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APPENDIX IV: PHARMACOLOGIC AGENTS

845

Warfarin sodium (Couma

Indications: Long-term prophylaxis and

din), anisindione (Miratreatment of venous thrombosis, PEt atrial

don)

fibrillation, or with prosthe£ic heart valve.

Mechanism of action: Interferes with

synthesis of vitamin K-dependent clotting

facrors that decrease prothrombin.

General side effects: Bleeding from gastrointestinal, genitourinary, respiratory. or

other tracts; dyspnea; headache; chest or

abdominal pain; systemic cholesterol

microcmbolism (purple coe syndrome).

Additional side effects of anisindione are

hemorrhage and dermatitis.

DVf = deep vein lhrombosis; NQW MI = non-Q wave myocardial infarction; PE = pulmonaryembolism .

• Ardeparin sodium only.

Sources: Dam from Drug Facts and Comparisons 2000 (54th cd).

St. Louis: Wolrers

Kluwer, 2000; and Anticoagulant, Amipiarclet, and Thrombolytic Drugs. Ln RA Lehne

(ed),

Pharmacology for Nursing Care (4th cd). Philadelphia: Saunders, 200 I.

Table rv-S. Anticonvulsant Agents·

Indication: To decrease seizure activity.

Mechanism of action: Exact mechanism is unclear; however, electrical impulses

from the cerebral motor cortex are decreased in frequency and voltage.

General side effects: Headache, nausea, vomiting, dizziness, vertigo,

confusion, agitation, fatigue, visual hallucinations, diplopia, tremor,

hyperreflexia, hypo- or hypertension, arrhythmia, congestive heart failure,

edema, urinary frequency or retention.

Generic name (trade name): Carbamazepine (Atretol, Carbarrol, Epitol. Tegretol), clonazepam (Klonopin), clorazepare dipotassium (Gen-Xene, Clorazepate), diazepam (Diasrat, Valium), ethosuximide (Zarontin), ethoroin (Peganone), felbamate (Felbarol), gabapentin (Neurontin), lamorrigine (Lamjctal), magnesium sulfate, methsuximide (Celontin), Phensuximide (Milontin), phenytoin, primidone (Mysoline), tiagabine hydrochloride (Gabitril Filmtabs),

ropiramare (Topamax), valproic acid (Depacon, Depakene, Depakore).

"Consists of multiple drug categories, including barbiturates, hydanroins, succinimides,

and benzodiazepines.

Sources: Data from Drug Facrs and Comparisons 2000 (54th ed). Sr. Louis: Wolters

Klllwcr, 2000; and Drug Facrs and Comparisons 200 1 (55th ed). Sr. LOllis: Wolters

Klllwer, 200 I .

846

ACUTE CARE HANDBOOK FOR PHYSICAl THFRAI)ISTS

Table rV-6. Antiemetic Agents

Indications: Control symptoms of nausea and vomiting associated with

chemotherapy, radiation treatment, or both.

Mechanism of action: Depressive effects on central nervous system that can

result in decreased nausea and vomiting, particularly if these symptoms are

associated with anxiety during chemotherapy.

Generic Name

Family Name

(Trade Name)

Side Effecrs

Phenorhiazines

Chlorprom-

Extrapyramidal reactions, sedation,

azine (Thoratardive dyskinesia, pseudoparkinzine)

sonism, orthostatic hypotension,

arrhythmias, blurred vision, electrocardiographic changes

Prochlorperazine Extrapyramidal reactions, sedation,

(Compazinc)

blurred vision, pseudoparkinsonism

Promethazine

Sedation, drowsiness, confusion,

(Phenergan)

hypotension, nausea, df)' mouth,

agra n u locytosis

Butyrophenones

Haloperidol

Severe extrapyramidal reaction,

(Haldol)

tardive dyskinesia, blurred vision,

neuroleptic malignant syndrome

Droperidol

Drowsiness, hypotension, extrapyram

(Inapsine)

idal reaction, orthostatic hypotension

Cannabinoids

Tetrahydrocan-

Impaired psychomotor performance,

nabinol

altered sensory perception,

(marijuana)

tachycardia, paresthesia, tinnitus

Antihistamines

Diphenhydra-

Drowsiness, nausea, dry mouth,

mine

vertigo, palpitations, confusion,

(Ben.dryl)

headache

Corticosteroids

Dexamethasone

Insomnia, hypertension, edema,

(Decadron,

muscle weakness, hyperglycemia

Hexadrol,

Dexone)

Benzodiazepines Lorazepam

Drowsiness, lethargy, restlessness,

(Ativan)

transient hypotension, visual

disturbances

APPENDIX IV: PHARMACOLOGIC AGENTS

847

Generic Name

Family Name

(Trade Name)

Side Effects

Mccociopra

Resdcssness, anxiety, drowsiness, dizmide (Reglan)

ziness, extrapyramidal symptoms,

tardive dyskinesia, dystonic reactions, transiem hypertension

Other

T rimethobenza

Drowsiness, hypotension, diarrhea,

mide (Tigan)

hepatotoxicity

Sources: Data from C Ciccone (ed). Cancer Chemotherapy. Philadelphia: FA Davis,

1 996; D Moreau (ed). Nursing '96 Drug Handbook. Springhouse, PA: Springhouse,

1996; and LM Tierney, 5j McPhee, MA Papadakis (eds). Currenr Medical Diagnosis

and Trearment. New York: McCraw-Hili, 2000.

Table IV-7. Antihistamines

Indications: To decrease inflammation and bronchoconstriction associated

with hypersensitivity reactions, such as allergic rhinitis

Mechanism of action: Reduce or prevent the physiologic effects of histamine

by competing for histamine binding sites

General side effects: Drowsiness, dizziness, decreased coordination,

orthostatic hypotension, hypotension, hypertension, palpitations,

bradycardia, tachycardia, epigastric distress, urinary frequency, thickening

of bronchial secretions, dry mouth

Generic namc (trade name); Astemizole (Claritin), azatadine maleate (Opt imine), azelastine hydrochloride (Astelin), chlorpheniramine maleate (Aller

Chlor, Allergy, Chlo-Amine, Chlor-Pro, Chlor-Trimeton, ciemastine fumarate (Anti-hist 1, Tavist), dexchtorpheniramine maleate, diphenhydramine hydrochloride (AllerMax, Benadryl, Banophen, Diphenhist, Siladryl,

Tusstat), promethazine hydrochloride (Anergan, Phenergan)

Source: Data from Drug Facts and Comparisons 2000 (54th cd). St. Louis: Wolters

Kluwer, 2000.