI: constipation, ileus, anorexia, dry tachycardia, diaphoresis, and
adrenergic-blocking disease mouth arrhythmias). Stop drug
GU: urinary retention, menstrual immediately if these occur.
irregularities, galactorrhea, gynecomastia,  Assess for extrapyramidal
inhibited ejaculation, priapism symptoms.
Hematologic: eosinophilia,
agranulocytosis, leukopenia, hemolytic Patient teaching
anemia, aplastic anemia,  Tell patient to take capsules or
thrombocytopenia tablets with a full glass of
Hepatic: jaundice, hepatitis water, with or without food.
Skin: rash, photosensitivity, pigmentation  Instruct patient not to crush
changes, sterile abscess sustained-release capsules.
Other: allergic reactions, hyperthermia,  Tell patient to mix oral
pain at injection site concentrate in juice, soda,
GENERAL CAUTION USE INTERACTIONS applesauce, or pudding.
INDICATION  Caution patient to avoid
Acute schizophrenia or cardiac disease, diabetes Avoid combination with beta-blockers driving and other hazardous
mania mellitus, respiratory Antipsychotic = alcohol =more CNS activities until he knows how
Nausea and vomiting disease, prostatic depression drug affects concentration and
Preoperative sedation hypertrophy, Antipsychotic + Anticholinergic = more alertness.
Intractable hiccups CNS tumors, epilepsy, anticholinergic effects  As appropriate, review all
intestinal obstruction other significant and life-
elderly patients threatening adverse reactions
pregnant or breastfeeding and interactions, especially
patients those related to the drugs, tests,
children. herbs, and behaviors
mentioned above.
 CLASSIFICATION/ MECHANISM OF CONTRAINDICATION SIDE/ADVERSE REACTIONS NURSING REPONSIBILITY
NAMES ACTION
 Atypical Antipsychotic effects Hypersensitivity to lithium CNS: dizziness, sedation, cognitive  Monitor neurologic status,
antipsychotic may occur through Significant renal or cardiac impairment, extrapyramidal symptoms, especially for signs and
antagonism of disease tardive dyskinesia, neuroleptic malignant symptoms of tardive dyskinesia,
* quetiapine fumarate dopamine D2 and syndrome, seizures, suicide suicidal ideation, or neuroleptic
serotonin 5-HT2 CV: tachycardia, palpitations, peripheral malignant syndrome.
receptors. Other effects edema, orthostatic hypotension,  Monitor blood pressure for
may result partly from hypertension, QT-interval prolongation orthostatic hypotension.
antagonism of other EENT: cataracts, ear pain, rhinitis,  Monitor patient closely for
receptors, such as pharyngitis prolonged QT interval.
histamine H1 and GI: constipation, dyspepsia, dry mouth,  Monitor fasting blood lipids
alpha1- adrenergic anorexia periodically during treatment.
receptors. Hematologic: leukopenia  Monitor CBC and differential in
Metabolic: hypothyroidism patients with preexisting low
Respiratory: cough, dyspnea white blood cell (WBC) count;
Skin: diaphoresis discontinue drug at first sign of
Other: weight gain, flulike symptoms, WBC decrease in absence of
acute withdrawal symptoms with other causes.
abrupt cessation
GENERAL CAUTION USE INTERACTIONS Patient teaching
INDICATION  Tell patient to take immediate-
Schizophrenia diabetes mellitus, hepatic Antihistamines, opioids, sedative- release tablets with or without
Acute manic episodes impairment, cardiovascular hypnotics, other CNS depressants: food and to take extended-release
associated with bipolar disease, cerebrovascular additive CNS depression form preferably in the evening,
I disorder disease, dehydration, swallowed whole, without food
Depression associated hypovolemia, or with a light meal. Instruct
with bipolar disorder Alzheimer’s dementia, patient not to crush, break, or
Adjunctive treatment hypothyroidism chew extended-release tablets.
of major history of seizures, suicide  Instruct patient to move slowly
depressive disorder attempt, or hypotensive when sitting up or standing, to
reactions avoid dizziness from sudden
history of cardiac arrhythmias blood pressure decrease.
such as bradycardia,  Tell patient not to stop taking
hypokalemia or drug abruptly. Tell him dosage
hypomagnesaemia, must be tapered.
elderly or debilitated patients
 Caution patient not to drink
pregnant patients
alcohol (Schull, 2013).
children
Reference: Schull, P. (2013). Nurses' Drug Handbook. United States: McGraw-Hill Education, LLC.