GENERIC NAME Carbamazepine Brands: Tegret ol, Tegretol XR , Equetro, Carbatrol

CLASSIFI-CATION Anticonvulstant

ACTION Decreases synaptic transmission in the CNS by affecting sodium channels in neurons

INDICATION / USES Reduces anxiety, irritability, elation Impulse control behavior

COMMON ADVERSE EFFECTS CNS: headache, tremors, confusion, restlessness, memory loss, seizures, slurred speech, muscle weakness, lack of coordination, lethargy, stupor CV: bradycardia, ECG changes, arrhythmias, hypotension, peripheral circulatory collapse EENT: blurred vision, tinnitus GI: anorexia, nausea, vomiting, abdominal cramps or pain, diarrhea,

CONTRAINDICATIONS Hypersensitivity Kidney disease Cardiovascular disease Seizure disorder, myasthenia gravis Dehydration Hypothyroidism

NURSING CONSIDERATIONS Administer medication with food to minimize gastric irritation. Tablets may be crushed if patient has difficulty swallowing. Do not crush or chew extendedrelease tablets. Instruct patient to take carbamazepine around the clock, exactly as directed. If a dose is missed, take as soon as possible but not just before next dose; do not double doses. Medication should be gradually discontinued to prevent seizures. May cause dizziness or drowsiness. Instruct patients that fever, sore throat, mouth ulcers, easy bruising, petechiae, unusual bleeding, abdominal pain, chills, rash, pale stools, dark urine or jaundice should

dry mouth, extreme thirst, metallic taste, weight gain GU: polyuria, glycosuria, proteinuria, incontinence, edema, hyponatremia Hematologic: leukocytosis Skin: rash, pruritus, alopecia, sweating, dryness or thinning of hair

be reported. Advise patient not to take alcohol or other CNS depressant concurrently with this medication. Caution patients to use sunscreen and protecting clothing to prevent photosensitivity reactions. Inform patient that frequent mouth rinses, good oral hygiene, and sugarless gum or candy may help reduce dry mouth. Saliva substitute may be used.

GENERIC NAME chlorpromazine

CLASSIFI-CATION Antipsychotics

ACTION Block dopamine receptors in the brain; also alter dopamine release and turnover. Prevention of seizures

Brand name: Thorazine

INDICATION / USES Acute and chronic psychoses, particularly when accompanied by increased psychomotor activity. Nausea and vomiting. Also used in the treatment of intractable hiccups. :

COMMON ADVERSE EFFECTS CNS: neurole ptic malignant syndrome, sedation, extrapyramidal reactions, tardive dyskinesia CV: hypotension (increased with IM, IV) EENT: blurred vision, dry eyes, lens opacities GI: constipation, dry mouth, anorexia, hepatitis, ileus GU: urinary retention Hematologic: agranulocytosi s, leukopenia Skin: photosensitivit y, pigment changes, rashes

CONTRAINDICATIONS Hypersensitivity. Cross-sensitivity may exist among phenothiazines. Should not be used in narrowangle glaucoma. Should not be used in patients who have CNS depression.

NURSING CONSIDERATIONS Assess mental status prior to and periodically during therapy. Monitor BP and pulse prior to and frequently during the period of dosage adjustment. May cause QT interval changes on ECG. Observe patient carefully when administering medication, to ensure that medication is actually taken and not hoarded. Monitor I&O ratios and daily eight. Assess patient for signs and symptoms of dehydration. Monitor for development of neuroleptic malignant syndrome (fever, respiratory distress, tachycardia, seizures, diaphoresis, hypertension or hypotension, pallor, tiredness, severe muscle stiffness, loss of bladder

control. Report symptoms immediately. May also cause leukocytosis, elevated liver function tests, elevated CPK. Advice patient to take medication as directed. Take missed doses as soon as remembered, with remaining doses evenly spaced throughout the day. May require several weeks to obtain desired effects. Do not increase dose or discontinue medication without consulting health care professional. Abrupt withdrawal may cause dizziness, nausea, and vomiting, GI upset, trembling, or uncontrolled movements of mouth, tongue or jaw.

GENERIC NAME Ferrous sulfate

CLASSIFI-CATION Iron Preparation

ACTION Elevates the serum iron concentration which then helps to form High or trapped in the reticuloendothel ial cells for storage and eventual conversion to a usable form of iron.

INDICATION / USES Prevention and treatment of iron deficiency anemias. Dietary supplement for iron.

COMMON ADVERSE EFFECTS Dizziness N&V Nasal Congestion Dyspnea Hypotension CHF MI Muscle cramps Flushing

CONTRAINDICATIONS Hypersensitivity Severe hypotension.

NURSING CONSIDERATIONS Advice patient to take medicine as prescribed. Caution patient to make position changes slowly to minimize orthostatic hypotension. Instruct patient to avoid concurrent use of alcohol or OTC medicine without consulting the physician. Advise patient to consult physician if irregular heartbeat, dyspnea, swelling of hands and feet and hypotension occurs. Inform patient that angina attacks may occur 30 min. after administration due reflex tachycardia. Encourage patient to comply with additional intervention for hypertension like proper diet, regular exercise, lifestyle changes and stress management.

Cortez, Melanie Joy T.

BSN 4C