Ch. 17 Drug Cards - Psychoses Flashcards
Chlorpromazine Therapeutic Class
First-generation antipsychotic; schizophrenia drug
Chlorpromazine Pharmacologic Class
D2 dopamine receptor antagonist; phenothiazine
Chlorpromazine education for the patient
Must take for 7-8 weeks before improvements take place
Chlorpromazine administration alert
Give deep IM, ONLY in the UPPER OUTER QUADRANT of the buttocks
Patient should remain SUPINE for 30-60 minutes after injection and then rise slowly
Extrapyramidal symptoms (EPS) - older, female, and pediatric patients who are dehydrated
Neuroleptic malignant syndrom (NMS)
Chlorpromazine adverse effects
Chlorpromazine drug interactions
Interacts with several drugs - avoid sedative medications (phenobarbital)
Chlorpromazine treatment of overdose for EPS
Treated with: Antiparkinsonism drugs
Barbiturates
Anticholinergics (benztropine [Cogentin])
haloperidol (Haldol) Therapeutic Class
Conventional antipsychotic; schizophrenia drug
haloperidol (Haldol) Pharmacologic class
D2 dopamine receptor antagonist; NONPHENOTHIAZINE
haloperidol (Haldol) actions and uses:
Acute and chronic psychotic disorders
Unprovoked aggressiveness and explosive hyperexcitability
haloperidol (Haldol) patient education
Do not abruptly discontinue, or severe adverse reactions may occur
haloperidol (Haldol) adverse effects
Incidence of EPS is high
haloperidol (Haldol) drug interactions
Interacts with MANY drugs
haloperidol (Haldol) treatment of overdose
With EPS, antiparkinsonism medication should be administered
risperidone (Risperdal) Therapeutic Class
Atypical antipsychotic; schizophrenia drug
risperidone (Risperdal) effects occur where?
Primarily from blockade of dopamine type 2, serotonin type 2, and alpha2-adrenergic receptors located within the CNS
risperidone (Risperdal) patient education
Several weeks are required for therapeutic effectiveness
When switching from other antipsychotics, discontinue medications to avoid overlap
risperidone (Risperdal) Adverse Effects
EPS (involuntary shaking of the head, neck, and arms)
May cause weight gain and hyperglycemia
risperidone (Risperdal) contraindications
Older Adults with dementia-related psychoses - at increased risk for heart failure, pneumonia, or sudden death
Patients with underlying cardiovascular disease - may be prone to dysrhythmias and hypotension
Avoided in patients with a history of seizures, suicidal ideations, or kidney or liver disease
risperidone (Risperdal) drug interactions
Avoid CNS depressants (alcohol, antihistamines, sedative-hypnotics, or opioid analgesics)
Due to inhibition of liver enzymes, other drugs that increase adverse effects include:
SSRIs - paroxetine, sertraline, and fluoxetine, and the azole antifungal drugs
risperidone (Risperdal) lab tests
Increased liver enzymes (ALT & AST)
Anemia
Thrombocytopenia
Leukocytosis
Leukopenia
