NAME OF DRUG

GENERIC NAME haloperidol BRAND NAME Hadol,Apohaloperidol. GENERIC NAME Haloperidol decanonat e BRAND Name haldol

CLASSIFICA TION
Dopaminergicblocking drug

ACTION
Antipsychotic post synaptic blocks dopamine receptors in the brain, depress the RAS, including those parts of the brain involve in wakefulness and emesis; chemically resembles the phenothiazines.

INDICATION
Management of the manifestation s of psychotic disorders. Control of tics and vocalizations in tourettes syndrome in adults and children. Behavioral problems in for children with combative. Short-term treatment of hyperactive children with excessive motor activity, mood liability. Haloperidol decanonate: prolonged parenteral therapy of chronic schizophrenia

CONTRAINDICATION
Contraindicated with hypersensitivity to typical antipsychotics, coma, or severe CNS depression .bone marrow depression, blood dyscrasia, circulatory collapse, sub cortical brain damage, Parkinsons disease, liver damage, cerebral arteriosclerosis, coronary disease ,severe hypotension or hypertension. Use cautiously with pregnancy, lactation, respiratory dis order.

ADVERSE EFFECTS
Autonomic Nausea, vomiting g anorexia salivation fever CNS Drowsiness, insomnia ,vertigo, headache, Weakness, C CV Hypotension, orthostatic hypotension, hypertension, tachycardia, bradycardia, CHF. Endocrine Lactation, breast encorgement in female, SIADH. Hematologic Eosinophilia,, leukupenia, anemia, aplastic anemia, Respiratory bronco spasm ,laryngo spasm dyspnea. Hypersensitivity Jaundice urticaria, gioneurotic edema,

DRUG TO DRUG INTERACTION

Additive anti-cholinergic effects and possibly decreased antipsychotic efficacy with anticholinergic drugs. Increased risk of toxic side effect with lithium. Decreased effectiveness with carbamazipine.

DRUG TO FOOD INTERACTION

NURSING CONSIDERATION
Assessment History: y severe CNS depression y bone marrow depression, y blood dyscrasia. Intervention y Do not give children IM injections y Do not use haloperidol decanonate for IV injection. y Teaching points y Take this drug exactly as prescribe y Avoid driving if dizziness or drowsiness or vision change occur y Avoid prolong exposure to sun y Maintain fluid intake y Report soar throat, fever, unusual bleeding nor bruising. Warning y Monitor elderly patient for dehydration y Discontinue drug if serum creatinine or BUN become abnormal or if WBC count is depressed.

DRUG NAME

CLASSIFICATION

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DRUG TO DRUG INTERACTION

Paralytic ileus sometime Fatal ,with other anticholinergics, properties,( phenothiazines,TCAs). Additive adverse CNS effect ( toxic psychosis ) with drug that have CNS anticholinergic properties ( phenothiazines TCAs.

DRUG TO FOOD INTERACTION

NURSING CONSIDERATIONS
History y y

GENERIC NAME: biperiden lactate

Antiparkinsonian

BRAND NAME: Akineton

Anticholinergic activity in the CNS that is believed to help normalize the hypothesized imbalance of cholinergic and dopaminergic neurotransmission in the basal ganglia in the brain of a parkinsonism patient. Reduce severity of rigidity ,and to lesser extent, akenesia and tremor .

Adjunct in the therapy of parkinsonism Relieve of symptoms of extra pyramidal disorders that accompany phenothiazine therapy.

Contraindicated with hypersensitivity to benztropine , glaucoma,. Use cautiously with tachycardia ,cardiac arrhythmias, hypertension , hypotension, hepatic or renal dysfunction, alcoholism chronic illness.

CNS Disorientation confusion memory loss hallucinations psychoses CV Tachycardia hypotension orthostatic hypotension palpitations Dermatologic Rash, urticaria, other dermatoses EENT Blurred vision .mydriasis,diplopia, Increased extra ocular tension GI Dry mouth constipation, dilation of the colon. , nausea, vomiting, epigastric distress. GU Urinary retention urinary hesitancy dysuria Other.

Hypersensitive to benztropine, glaucoma, pyloric and duodenal obstruction .stenosing peptic ulcer.

Physical y Body weight:, T;,skin color, lesions, v/S.

TEACHING POINTS y Take this drug exactly as prescribe. y Avoid using alcohol sedatives and other OTC drugs. y You may experience this side effects: y Drowsiness, blurred of vision dizziness confusion. Report difficult or painful urination, constipation, and rapid pounding heartbeat, eye Give With caution ,and reduce dosage in hot weather Give with meals if GI upset is occurs Ensure that the patient voids just before receiving each thosofdrugs

y Flushing decreased sweating, elevated temperature.

y y

DRUG NAME

CLASSIFICATIO N Phenothiazine Dopaminergicblocking drug Antipsychotic

ACTION

INDICATION

CONTRAINDICATION

ADVERSE EFFECT

DRUG TO DRUG INTERACTION Additive CNS depression with alcohol, barbiturates, and other sedative. Additive anticholinergic effects possibly decreased antipsychotic efficacy with anti cholinergic drugs.

FOOD TO INTERACTION

NURSING CONSIDERATION

GENERIC NAME: Fluphenazine BRAND NAME: Prolixin Decanoate

Mechanism not fully understood: antipsychotic drugs block the postsynaptic dopamine receptors in the brain ,depress the RAS ,including the part of the brain involve in wakefulness and emesis; anticholinergic ,antihistmatic

Manage of manifestation of psychotic disorders; maage ment of patient ( schizophrenics ) that require prolonged parenteral thearapy.

Contraindicated with hypersensitivity to fluphenazine, and other phenothiazines. tartrazine or aspirin. Bone marrow depression ,blood dyscrasia, circulatory collapse liver damnage Coronary disease. Use cautiously with respiratory disorders, prostatic hypertrophy ,urinary retention, glaucoma.

Autonomic Dry mouth, salivation, nasal congestion, nausea , vomiting, anorexia. CNS Drowsiness,v ertigo, headache, insomnia, weakness ,treamors, ataxia CV Hypertension, Orthostatic hypotention, hyopertension , bradycardia, tachycardia, cardiac arrest,CHF. Endocrine Lactation engorgement in females. galactorrhea. ,amenorrhea, Menstrual, irregularities Hematologic Eosinophilia leucopenia Leukocytosis ,anemia. Hypersensitivity: Urticaria, angioneurotic edema,laryngeal edema. Respiratory Bronchospasm,laryngosp asm, dyspnea, suppression of cough.

History Coma or severe CNS depression, bone marrow depression. Blood dyscrasia Physical Weight, t; reflexes ,orientation, IOP;V/S,adventicious sound. Intervention y Arrange for discontinuation of drug if serum creatinine of BUN become abnormal or If WBC count is depressed. y Monitor elderly for dehydration; y Institute remedial measures promptly y Consult physician regarding appropriate warning of patients guardian about tardive dyskinesias. y Consult physician about dosage reduction Teaching points y y Take drug exactly as prescribed. Avoid driving if drowsiness, weakness tremor. Avoid prolong exposure to sun Maintain fluid intake. Report sore throat, fever, weakness.

y y y

NAME OF DRUG

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DRUG TO DRUG INTERACTION

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Generic Name: ferrous sulfate Trade Name: Feosol,Apo-ferrous sulfate

Iron Preparation

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

Prevention and treatment of iron deficiency anemia. Dietary supplement for iron.

Hypersensitivity Severe hypotension.

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

Decresed anti- infective response to cifloxacin,norfloxacin,ofl oxacin,separate doses by atleasdt 2 hours Decreased absorbtion with antacids,,cimetidine. Decrease effect with levedopa. If taken with iron. Increased serum level iron with chloramphenicol.

Decrease absorption with antacids,eggs or milk ,coffee and tea; avoid concurrent administration of any of these.

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.

NAME OF DRUG

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FOOD TO DRUG INTERACTIO N

NURSING CONSIDERATION

y Generic name: paracetamol y y Analgesic Muscle Relaxants y Decreases fever by inhibiting the effects of pyrogens on the hypothalamus heat regulating centers & by a hypothalamic action leading to sweating & vasodilatation. Relieves pain by inhibiting prostaglandin synthesis at the CNS but does not have anti-inflammatory action because of its minimal effect on peripheral prostaglandin synthesis. Relief of mild-tomoderate pain; treatment of fever Contraindicated to patients with: y y Hypersensitivity intolerance to tartrazine (yellow dye #5), alcohol, table sugar, saccharin Contraindicated with allergy to acetaminophen Stimulation, drowsiness, nausea, vomiting, abdominal pain, hepatotoxicity, hepatic seizure(overdose, Renal failure(high, prolonged doses), leucopenia, neutropenia, hemolytic anemia (long term use) thrombocytopenia, pancytopenia, rash, urticaria, hypersensitivity, cyanosis, anemia, jaundice, CNS, stimulation, delirium followed by vascular collaps, convulsions, coma, death.

Assess patients fever or pain: typeof pain, location, intensity, duration, temperature, and diaphoresis. Assess allergic reactions: rash, urticaria; if these occur, drug may have to be discontinued. Teach patient to recognize signs of chronic overdose: bleeding, bruising, malaise, fever, sore throat. Tell patient to notify prescriber for pain/ fever lasting for more than 3 days.

Brand name: Biogesic y

NAME OF DRUG

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Do not take with high-fat meals or grapefruit juice .

NURSING CONSIDERATION

Assessment Generic name; Calcium channelblocker Antianginal Antihypertensive Inhibits the movement bof calcium ions across the membranes of cardiac and arterial musclen cells . Inhibition of transmembrane calcium flow results in the depression of impulse formation in specialized cardiac pacemaker cells in slowing the velocity of conduction of the cardiac impulse. Angina pectoris due to coronary artery spasm. Chronic stable angina SR preparation only: treatment of hypertension Orphan drug use: treatment of interstitial cystitis. Contraindicated with allergy to nifedipine. Use cautiously with lactation, pregnancy. CNS Dizziness,headache,asthe nia,fatigue,nervousness, CV Peripheral edema, angina, hypotention arrhythmias Dermatologic Flushing, rush, dermatitis, pruritus G.I Nausea , diarrhea, constipation,cramps,flatul ence,hepatic injury. Others Nasal congestion ,cough,fever, chills, shortness of breath. Increase effects with cemitidine. History y Allergy to nifedipine ;pregnancy, lactation,

Brand name:

Physical y Skin lesions, color, edema Intervention y Monitor BP very carefully if patient is on concurrent doses of nitrates or other antihypertensive. Monitor cardiac rhythm during stabilization of dosage and periodically during long term therapy Administer drug without regard to meals.

Teaching points. y y Take drug with meals if GI upset stomach occurs Do not take with high-fat meals or grapefruit juice while using this drug. Swallow tablet whole: do not chew, cut or crush. You may experience these side effects; nausea ,vomiting Report irregular heartbeat, shortness of breath.

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Generic name: Amlodipine besylate

y y

Antianginal Antihypertensiv e

y y calcium Channel blocker

Brand name: Norvasc Pregnancy catecory C

Inhibit the movement of calcium ions across the membranes of cardiac and arterial muscle cells. Inhibit transmembrane calcium flow which results in the depression of impulse formation in specialized cardiac pacemaker cells, slowing of the velocity of the conduction of the cardiac impulse,depressiojn of mayocardial contractility and dilation of coronary arteries.

Angina pectoris due to coronary artery spasm. Chronic stable angina, alone or in combination with other drugs. To reduce the risk of hospitalization due to angina and to reduce the need for coronary revascularizatio n procedures in patients with angiographicall y documented CAD without heart failure Essential hypertension alone or in combination with other antihypertensiv e.

y y

Contraindicate d with allergy to amlodepine. Impaired hepatic and renal function Use cautiously with heart failure,pregnan cy

CNS: dizziness, light headedness.astheria .fatigue,lethargy. CV: -peripheral edema Arrhythmias. GI: nausea abdominal discomfort

Assessment History : allergy to amlodipine impaired hepatic or renal function . Physical: skin le3sions, color edema. Interventions y Monitor patients carefully ( Bp ,cardiac rhythm ) and output, while adjusting drug to drug to therapeutic dose. Administer drug without regard to meals

Teaching points y y Take with meals if upset occurs. You may experience these side effects nausea, vomiting, and headache. Report irregular heart beat

NAME OF DRUG

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Delayed or reduced GI absorption with food. amoxixillin is not affected by food

NURSING CONSIDERATION

y Generic name: amoxicillin trihydrate Brand name: Amoxil y Antibiotic ( penicillin ampicillin type) Bactericidal; inhibits synthesis of cell wall of sensitive organisms causing cell death.

Treatment of tonsillitis and pharyngitis caused by streptococans progenies. Infection due to susceptible strains of haemophilus influenza,Escheri chia coli. Helicobacter pylori infection combination with other agents. Post exposure prophylaxis against bacillus anthraces

Contraindicat ed with allergies to penicillin, cephalospori ns or other allergens. Use cautiously with renal disorders, lactation.

CNS: Lethargy , hallucinations, seizures GI: Glossitis, stomatitis gastritis sore mouth, ,abdominal pain. GU: Nephritis Hematologic:

Increase effect with probenicid, Decrease effectiveness with tetracycline, chloramphenicol. Decrease efficacy of hormonal contraceptives.

Assessment y History; allergies to penicillins cephalosporins , or other allergens .renal disorder, lactation. Physical: y Culture infected area prior to treatment ,reculture area if response is not as expected. Give oral preparations only,amoxixillin is not affected by food. Use corticosteroids or antihistamine for skin reactions.

Anemia thrombocytopenia, leucopenia Hypersensitivity: Rash, fever Other: Super infections- oral and rectal monoliasis ,vaginitis.

Teaching points y y Take this drug around the clock. Take the full course of therapy; do not stop because you feel better. This antibiotic is specific for this problem and should not be used to self treat and other infections. You may experience these side effects, nausea; n ,vomiting Gi upset, diarrhea , sore mouth. Report unusual bleeding or abrasions, sore throat. Fever rash, severe diarrhea.

y y