Drug Name Generic Name: carbam azepine Brands: Tegret ol, Tegretol XR , Equetro, Carbatrol
Dosage 200mg BID oral
Indication AntiConvulsant Reduces anxiety, irritability, elation Impulse control behavior
Mechanism of Action Decreases synaptic transmission in the CNS by affecting sodium channels in neurons
Adverse Reactions 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, 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
Contraindications Hypersensitivity Kidney disease Cardiovascular disease Seizure disorder, myasthenia gravis Dehydration Hypothyroidism.
Nursing Considerations May cause dizziness or drowsiness. Administer medication with food to minimize gastric irritation. Tablets may be crushed if patient has difficulty swallowing. Do not crush or chew extended-release tablets. Inform patient that frequent mouth rinses, good oral hygiene, and sugarless gum or candy may help reduce dry mouth. Saliva substitute may be used.
Drug Name Generic name: chlorpromazine Brand name: Thorazine
Dosage 100 mg oral
Indication Acute and chronic psychoses, particularly when accompanied by increased psychomotor activity. Nausea and vomiting.
Mechanism of Action Block dopamine receptors in the brain; also alter dopamine release and turnover.
Adverse Reactions CNS: neuroleptic 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: agranulocytosis, leukopenia Skin: photosensitivity, pigment changes, rashes
Contraindication 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. Advise patient to take medication as directed. Take missed doses as soon as remembered, witih remaining doses evenly spaced through out 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, vomiting, GI upset, trembling, or uncontrolled movements of mouth, tongue or jaw.