CLASSIFICATION & DRUG

MECHANISM OF ACTION NURSING IMPLICATIONS

EXAMPLES
Acetylcholinesterase inhibitors
Acetylcholinesterase Inhibitors reduce acetylcholine breakdown,
examples:Donepezil (Aricept) whereas NMDA receptor antagonists  Explain the importance of taking medication
Galantamine (Razadyne, Reminyl) limit the effects of glutamate. Both as directed; teach about discontinuation & decline
Rivastigmine (Exelon) drugs have a modest effect in slowing in function.
an individual’s rate of cognitive  Provide patient education regarding dizziness,
N-Methyl-d-aspartate (NMDA) decline in Alzheimer disease. headache, gastrointestinal (GI) upset, & fatigue.
Receptor Antagonists examples:
 Promote adequate fluid intake.
Memantine (Namenda) combination May also be used for:  Monitor patient’s pulse rate.
NMDA receptor antagonist &
 Vascular dementia  Use with caution in patients with respiratory
acetylcholinesterase inhibitors
 Parkinson-related dementia. conditions (e.g., asthma, COPD).
 Combination agent (Namzaric)  Avoid the use of tricyclics & anticholinergic
Memantine hydrochloride extended-
used only after patients have been drugs because of their antagonistic effects.
release & donepezil hydrochloride
(Namzaric) stabilized on memantine &
donepezil
 Monitor for anticholinergic symptoms, such as
dry mouth, orthostatic hypotension, constipation,
urinary retention, sedation, & sexual dysfunction.
 Teach patient strategies to address
Conventional Antipsychotics
anticholinergic effects (e.g., rising slowly,
Both phenothiazines & increasing fluid intake, & increasing fiber intake).
Phenothiazines: examples: nonphenothiazines block D2  Monitor for extrapyramidal symptoms (EPS),
Chlorpromazine (Thorazine) dopamine receptors in the brain, such as acute dystonia, akathisia, parkinsonism, &
Fluphenazine increasing synaptic levels of tardive dyskinesia (TD).
Perphenazine dopamine & leading to a decrease in  Monitor for signs of hyperprolactemia
Prochlorperazine (Compazine) symptoms of psychosis (including (menstrual irregularities, decreased libido,
Thioridazine delusions & hallucinations). gynecomastia, & osteoporosis). Adjunctive
Trifluoperazine
therapies, counseling, or changing to a different
May also be used for: agent may improve some aspects of sexual
Nonphenothiazines: examples:
 Schizophrenia & other psychotic dysfunction.
Haloperidol (Haldol)
disorders  Monitor for autonomic instability associated
Loxapine (Loxitane)
 Tourette syndrome. with neuroleptic malignant syndrome.
Pimozide (Orap)
 Teach patients importance of adhering to
Thiothixene (Navene)
medication regimen & not to abruptly discontinue
medication.
 Teach patients importance of wearing
sunscreen.
Atypical Antipsychotics Block D2 & serotonin receptors; treat
examples: both positive & negative symptoms of  Monitor for adverse effects, such as alterations
Risperidone (Risperdal) schizophrenia & psychotic disorders, in glucose metabolism, hyperlipidemia,
Olanzapine (Zyprexa) exert mood-stabilizing effect. cardiovascular & cerebrovascular alterations &
Clozapine (Clozaril) blood abnormalities.
Asenapine (Saphris) May also be used for:  Teach importance of healthy diet & exercise.
Paliperidone (Invega)  Schizophrenia & other psychotic  Monitor for EPS & neuroleptic malignant
Quetiapine (Seroquel) disorders syndrome.
Ziprasidone (Geodon)  Bipolar disorder.
 Although generally well tolerated, patients
should still be monitored for EPS, neuroleptic
malignant syndrome (NMS), & medical effects
Third-generation associated with atypical antipsychotics.
Antipsychotics Partial agonists of D2 receptors, also  Akathisia & restlessness may be more
examples: Aripiprazole (Abilify) block serotonin receptors. pronounced with this medication.
Brexpiprazole (Rexulti)  Teaching should address healthy diet &
exercise, importance of adherence, & recognizing
& reporting adverse effects.

 Monitor for dependency, drowsiness,

Anxiolytics Probably inhibits serotonin reuptake
hypotension, tolerance, dizziness, & GI upset.
Nonbenzodiazepines & activates dopamine receptors in the
 These agents may increase confusion.
examples: brain, leading to a decrease in
 Abrupt discontinuation may lead to rebound
Buspirone (BuSpar) symptoms of anxiety.
anxiety.
Inhibits reuptake of serotonin in the
central nervous system, leading to a  Monitor for suicide risk.
decrease in symptoms of depression  Monitor for serotonin syndrome.
& anxiety.  Abrupt discontinuation may cause serotonin
Selective Serotonin Reuptake
May also be used for: withdrawal.
Inhibitors (SSRIs) examples:
 Depression  Provide patient education regarding dizziness,
Sertraline (Zoloft), Fluoxetine
insomnia, somnolence, GI upset, nausea or
(Prozac)  Anxiety
diarrhea, & avoiding over-the-counter (OTC)
 Obsessive-compulsive disorder
preparations that may increase risk of serotonin
 Posttraumatic stress disorder syndrome.
 Social anxiety disorder.