DRUGINDICATION/

CONTRAINDICATIONSACTION

SIDE EFFECTS AND ADVERSE

REACTION

NURSING CONSIDERATION

PATIENT TEACHING

Generic Name:Diphenhydramine

Brand Name:Benadryl

ClassificationAnticholinergic

Dosage50 mg/tab

FrequencyPRN

RouteOral

Date Started:Sept. 21, 2010

Diphenhydramine is used for its antimuscarinic properties in the control of parkinsonism and drug-induced extrapyramidal effects

CONTRA-INDICATIONS:• cardiac disease or hypertension•glaucoma• gastric or duodenal ulcers

Blocks the action of acetylcholine (anticholinergic effect) and is used as a sedative because it causes drowsiness. 

•CNS: headache, fatigue, anxiety, tremors, vertigo, confusion, depression, seizures, hallucinations

•CV: tachycardia, palpitations, orthostatic hypotension

•EENT: blurred vision

• GI: dry mouth, nausea, vomiting, constipation, flatulence

• GU: urinary hesitancy or frequency, urine retention

•Skin: photosensitivity, dermatitis

• Explain to the client that arising quickly from a lying or sitting position may cause orthostatic hypotension.

• When taking these medications, the client needs to have blood cells counts, renal function, hepatic function, and blood pressure monitored.

• History of glaucoma, increased pressure in the eye, stomach ulcer, enlarged prostate, difficulty urinating, hyperthyroidism, hypertension, asthma

• Avoid driving and doing any activities when feeling dizzy

• Take the medication with food to decrease GI upset.

• Slowly get up on bed to avoid orthostatic hy-potension.

• Keep it in a room temperature. Explain to the client that use of these drugs in warm weather may increase the likelihood of heat-stroke.

DRUG INDICATIONS/CONTRAINDICATIONS

ACTION SIDE EFFECTS/ADVERSE

REACTION

NURSING CONSIDERATION

HEALTH TEACHING

Generic Name:Levomepromazine

Brand Name:Nozinan

Classification:CNS/ Psychotropic Drugs/ Antipsychotics/ Phenothiazines

Dosage100 mg

FrequencyHS 10/24/10

RouteOral

palliative care of terminally illness particularly in those marked by restlessness, anxiety, agitation, emotional disturbance, nausea, and vomiting

In association with an antidepressant – short-duration treatment of certain severe forms of major depressive episodes.

Contraindications:liver dysfunction or cardiac disease

Potentiates the action of other central nervous system depressants but may be given in conjunction with appropriately modified doses of narcotic analgesics in the management of severe pain. It does not significantly depress respiration and is particularly useful where pulmonary reserve is low. 

somnolence asthenia dry mouth hypotension photosensitivity allergic skin reaction

*In high oral doses, complete bed rest necessary during the 1st few days.

*the absorption of alcohol, as well as the administration of medicines containing alcohol, is strongly inadvisable during the entire period of the treatment.

* inform client that in case of the appearance of fever, throat infection or any other infection, it is imperative to inform at once the attending physician.

* tell client to avoid alcohol.

DRUG INDICATIONS/CONTRAINDICATIONS

ACTION SIDE EFFECTS/ADVERSE

REACTION

NURSING CONSIDERATION

HEALTH TEACHING

Generic Name:Amisulpride Brand Name:Solian

Classification:CNS/ Psychotropic Drugs/ Antipsychotics/ Phenothiazines

Dosage100 mg

FrequencyBID – 10/17/2010 OD – 10/24/2010

RouteOral

Treatment of acute and chronic schizophrenia characterized by positive symptoms (delusions, hallucinations, thought disorders) and/or negative symptoms (blurred effects, emotional and social withdrawal)

Contraindications:Confirmed or suspected pheochromocytoma.

Concomitant prolactin-dependent tumors

Characterized by selective and predominant affinity for the D2 and D3 dopaminergic receptors of the limbic system.

Side effects:Drowsiness, weight gain, dizziness, increased appetite, constipation, dry mouth, insomnia, anxiety, agitation

Adverse reactions:CNS: Insomnia, anxiety, agitation

EPS: tremor, hypertonia, hypersalivation

Endocrine and metabolic disorders: elevation of serum prolactin levels, and impotence

GI: constipation, nausea, vomiting, dry mouth

Cardiac disorders:

*Since amisulpride is eliminated via the kidneys, the dose should be reduced in patients with renal insufficiency

*Neuroleptics are known to reduce the epileptogenic threshold. Patients with history of seizures must be carefully monitored

*Neuroleptics should only be prescribed for these patients if absolutely necessary.

*stress the importance of taking this drug to help client be well.

*instruct client to be careful if he is unwell, some people may experience side effects such as drowsiness, confusion, dizziness and unsteadiness, which may increase the risk of a fall.

hypotension, bradycardia

Hepatic disorders: increase in liver enzymes, transaminases

DRUGINDICATION/

CONTRAINDICATIONSACTION

SIDE EFFECTS AND ADVERSE

REACTION

NURSING CONSIDERATION

PATIENT TEACHING

Generic Name:Biperiden

Brand Name:Akineton

ClassificationAnticholinergic

Dosage2 mg/tab

FrequencyBID – Sept 21, 2010OD – Oct 24, 2010

RouteOral

Counteractmuscular rigidity and tremor;extrapyramidal symptoms.

CONTRA-INDICATIONS:Untreated narrow angleglaucoma, intestinalstenosis or obstruction,mega colon, prostatichypertrophy, lifethreatening tachycardia

Blocks acetylcholine's action at the cholinergic receptor sites.it restores the brain's normal dopamine and acetylcholine balance, which relaxes muscle movements and decreases rigidity and tremors.

•CNS: skin rashes,dyskinesia, ataxia,twitching, impairedspeech, micturitiondifficulties. Fatigue,dizziness, at higherdoses, restlessness,agitation, anxiety,confusion.

•Assess fortolerance over longterm therapy,dosage may haveto be increased orchanged.

•Avoid activitiesthat requirealertness, maycause dizziness,drowsiness andblurring of vision.

• Instruct patient that doses should not be doubled, but missed dose may be taken up to 2 hrs before the next dose

• Explain to the client that

•The drug should be taken without food.

• Avoid driving and doing any activities when feeling dizzy

• Avoid hot and humid places to reduce the risk for heatstroke

Emphasize the need for periodic eye checkups so as to know if there is glaucoma forming in the patient’s eyes.

arising quickly from a lying or sitting position may cause orthostatic hypotension..