NAME OF DRUG Haloperidol

CLASSIFICATION

ACTIONS

INDICATIONS

ADVERSE EFFECTS Not all effects have been reported with haloperidol; however, because haloperidol has certain pharmacologic similarities to the phenothiazine class of antipsychotic drugs, all adverse effects associated with phenothiazine therapy should be kept in mind when haloperidol is used. >CNS: Drowsiness, insomnia, vertigo, headache, weakness, tremor, ataxia, slurring, cerebral edema, seizures, exacerbation of psychotic symptoms, extrapyramidal syndromes,pseudo parkinsonism; dystonias; akathisia, tardive

CONTRAINDICATIONS

>Antipsychotic >Dopaminogern ic blocker

>antipsychotics block postsynaptic dopamine receptors in the brain, depress the RAS, including those parts of the brain involved with wakefulness and emesis; chemically resembles the phenothiazines

>management of manifestations of psychotic disorders >control of tics and vocalizations in Tourette syndrome in adults and children > explosive hyperexcitability that cannot be attributed to immediate provovation >short-term treatment of hyperactive children with excessive motor activity, mood lability >Haloperidol decanoate: Prolonged parenteral therapy of chronic schizophrenia

>contraindicated with hypersensitivity to typical antipsychotics, coma or severe CNS depression, bone marrow depression, blood dyscrasia, circulatory collapse, subcortical brain damage, Parkinsons disease, liver damage, cerebral arteriosclerosis, coronary disease, severe hypotension or hypertension

NURSING RESPONSIBILITIE S >do not give children IM injection >do not use haloperidol deconoate for IV

dyskinesias, potentially irreversible (no known treatment)

NAME OF DRUG Aripiprazole

CLASSIFICATION >Atypical antipsychotic >Dopamine, serotonin agonist and antagonist >Psychotic drug

ACTIONS >acts as an agonist at dopamine and serotonin sites and antagonist at other serotonin receptor sites; this combination of actions is thought to be responsible for the drugs effectiveness in treating schizophrenia, though the mechanism of action is not understood

INDICATIONS >treatment of schizophrenia in patients 13 years and older >treatment of major depressive disorder as adjunct to antidepressant therapy >treatment and maintenance of acute manic and mixed episodes associated with bipolar disorders in patients 10 years and older >adjunct to lithium or valproate for acute treatment of manic or mixed episodes associated with bipolar disorder in patients 10 years and older >treatment of agitation associated with schizophrenia or bipolar disorder, manic or mixed (injection)

ADVERSE EFFECTS >CNS: Headache, anxiety, insomnia, lightheadedness , somnolence, tremor, asthenia, tardive dyskinesia, blurred vision, seizures (potentially lifethreatening), akathisia, dizziness, restlessness

CONTRAINDICATION S >hypersensitivity to drug >use cautiously in cerebrovascular dse,HPN, seizure is disorder and suicidal ideation >high risk for aspiration pneumonia

NURSING RESPONSIBILITIES >have patient place orally disintegrating tablet on time >allow to dissolve then swallow >protect patient from extremes, of heat >monitor blood pressure if overheating occurs

NAME OF DRUG Escitalopram Oxalate (Talobpram)

CLASSIFICATION >Antidepressant >SSRI

ACTIONS >potentiates serotonergic activity in the CNS by inhibiting reuptake of serotonin resulting in antidepressant effect with little effect on norepinephrine or dopamine; an isomer of citalopram

INDICATIONS >treatment of major depressive disorder >maintenance of patients with major depressive disorder >treatment of generalized anxiety disorder >maintenance treatment for major depressive disorder in patients 12-17 years

ADVERSE EFFECTS >CNS: Somnolence, dizziness, insomnia, fatigue, complex sleep disorders, serotonin syndrome (with abrupt discontinuation)

CONTRAINDICATIONS >contraindicated with MAOI, pimozide use; with allergy to drug or to citalopram or any component of the drug

NURSING RESPONSIBILITIES >encourage patient to continue use for 4-6 weeks directed to ensure adequate level to affect depression >give once a day in the morning or in the evening, may be taken with food if desired

NAME OF DRUG Diphenhydramine Hydrochloride

CLASSIFICATION >Antihistamine >Antimotionsickness drug >Antiparkinsonian >Cough suppressant >Sedativehypnotic

ADVERSE EFFECTS >interferes with >active and >CNS: histamine effects prophylactic Drowsiness, at histamine1- treatment of sedation, receptor sites; motion sickness dizziness, prevents but disturbed doesnt reverse coordination, histaminefatigue, mediated confusion, response restlessness, >possesses CNS excitation, depressant and nervousness, anticholinergic tremor, properties headache, blurred vision, diplopia

ACTIONS

INDICATIONS

CONTRAINDICATIONS

NURSING RESPONSIBILITIES >hypersensitivity to >administer with drug food if GI upset >contraindicated with occurs allergy to >administer syrup antihistamine form if patient is unable to take tablets >monitor patient response and arrange for adjustment of dosage to lowest possible effective dose

NAME OF DRUG Biperiden

CLASSIFICATION >Antiparkinsonian

ACTIONS >anticholinergic activity in the CNS that is believed to help normalize the hypothesized in balance of cholinergic and dopaminergic neurotransmission in the basal ganglia in the brain of parkinsonian patient >reduces severity of rigidity and to lessen extent akinesia and tremor characterizing parkinsonism

INDICATIONS >in the therapy of parkinsonism/postce phalitic, arteriosclerotic, and idiopathic types >relief of symptoms of extrapyramidal disorder that accompany phenothiazine therapy

ADVERSE EFFECTS >CNS: Disorientation, confusion, memory loss, halllucination, psychosis, agitation, nervousness, delusion, delirium, paronia, euphoria, excitement, lightheadednes s, dizziness, depression, drowsiness, weakness, paresthesia, heaviness of the limbs

CONTRAINDICATIONS >contraindicated with hypersensitivity to benzotropine, glaucoma, especially angle-closure glaucoma, pyloric duodenal obstruction, stenosing peptic ulcers, hypertrophy of bladder, neck obstructions, myasthenia gravis

NURSING RESPONSIBILITIES >decrease dosage or discontinue temporarily if dry mouth makes swallowing or speaking difficult >give with meals if GI upset occurs; give before meals to patient with dry mouth; give after meals if drooling or nausea occur >ensure that the patient voids just before receiving each dose of drug if urinary retention is the problem