Nursing

Name of Drug Classification Mechanism of Action Indication Contraindication Side Effects

Responsibilities
Generic Name: Pharmacologic Pharmacodynamics or General Indication: - Hypersensitivity to CNS: Depression, Before Drug
Quetiapine Fumarate Class: Mechanism of Action:  To treat quetiapine dizziness, drowsiness, Administration
Dibenzothiazepine Antagonizes multiple schizophrenia - Alcohol use dystonia, - Know that quetiapine
Trade/Brand Name: derivative neurotransmitter  To manage - Suicidal ideation extrapyramidal should not be given to
Seroquel, Seroquel XR receptors in the brain psychotic disorders - Dementiarelated reactions, hypertonia, patients who have a
Therapeutic including serotonin (5- other than psychosis in older hypothermia, lethargy, history of cardiac
Dose: Class: HT1A and 5-HT2) as schizophrenia adults restless leg syndrome, arrhythmias, such as
Bipolar Depression Antipsychotic well as dopamine D1  To treat depressive retrograde amnesia, bradycardia, or who
Adult: PO Day 1: 50 and D2 receptors. episodes in bipolar Interaction: somnolence, suicidal experience
mg at bedtime, Day 2: Pregnancy Effectiveness indicated disorder DRUGS ideation, tardive hypokalemia.
100 mg at bedtime, Category: by a reduction in - antibiotics such as dyskinesia - The drug also should
Day 3: 200 mg at C psychotic behavior. gatifloxacin or not be used with other
bedtime, then 300 mg moxifloxacin; CV: Cardiomyopathy, drugs that prolong the
daily at bedtime Pharmacokinetics: antipsychotic drugs hypercholesterolemia, QT interval.
Absorption: Rapidly and such as myocarditis, - Use quetiapine
Schizophrenia Adult: completely absorbed chlorpromazine, orthostatic cautiously in patients
PO Immediate release: from GI tract. thioridazine, hypotension, who have a history of
Start 25 mg b.i.d., may ziprasidone; class palpitations cardiovascular disease,
increase by 25–50 mg Peak: 1.5 h. 1A antiarrythmics a family history of QT
b.i.d. to t.i.d. on the such as quinidine or EENT: Dry mouth, prolongation.
second or third day as Distribution: procainamide; class nasal congestion, - Obtain baseline BP.
tolerated to a target 83% protein bound. III antiarrythmics pharyngitis, rhinitis
dose of 300–400 such as amiodarone During Drug
mg/day divided b.i.d. Metabolism: In liver or sotatol; ENDO: Galactorrhea, Administration
to t.i.d., may adjust (CYP3A4). levomethadyl hyperglycemia, - Instruct patient to
dose by 25–50 mg acetate, methadone, syndrome of take quetiapine with
b.i.d. daily as needed Elimination: 73% in pentamidine: inappropriate ADH food to reduce stomach
(max: 800 mg/day); urine, 20% in feces. Possibly increased secretion upset.
Extended release: 300 risk of prolonged - Inform patient that
mg daily at bedtime, Half-Life: 6 h. QT interval GI: Anorexia, quetiapine therapy may
titrate up to 400–800 constipation, cause dizziness or
mg daily (max: 800 - antihypertensives: indigestion, drowsiness.
mg/day Adolescent: Possibly enhanced pancreatitis - Advise patient not to
PO Immediate release: antihypertensive stop taking quetiapine
25 mg b.i.d. then taper effects of these GU: Nocturnal suddenly because
up by 50 mg daily up drugs cimetidine, enuresis doing so may
to 200 mg b.i.d. erythromycin, exacerbate his
fluconazole, HEME: symptoms or produce
Manic Episodes in itraconazole, Agranulocytosis, withdrawal symptoms.
Bipolar Disorder ketoconazole: decreased platelet
Monotherapy or with Decreased clearance count, leukopenia, After Drug
Lithium/Divalproex and possibly neutropenia Administration
(Immediate Release increased effects of - Instruct patient to rise
Only) Adult: PO Start quetiapine MS: Dysarthria, slowly from a seated or
with total of 100 mg muscle weakness, lying position to
(in two doses) day 1, - CNS depressants: rhabdo-myolysis reduce the risk of
increase to 400 mg/day Possibly increased dizziness or fainting.
(in two doses) by day 4 CNS depression RESP: Cough, dyspnea - Monitor patients
OR extended release closely for suicidal
300 mg on day 1, then - lorazepam: SKIN: Diaphoresis, tendencies, especially
600 mg on day 2, may Possibly increased Stevens-Johnson when therapy starts or
adjust by 400–800 effects of lorazepam syndrome, toxic dosage changes,
mg/day based on epidermal necrolysis because depression
response. - phenytoin, may worsen
thioridazine: Other: Anaphylaxis, temporarily during
Route: Increased flulike symptoms, these times.
PO clearance and hyponatremia, weight - Monitor patient for
possibly decreased gain orthostatic
Frequency: effectiveness of hypotension, especially
quetiapine during initial dosage
Availability: titration period.
Tablet ACTIVITIES - Monitor patient’s
Extended release tablet - alcohol use: blood glucose and lipid
Possibly enhanced levels routinely, as
Content: CNS depression ordered, because drug
povidone, dibasic increases the risk of
dicalcium phosphate hyperglycemia and
dihydrate, hypercholesterolemia.
microcrystalline - Caution patient to
cellulose, sodium avoid consuming
starch glycolate, alcoholic beverages
lactose monohydrate, because they can
magnesium stearate, increase dizziness and
hypromellose, drowsiness.
polyethylene glycol,
and titanium dioxide

References:

Vallerand, A., Sanoski, C., & Deglin, J. (2017). Drug Guide for Nurses. 15th Ed. FA Davis Company: Philadelphia

Schull, P. D. (2013). McGraw-Hill nurses drug handbook. New York: McGraw-Hill Medical.

JONES & BARTLETT LEARNING. (2018). Nurses Drug Handbook. SUDBURY.

PRODUCT ASSESSMENT RUBRICS FOR DRUG STUDY

Student Name: ROSALES, GWYN A. Year/Section: BSN- 3B Date: April 27, 2021 Score: /30
Directions: Please select the appropriate rating using the following descriptions.

Element Very Satisfactory Satisfactory Needs Improvement Comments

Drug ☐ Accurately presented all of the patient and drug information ☐ Accurately presented most of the patient and drug ☐ Accurately presented some of the patient and drug information
Information (name [brand & generic], dosage [patient’s dose; min. & max], information related to the case. 1 missing information or error related to the case. 2 or more missing information or errors noted.
(10%) frequency, route, availability, contents) related to the case. [3] noted. [2] [1]

Classification ☐ Accurately presented the classification (therapeutic and ☐ Accurately presented the classification related to the drug ☐ Inaccurately presented the classification related to the drug.
(10%) pharmacologic) related to the drug. [3] but with 1 irrelevant information or error noted. [2] Classification is not relevant to the drug. [1]
☐ Accurately presented the indication/s (general & patient- ☐ Accurately presented the indication/s related to the drug ☐ Inaccurately presented the indication/s related to the drug.
Indication (10%) specific) related to the drug. [3] but with 1 irrelevant information or error noted. [2] Indication is not relevant to the drug. [1]
Mechanism of ☐ Accurately presented the mechanism of action ☐ Accurately presented the mechanism of action of the drug ☐ Inaccurately presented the mechanism of action of the drug.
Action (10%) (pharmacokinetics, pharmacodynamics) of the drug. [3] but with 1 irrelevant information or error noted. [2] Mechanism of action is not relevant to the drug. [1]
☐ Accurately presented all of the common contraindications ☐ Accurately presented most of the common ☐ Accurately presented some of the common contraindications
Contraindication related to the drug. [3] contraindications related to the drug. 1 missing information related to the drug. 2 or more missing information or errors noted.
(10%) or error noted. [2] [1]
Side Effects ☐ Accurately presented all of the common side effects related ☐ Accurately presented most of the common side effects ☐ Accurately presented some of the common side effects related
(10%) to the drug. [3] related to the drug. 1-2 missing information or errors noted. to the drug. 3 or more missing information or errors noted. [1]
[2]
Nursing ☐ Accurately presented all of the common nursing ☐ Accurately presented most of the common nursing ☐ Accurately presented some of the common nursing
Responsibilities responsibilities (before, during, and after) related to the drug. [9] responsibilities related to the drug. 1-2 missing information or responsibilities related to the drug. 3 or more missing information
(30%) errors noted. [7] or errors noted. [3]
☐ Presented at least 2 sources that are updated (within 5 years), ☐ Presented only one source that is updated (within 5 years), ☐ No source was presented. Sources are not updated (more than
References relevant, and credible. [3] relevant, and credible. Other sources are not updated, credible 5 years), relevant, and credible. [1]
(10%) or relevant. [2]
Sub-score = = =

Evaluated by:

Signature over Printed Name of Clinical Instructor