DRUG STUDY NO.

Brand Name: Risperidone

Generic Name: Respirdal
Classification: Anti-pshychotics, mood stabilizers
Dosage: 200mg/tab 1tab BID PO

Indication:
Schizophrenia in adults and adolescents age 13–17 yr. Bipolar mania (oral only) in adults
and children 10–17 yr in adults and children 10–17 yr; can be used with lithium or valproate
(adults only). Treatment of irritability associated with autistic disorder in children age 5–16 yr.
Action:
May act by antagonizing dopamine and serotonin in the CNS.
Therapeutic Effects: Decreased symptoms of psychoses, bipolar mania, or autism.
Contraindications/ Precaution:
Contraindicated in: Hypersensitivity; Lactation: Discontinue drug or bottle feed;
Phenylketonuria (orally disintegrating tablets contain aspartame). Use Cautiously in: Patients
with hepatic impairment; Patients at risk for aspiration; Cardiovascular or cerebrovascular
disease; History of seizures; History of attempted suicide; Diabetes or risk factors for diabetes
(may worsen glucose control); Prostatic hyperplasia; Angle-closure glaucoma; History of
paralytic ileus; Dysphagia and aspiration have been associated with antipsychotic drug use; use
with caution in patients at risk for aspiration; OB: Neonates atqrisk for extrapyramidal symptoms
and withdrawal after delivery when exposed during the 3rd trimester; use only if maternal benefit
outweighs risk to fetus; Pedi: Children 13 yr (safety not established); adolescents atqrisk for
weight gain and hyperlipidemia; Geri:May requirepdoses; qrisk of mortality in elderly patients
treated for dementia-related psychosis.Adverse Reaction:
CNS: NEUROLEPTIC MALIGNANT SYNDROME, aggressive
behavior, dizziness, extrapyramidal reactions, headache, increased dreams, increased sleep
duration, insomnia, sedation, fatigue, impaired temperature regulation, nervousness, tardive
dyskinesia. EENT: pharyngitis, rhinitis, visual disturbances. Resp: cough,
dyspnea. CV: arrhythmias, orthostatic hypotension, tachycardia. GI: constipation, diarrhea, dry
mouth, nausea, abdominal pain, anorexia, dyspepsia, increased salivation, vomiting, weight gain,
weight loss, polydipsia. GU: decreased libido, dysmenorrhea/menorrhagia, difficulty urinating,
polyuria. Derm: itching/skin rash, dry skin, increased pigmentation, increased sweating,
photosensitivity, seborrhea. Endo: galactorrhea, hyperglycemia. MS: arthralgia, back pain

Nursing Implication:
 Monitor and report signs of neuroleptic malignant syndrome, including hyperthermia,
diaphoresis, generalized muscle rigidity, altered mental status, tachycardia, changes in
blood pressure (BP), and incontinence. Symptoms typically occur within 4–14 days after
initiation of drug therapy, but can occur at any time during drug use.

Assess motor function, and be alert for extrapyramidal symptoms. Report these symptoms
immediately, especially tardive dyskinesia, because this problem may be irreversible. Common
extrapyramidal symptoms include:

 Tardive dyskinesia (uncontrolled rhythmic movement of mouth, face, and extremities, lip
smacking or puckering, puffing of cheeks, uncontrolled chewing, rapid or worm-like
movements of tongue).

 Assess heart rate, ECG, and heart sounds, especially during exercise (See Appendices
G, H). Report a rapid heart rate (tachycardia) or signs of other arrhythmias, including
palpitations, chest discomfort, shortness of breath, fainting, and fatigue/weakness.

 Assess BP when patient assumes a more upright position (lying to standing, sitting to
standing, lying to sitting). Document orthostatic hypotension and contact physician when
systolic BP falls >20 mm Hg or diastolic BP falls >10 mm Hg.
 Report any troublesome respiratory problems, including severe or prolonged cough,
nasopharyngeal irritation, or difficult/labored breathing.
 Be alert for signs of hyperglycemia, including confusion, drowsiness, flushed/dry skin,
fruit-like breath odor, rapid/deep breathing, polyuria, loss of appetite, and unusual thirst.
Patients with diabetes mellitus should check blood glucose levels frequently.
 Monitor personality changes, including nervousness,
 DRUG STUDY NO.2

Brand Name: Fluphenazine

Generic Name: Prolixin
Classification: Anti-pshychotics
Dosage: 25mg deltoid

Indication:
Acute and chronic psychoses.
Action:
Alters the effects of dopamine in the CNS. Has anticholinergic and alpha-adrenergic
blocking activity. Therapeutic Effects:Diminished signs and symptoms of psychoses.
Contraindications/ Precaution:
Contraindicated in: Hypersensitivity; Lactation: Discontinue drug or bottle feed;
Phenylketonuria (orally disintegrating tablets contain aspartame). Use Cautiously in: Patients
with hepatic impairment; Patients at risk for aspiration; Cardiovascular or cerebrovascular
disease; History of seizures; History of attempted suicide; Diabetes or risk factors for diabetes
(may worsen glucose control); Prostatic hyperplasia; Angle-closure glaucoma; History of
paralytic ileus; Dysphagia and aspiration have been associated with antipsychotic drug use; use
with caution in patients at risk for aspiration; OB: Neonates atqrisk for extrapyramidal symptoms
and withdrawal after delivery when exposed during the 3rd trimester; use only if maternal benefit
outweighs risk to fetus; Pedi: Children 13 yr (safety not established); adolescents atqrisk for
weight gain and hyperlipidemia; Geri:May requirepdoses; qrisk of mortality in elderly patients
treated for dementia-related psychosis.
Adverse Reaction:
CNS: NEUROLEPTIC MALIGNANT SYNDROME, extrapyramidal reactions,
sedation, tardive dyskinesia. EENT: blurred vision, dry eyes. CV: hypertension, hypotension,
tachycardia. GI: anorexia, constipation, drug-induced hepatitis, dry mouth, ileus, nausea, weight
gain. GU: urinary retention. Derm: photosensitivity, pigment changes,
rashes. Endo: galactorrhea. Hemat:AGRANULOCYTOSIS, leukopenia,
thrombocytopenia. Misc: allergic reactions.

Nursing Implication:

 Monitor and report signs of neuroleptic malignant syndrome (hyperthermia, diaphoresis,

generalized muscle rigidity, altered mental status, tachycardia, changes in blood pressure
[BP], incontinence). Symptoms typically occur within 4–14 days after initiation of drug
therapy, but can occur at any time during drug use.
 Monitor signs of agranulocytosis and leukopenia (fever, sore throat, mucosal lesions,
signs of infection) or thrombocytopenia (bruising, nose bleeds, bleeding gums). Report
these signs to the physician or nursing staff immediately.

Assess motor function, and be alert for extrapyramidal symptoms. Report these
symptoms immediately, especially tardive dyskinesia, because this problem may be
irreversible. Common extrapyramidal symptoms include:

 Tardive dyskinesia (uncontrolled rhythmic movement of mouth, face, and extremities, lip
smacking or puckering, puffing of cheeks, uncontrolled chewing, rapid or worm-like
movements of tongue).
 DRUG STUDY NO.1

Brand Name: Olanzapine

Generic Name: Zyprexa
Classification: Anti-pshychotics, mood stabilizers
Dosage: 200mg/tab 1tab BID PO

Indication:
Schizophrenia. Acute therapy of manic or mixed episodes associated with bipolar I
disorder (as monotherapy [adults and adolescents] or with lithium or valproate [adults only]).
Maintenance therapy of bipolar I disorder. Acute agitation due to schizophrenia or bipolar I
mania (IM). Depressive episodes associated with bipolarI disorder (when used with fluoxetine).
Treatment-resistant depression (when used with fluoxetine). Unlabeled Use: Management of
anorexia nervosa. Treatment of nausea and vomiting related to highly emetogenic chemotherapy
Action:
Antagonizes dopamine and serotonin type 2 in the CNS. Also has anticholinergic,
antihistaminic, and anti– alpha1-adrenergic effects. Therapeutic Effects: Decreased
manifestations of psychoses.
Therapeutic Effects: Decreased symptoms of psychoses, bipolar mania, or autism.
Contraindications/ Precaution:
Contraindicated in: Hypersensitivity; Lactation: Discontinue drug or bottle feed;
Phenylketonuria (orally disintegrating tablets contain aspartame). Use Cautiously in: Patients
with hepatic impairment; Patients at risk for aspiration; Cardiovascular or cerebrovascular
disease; History of seizures; History of attempted suicide; Diabetes or risk factors for diabetes
(may worsen glucose control); Prostatic hyperplasia; Angle-closure glaucoma; History of
paralytic ileus; Dysphagia and aspiration have been associated with antipsychotic drug use; use
with caution in patients at risk for aspiration; OB: Neonates atqrisk for extrapyramidal symptoms
and withdrawal after delivery when exposed during the 3rd trimester; use only if maternal benefit
outweighs risk to fetus; Pedi: Children 13 yr (safety not established); adolescents atqrisk for
weight gain and hyperlipidemia; Geri:May requirepdoses; qrisk of mortality in elderly patients
treated for dementia-related psychosis.
Adverse Reaction:
CNS: NEUROLEPTIC MALIGNANT SYNDROME, aggressive
behavior, dizziness, extrapyramidal reactions, headache, increased dreams, increased sleep
duration, insomnia, sedation, fatigue, impaired temperature regulation, nervousness, tardive
dyskinesia. EENT: pharyngitis, rhinitis, visual disturbances. Resp: cough,
dyspnea. CV: arrhythmias, orthostatic hypotension, tachycardia. GI: constipation, diarrhea, dry
mouth, nausea, abdominal pain, anorexia, dyspepsia, increased salivation, vomiting, weight gain,
weight loss, polydipsia. GU: decreased libido, dysmenorrhea/menorrhagia, difficulty urinating,
polyuria. Derm: itching/skin rash, dry skin, increased pigmentation, increased sweating,
photosensitivity, seborrhea. Endo: galactorrhea, hyperglycemia. MS: arthralgia, back pain

Nursing Implication:
Assessment
● Assess mental status (orientation, mood, behavior) before and periodically during
therapy. Monitor closely for notable changes in behavior that could indicate the
emergence or worsening of suicidal thoughts or behavior or depression.
● Monitor BP (sitting, standing, lying), ECG, pulse, and respiratory rate before and
frequently during dose adjustment.
● Assess weight and BMI initially and throughout therapy.
● Observe patient carefully when administering medication to ensure that medication is
taken and not hoarded or cheeked.
● Assess fluid intake and bowel function. Increased bulk and fluids in the diet may help
minimize constipation.
● Monitor patient for onset of akathisia (restlessness or desire to keep moving) and
extrapyramidal side effects (parkinsonian—difficulty speaking or swallowing, loss of
balance control, pill rolling of hands, mask-like face, shuffling gait, rigidity, tremors; and
dystonic—muscle spasms, twisting motions, twitching, inability to move eyes, weakness
of arms or legs) every 2 mo during therapy and 8– 12 wk after therapy has been
discontinued. Report these symptoms if they occur, as reduction in dose or
discontinuation of medication may be necessary. Trihexyphenidyl or benztropine may be
used to control symptoms.
● Monitor for tardive dyskinesia (uncontrolled rhythmic movement of mouth, face, and
extremities; lip smacking or puckering; puffing of cheeks; uncontrolled chewing; rapid or
worm-like movements of tongue, excessive blinking of eyes). Report immediately; may
be irreversible