V.

IMPLEMENTATION
MANAGEMENT
a. Medications

Drug name Dosage Mechanism Indications Contraindication Side effects Nursing precaution
of action s
Biperidine Administer with Blocks Parkinsonian Pregnancy
or after meals to acetylcholine syndrome Narrow angle Skin rashes, Elderly
prevent G.I action at especially to glaucoma, dyskinesia, ataxia, and Lactation
irritation. cholinergic counter act mechanical twitching, impaired Avoid operating machineries
receptor sites. muscular stenosis in speech, fatigue, Monitor input-output ratio,
Severe Cases: Restores the rigidity and gastrointestinal dizziness at higher retention commonly cause
10–20mg brains normal tremor; extra and mega colon; doses, restlessness, decreased urinary output,
intramuscular dopamine pyramidal Hypersensitivity agitation, anxiety, distention frequency, or
(IM) or slow and symptoms. to Biperiden. confusion. incontinence.
intravenous (IV) acetylcholine Assess mental status; affect
as single dose if balance, mood, CNS, depression,
necessary, which relaxes worsening of mental symptoms
repeat same muscle during early therapy.
dose after movement Monitor for constipation,
30mins. Max and decreases cramping pain in abdomen and
(10-20mg) per rigidity and abdominal distention. Increase
day. tremors. fluids and add fiber to diet and
exercise f there occurs.
Drug name Dosage Mechanism Indications Contraindications Side effects Nursing
of action precaution
Diphenhydra Administer after An Systemic reaction of Hypersensitivity to Orthostatic Assess respiratory
mine meal if patient is antihistamine allergic condition. antihistamine, hypotension; status; rate reading
prone to used for Condition including narrow angle palpitation, and increase in
excessive treating urticaria and glaucoma; bradycardia, bronchial secretion
salivation. If allergic angioedema, rhinitis, stenosing peptic tachycardia, reflex
mouth dries reaction, pruritic skin disorder and ulcer, symptomatic tachycardia, faintness, Provide fluids to 2
excessively, sedative and conjunctivitis prostatic drowsiness, sedation, liters per day to
administer drug hypnotic hypertrophy, dizziness, disturbed decrease sickness
before meal. For effect. It is also used for its anti- asthmatic attack, coordination, nasal
most indications, emetic properties in the bladder neck stiffness, dry mouth, Monitor output and
diphenhydramine treatment of nausea and obstruction, nose and throat; sour input ratio
chloride is given vomiting particularly in pyloroduodenal throat, Epigastric
by mouth in usual the prevention and obstruction, distress; nausea, Assess sleep
doses of 25-50 treatment if motion monoamine vomiting, diarrhea, pattern
mg 3-4 times a sickness which is given oxidase inhibitors constipation, Assess nausea,
day or a total 30 mins before travelling therapy, history of hemolytic anemia, vomiting, bowel
daily dose of 5 in the treatment of sleep apnea aggranulocytosis, sound and
mg per kg body. vertigo increase appetite, abdominal pain.
Weight in divided thickening of
doses. Maximum It is used in the control of bronchial secretion,
dose in adults and parkinsonia and drugs chest tightness
children is 300 induce exra pyramidal
mg daily. disorders
Drug name Dosage Mechanism of Indications Contraindications Side effects Nursing precaution
action
Clozapine Administer tablet Binds Management Agranulocytosis, Most Common: Assess for mental
with food or milk selectively to of severely ill impaired bone Drowsiness, status:
to decrease dopaminergic schizophrenics marrow function, dizziness, Orientation, mood,
GI irritations receptors in who are uncontrolled tachycardia, behaviors, presence of
12.5 mg once to the CNS. unresponsive epilepsy, alcoholic constipation, hallucinations and type
twice a day on to standard and other toxic hypersalivation. before initial
the first day, 25 antipsychotic psychosis, drug administration and
or 50 mg on the drugs. intoxication, Rare/Serious: monthly.
second day Reduction of comatose condition, Agranulocytosis, Check for swallowing
followed by step the risk of CNS depression, eosinophilia, keto of oral medication;
twice dosage recurrent several renal or acidosis, seizures, check for hoarding or
increases up to suicidal cardiac disorders, convulsions, giving medication to
300-450mg per behavior in active liver disease myocarditis, other patient.
day in divided patients with associated with respiratory, Monitor input-output
doses. Maximum schizophrenia nausea, anorexia or depression, fecal ratio, palpate bladder if
oral dose; 900mg or jaundice, hepatic impaction, hepatitis, low urinary output
per day. schizoaffective failure. pancreatitis, occurs, especially in
disorders. nephritis, elderly; urinalysis
Maintenance: unexplained sudden recommended before
Lower doses may death. during prolonged
suffice. therapy. Assess affect
orientation, LOC, gait
and coordination.
Check for dizziness,
faintness, and
tachycardia on rising.