VIRGEN MILAGROSA UNIVERSITY FOUNDATION
Martin P. Posadas Avenue, San Carlos City, Pangasinan, Philippines 2420
                                                            COLLEGE OF NURSING
Drug name          Dosage          Mechanism       Indications  Contraindicatio            Side effects              Nursing precaution
                                     of action                         ns
Generic:       Usual:             Alters effects   Schizophreni Hypersensitivity;     CNS: NEUROLEPTIC         1. Assess mental status prior to
Chlorproma     PO (Adults):       of dopamine      a and        hypersensitivity      MALIGNANT                and periodically during therapy.
zine           Psychoses: 10–     (D2) in CNS.     psychoses.   to        sulfites    SYNDROME,
               25 mg 2–4          Has              Hyperexcita (injectable) or        sedation,
               times daily;       significant      ble,         benzyl alcohol        extrapyramidal           2. Monitor BP and pulse prior to
               may ↑ every 3–     anticholinergi   combative,   (SR    capsules);     reactions, TD.           and frequently during the period
               4 days             c/               explosive    cross-sensitivity     EENT: Blurred            of dosage adjustment. May cause
BRAND:         (usual dose is     alpha-           behavior in  with        other     vision, dry eyes, lens   QT interval changes on ECG.
Thorazine      200 mg/day;        adrenergic       children.    phenothiazines        opacities.
               up to 1 g/day)     blocking         Hyperactive may         occur;     CV: Hypotension (↑       3. The drug may be taken with or
               or 30–300 mg       activity.        child with   angle-closure         with IM, IV),            without food.
               1–3 times daily                     conduct      glaucoma; bone-       tachycardia.
               as extended-                        disorder.    marrow                GI: Constipation, dry    4. Observe patient carefully when
               release                             Acute mania. depression;           mouth, anorexia,         administering medication.
               capsules.                           Nausea and   severe liver/CV       hepatitis, ileus,
CLASSIFICA                                         vomiting.    disease;              priapism.                5. Monitor I&O ratios and daily
TION:          IM (Adults):                        Intractable  concurrent            GU: Urinary              weight.
Antiemetics,   Severe                              hiccups.     pimozide use.         retention. Derm:
Antipsychoti   psychoses: 25–                      Preoperative                       photosensitivity,        6. Monitor for development of
cs             50 mg initially,                    apprehensio                        pigment changes,         neuroleptic malignant syndrome
               may be                              n. Acute                           rashes.                  (fever, respiratory distress,
               repeated in 1                       intermittent                       Endo: Galactorrhea,      tachycardia, seizures,
               hr; ↑ to                            porphyria.                         amenorrhea.              diaphoresis, hypertension or
               maximum of                                                             Hemat:                   hypotension, pallor, tiredness,
               400 mg every                        Off-Label                          AGRANULOCYTOSIS,         severe muscle stiffness, loss of
               3–12 hr if                          Use: Vascular                      leukopenia.              bladder control. Report
               needed (up to 1                     headache.                          Metab:                   symptoms immediately. May also
               g/day).                             Bipolar                            Hyperthermia. Misc:      cause leukocytosis, elevated liver
                                                   disorder.                          Allergic reactions.      function tests, elevated CPK.
            VIRGEN MILAGROSA UNIVERSITY FOUNDATION
Martin P. Posadas Avenue, San Carlos City, Pangasinan, Philippines 2420
                       COLLEGE OF NURSING
                                                                          7. Advise patient to take
                                                                          medication as directed. Take
                                                                          missed doses as soon as
                                                                          remembered, with remaining
                                                                          doses evenly spaced throughout
                                                                          the day.
                                                                          8. Do not increase dose or
                                                                          discontinue medication without
                                                                          consulting health care
                                                                          professional.
                                                                          9. Instruct patient to report
                                                                          significant changes in
                                                                          neurological status, such as
                                                                          seizures, extreme lethargy,
                                                                          slurred speech, disorientation or
                                                                          ataxia.
                                                                          10. Monitor kidney and liver
                                                                          function of the patient.
                                                  VIRGEN MILAGROSA UNIVERSITY FOUNDATION
                                      Martin P. Posadas Avenue, San Carlos City, Pangasinan, Philippines 2420
                                                             COLLEGE OF NURSING
 Drug name           Dosage             Mechanism of         Indicatio    Contraindicati         Side effects            Nursing precaution
                                           action                ns              ons
Generic Name     Schizophrenia                               For    the   Hypersensitivit   Body as a Whole:         • Monitor diabetics for loss
aripiprazole     Adult: PO 10–15        Aripiprazole's       treatment    y to              Headache, asthenia,            of glycemic control.
                 mg once daily,         antipsychotic        of           aripiprazole;     fever, flu-like          • Monitor cardiovascular
 Trade Name      may increase at        activity is likely   schizophr    dementia in       symptoms, peripheral           status. Assess for and
   Abilify       2-wk intervals to      due      to      a   enia and     elderly; QT       edema, chest pain,             report orthostatic
                 max of 30              combination of       related      prolongation;     neck pain, neck                hypotension. Take BP
Classification   mg/day if              antagonism at        psychotic    lactation.        rigidity.                      supine then in sitting
   Atypical      needed                 D2 receptors in      disorders.                     CNS: Anxiety,                  position. Report
antipsychotic    Adolescent/Child       the mesolimbic                                      insomnia,                      systolic drop of
                 (at least 10 y         pathway and                                         lightheadedness,               greater than 15–20
                 old): PO 2 mg          5HT2A                                               somnolence, akathisia,         mm Hg. Patients at
Time/frequenc    daily, increase to     receptors in the                                    tremor,                        increased risk are
      y          5 mg after 2           frontal cortex.                                     extrapyramidal                 those who are
   Morning       days, increase to      Antagonism at                                       symptoms,                      dehydrated,
                 10 mg after 2          D2 receptors                                        depression,                    hypovolemic, or
                 more days. Can         relieves                                            nervousness,                   receiving concurrent
                 increase up to 30      positive                                            increased salivation,          antihypertensive
                 mg.                    symptoms                                            hostility, suicidal            therapy.
                                        while                                               thought, manic           • Monitor body temperature
                                        antagonism at                                       reaction, abnormal             in situations likely to
                                        5HT2A                                               gait, confusion,               elevate core
                                        receptors                                           cogwheel rigidity.             temperature (e.g.,
                                        relieves                                            CV: Hypertension,              exercising
                                        negative                                            tachycardia,                   strenuously, exposure
                                        symptoms        of                                  hypotension,                   to extreme heat,
                                        schizophrenia.                                      bradycardia. Risk of           receiving drugs with
                                                                                            stroke in elderly with         anticholinergic
                                                                                            dementia-related               activity, or being
                                                                                            psychosis.                     subject to
            VIRGEN MILAGROSA UNIVERSITY FOUNDATION
Martin P. Posadas Avenue, San Carlos City, Pangasinan, Philippines 2420
                       COLLEGE OF NURSING
                                                    GI: Nausea, vomiting,            dehydration).
                                                    constipation, anorexia.   • Monitor for and report
                                                    Hematologic:                     signs of tardive
                                                    Ecchymosis, anemia.              dyskinesia.
                                                    Metabolic: Weight         • Monitor for and
                                                    gain, weight loss,               immediately report
                                                    hyperglycemia,                   S&S of neuroleptic
                                                    diabetes mellitus,               malignant syndrome
                                                    increased creatine               (NMS) that include:
                                                    kinase.                          Hyperpyrexia, muscle
                                                    Musculoskeletal:                 rigidity, altered
                                                    Muscle cramp.                    mental status,
                                                    Respiratory: Rhinitis,           irregular pulse or
                                                    cough.                           blood pressure,
                                                    Skin: Rash.                      tachycardia,
                                                    Special Senses:                  diaphoresis, and
                                                    Blurred vision.                  cardiac dysrhythmia.
                                                                                     Withhold drug if NMS
                                                                                     is suspected.
                                                                              Lab        tests:      Monitor
                                                                              periodically Hct and Hgb.
                                                                              Monitor periodically blood
                                                                              glucose. Monitor for elevated
                                                                              CPK and myoglobinuria if
                                                                              NMS is suspected.