Medication Side Effects MEDICATION SIDE EFFECTS All medications

Medication Side Effects

MEDICATION SIDE EFFECTS All medications can cause side effects n Contributing factors n – Age – Weight – Sex – Overall health – Ethnicity – Severity of disease

Medication Side Effects n n Side Effect: an undesirable secondary effect of a drug or other form of medical treatment – Minimal to serious and harmful – New medication – Change in dosage – Stops using medication Team Member – Seek medical help – Document the side effect and medical intervention and file Incident Report

COMMON MEDICATION SIDE EFFECTS n n n n Nausea Vomiting Fatigue Dizziness Dry Mouth Headache Itching Muscle Aches and Pains

NEED FOR MEDICAL ATTENTION n n n n Abdominal Pain Blurred Vision Constipation Diarrhea Dizziness Headaches Loss of Appetite Memory Loss n n n Heart Palpitations Coordination Problems Ringing in the Ears Skin Rashes or Hives Swelling of Hands or Feet Loss of Consciousness or Fainting

APPROPRIATE RESPONSE TO OBSERVED SIDE EFFECTS n Previously unobserved side effect the person’s physician should be contacted immediately. n Medication should NEVER be discontinued without approval from the person’s physician. n If the side effect appears to be serious call the nurse and physician and then get the person to the emergency room as quickly as possible.

COMMON MEDICATIONS FOR PERSONS WITH INTELLECTUAL DISABILITIES n n n Intellectually Disabled have greater incidences – Epilepsy or other seizure disorders – Mental illness – Behavior disorders Anti-Seizure Medications Psychotropic or Antipsychotic Medications

ANTI-SEIZURE MEDICATIONS AND THEIR SIDE EFFECTS BRAND NAME (generic name) SIDE EFFECTS ATIVAN (lorazepam) Dizziness, drowsiness, blurred or double vision, nausea, skin rashes, abnormal blood counts (rare) DEPAKENE (valproate) Upset stomach, altered bleeding time, liver toxicity, hair loss, weight gain, tremor DEPAKOTE (divalproex sodium) Upset stomach, altered bleeding time, liver toxicity, hair loss, weight gain, tremor DIAMOX (acetazolamide) Appetite loss, frequent urination, drowsiness, confusion, extremity numbness, kidney stones

KEPPRA (levetiracetam) Sleepiness, fatigue, poor coordination, loss of strength, dizziness KLONOPIN (clonazepam) Drowsiness, sleepiness, fatigue, poor coordination, unsteadiness, behavior changes LAMICTAL (lamotrigine) Dizziness, headache, blurred vision, clumsiness, sleepiness, nausea, skin rash MYSOLINE (primidone) Clumsiness, dizziness, appetite loss, fatigue, drowsiness, hyperirritability, insomnia, depression, hyperactivity NEURONTIN (gabapentin) Sleepiness, dizziness, clumsiness, fatigue, twitching PHENOBARBITAL (phenobarbital) Drowsiness, irritability, hyperactivity (children), behavioral problems, difficulty concentrating, depression

PHENYTEK (extended phenytoin sodium) Clumsiness, insomnia, motor twitching, nausea, rash, gum overgrowth, hairiness TEGRETOL (carbamazepine) Dizziness, drowsiness, blurred or double vision, nausea, skin rashes, abnormal blood counts (rare) TEGRETOL XR (extended release carbamazepine) Dizziness, drowsiness, blurred or double vision, nausea, skin rashes, abnormal blood counts (rare) TOPAMAX (topiramate) Confusion, sleepiness, dizziness, clumsiness, difficulty thinking or talking, tingling sensation of the skin, nausea, decreased appetite TRANXENE (clorazepate) Drowsiness, sleepiness, fatigue, poor coordination, unsteadiness, behavior change TRILEPTAL (oxcarbazepine) Difficulty concentrating, sleepiness, fatigue, dizziness, double vision, nausea, unsteadiness, rash

ZARONTIN (ethosuximide) Appetite loss, nausea, drowsiness, headache, dizziness, fatigue, rash, abnormal blood counts (rare) ZONEGRAN (zonisamide) Sleepiness, dizziness, loss of appetite, headache, nausea, irritability, difficulty concentrating, unsteadiness, fever, kidney stones, rash NOTE: It is not necessary to memorize this or any chart in the training. It is, however, necessary to have this and other information on medication side effects readily available when working with persons with intellectual disabilities who may not be able to tell you that they are having these effects. The team member must recognize the side effects and respond appropriately.

EXTRAPYRAMIDAL SIDE EFFECTS OF ANTI-PSYCHOTIC MEDICATIONS n n n Improper dosing Unusual reactions to neuroleptic medications Physical Symptoms – Tremor – Slurred speech – Akathisia n restlessness in body and muscles, n move constantly

EXTRAPYRAMIDAL SIDE EFFECTS OF ANTI-PSYCHOTIC MEDICATIONS (2) – Dystonia n handwriting deterioration, n foot cramps or foot pulls up or drags n Neck turns or pulls involuntarily n Rapid, uncontrolled blinking – Paranoia n Anxiety or fear n Irrationality n Delusion – Bradyphrenia - Slow thought process

More Typical Side Effects of Anti-Psychotic Medications n Aggression n Self-injurious behavior n Agitation n n Anger Socially inappropriate behavior Depression n Temper Tantrums n Hostility n Difficulties concentrating n Hyperactivity n Confusion n Irritability n Sedation Destruction of Property n Motor Uncoordination n n

More Typical Side Effects of Anti-Psychotic Medications n Deterioration of teeth n Neuroleptic malignant syndrome – a sudden increase in temperature to dangerous levels n Dysphoria – disquiet; restlessness; a vague sense of mental or moral ill-being Impotence n n Tardive Dyskinesia – jerky, abnormal or delayed movements in the face; head; trunk or extremities, such as rapid eye blinking or repetitive lip sucking, rocking, or twisting n Lethargy n Intense dreams or nightmares

COMMON SIDE EFFECTS OF MORE TYPICAL TYPES OF MEDICATION Types of Medications causing potential side effects Potential Side Effects Pain relievers; anti inflammatory agents (such as Ibuprofen); muscle relaxants; and sedatives Agitation Weight control; antidepressants; cholesterol reducers; cold/cough medicines; decongestants; and tranquilizers Anxiety Pain relievers, angina relief; arrhythmia control; anticonvulsants; antidepressants; antihistamines; anti-hypertension; antiinflammatory agents; cold/cough medicines; steroids; decongestants; diuretics; muscle relaxants; sedatives; tranquilizers Confusion

Anti-depressants Concentration Problems Arrhythmia Control; Antidepressants Delirium Angina relief; arrhythmia control; anticonvulsants; anti-inflammatory agents; migraine relief; cancer treatments; diuretics; hormones; muscle relaxants; birth control; sedatives; and tranquilizers Depression Pain relievers; antidepressants; migraine relief; nausea relief; cancer treatments; Sedatives; and tranquilizers Disorientation Anticonvulsants (anti-seizure) and most recreational drugs Emotional Disturbances Cold/cough medicines and tranquilizers Giddiness

Arrhythmia control; antihistamines; antiitching drugs; cold/cough medicines; decongestants; muscle relaxants; and tranquilizers Excitability Pain relievers; weight control; antidepressants; antihistamines; migraine relief; anti-itching drugs; cold/cough medicines; steroids; decongestants; and tranquilizers Euphoria (a sense of emotional well-being) Pain relievers; antidepressants; antiinflammatory agents; cold/cough medicines; decongestants; sedatives; and tranquilizers Hallucinations Tranquilizers Hyperactivity Antihistamines and anti-itching drugs Hysteria Anti-hypertension; diuretics; tranquilizers Impotence

Arrhythmia control; antidepressants; antihistamines; Insomnia anti-hypertension; anti-inflammatory agents; migraine relief; nausea relief; anti-itching drugs; antispasmodics; bronchodilators; cholesterol reducers; cold/cough medicines; decongestants; muscle relaxants; sedatives and thyroid drugs Anticonvulsants; antihistamines; bronchodilators; cold/cough medicines; decongestants Irritability Anti-inflammatory agents; cancer treatments; and tranquilizers Lethargy Weight control drugs Overstimulation Anticonvulsants; antihistamines; anti-hypertension; nausea relief; anti-itching drugs; antispasmodics; bronchodilators; cholesterol reducers; cold/cough medicines; decongestants; diuretics; oral contraceptives/birth control; sedatives; thyroid medicines; tranquilizers; and vasodilators Nervousness

Antidepressants; nausea relief; sedatives; and tranquilizers Nightmares Cancer treatments; estrogens (hormones); and oral contraceptives Pre-menstrual symptoms Anti-nausea medicines; and tranquilizers; Psychotic symptoms as well as allergies to drugs Pain relievers; weight control; angina relief; anti-hypertension; nausea relief; bronchodilators; cold/cough drugs; decongestants; diuretics; tranquilizers; and vasodilators Restlessness Anti-Itch medicines and cold/cough medicines Weariness

SOURCES FOR RESEARCH ABOUT SIDE EFFECTS n n n Physician’s Desk Reference (PDR) – Physician Drug and Health Information PDR. NET – website for professional medical information Medline. Plus – offers patient-friendly information on medications and herbs: medlineplus. gov RXList – provides information on medications and side effects: www. rxlist. com PDR Health – Prescription Drug and Health Information: www. pdrhealth. net