DRUG MECHANISM OF ACTION

INDICATION NURSING RESPONSIBILITIES

GENERIC NAME:Biperiden

BRAND NAME:

Biperiden Hdrochloride

CLASSIFICATION:Antiparkinsonian

FREQUENCY:Once a day (A.m.)

DOSAGE:2 milligram

ROUTE: PO

Blocks acetylcholine action at cholinergic receptor sites. This action restores the brain’s normal dopamine and acetylcholine balance, which relaxes muscle movement and decreases rigidity and tremors.

Indicated for Parkinsonian syndrome especially to counteract muscular rigidity and tremor; extrapyramidal symptoms.

•Observe for the ten rights:1. Assess for clients History2. Right patient3. Right medication4. Right dosage5. Right route6. Right time7. Right documentation8. Right client education9. Drug- to- drug interaction10. Assess for allergy

• Assess for Parkinsonism, EPS.

• Assess for mental status.

• Assess patient response if anticholinergics are given.

• Assess for tolerance over long term therapy, dosage may have to be increased or changed.

• Avoid activities that require alertness, may cause dizziness, drowsiness and blurring of vision.

ADVERSE EFFECTS CONTRAINDICATION

CNS and peripheral effects, skin rashes, dyskinesia, ataxia, twitching, impaired speech. Fatigue, dizziness, at higher doses, restlessness, agitation, anxiety, confusion.

Bladder neck obstruction, hypersensitivity to biperiden, untreated narrow angle glaucoma, intestinal stenosis or obstruction, mega colon, prostatic hypertrophy, life threatening tachycardia.

DRUG MECHANISM OF ACTION

INDICATION NURSING RESPONSIBILITIES

GENERIC NAME: Haloperidol

BRAND NAME: Haldol

CLASSIFICATION: Typical Antipsychotics

FREQUENCY:BID

DOSAGE:20 mg ½ tab

ROUTE:PO (Oral)

Haloperidol produces its effects by blocking dopamine (specifically, D2), alpha, and serotonin receptors. It has minimal blocking effects at cholinergic and histamine receptors.

Management of manifestations of psychotic disorders. Prolonged parenteral therapy of chronic schizophrenia.

•Observe for the ten rights:1. Assess for clients History2. Right patient3. Right medication4. Right dosage5. Right route6. Right time7. Right documentation8. Right client education9. Drug- to- drug interaction10. Assess for allergy

• Assess mental status prior to and periodically during therapy.

• Monitor Blood pressure and pulse prior to and frequently during the period of dosage adjustment. May cause QT and 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 weight. Assess patient for signs and symptoms of dehydration.

•Monitor for exacerbation of seizure

ADVERSE EFFECTS

CONTRAINDICATION

CNS: Extra pyramidal symptoms such muscle rigidity or spasm, shuffling gait, posture leaning forward, drooling , drowsiness, sedation, lethargy, and dysphoria (a decline in mood)CV: Tachycardia, arrhythmias, hypertensionEENT: Blurred vision GI: Dr mouth, nausea and vomiting, anorexia

Haloperidol is contraindicated if the patient has hypersensitivity to any of the drug’s components. It is also contraindicated in Parkinson disease because cholinergic stimulation in that disorder is already excessive.

activity.

• 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.

• 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.

DRUG MECHANISM OF ACTION

INDICATION NURSING RESPONSIBILITIES

GENERIC NAME:Risperidone

BRAND NAME:Risperdal

CLASSIFICATION: Atypical

Mechanism may be due to a combination of antagonism of dopamine (D2) and serotonin (5-HT2) receptors. Also has high affinity for the alpha1-, alpha2-,

To manage symptoms of psychosis including schizophrenia.

•Observe for the ten rights:1. Assess for clients History2. Right patient3. Right medication4. Right dosage5. Right route6. Right time7. Right documentation

Antipsychotic

FREQUENCY:OD ( Once a day)

DOSAGE:2 mg

ROUTE: PO

and histamine 1 receptors.

8. Right client education9. Drug- to- drug interaction10. Assess for allergy

•Maintain seizure precautions, especially when initiating therapy and increasing dosage.

•Open blister units of orally disintegrating tablets individually; do not push tablet through the foil. Use dry hands to remove tablet, immediately place on tongue. Do not allow patient to chew tablet.

•Monitor patient regularly for signs and symptoms of diabetes mellitus.

•Monitor temperature. If fever occurs, rule out underlying infection, and consult physician for appropriate comfort measures.

•Follow guidelines for discontinuation or reinstitution of the drug carefully.

ADVERSE EFFECTS

CONTRAINDICATION

Agitation, anxiety, extrapyramidal symptoms, headache, insomnia, constipation, dyspepsia, weight gain, rhinitis, dry mouth, sexual dysfunction, orthostatic hypotension.

Hypersensitivity, lactation, dysrhythmias, blood dyscrasias, liver damage.