Clozapine Flashcards
Indication
-Treat severe schizophrenia unresponsive to standard drugs
-Reduce the risk of recurrent suicidal behavior in schizoaffective disorders
Mechanism of Action
Production of antipsychotic effects by interference with dopamine binding to dopamine receptors in limbic region of the brain
Contraindication
-Hypersensitivity
-Avoid alcohol
-Avoid smoking
-Avoid caffeine
-ANC <1500/mm3
Interactions
Adverse reactions with select antidepressants, ClassIA&III, and antiarrhythmics increase reactions
Carbamazepine, phenytoin, and rifampin decrease the plasma level of clozapine
Side Effects
CNS: akinesia, ataxia, confusion, delirium, insomnia, paresthesia, cataplexy, TD, (see p 253)
CV: palpitations, hypercholesterolemia, hypertriglyceridemia, HTN
EENT: blurred vision, dry mouth, glaucoma
GI: abdominal discomfort, anorexia, cholestasis, colitis, N/V
GU: ejaculatory disorders, priapism, urinary retention
HEME: elevated hemoglobin, hematocrit, and erythrocyte rate
MS: myalgia
RESP: lower resp tract infection
SKIN: photosensitivity
Other: hyperuricemia, weight gain
Life-threatening SE
CNS: neuroleptic malignant syndrome, seizures, sleep apnea, status epilepticus
CV: atrial or ventricular fibrillation, cardiac arrest, cardiomyopathy, DVT, MI, Torsades de pointes
ENDO: DKA
GI: acute pancreatitis, hepatic cirrhosis, liver failure
GU: renal failure
HEME: agranulocytosis, bone marrow suppression,
MS: Rabdo
RESP: aspiration, PE, respiratory arrest
SKIN: erythema multiforme, Stevens-Johnson syndrome
Other: angioedema, hypersensitivity reactions, hyponatremia, sepsis