CHLORPROMAZINE (Thorazine) - HEME: Agranulocytosis, aplastic

anemia, eosinophilia, hemolytic anemia,

CLASSIFICATION
leukopenia, pancytopenia,
- Anti-Psychotics/ Neuroleptics thrombocytopenic purpura
- SKIN: Exfoliative dermatitis, jaundice,
photosensitivity, tissue necrosis, urticaria
MECHANISM OF ACTION:
- Blocks dopamine receptors in the CNS
and sympathetic nervous system. NURSING RESPONSIBILITIES/PRIORITIES
1. Assess client’s response to therapy.
INDICATION 2. Monitor for signs of infection, liver, toxicity,
extrapyramidal symptoms
- To manage symptoms of psychotic 3. Monitor V/S
disorders or control manic manifestations 4. Give medication at bedtime
of manic-depression in outpatients 5. Health Teaching
a) Avoid alcohol use
CONTAINDICATION b) Avoid driving or other hazardous
activities
- Comatose states; hypersensitivity to c) Avoid exposure to direct sunlight
chlorpromazine, phenothiazines, or their d) Good oral hygiene
components; use of large amounts of e) Report extrapyramidal symptoms
CNS depressants or signs of infection

SIDE EFFECTS
- Drowsiness
- Dizziness
- Lightheadedness
- Dry mouth
- Blurred vision
- Tiredness
- Nausea
- Constipation
- Weight gain
- Trouble sleeping

ADVERSE EFFECTS
- CNS: Drowsiness, extrapyramidal
reactions (Such as dystonia, fever, motor
restlessness, pseudo parkinsonism, and
tardive dyskinesia), neuroleptic
malignant syndrome, seizures
- CV: ECG changes, such as nonspecific,
usually reversible Q- and T-wave
changes; orthostatic hypotension;
tachycardia
- EENT: Blurred vision, dry mouth, nasal
congestion, ocular changes (fine particle
deposits in lens and cornea) with long-
term therapy
- ENDO: Gynecomastia, hyperglycemia,
hypoglycemia, lactation, moderate breast
engorgement
- GI: Constipation, ileus, nausea
- GU: Amenorrhea, ejaculation disorders,
impotence, priapism, urine retention
HALOPERIDOL (Haldol) - GI: Constipation, nausea, vomiting
- GU: Decreased libido, difficult
CLASSIFICATION
ejaculation, impotence, menstrual
- Anti-Psychotics/ Neuroleptics irregularities, urine retention
- HEME: Agranulocytosis, anemia,
leukocytosis, leukopenia
MECHANISM OF ACTION: - SKIN: Diaphoresis, photosensitivity, rash
- Other: Heatstroke, weight gain
- Blocks dopamine receptors in the CNS
and sympathetic nervous system.
NURSING RESPONSIBILITIES/PRIORITIES
1. Assess client’s response to therapy.
INDICATION 2. Monitor for signs of infection, liver, toxicity,
- Treatment of psychotic symptoms in extrapyramidal symptoms
schizophrenia, psychosis, and Tourette’s 3. Monitor V/S
syndrome. 4. Give medication at bedtime
5. Health Teaching
a) Avoid alcohol use
CONTAINDICATION b) Avoid driving or other hazardous
activities
- Hypersensitivity to haloperidol c) Avoid exposure to direct sunlight
- CNS depression d) Good oral hygiene
- Coma e) Report extrapyramidal symptoms
- Parkinson’s disease. or signs of infection

SIDE EFFECTS
- Blurred vision
- Constipation
- Orthostatic hypotension
- Dry mouth
- Swelling or soreness of female breasts
- Peripheral edema

ADVERSE EFFECTS
- CNS: Agitation, anxiety, confusion,
drowsiness, dystonia, euphoria,
extrapyramidal reactions that may be
irreversible (Akathisia, pseudo
parkinsonism, tardive dyskinesia),
hallucinations, headache, insomnia,
neuroleptic malignant syndrome,
restlessness, slurred speech, tremor,
vertigo
- CV: Cardiac arrest, hypertension,
orthostatic hypotension, QT-interval
prolongation, ventricular arrhythmias,
tachycardia, torsades de pointes
- EENT: Blurred vision, dry mouth,
increased salivation (all drug forms);
stomatitis (oral solution)
- ENDO: Breast engorgement,
galactorrhea
THIORIDAZINE (Mellaril) - EENT: Blurred vision, change in color
perception, dry mouth, impaired night
CLASSIFICATION
vision, mydriasis, photophobia
- Anti-Psychotics/ Neuroleptics - ENDO: Breast engorgement,
galactorrhea
- GI: Constipation, ileus, nausea
MECHANISM OF ACTION: - GU: Amenorrhea, decreased libido,
ejaculation disorders, impotence,
- Blocks dopamine receptors in the CNS menstrual irregularities, priapism, urine
and sympathetic nervous system. retention
- HEME: Agranulocytosis, anemia,
aplastic anemia, eosinophilia,
INDICATION leukocytosis, leukopenia, pancytopenia,
- To treat schizophrenia in patients thrombocytopenia
unresponsive to other antipsychotic - SKIN: Hyperpigmentation, jaundice,
drugs photosensitivity
- Other: Weight gain

CONTAINDICATION
NURSING RESPONSIBILITIES/PRIORITIES
- Coma
- Concurrent use of drugs that inhibit the 1. Assess client’s response to therapy.
metabolism of thioridazine 2. Monitor for signs of infection, liver,
- Concurrent use of drugs that prolong the toxicity, extrapyramidal symptoms
QT interval 3. Monitor V/S
- Concurrent use of high doses of a CNS 4. Give medication at bedtime
depressant 5. Health Teaching
- History of arrhythmias; hypersensitivity to a) Avoid alcohol use
thioridazine, other phenothiazines, or b) Avoid driving or other hazardous
their components activities
- Severe CNS depression; severe c) Avoid exposure to direct sunlight
hypertensive or hypotensive cardiac d) Good oral hygiene
disease e) Report extrapyramidal symptoms
or signs of infection

SIDE EFFECTS
- Dizziness
- Lightheadedness
- Drowsiness
- Difficulty urinating
- Constipation
- Restlessness
- Headache
- Blurred vision
ADVERSE EFFECTS
- CNS: Akathisia, altered temperature
regulation, depression, dizziness,
drowsiness, extrapyramidal reactions
(Dystonia, laryngospasm, motor
restlessness, pseudoparkinsonism),
headache, insomnia
- CV: ECG changes, hypertension,
hypotension, prolonged QT interval,
torsades de pointes, ventricular
tachycardia
FLUPHENAZINE (Prolixin) - Dry Mouth
CLASSIFICATION - Extrapyramidal side effects (EPS)
- Anti-Psychotics/ Neuroleptics *Acute dystonia
*Pseudo-Parkinsonism
MECHANISM OF ACTION: *Akathisia
- Blocks dopamine receptors in the CNS *Tardive dyskinesia
and sympathetic nervous system.

NURSING RESPONSIBILITIES/PRIORITIES
INDICATION
1. Assess client’s response to therapy.
- Treatment of psychotic symptoms in 2. Monitor for signs of infection, liver, toxicity,
schizophrenia, psychosis, and Tourette’s extrapyramidal symptoms
syndrome. 3. Monitor V/S
4. Give medication at bedtime
5. Health Teaching
CONTAINDICATION a) Avoid alcohol use
b) Avoid driving or other hazardous
- Blood dyscrasias activities
- Bone marrow depression c) Avoid exposure to direct sunlight
- Cerebral arteriosclerosis d) Good oral hygiene
- Coma e) Report extrapyramidal symptoms
- Concomitant use of large amounts of or signs of infection
another CNS depressant
- Coronary artery disease
- Hepatic dysfunction
- Hypersensitivity to phenothiazines
- Myeloproliferative disorders
- Severe CNS depression
- Severe hypertension or hypotension
- Subcortical brain damage

SIDE EFFECTS
- Drowsiness
- Lethargy
- Dizziness
- Lightheadedness
- Nausea
- Loss of appetite
- Sweating
- Dry mouth
- Blurred vision
- Headache
- Constipation

ADVERSE EFFECTS
- Excessive sedation
- Jaundice
- Orthostatic hypertension
- Urinary retention
- Anorexia
CLOZAPINE (Clozaril) *Akathisia
CLASSIFICATION *Tardive dyskinesia
- Anti-Psychotics/ Neuroleptics
NURSING RESPONSIBILITIES/PRIORITIES
MECHANISM OF ACTION: 1. Assess client’s response to therapy.
2. Monitor for signs of infection, liver, toxicity,
- Blocks dopamine receptors in the CNS
extrapyramidal symptoms
and sympathetic nervous system.
3. Monitor V/S
4. Give medication at bedtime
5. Health Teaching
INDICATION a) Avoid alcohol use
- To treat severe schizophrenia b) Avoid driving or other hazardous
unresponsive to standard drugs; to activities
reduce risk of recurrent suicidal behavior c) Avoid exposure to direct sunlight
in schizophrenia or schizoaffective d) Good oral hygiene
disorders e) Report extrapyramidal symptoms
or signs of infection

CONTAINDICATION
- Angle-closure glaucoma
- Coma
- History of clozapine-induced
agranulocytosis or severe
granulocytopenia
- Hypersensitivity to clozapine or its
components
- Myeloproliferative disorders
- Severe CNS depression
- Uncontrolled epilepsy
- WBC count below 3,500/mm3

SIDE EFFECTS
- Drowsiness
- Salivation
- Tachycardia
- Dizziness
- Constipation

ADVERSE EFFECTS
- Excessive sedation
- Jaundice
- Orthostatic hypertension
- Urinary retention
- Anorexia
- Dry Mouth
- Extrapyramidal side effects (EPS)
*Acute dystonia
*Pseudo-Parkinsonism
RISPERIDONE (Risperdal) 5. Health Teaching
a) Avoid alcohol use
CLASSIFICATION
b) Avoid driving or other hazardous
- Anti-Psychotics/ Neuroleptics activities
c) Avoid exposure to direct sunlight
d) Good oral hygiene
MECHANISM OF ACTION: e) Report extrapyramidal symptoms
or signs of infection
- Blocks dopamine receptors in the CNS
and sympathetic nervous system.

INDICATION
- Treatment of psychotic symptoms in
schizophrenia, psychosis, and Tourette’s
syndrome.

CONTAINDICATION
- Hypersensitivity to risperidone.

SIDE EFFECTS
- Agitation
- Anxiety
- Insomnia
- Headache
- Constipation

ADVERSE EFFECTS
- Excessive sedation
- Jaundice
- Orthostatic hypertension
- Urinary retention
- Anorexia
- Dry Mouth
- Extrapyramidal side effects (EPS)
*Acute dystonia
*Pseudo-Parkinsonism
*Akathisia
*Tardive dyskinesia

NURSING RESPONSIBILITIES/PRIORITIES
1. Assess client’s response to therapy.
2. Monitor for signs of infection, liver, toxicity,
extrapyramidal symptoms
3. Monitor V/S
4. Give medication at bedtime
OLANZAPINE (Zyprexa) e) Report extrapyramidal symptoms
or signs of infection
CLASSIFICATION
- Anti-Psychotics/ Neuroleptics

MECHANISM OF ACTION:
- Blocks dopamine receptors in the CNS
and sympathetic nervous system.

INDICATION
- Treatment of acute agitation associated
with schizophrenia and bipolar I mania

CONTAINDICATION
- Hypersensitivity to Olanzapine

SIDE EFFECTS
- Drowsiness
- Agitation
- Insomnia
- Headache
- Nervousness
- Hostility
- Dizziness
- Rhinitis

ADVERSE EFFECTS
- Rare reactions include seizures,
neuroleptic malignant syndrome, a
potentially fatal syndrome characterized
by hyperpyrexia, muscle rigidity, irregular
pulse or B/P, tachycardia, diaphoresis,
cardiac arrhythmias. Extrapyramidal
symptoms (EPS), dysphagia may occur.
Overdose (300 mg) produces
drowsiness, slurred speech.

NURSING RESPONSIBILITIES/PRIORITIES
1. Assess client’s response to therapy.
2. Monitor for signs of infection, liver, toxicity,
extrapyramidal symptoms
3. Monitor V/S
4. Give medication at bedtime
5. Health Teaching
a) Avoid alcohol use
b) Avoid driving or other hazardous
activities
c) Avoid exposure to direct sunlight
d) Good oral hygiene
QUETIAPINE (Seroquel) 2. Monitor for signs of infection, liver, toxicity,
extrapyramidal symptoms
CLASSIFICATION
3. Monitor V/S
- Anti-Psychotics/ Neuroleptics 4. Give medication at bedtime
5. Health Teaching
a) Avoid alcohol use
MECHANISM OF ACTION: b) Avoid driving or other hazardous
activities
- Blocks dopamine receptors in the CNS c) Avoid exposure to direct sunlight
and sympathetic nervous system. d) Good oral hygiene
e) Report extrapyramidal symptoms
or signs of infection
INDICATION
- Treatment of bipolar disorder, major
depressive disorder, and schizophrenia.

CONTAINDICATION
- Hypersensitivity to quetiapine.

SIDE EFFECTS
- Drowsiness
- Agitation
- Insomnia
- Headache
- Nervousness
- Hostility
- Dizziness
- Rhinitis

ADVERSE EFFECTS
- Metabolic changes including
hyperglycemia, ketoacidosis,
hyperosmolar coma, diabetes,
dyslipidemia may occur.
- Agranulocytosis, leukopenia,
neutropenia was reported.
- Cognitive and motor impairment reported
in 24% of pts.
- Other effects may include body
temperature dysregulation, cataracts,
dysphagia, dystonia, extrapyramidal
symptoms, orthostatic hypotension, falls,
syncope, seizures.

NURSING RESPONSIBILITIES/PRIORITIES
1. Assess client’s response to therapy.
ZIPRASIDONE (Geodon) 5. Health Teaching
a) Avoid alcohol use
CLASSIFICATION
b) Avoid driving or other hazardous
- Anti-Psychotics/ Neuroleptics activities
c) Avoid exposure to direct sunlight
d) Good oral hygiene
MECHANISM OF ACTION: e) Report extrapyramidal symptoms
or signs of infection
- Blocks dopamine receptors in the CNS
and sympathetic nervous system.

INDICATION
- Treatment of schizophrenia, acute
agitation in pts with schizophrenia.

CONTAINDICATION
- Hypersensitivity to ziprasidone
- Conditions associated with risk of
prolonged QT interval, congenital long
QT syndrome, concurrent use of other
QT-prolongation medications (e.g.,
amiodarone, moxifloxacin, tacrolimus,
thioridazine)
- Uncompensated HF
- Recent MI

SIDE EFFECTS
- Frequent (30%–16%): Headache,
drowsiness, dizziness.
- Occasional: Rash, orthostatic
hypotension, weight gain, restlessness,
constipation, dyspepsia.
- Rare: Hyperglycemia, priapism.

ADVERSE EFFECTS
- Prolongation of QT interval (as seen on
ECG) may produce torsades de pointes,
a form of ventricular tachycardia.
- Other effects may include body
temperature dysregulation, cataracts,
dysphagia, dystonia, extrapyramidal
symptoms, orthostatic hypotension, falls,
syncope, seizures.

NURSING RESPONSIBILITIES/PRIORITIES
1. Assess client’s response to therapy.
2. Monitor for signs of infection, liver, toxicity,
extrapyramidal symptoms
3. Monitor V/S
4. Give medication at bedtime
PENTOBARBITAL (Nembutal) PHENOBARBITAL (Solfoton)
CLASSIFICATION CLASSIFICATION
- Sedative-Hypnotics - Sedative-Hypnotics

MECHANISM OF ACTION: MECHANISM OF ACTION:

- Depress all levels of CNS (Sensory - Depress all levels of CNS (Sensory
motor, cerebellar functions) by motor, cerebellar functions) by
potentiating gamma-aminobutyric acid potentiating gamma-aminobutyric acid
(GABA) (GABA)

INDICATION INDICATION
- Treatment of insomnia (sedation, - Treatment of seizure (insomnia,
seizure, anxiety) sedation, anxiety)

CONTAINDICATION
CONTAINDICATION
- Hepatic disease; history of addiction to
- Hypersensitivity to phenobarbital, other
hypnotics or sedatives
barbiturates, porphyria, dyspnea or
- Hypersensitivity to pentobarbital,
airway obstruction, use in nephritic pts
barbiturates, or their components
(large doses), severe hepatic impairment
- Nephritis
- History of sedative/ hypnotic addiction.
- Porphyria
Intra-arterial or SQ administration.
- Severe respiratory disease with airway
- Pregnancy
obstruction or dyspnea
- Pregnancy
SIDE EFFECTS
SIDE EFFECTS - Occasional (3%–1%): Drowsiness.
- Rare (less than 1%): Confusion,
- Confusion, agitation, hallucinations
paradoxical CNS reactions (hyperactivity,
- Weak or shallow breathing
anxiety in children; excitement,
- Slow heart rate, weak pulse
restlessness in elderly, generally noted
- Light-headed feeling, like you might pass
during first 2 weeks of therapy,
out.
particularly in presence of uncontrolled
pain).
ADVERSE EFFECTS
ADVERSE EFFECTS
- Barbiturate Toxicity; Hypertension,
pulmonary constriction, cold and clammy - Barbiturate Toxicity; Hypertension,
skin, cyanosis of lips, insomnia, pulmonary constriction, cold and clammy
hallucination, and delirium skin, cyanosis of lips, insomnia,
hallucination, and delirium

NURSING RESPONSIBILITIES/PRIORITIES
NURSING RESPONSIBILITIES/PRIORITIES
1. Monitor client’s response to medication
2. Health teaching 1. Monitor client’s response to medication
a) Take medication exactly as 2. Health teaching
prescribed a) Take medication exactly as
b) Avoid alcohol prescribed
c) Avoid driving and other hazardous b) Avoid alcohol
activities c) Avoid driving and other hazardous
activities
SECOBARBITAL (Seconal)
CLASSIFICATION
- Sedative-Hypnotics

MECHANISM OF ACTION:
- Depress all levels of CNS (Sensory
motor, cerebellar functions) by
potentiating gamma-aminobutyric acid
(GABA)

INDICATION
- Treatment of insomnia, sedation,
seizure, anxiety

CONTAINDICATION
- History of barbiturate addiction
- Hypersensitivity to secobarbital, other
barbiturates, or their components
- Nephritis
- Porphyria
- Severe hepatic or respiratory impairment
- Pregnancy

SIDE EFFECTS
- Unwanted sleepiness, trouble waking up,
drowsiness, dizziness, headache,
tiredness, loss of appetite, nausea,
vomiting, problems with memory or
concentration, excitement (especially in
children or older adults), upset stomach,
constipation, or "hangover" effect.

ADVERSE EFFECTS
- Barbiturate Toxicity; Hypertension,
pulmonary constriction, cold and clammy
skin, cyanosis of lips, insomnia,
hallucination, and delirium

NURSING RESPONSIBILITIES/PRIORITIES
1. Monitor client’s response to medication
2. Health teaching
a) Take medication exactly as
prescribed
b) Avoid alcohol
c) Avoid driving and other hazardous
activities
BENZODIAZEPINES: ALPRAZOLAM (Xanax) b) Use caution when driving or
hazardous
CLASSIFICATION
c) Action potentiated with alcohol or
- Anti-Anxiety/Anxiolytics sedatives
d) Never abruptly stop the medication
e) Librium = Avoid excessive sunlight
MECHANISM OF ACTION:
- Enhances the inhibitory effects of the
neurotransmitter gamma-aminobutyric
acid in the brain.

INDICATION
- Treatment of anxiety and sleep disorders

CONTAINDICATION
- Hypersensitivity to Alprazolam.
- Acute narrow angle-closure glaucoma,
concurrent use with ketoconazole or
itraconazole or other strong CYP3A4
inhibitors.
- Liver Disease

SIDE EFFECTS
- Frequent (41%–20%): Ataxia, light-
headedness,drowsiness, slurred speech
(particularly in elderly or debilitated pts).
- Occasional (15%–5%): Confusion,
depression, blurred vision, constipation,
diarrhea, dry mouth, headache, nausea.
- Rare (4% or less): Behavioral problems
such as anger, impaired memory;
paradoxical reactions (insomnia,
nervousness, irritability).

ADVERSE EFFECTS
- Dizziness
- Drowsiness
- Lethargy
- Orthostatic Hypertension
- Skin Rash
- Blood Dyscrasia

NURSING RESPONSIBILITIES/PRIORITIES
1. Notify health care provider if systolic BP
drops 20 mmHg
2. Administer with food and milk
3. Health teaching
a) Do not take OTC medication without
health care provider’s approval
BENZODIAZEPINES: DIAZEPAM (Valium) NURSING RESPONSIBILITIES/PRIORITIES
CLASSIFICATION 1. Notify health care provider if systolic BP
drops 20 mmHg
- Anti-Anxiety/Anxiolytics
2. Administer with food and milk
3. Health teaching
a) Do not take OTC medication without
MECHANISM OF ACTION: health care provider’s approval
- Depresses all levels of CNS by b) Use caution when driving or
enhancing action of gamma- hazardous
aminobutyric acid (GABA), a major c) Action potentiated with alcohol or
inhibitory neurotransmitter in the brain. sedatives
d) Never abruptly stop the medication
e) Librium = Avoid excessive sunlight
INDICATION
- Treatment of anxiety and sleep disorders

CONTAINDICATION
- Hypersensitivity to diazepam.
- Acute narrow-angle glaucoma, untreated
open-angle glaucoma, severe respiratory
depression, severe hepatic insufficiency,
sleep apnea syndrome, myasthenia
gravis.
- Children younger than 6 months (oral).

SIDE EFFECTS
- Pain with IM injection, drowsiness,
fatigue, ataxia.
- Occasional: Slurred speech, orthostatic
hypotension, headache, hypoactivity,
constipation, nausea, blurred vision.
- Rare: Paradoxical CNS reactions
(hyperactivity/nervousness in children,
excitement/restlessness in
elderly/debilitated pts) generally noted
during first 2 weeks of therapy,
particularly in presence of uncontrolled
pain.

ADVERSE EFFECTS
- Dizziness
- Drowsiness
- Lethargy
- Orthostatic Hypertension
- Skin Rash
- Blood Dyscrasia
BENZODIAZEPINES: CHLORDIAZEPOXIDE d) Never abruptly stop the medication
(Librium) e) Librium = Avoid excessive sunlight
CLASSIFICATION
- Anti-Anxiety/Anxiolytics

MECHANISM OF ACTION:
- May potentiate the effects of gamma
aminobutyric acid (GABA) and other
inhibitory neurotransmitters by binding to
specific benzodiazepine receptors in
limbic and cortical areas of the CNS.

INDICATION
- Treatment of anxiety and sleep disorders

CONTAINDICATION
- Hypersensitivity to chlordiazepoxide or
its components
- Acute narrow glaucoma
- Liver Disease

SIDE EFFECTS
- Drowsiness
- Trouble with balance or coordination
- Confusion

ADVERSE EFFECTS
- Dizziness
- Drowsiness
- Lethargy
- Orthostatic Hypertension
- Skin Rash
- Blood Dyscrasia

NURSING RESPONSIBILITIES/PRIORITIES
1. Notify health care provider if systolic BP
drops 20 mmHg
2. Administer with food and milk
3. Health teaching
a) Do not take OTC medication without
health care provider’s approval
b) Use caution when driving or
hazardous
c) Action potentiated with alcohol or
sedatives
BENZODIAZEPINES: LORAZEPAM (Ativan) b) Use caution when driving or
hazardous
CLASSIFICATION
c) Action potentiated with alcohol or
- Anti-Anxiety/Anxiolytics sedatives
d) Never abruptly stop the medication
e) Librium = Avoid excessive sunlight
MECHANISM OF ACTION:
- Enhances action of inhibitory
neurotransmitter gamma-aminobutyric
acid (GABA) in CNS, affecting memory,
motor, sensory, cognitive function.

INDICATION
- Treatment of anxiety and sleep disorders

CONTAINDICATION
- Hypersensitivity to lorazepam, other
benzodiazepines.
- Acute narrow-angle glaucoma, severe
respiratory depression (except during
mechanical ventilation).
- Liver Disease

SIDE EFFECTS
- Frequent (16%–7%): Drowsiness,
dizziness.
- Rare (less than 4%): Weakness, ataxia,
headache, hypotension, nausea,
vomiting, confusion, injection site
reaction.

ADVERSE EFFECTS
- Dizziness
- Drowsiness
- Lethargy
- Orthostatic Hypertension
- Skin Rash
- Blood Dyscrasia

NURSING RESPONSIBILITIES/PRIORITIES
1. Notify health care provider if systolic BP
drops 20 mmHg
2. Administer with food and milk
3. Health teaching
a) Do not take OTC medication without
health care provider’s approval
AZAPIRONE: BUSPIRONE (Baspar) NURSING RESPONSIBILITIES/PRIORITIES
CLASSIFICATION 1. Notify health care provider if systolic BP
drops 20 mmHg
- Anti-Anxiety/Anxiolytics
2. Administer with food and milk
3. Health teaching
a) Do not take OTC medication without
MECHANISM OF ACTION: health care provider’s approval
- Exact mechanism of action unknown. b) Use caution when driving or
Binds to serotonin, dopamine at hazardous
presynaptic neurotransmitter receptors in c) Action potentiated with alcohol or
CNS. sedatives
d) Never abruptly stop the medication
e) Librium = Avoid excessive sunlight
INDICATION
- Treatment of anxiety and sleep disorders

CONTAINDICATION
- Hypersensitivity to buspirone
- Concomitant use of MAOIs intended to
treat depression or within 14 days of
discontinuing MAOIs intended to treat
depression
- Concomitant use of MAOIs within 14
days of discontinuing buspirone
- Initiation of buspirone in pts receiving IV
methylene blue or linezolid.

SIDE EFFECTS
- Frequent (12%–6%): Dizziness,
drowsiness, nausea, headache.
- Occasional (5%–2%): Nervousness,
fatigue, insomnia, dry mouth, light-
headedness, mood swings, blurred
vision, poor concentration, diarrhea,
paresthesia.
- Rare: Muscle pain/stiffness, nightmares,
chest pain, involuntary movements.

ADVERSE EFFECTS
- Dizziness
- Drowsiness
- Lethargy
- Orthostatic Hypertension
- Skin Rash
- Blood Dyscrasia
INHALATION ANESTHETICS : IV BARBITURATES:
CYCLOPROPRANE, ENFLURANE, ETHER, THIOPENTAL (Pentothal)
NITROUS OXIDE
CLASSIFICATION
CLASSIFICATION
- General Anesthetics
- General Anesthetics

MECHANISM OF ACTION:
MECHANISM OF ACTION:
- Depress the CNS through a progressive
- Depress the CNS through a progressive sequence.
sequence.

INDICATION
INDICATION
- To control seizures from anesthesia or
- NO2 is usually used for dental surgery. It other causes, facilitate narcoanalysis,
is also combined with other drugs for and treat cerebral hypertension.
anesthetic use.
- Volatile liquids: Motility and maintenance
CONTAINDICATION
of general anesthesia
- CVA
CONTAINDICATION - Increased ICP
- CVA - Severe Hypertension
- Increased ICP
- Severe Hypertension - Cardiac Decompensation
- Cardiac Decompensation

SIDE EFFECTS
SIDE EFFECTS - Coughing
- Nausea and Vomiting - Sneezing
- Shivering - Hiccups
- Cardiac Arrhythmias - Slowed breathing
- Malignant Hyperthermia - Slow heart rate
- Cardiac arrhythmias,
- Prolonged sleepiness and recovery
ADVERSE EFFECTS - Shivering.
- Excitement
- Restlessness
- Nausea ADVERSE EFFECTS
- Vomiting - Respiratory Distress
- Respiratory Distress - Hypotension
- Tachycardia
- Laryngospasm
NURSING RESPONSIBILITIES/PRIORITIES
1. Have 0/2 and emergency treatment NURSING RESPONSIBILITIES/PRIORITIES
available.
2. Monitor V/S 1. Have 0/2 and emergency treatment
3. Use precautions if agent is flammable available.
4. Safety Precautions 2. Monitor V/S
3. Use precautions if agent is flammable
4. Safety Precautions
IV BARBITURATES: IV AND IM NON-BARBITURATES:
METHOHEXITAL SODIUM (Brevital) MIDAZOLAM (Versed)
CLASSIFICATION CLASSIFICATION
- General Anesthetics - General Anesthetics

MECHANISM OF ACTION: MECHANISM OF ACTION:

- Depress the CNS through a progressive - Depress the CNS through a progressive
sequence. sequence.

INDICATION INDICATION
- To induce deep sedation. - Continuous sedation during mechanical
ventilation

CONTAINDICATION
CONTAINDICATION
- Porphyria
- Hypersensitivity to midazolam
- Hypersensitivity to barbiturates
- Acute narrow-angle glaucoma,
- Relative: cardiovascular disease,
concurrent use of protease inhibitors
hypotension, respiratory disease
(e.g., atazanavir, darunavir).

SIDE EFFECTS SIDE EFFECTS

- Drowsiness - Frequent (10%–4%): Decreased

- Nausea, vomiting, stomach pain respiratory rate, tenderness at IM or IV
- Chills or shivering injection site, pain during injection,
- Coughing, hiccups oxygen desaturation, hiccups.
- Itching - Occasional (3%–2%): Hypotension,
paradoxical CNS reaction.
- Rare (less than 2%): Nausea, vomiting,
ADVERSE EFFECTS headache, coughing.

- Respiratory Distress
- Hypotension ADVERSE EFFECTS
- Tachycardia - Respiratory failure
- Laryngospasm - Hyper/Hypotension Rigidity
- Psychiatric disturbance

NURSING RESPONSIBILITIES/PRIORITIES
1. Have 0/2 and emergency treatment NURSING RESPONSIBILITIES/PRIORITIES
available. 1. Have 0/2 and emergency treatment
2. Monitor V/S available.
3. Use precautions if agent is flammable 2. Monitor V/S
4. Safety Precautions 3. Use precautions if agent is flammable
4. Safety Precautions
IV AND IM NON-BARBITURATES: IV AND IM NON-BARBITURATES:
KETAMIN (Ketaject/Ketalar)
PROPOFOL (Diprivan)
CLASSIFICATION
CLASSIFICATION
- General Anesthetics
- General Anesthetics

MECHANISM OF ACTION:
MECHANISM OF ACTION:
- Depress the CNS through a progressive
- Depress the CNS through a progressive
sequence.
sequence.

INDICATION
INDICATION
- Anesthesia - induction and maintenance
- General anesthesia and for sedation
- Analgesia for procedures.

CONTAINDICATION
CONTAINDICATION
- Hypersensitivity to propofol, eggs, egg
- Hypersensitivity
products, soybean or soy products.
- Conditions in which an increase in blood
pressure would be hazardous.
SIDE EFFECTS
- Frequent: Involuntary muscle
SIDE EFFECTS
movements, apnea (common during
- Emergence reactions, hypertension, induction; often lasts longer than 60 sec),
increased cardiac output, increased hypotension, nausea, vomiting, IV site
intracranial pressure, fast or slow heart burning/stinging.
rate, seizures, visual hallucinations, vivid - Occasional: Twitching, thrashing,
dreams, double vision, hypotension, headache, dizziness, bradycardia,
increased intraocular (eye) pressure, hypertension, fever, abdominal cramps,
injection site pain, and involuntary eye paresthesia, coldness, cough, hiccups,
movement. facial flushing, green-tinted urine.
- Rare: Rash, dry mouth, agitation,
confusion, myalgia, thrombophlebitis.
ADVERSE EFFECTS
- Respiratory failure
ADVERSE EFFECTS
- Hyper/Hypotension Rigidity
- Respiratory failure
- Psychiatric disturbance
- Hyper/Hypotension Rigidity
- Psychiatric disturbance
NURSING RESPONSIBILITIES/PRIORITIES
1. Have 0/2 and emergency treatment
available. NURSING RESPONSIBILITIES/PRIORITIES
2. Monitor V/S
1. Have 0/2 and emergency treatment
3. Use precautions if agent is flammable
available.
4. Safety Precautions
2. Monitor V/S
3. Use precautions if agent is flammable
4. Safety Precautions
TOPICAL: BENZOCAINE (Orajel) TOPICAL: LIDOCAINE (Xylocaine)
CLASSIFICATION CLASSIFICATION
- Local Anesthetics - Local Anesthetics

MECHANISM OF ACTION: MECHANISM OF ACTION:

- Decrease nerve membrane permeability - Decrease nerve membrane permeability
to sodium ion to sodium ion

INDICATION INDICATION
- PAIN CONTROL while the client is - PAIN CONTROL while the client is
conscious conscious
- Local anesthesia: dentistry, minor
- To treat ventricular tachycardia or
trauma, and as preparation for infiltrative
ventricular fibrillation and provide topical
anesthesia.
anesthesia for skin or mucous
- Topical anesthesia: a wide variety of
membranes
conditions including skin irritation, oral
pain, and hemorrhoids

CONTAINDICATION
CONTAINDICATION
- Adams-Stokes syndrome
- Hypersensitivity to benzocaine or other - Hypersensitivity to lidocaine, amide
ester-type local anesthetics. anesthetics, or their components
- Secondary bacterial infection of treated - severe heart block (without artificial
area. pacemaker); Wolff-Parkinson- White
syndrome
SIDE EFFECTS
SIDE EFFECTS
- Mild stinging, burning, or itching where
the medicine is applied - CNS effects generally dose-related and
- Skin tenderness or redness or of short duration.
- Dry white flakes where the medicine was - Occasional: Infiltration/ nerve block:
applied. Pain at injection site.
- Topical: Burning, stinging, tenderness at
application site.
ADVERSE EFFECTS
- Allergic reaction
ADVERSE EFFECTS
- Respiratory arrest
- Arrythmias/Cardiac arrest - Allergic reaction
- Convulsion - Respiratory arrest
- Hypotension - Arrythmias/Cardiac arrest
- Convulsion
- Hypotension
NURSING RESPONSIBILITIES/PRIORITIES
1. Have oxygen and emergency equipment
NURSING RESPONSIBILITIES/PRIORITIES
available
2. Monitor V/S during local anesthesia 1. Have oxygen and emergency equipment
available
2. Monitor V/S during local anesthesia
TOPICAL: COCAINE (Goprelto) SPINAL: DIBUCAINE (Nupercaine/cainal)
CLASSIFICATION CLASSIFICATION
- Local Anesthetics - Local Anesthetics

MECHANISM OF ACTION: MECHANISM OF ACTION:

- Decrease nerve membrane permeability - Decrease nerve membrane permeability
to sodium ion to sodium ion

INDICATION INDICATION
- PAIN CONTROL while the client is - PAIN CONTROL while the client is
conscious conscious
- Local (topical) anesthesia of accessible - Treat minor pain and itching caused
mucous membranes of the oral, by minor cuts or burns, insect bites or
laryngeal and nasal cavities stings, sunburn, or other skin irritations.
-
CONTAINDICATION
CONTAINDICATION
- Hypersensitivity to dibucaine, other
- Hypersensitivity to ester-type local
amide-type local anesthetics, or any
anesthetics, para-aminobenzoic
ingredient in the formulation
acid (PABA), or parabens
Ophthalmologic anesthesia (causing
SIDE EFFECTS
sloughing of the corneal epithelium)
- severe burning or stinging
- rectal bleeding
SIDE EFFECTS
- a rash or other irritation of your skin.
- Abdominal or stomach pain
- Confusion
ADVERSE EFFECTS
- Dizziness or lightheadedness
- Excitement, nervousness, restlessness, - Allergic reaction
or any mood or mental changes - Respiratory arrest
- Fast or irregular heartbeat - Arrythmias/Cardiac arrest
- General feeling of discomfort or illness - Convulsion
- Hallucinations or seeing, hearing, or - Hypotension
feeling things that are not there
- Headache (sudden)
NURSING RESPONSIBILITIES/PRIORITIES
1. Have oxygen and emergency equipment
ADVERSE EFFECTS available
2. Monitor V/S during local anesthesia
- Allergic reaction
3. SPINAL ANESTHESIA: keep the client
- Respiratory arrest
flat for 6-12 hours to prevent spinal
- Arrythmias/Cardiac arrest
headache
- Convulsion
- Hypotension

NURSING RESPONSIBILITIES/PRIORITIES
1. Have oxygen and emergency equipment
available
2. Monitor V/S during local anesthesia
SPINAL: PROCAINE (Novocaine) NERVE BLOCK: BUPIVACAINE (Marcaine)
CLASSIFICATION CLASSIFICATION
- Local Anesthetics - Local Anesthetics

MECHANISM OF ACTION: MECHANISM OF ACTION:

- Decrease nerve membrane permeability - Decrease nerve membrane permeability
to sodium ion to sodium ion

INDICATION INDICATION
- PAIN CONTROL while the client is - PAIN CONTROL while the client is
conscious conscious
- Used as a local anesthetic primarily in - The production of local or regional
oral surgery anesthesia or analgesia for surgery,
dental and oral surgery procedures,
diagnostic and therapeutic procedures,
CONTAINDICATION and for obstetrical procedures.

- Hypersensitivity, complete heart block

- Inflamed or traumatized surface, low
CONTAINDICATION
plasma-cholinesterase conc
- Generalized septicemia - Septicemia
- Cerebrospinal disease, - Severe hemorrhage, severe hypotension
cardiogenic/hypovolemic shock or or shock, due to a reduced cardiac output
altered coagulation states - Clinically significant arrhythmias, such as
complete heart block, due a reduced
cardiac output.
SIDE EFFECTS
- Heartburn, migraines, and a serious SIDE EFFECTS
condition called
- Fever
systemic lupus erythematosus (SLE).
- Headache
SLE causes a variety of symptoms
- Shakiness in the legs, arms, hands, or
including joint pain, rashes, lung
feet
problems, and many other symptoms.
- Swelling or discharge where the implant
is placed
ADVERSE EFFECTS
- Allergic reaction ADVERSE EFFECTS
- Respiratory arrest
- Allergic reaction
- Arrythmias/Cardiac arrest
- Respiratory arrest
- Convulsion
- Arrythmias/Cardiac arrest
- Hypotension
- Convulsion
- Hypotension

NURSING RESPONSIBILITIES/PRIORITIES
1. Have oxygen and emergency equipment NURSING RESPONSIBILITIES/PRIORITIES
available
1. Have oxygen and emergency equipment
2. Monitor V/S during local anesthesia
available
3. SPINAL ANESTHESIA: keep the client
2. Monitor V/S during local anesthesia
flat for 6-12 hours to prevent spinal
headache
NERVE BLOCK: MEPIVACAINE (Carbocaine)
CLASSIFICATION
- Local Anesthetics

MECHANISM OF ACTION:
- Decrease nerve membrane permeability
to sodium ion

INDICATION
- PAIN CONTROL while the client is
conscious
- For production of local or regional
analgesia and anesthesia by local
infiltration, peripheral nerve block
techniques, and central neural
techniques including epidural and caudal
blocks.

CONTAINDICATION
- Complete heart block
- Porphyria
- Do not inject through infected skin when
using for epidural anesthesia
- Allergic reaction to any type of numbing
medicine.

SIDE EFFECTS
- Anxiety, feeling restless or excited
- Depression, dizziness
- Tremors
- Blurred vision, ringing in your ears

ADVERSE EFFECTS
- Allergic reaction
- Respiratory arrest
- Arrythmias/Cardiac arrest
- Convulsion
- Hypotension

NURSING RESPONSIBILITIES/PRIORITIES
1. Have oxygen and emergency equipment
available
2. Monitor V/S during local anesthesia