GENERIC NAME ACTION CONTRAINDICATION NURSING Cont.

Ziproc Tricyclic History of drug-induced INTERVENTIONS -

antidepressant. It neutropenia/agranulocyt
BRAND NAME has the capability to osis or w/
inhibit neuronal myeloproliferative
CLASSIFICATION uptake of disorders; alcoholic &
Antipsychotic drug norepinephrine toxic psychoses, drug
thereby potentiating intoxication, comatose
DOSAGE the action of conditions & other forms
Take with or without norepinephrine. of severe CNS
food. depression; severe
Adult 25-50 mg on INDICATION hepatic & renal
the 1st day. May be impairment. Pregnancy &
increased in Management of lactation.
increments of 25-50 schizophrenia;
mg/day up to 300 patients who fail to SIDE-EFFECTS
mg/day. Max: 900 respond to or Most commonly,
mg/day. experience severe dizziness & fatigue. Other
extrapyramidal side CNS reactions include
effects w/ classical seizures, dizziness &
antipsychotics. headache.
Extrapyramidal
symptoms mainly tremor,
akathisia & rigidity. Dry
mouth, sweating & temp
regulation disturbance
have been reported.
Tachycardia, postural
hypotension esp in initial
wk of treatment. Nausea,
vomiting & constipation
may occur.
GENERIC NAME ACTION INDICATION SIDE-EFFECTS NURSING
Clozapine INTERVENTIONS
Works by blocking Clozapine is use in the severe reduction in Assess mental
BRAND NAME receptors in the management of white blood cell status: orientation,
Clozaril brain for several psychotic disorders count, a condition mood, behavior,
neurotransmitters including schizophrenia. known as presence of
CLASSIFICATION (chemicals that Because of concern for agranulocytosis, in hallucination, and
Antipsychotic drug nerves use to the side effect of approximately 1 in type before initial
communicate with agranulocytosis, 100 patients who administration and
DOSAGE each other) clozapine should be take it for at least monthly.
Take with or without including dopamine reserved for patients who one year. White Check for swallowing
food. type 4 receptors, have failed to respond to blood cells fight of oral medication
serotonin type 2 other standard infections, and a Monitor input-output
Tablets: 25 receptors, medications or who are severe reduction in ratio.
and 100 mg. norepinephrine at risk for recurring white blood cells Monitor bilirubin,
receptors, suicidal behavior. can result in severe CBC, liver function
Clozapine is given acetylcholine infections. If not studies.
once, twice, or three receptors, and caught early,
times daily. The histamine receptors. agranulocytosis can
dose often is Unlike traditional CONTRAINDICATION be fatal. Therefore,
increased slowly anti-psychotic History of drug-induced the white blood cell
until the optimal agents, such as neutropenia/agranulocyt count should
dose is found. The chlorpromazine osis or w/ be measured (with
full effects of (Thorazine) and myeloproliferative a blood test) prior to
clozapine may not haloperidol (Haldol) disorders; alcoholic & starting treatment
be seen until several as well as the newer toxic psychoses, drug and regularly
weeks after anti-psychotics, intoxication, comatose (weekly) while
treatment is begun risperidone conditions & other forms patients receive this
(Risperdal) and of severe CNS medication, and for
olanzapine depression; severe 4 weeks after it is
(Zyprexa), clozapine hepatic & renal stopped.
only weakly blocks impairment. Pregnancy &
 dopamine type 2 lactation.
receptors.

GENERIC NAME ACTION CONTRAINDICATIO NURSING INTERVENTIONS Cont.

Olanzapine Unknown; may N Assessment
• WARNING:
Monitor elderly
mediate Olanzapine is • History: patients for
BRAND NAME antipsychotic activity contraindicated in Allergy to dehydration and
Zyprexa by both dopamine patients with a known olanzapine, institute
myeloproliferati remedial
and serotonin type 2 hypersensitivity to ve disorders, measures
CLASSIFICATION (5- the product. severe CNS promptly;
Antipsychotic drug hydroxytryptamine Contraindicated with depression, sedation and
comatose decreased
[HT]2 antagonism; allergy to olanzapine, states, history sensation of
DOSAGE also, may antagonize myeloproliferative of seizure thirst related to
disorders, CNS effects of
Take with milk or muscarinic receptors, disorders, severe CNS lactation; CV or drug can lead to
with food to decrease histamic(H1)- and depression, comatose cerebrovascular dehydration.
GI upset. alphaadrenergic states, lactation. disease, • Encourage
dehydration, patient to void
Initially 5-10 mg OD receptors. Alzheimer's before taking
When dosage SIDE-EFFECTS disease, the drug to help
adjustment are INDICATION - agitation; prostate decrease
enlargement, anticholinergic
necessary, dose For the treatment of - changes in vision; narrow-angle effects of
increments/decreme schizophrenia and - coma (loss of glaucoma, urinary
history of retention.
nts of 5mg 4x/day manic depression consciousness for a paralytic ileus • Monitor for
are recommended (bipolar disorder). period of time); or breast elevations of
- constipation; cancer, elderly temperature
or debilitated and
- depression; patients, differentiate
- difficulty breathing pregnancy between
or swallowing; • Physical: T, infection and
neuroleptic
- difficulty falling weight;
malignant
reflexes,
asleep or staying orientation, IOP, syndrome.
asleep; ophthalmologic • Monitor for
orthostatic
- difficulty walking; examination; P,
- dizziness; BP, orthostatic hypotension
BP, ECG; R, and provide
- drowsiness; adventitious appropriate
- dry mouth; sounds; bowel safety measures
- excess sweating; sounds, normal as needed.
output, liver
- fast heartbeat; evaluation; Teaching points
- fast or irregular prostate • Take this drug
palpation, exactly as
heartbeat; normal urine prescribed; do
- fever; output; CBC, not change
- hives; urinalysis, liver dose without
and renal consulting your
- pain in arms, legs, function tests physician.
back, or joints; • Peel back foil on
Interventions
- rash; blister pack of
• Do not dispense disintegrating
- restlessness; more than 1-wk tablets; do not
- seizures; supply at a push through
time. foil; use dry
- slurred speech;
• Peel back foil on hands to
- sudden movements blister pack of remove tablet,
that you cannot disintegrating place entire
tablets; do not tablet in mouth.
control; push through • This drug
- swelling of the arms, foil; use dry cannot be taken
hands, feet, ankles, or hands to during
remove tablet pregnancy. If
lower legs; and place in you think you
- unusual behavior; mouth. are pregnant or
- unusual movements • Prepare solution
wish to become
pregnant,
of your face or body for IM injection
contact your
using 2.1 mL
that you cannot sterile water for
health care
provider.
control; injection.
Resulting • You may
- very stiff muscles; experience
solution
- weakness; contains these side
effects:
- weight gain; 5 mg/mL.
Drowsiness,
Solution should
be clear yellow. dizziness,
Use within 1 hr sedation,
of seizures (avoid
reconstitution. driving,
Discard any operating
unused portion. machinery, or
performing
• Monitor for the
tasks that
many possible
require
drug
 interactions concentration);
before dizziness,
beginning faintness on
therapy. arising (change
positions slowly,
use caution);
increased
salivation (if
bothersome,
contact your
health care
provider);
constipation
(consult with
your health care
provider for
appropriate
relief
measures); fast
heart rate (rest
and take your
time if this
occurs).
• Report lethargy,
weakness,
fever, sore
throat, malaise,
mouth ulcers,
and flulike
symptoms.

GENERIC NAME ACTION CONTRAINDICATIO NURSING

Modezine N INTERVENTIONS
INDICATION Suspected or
BRAND NAME established
Management of subcortical brain
CLASSIFICATION schizophrenia, mania damage. Patients
Antipsychotic drug & other psychoses. receiving large doses
of hypnotics. Childn
DOSAGE <12 yr.
Take with or without Hypersensitivity &
food. cross-sensitivity to
12.5-25 mg (0.5-1 phenothiazine
mL) IM every 2-5 wk derivatives.

Extrapyramidal
symptoms (dystonic
reactions & akathisia
are common).
Occasionally,
galactorrhea,
augmentation of
epilepsy, epigastric
pain or jaundice. May
release
catecholamines, use
w/ caution in
pheochromocytoma

SIDE-EFFECTS
Extrapyramidal
symptoms, eg
pseudoparkinsonism,
dystonia, dyskinesia,
akathisia, oculogyric
crises, opisthotonos &
hyperreflexia. Muscle
rigidity sometimes w/
hyperthermia.

GENERIC NAME ACTION CONTRAINDICATIO NURSING Cont.

Zolodin N INTERVENTIONS -
INDICATION Severe renal or
BRAND NAME hepatic failure and
Used in the uncontrolled
CLASSIFICATION treatment of epilepsy. Patients
Antidepressant depression, receiving MAOIs or
drug obsessive- for at lest 2 weeks
compulsive after their
DOSAGE disorder, panic discontinuation.
Take with or disorder, social
without food. phobia. SIDE-EFFECTS
Initial Dose: 50 mg Dry mouth, nausea,
daily. If necessary, vomiting,
increments of 50 dyspepsia,
mg at intervals of constipation,
at least a wk. Max diarrhea. Anxiety,
Dose: 200 mg daily restlessness,
nervousness and
insomia, drowsiness
and fatigue,
headache, tremor,
dizziness,
convulsions,
hallucinations,
extrapyramidal
effects eg dystonias
(teeth clenching),
dyskinesias (teeth
grinding) sexual
dysfunction.