Name: _______________________________________
DRUG STUDY
Drug Order
Generic Name:
Clozapine
Brand Name: Ziproc
Clozaril, Versacloz,
Dosage:
ELDERLY: Initially, 12.5
mg/day for 3 days, then 25
mg/day for 3 days. May
further increase in increments
of 12.5–25 mg daily q3days.
Mean dose: 300 mg/day.
Maximum: 700 mg/day
Route: PO
Frequency:
OD, BID
Classification:
Mechanism of Action
-Interferes with binding of
Dopamine and serotonin
receptor sites. Also acts as
an antagonist at alpha-
adrenergic, histamine H1,
cholinergic, and other
dopaminergic and
serotonergic receptors.
Therapeutic Effect:
Diminishes schizophrenic
behavior
Indication
-Indicated in the
management of severely ill
schizophrenics who are
unresponsive to standard
antipsychotic drugs
-Reduction of risk of
recurrent suicidal behavior
patients with schizophrenia
or shizoaffective disorder
Date: ____________________________
Contraindications Side Effects / Adverse
Effects
Contraindicated: SIDE EFFECTS:
-Hypersensitivity to
Clozapine. Frequent (39%–14%):
-History of Clozapine- Drowsiness, salivation,
induced agranulocytosis or tachycardia, dizziness,
severe granulocytopenia. constipation.
Cautions: Occasional (9%–4%):
-History of seizures Hypotension, headache,
-Cardiovascular disease, tremor, syncope,
myocarditis, respiratory/ diaphoresis, dry mouth,
hepatic/renal impairment, nausea, visual
-Alcohol withdrawal disturbances, nightmares,
-High risk of suicide, restlessness, akinesia,
-Paralytic ileus, agitation, hypertension,
-visual disturbances, abdominal discomfort,
-history of bowel heartburn, weight gain.
obstruction Rare: Rigidity, confusion,
-diabetes mellitus. fatigue, insomnia, diarrhea,
rash
-History of long QT
prolongation/ ventricular
arrhythmias;
-Hypokalemia ADVERSE EFFECTS:
-Hypomagnesemia. Seizures occur occasionally
(3% of pts). Overdose
produces CNS depression
(sedation, delirium, coma),
respiratory depression,
hypersalivation. Blood
Responsibilities in
administering the drug
-Give without regard to
food.
-Suspension: Use oral
syringes (provided). Shake
well, administer dose
immediately after
preparing. Suspension
stable for 100 days after
initial bottle opening.
-Monitor B/P for
hypertension/hypotension.
-Assess pulse for
tachycardia (common side
effect).
-Monitor CBC for blood
dyscrasias.
-Monitor ANC, WBC count
every wk for first 6 mos,
then biweekly for 6 mos.
-Supervise suicidal risk pt
closely during early therapy
(as depression lessens,
energy level improves,
increasing suicide
potential).
Name: _______________________________________ Date: ____________________________

dyscrasias, particularly
Second generation agranulocytosis, mild
(atypical) antipsychotic. leukopenia, may occur
Name: _______________________________________
Drug Order
Generic Name:
Clonazepam
Brand Name: Rivotril,
Klonopin
Dosage:
ADULTS, ELDERLY: Initially,
0.25 mg twice daily. Increase
in increments of 0.125–0.25
mg twice daily every 3 days.
Target dose: 1 mg/day.
Maximum: 4 mg/day.
Discontinue gradually by
0.125 mg twice daily q3days
until completely withdrawn.
Route: PO
Frequency:
BID
DRUG STUDY
Mechanism of Action Indication
- Enhances activity of - Indicated for the
Gamma‐aminobutyric treatment of panic
acid (GABA) an inhibitory disorder, with or without
neurotransmitter; agoraphobia, as defined in
depresses nerve impulse the DSM-V
transmission in motor
cortex. - Indicated as
monotherapy or as an
Therapeutic Effect: adjunct in the treatment of
Produces anxiolytic, Lennox-Gastaut syndrome
anticonvulsant effects. (petit mal variant),
akinetic, and myoclonic
seizures.
-May also be of some
value in patients with
absence spells (petit mal)
who have failed to respond
to succinimides.
Date: ____________________________
Contraindications Side Effects / Adverse
Effects
Contraindicated: SIDE EFFECTS:
- Hypersensitivity to
Clonazepam. Frequent (37%–11%):
-Active narrow-angle Mild, transient drowsiness;
glaucoma ataxia, behavioral
-Severe hepatic disease. disturbances (aggression,
irritability, agitation), esp.
Cautions: in children.
-Renal/hepatic impairment
-Impaired gag reflex Occasional (10%– 5%):
-Chronic respiratory Dizziness, ataxia, URI,
disease fatigue.
-Elderly, debilitated pts,
depression Rare (4% or less): Impaired
-Pts at risk of suicide or memory, dysarthria,
drug dependence nervousness, sinusitis,
-Concomitant use of other rhinitis, constipation,
CNS depressants. allergic reaction
ADVERSE EFFECTS:
-Abrupt withdrawal may
result in pronounced
restlessness
-Irritability, insomnia, hand
tremors
-Abdominal/muscle cramps
-Diaphoresis
-Vomiting
-Status epilepticus. -
Overdose results in
Responsibilities in
administering the drug
- Give without regard to
food. Swallow whole with
water
- Observe for excess
sedation, respiratory
depression, suicidal
ideation.
-Assess elderly for
paradoxical reaction,
particularly during early
therapy.
-Assist with ambulation if
drowsiness, ataxia occur.
-Evaluate for therapeutic
response: decreased
intensity and frequency of
seizures or, if used in panic
attack, calm facial
expression, decreased
restlessness
Name: _______________________________________ Date: ____________________________

Classification: drowsiness
Benzodiazepine (Schedule -Confusion
IV) -Diminished reflexes
-Coma.
Clinical Class:
Anticonvulsant, antianxiety Antidote: Flumazenil
Name: _______________________________________ Date: ____________________________

DRUG STUDY
Drug Order Mechanism of Action Indication Contraindications Side Effects / Adverse Responsibilities in
Effects administering the drug

Generic Name: - Inhibits hydrogen- -Indicated as the First line Contraindicated: SIDE EFFECTS: -Give before meals
Omeprazole potassium adenosine therapy in treatment of -Hypersensitivity to (breakfast preferred).
triphosphatase (H+/K+ ATP heartburn or symptoms of omeprazole, other proton -Frequent (7%): Headache
pump), an enzyme on the GERD pump inhibitors. -Give whole. Do not break,
surface of gastric parietal Concomitant use with - Occasional (3%–2%): crush, dissolve, or divide
Brand Name: Losec, cells. -Treatment of frequent products containing Diarrhea, abdominal pain, delayed-release forms.
PriLOSEC, PriLOSEC OTC heartburn rilpivirine. nausea.
Therapeutic Effect: Rare (2%): Dizziness, -May open capsule, mix
Increases gastric pH, Cautions: asthenia, vomiting, with applesauce, and give
Dosage: reduces gastric acid May increase risk of constipation, upper immediately.
ADULTS, ELDERLY: 20 mg/day production. fractures, gastrointestinal respiratory tract infection,
for 14 days. May repeat after infections. Hepatic back pain, rash, cough - Report headache, onset
4 mos if needed. impairment, pts of Asian of black, tarry stools,
descent. ADVERSE EFFECTS: diarrhea, abdominal pain.
-Pancreatitis
Route: PO -Hepatotoxicity - Avoid alcohol.
-Interstitial nephritis occur
rarely. -Swallow capsules whole;
-May increase risk of C. do not chew, crush,
Frequency: difficile infection dissolve, or divide.
OD, BID, TID

Classification:
Benzimidazole

Clinical Class:
Proton pump inhibitor
Name: _______________________________________ Date: ____________________________

DRUG STUDY
Drug Order Mechanism of Action Indication Contraindications Side Effects / Adverse Responsibilities in
Effects administering the drug

Generic Name: - Blocks uptake of -Indicated in the treatment Contraindicated: SIDE EFFECTS: -Give without regard to
Escitalopram neurotransmitter serotonin of major depressive - Hypersensitivity to Frequent (21%–11%): food.
at neuronal presynaptic disorder escitalopram. Nausea, dry mouth,
membranes, increasing its -Maintenance treatment -Use of MAOI intended to drowsiness, insomnia, -Do not break, crush,
availability at postsynaptic for patients with major treat psychiatric disorders diaphoresis. dissolve, or divide tablets.
Brand Name: Cipralex , receptor sites. depressive disorder (concurrent or within 14
Lexapro -Indicated in the treatment days of discontinuing Occasional (8%–4%): -Observe, record behavior
Therapeutic Effect: for generalized anxiety either escitalopram or Tremor, diarrhea, and assess psychological
Antidepressant effect. disorder MAOI). abnormal ejaculation, status, thought content,
Dosage: -Unlabeled use: Panic -Initiation in pts receiving dyspepsia, fatigue, anxiety, sleep pattern, appearance,
ELDERLY: 10 mg/day. Disorder linezolid or IV methylene vomiting, anorexia. interest in environment.
blue.
-Concurrent use with Rare (3%–2%): Sinusitis, -Monitor for suicidal
Route: PO pimozide. sexual dysfunction, ideation (esp. at beginning
menstrual disorder, of therapy or when doses
Cautions: abdominal pain, agitation, are increased or decreased)
-Hepatic/renal impairment decreased libido.
Frequency: -History of seizure disorder -Report worsening
OD concurrent use of CNS ADVERSE EFFECTS: depression, suicidal
depressants - May include mental ideation, unusual changes
Classification: - Pts at high risk of suicide, status changes (agitation, in behavior.
concomitant aspirin, hallucinations, delirium,
Selective serotonin NSAIDs, warfarin (may coma)
reuptake inhibitor. potentiate bleeding risk), -Autonomic instability
elderly, metabolic disease; (tachycardia, labile blood
Clinical Class
Name: _______________________________________ Date: ____________________________

Antidepressant recent history of MI, pressure, dizziness,

cardiovascular disease sweating, flushing,
hyperthermia)

-Neuromuscular symptoms
(tremor, rigidity,
myoclonus hyperactive
reflexes, incoordination).

-May cause hyponatremia

as a result of syndrome of
inappropriate antidiuretic
hormone (SIADH).

-May increase risk of

bleeding; narrow angle
glaucoma; seizures.
Name: _______________________________________
Drug Order
Generic Name:
Olanzapine
Brand Name: Zyprexa,
Zyprexa Relprevv, Zyprexa
Zydis
Dosage:
ADULTS, ELDERLY: Initially, 5–
10 mg once daily. May
increase to 10 mg/day within
5–7 days. If further
adjustments are indicated,
may increase by 5 mg/day at
7-day intervals.
Maintenance: 10–20 mg/day.
Maximum: 20 mg/day
Route: PO
Frequency:
Date: ____________________________
DRUG STUDY
Mechanism of Action Indication Contraindications Side Effects / Adverse Responsibilities in
Effects administering the drug
-Antagonizes alpha1- -Indicated in the treatment Contraindicated: SIDE EFFECTS: -Give without regard to
adrenergic, Dopamine, of Schizophrenia - Hypersensitivity to food.
histamine, muscarinic, Olanzapine. -Frequent (26%–10%):
serotonin receptors. -Treatment of acute mixed Drowsiness, agitation, -Monitor B/P, serum
Produces anticholinergic, or manic episodes Cautions: insomnia, headache, glucose, lipids, LFT.
histaminic, CNS depressant associated with bipolar -Disorders in which CNS nervousness, hostility,
effects. disorder 1 and depression is prominent - dizziness, rhinitis. -Assess for tremors,
maintenance of bipolar 1 Cardiac disease, changes in gait, abnormal
Therapeutic Effect: disorder as monotherapy -Hemodynamic instability, -Occasional (9%–5%): muscular movements,
Diminishes psychotic prior MI Anxiety, constipation, behavior.
symptoms through -Treatment of agitation -Ischemic heart disease nonaggressive atypical
combined antagonism of associated with -Hyperlipidemia behavior, dry mouth, -Supervise suicidal-risk pt
dopamine and serotonin schizophrenia and bipolar -Pts at risk for aspiration weight gain, orthostatic closely during early therapy
receptors 1 mania pneumonia hypotension, fever, (as depression lessens,
-Decreased GI motility, arthralgia, restlessness, energy level improves,
urinary retention cough, pharyngitis, visual increasing suicide
-BPH changes (dim vision). Rare: potential).
-Narrow-angle glaucoma, Tachycardia; back, chest,
diabetes abdominal, or extremity -Assist with ambulation if
- Elderly, pts at risk for pain; tremor dizziness occurs.
suicide, Parkinson’s
disease, severe ADVERSE EFFECTS: -Assess sleep pattern.
renal/hepatic impairment, - Neuroleptic malignant Notify physician if
predisposition to seizures. syndrome, a potentially extrapyramidal symptoms
fatal syndrome (EPS) occur.
Name: _______________________________________ Date: ____________________________
OD characterized by
hyperpyrexia, muscle
Classification: rigidity, irregular pulse or
B/P, tachycardia,
Second generation diaphoresis, cardiac
(atypical) antipsychotic. arrhythmias.
Clinical class: -Extrapyramidal symptoms
Antipsychotic. (EPS), dysphagia may
occur.
-Overdose (300 mg)
produces drowsiness,
slurred speech.
-Advise to increase fluid
intake to avoid
dehydration, particularly
during exercise, exposure
to extreme heat,
concurrent use of
medication causing dry
mouth, other drying
effects.