Therapeutic Classification

Action Contraindication Toxicity Effect Indication Safety Dose

Seroquel xr

Generic Name quetiapine fumarate

ClassificationAntipsychotic Drugs

he mechanism of action of SEROQUEL, as with other antipsychotic drugs, is unknown. However, it has been proposed that this drug's therapeutic activity in schizophrenia is mediated through a combination of dopamine type 2 (D2) and serotonin type 2 (5HT2) antagonism. Antagonism at receptors other than dopamine and 5HT2 with similar receptor affinities may explain some of the other effects of SEROQUEL. SEROQUEL's antagonism of histamine H1 receptors may explain the somnolence observed with this drug.

SEROQUEL's antagonism of adrenergic a1 receptors may explain the orthostatic hypotension observed with this drug.

The mechanism of action

SEROQUEL is contraindicated in individuals with a known hypersensitivity to this medication or any of its ingredients.

Severe HTN, severe coronary artery disease.

very stiff (rigid) muscles, high fever,

sweating, confusion, fast or uneven

heartbeats, tremors;

feeling like you might pass out;

jerky muscle movements you cannot

control, trouble swallowing, problems

with speech;

tremors, or restless muscle

movements in your eyes, tongue, jaw,

neck, arms, or legs;

mask-like appearance of the face,

trouble swallowing, problems with

speech;

blurred vision, eye pain, or seeing

halos around lights;

increased thirst and urination,

excessive hunger, fruity breath odor,

weakness, nausea and vomiting; or

fever, chills, body aches, flu

symptoms, white patches or sores

inside your mouth or on your lips.

Less serious side effects may include:

dizziness, drowsiness, tired feeling;

dry mouth, sore throat;

stomach pain, upset stomach, nausea,

vomiting, constipation;

breast swelling or discharge;

missed menstrual periods; or

increased appetite, weight gain.

Phenylephrine HCl

indicated in adults for (1) adjunctive therapy to antidepressants in major depressive disorder; (2) acute depressive episodes in bipolar disorder; (3) acute manic or mixed episodes in bipolar I disorder, as either monotherapy or adjunct therapy to lithium or divalproex; (4) maintenance treatment of bipolar I disorder as an adjunct to lithium or divalproex; and (5) schizophrenia.

SEROQUEL is indicated in adults for the treatment of (1) acute depressive episodes in bipolar disorder; (2) acute manic episodes in bipolar I disorder, as either monotherapy or adjunct therapy to lithium or divalproex; (3) maintenance treatment of bipolar I disorder as an adjunct to lithium or divalproex, and (4) schizophrenia. Patients should be periodically reassessed to determine the need for treatment and the appropriate dose.

Headache, muscle &

Psychosis – initiate with 25 mg bid, may increase by 25 – 50 mg bid to tid on the second or third day as tolerated toa target dose of 300 – 400 mg/d divided by bid to tid, may adjust dose by 25 – 50 mg bid qd as needed (max. 800 mg/d)Agitation/Dementia – initiate with 25 mg bid, may increase by 25 – 50 mg bid, q 2-7 if needed, (max 200 mg/d)

Adults and Children 12 years

Decolgen(No Drowse)

Generic NamePhenylephrine HCl + Paracetamol

ClassificationNasal Decongestant / Analgesic-Antipyretic

is associated with inhibition of prostaglandin synthesis, the predominant influence on the thermoregulation center in the hypothalamus, enhances heat transfer.

Inhibits formation of

Concomitant or w/in 14 days of MAOIs

hematologictoxicity:neutropenia,thrombocytopenia,agranu

Increased blood pressure

Headache

Seizures

Palpitation

Paresthesia (sensation of

tingling, pricking, or

numbness of the skin)

Vomiting

Cerebral hemorrhage

(bleeding from a ruptured

blood vessel in the brain)

Paracetamol

Overdosage of paracetamol usually

involves 4 phases with the following

signs and symptoms:

I. Eating disorder, nausea, vomiting,

malaise, and excessive sweating

II. Right upper abdominal pain or

tenderness, liver enlargement which may

be

characterized by abdominal

discomfort of “feeling full”, elevated

bilirubin and liver

enzyme concentrations,

prolongation of prothrombin time, and

occasionally decreased

urine output

III. Eating disorder, nausea, vomiting,

and malaise recur and signs of liver (e.g.,

jaundice)

and possibly kidney failure

IV. Recovery or progression to fatal

complete liver failure

diarrhea that is watery or

bloody;

joint pains,general malaise, fever & chillsassociated w/ upper resp infections

treatment of infections

and older: Orally, 1 tab every 6 hrs, or, as recommended by a doctor.

It is a fixed combination

Co-Trimoxazole

Generic NameTrimethoprim/Sulfamethoxazole

ClassificationAntibacteria

dihydrofolic acid from PABA; trimethoprim component inhibits dihydrofolate reductase. BOTH DECREASE BACTERIAL FOLIC ACIDSYNTHESIS

Parkinsonism is thought

locytosis, aplasticanemia Contraindicated in patients with known hypersensitivity to trimethoprim or sulfonamides,or with documented megaloblastic anemia secondary to folate deficiency use with cautionin patients with impairedrenal orhepatic function or with possible folate or G-6-PDdeficiency

You cannot take biperiden if you

fever, chills, swollen glands,

body aches, flu symptoms,

sores in your mouth and

throat;

new or worsening cough;

pale skin, feeling light-

headed, rapid heart rate,

trouble concentrating;

easy bruising, unusual

bleeding (nose, mouth,

vagina, or rectum), purple or

red pinpoint spots under

your skin;

severe tingling or

numbness, slow heart rate,

weak pulse, muscle

weakness;

nausea, upper stomach

pain, itching, loss of

appetite, dark urine, clay-

colored stools, jaundice

(yellowing of the skin or

eyes);

urinating less than usual or

not at all;

hallucinations, seizure

(convulsions);

low blood sugar (headache,

hunger, weakness,

sweating, confusion,

irritability, or feeling jittery);

the first sign of any skin

rash, no matter how mild; or

severe skin reaction -- fever,

sore throat, swelling in your

face or tongue, burning in

your eyes, skin pain,

followed by a red or purple

skin rash that spreads

(especially in the face or

upper body) and causes

blistering and peeling.

f you experience any of the following

serious side effects, stop taking

due to susceptible organisms

As an adjunct in the

product containing sulfamethoxazole and trimethoprim in 5:1 ratio. Adult- PO- The recommended dose is 2 tablets every 12 hours for a period of 10 to 14 days. Child- The recommended dose is 8 mg/kg of trimethoprim and 40 mg/kg of sulfamethoxazole daily in 2 divided doses every 12 hours. 

Akidin

Generic Name Biperiden HCL

ClassificationAntiparkinsonian drugs/ anticholinergic

to result from an imbalance between the excitatory (cholinergic) and inhibitory (dopaminergic) systems in the corpus striatum. The mechanism of action of centrally active anticholinergic drugs such as biperiden is considered to relate to competitive antagonism of acetylcholine at cholinergic receptors in the corpus striatum, which then restores the balance.

Alter the effects of

have ever had an allergic reaction to it,

have narrow-angle glaucoma,

have an obstruction in your bowel or a complication of bowel disease known as megacolon; or

have myasthenia gravis.

Seizure Disorder

biperiden and seek emergency medical

attention:

an allergic reaction (difficulty

breathing; closing of your

throat; swelling of your lips,

tongue, or face; or hives);

unusual fever;

fast or irregular heartbeat;

anxiety, hallucinations,

confusion, agitation,

hyperactivity, or loss of

consciousness;

seizures;

a rash; or

eye pain.

Extrapyramidal symptoms

therapy of all forms of parkinsonism (idiopathic, postencephalitic, arteriosclerotic)Control of extrapyramidal disorders secondary to neuroleptic drug therapy (e.g., phenothiazines)

Oral: One tablet one to three times daily.

Parkinson's Disease: Oral: The usual beginning dose is one tablet three or four times daily. The dosage should be individualized with the dose titrated upward to a maximum of 8 tablets (16 mg) per 24 hours.

Haloperidol

ClassificationAntipsychotic

dopamine in the cns

Also has Anticholinergic and alphaadrenergic blocking activity.Diminished signs and symptoms of psychoses

Exert its action through a

Glaucoma Elderly Client

There are no absolute contraindication

such as muscle rigidity or

spasm ,shuffling gait,posture

leaning

forward.drooling,masklike

facial

appearance ,dysphagia,akit

hesia

,tardice

dyskinesia,

headache,

seizures.

Tachycardia

Arrythmias

Hypertension

Blurred Vision

Glaucmoa

The most common side effect is

Organic Pschoses

Acute Psychotic SymptomsRelieve Hallucinations,Delusion,Disorganized Thinking

Severe anxietySeizures

Levomepromazine is

@.5Mg OD

Nozinan

Generic NameLevomepromazine

Classificaitonanalgesic and antiemetic

central adrenergic blocking.a dopamine blocking,a serotonin blocking and a anticholinergic blocking.

akathisia. Levomepromazine has

prominent sedative and

anticholinergic/sympatholytic effects (dry

mouth, hypotension, sinus tachycardia,

night sweats) and may cause weight

gain. These side effects normally

preclude prescribing the drug in doses

needed for full remission of

schizophrenia, so it has to be combined

with a more potent antipsychotic. In any

case, blood pressure and EKG should be

monitored regularly.

used for the treatment of psychosis, particular those of schizophrenia, and manic phases of bipolar disorder. It should be used only with caution in the treatment of agitated depressions, as it can cause akathisia as a side effect, which could worsen the agitation.

Levomepromazine is also used at lower doses for the treatment of nausea and insomnia.

PATIENTS DATA

Name: patient X

Age: 25 years old

Gender: Male

Civil Status: Single

Address: Marville Homes Subdivision Lucena City

Nationality: Filipino

Birthday: October 4, 1987

Educational Attainment: Bachelor of Science in Nursing

Previous Admission: 4/23/2012

Present Admission: 01/30/2013

Chief complaint: Changes in Behavior

Admitting diagnosis: Psychosis

History of Present Illness:

Patient as diagnosed with psychosis with meds seroquil XR OD

December 2012- (+) changes in behaviour to be stressed related @ work.

Resistance of the above condition, with frequent striking often talks to himself alone and

inability to sleep hence prompted admitted.

Physical and Mental Assessment

Name: PATIENT X Age: 25y/o Gender: Male

1. General Description:

The client appears stated with his age of 25 years old, black t-shirt, seems thirsty as evidence by his frequent drinking of water, well groomed and with good personal hygiene. He’s taking a bath everyday with a good daily routine. The client has a good posture, gait and coordination. During interaction, he has a good eye to eye contact and facial expression with regards to a certain situation. He was well nourished and has a fair skin as evidenced by his good body built and has no sleeping difficulties by the absence of dark circles under his eyes .He was well oriented with time, place, date and reality. The client considered the interview as a normal thing and he was guided accordingly with no harsh or offending questions thrown to him during the interview. He was cooperative with consistency of speech and behavior.

2. Mood and Affectivity:

The client show appropriate affect with regards to a certain situation.

3. Speech Characteristics:

Low pitch tone

4. Perception:

Hallucinations: no

Illusion: no

5. Thought Content and Mental Trends:

a. Flight of ideas- no

b. Looseness of associations- no

c. Circumstantiality- yes

d. Tangentiality- no

e. Delusion- no

f. Preoccupations- no

g. Suicidal- no

6. Sensorium and Cognition

a. Consciousness: alert

b. Oriented to time: yes

c. Oriented to person: yes

d. Oriented to place: yes

e. Remote memory: intact

f. Recent past memory: intact

g. Recent memory: intact

h. Immediate retention and recall: intact

i. Confabulation: no

7. Concentration and attention

a. Reading and writing: not assessed

b. Visual spatial ability: not assessed

c. Abstract thought: not assessed

d. Serial 7’s: not assessed

8. Impulsivility

a. Impulse control

9. Judgement ad insight:

a. Judgement: poor

b. Insight: denial

10. Reliability:FairTreatment Plan: Pharmacological treatment