Antipsychotic Drugs for HESI Comp
Nursing Considerations for Phenothiazines
-2-3 weeks for effectiveness to be achieved -Monitor older patients closely -EPS are a major concern -Teach pt to remain supine for 1 hr after administration b/c of orthostatic hypotension risk -AVOID: CNS Depressants, Alcohol, sedatives, Antacids (disrupt absorption)
Fluphenazine HCL special nursing considerations
-Absorbed slowly -Useful for treating psychomotor agitation associated with thought disorders -Given via IM injection q14days
ADEs/SEs of Nonphenothiazines
-Anitcholinergic Effects: Dry mouth, blurred vision, urinary retention -SEVERE EPS -Leukocytosis
Indications for Long-Acting Antipsychotic Drugs
-Clients who require supervision w/ medication regimens
Indications of Nonphenothiazines
-Control Psychotic behavior -Less potent sedative effects compared w/ phenothiazines
List traditional antipsychotic drug classes
-Phenothiazines -Nonphenothiazines -Long-acting Drugs -Atypical Antipsychotic Drugs
ADEs/SEs of Phenothiazine use
-Weight gain, orthostatic hypotension, drowsiness, Anticholinergic effects Extrapyramidal Effects: -Pseudoparkinsonism -Akathisia -Dystonia -Tardive Dyskinesia -Photosensitivity -Blood Dyscrasias: Leukopenia, Granulocytosis -Neuroleptic Malignant Syndrome
List common Phenothiazines
Chlorpromazine HCL Thioridazine HCL Trifluoperazine HCL Loxapine Triflupromazine Fluphenazine HCL Perphenazine
Indications for Phenothiazine use
Control psychotic behavior, hallucinations, delusions and bizarre behavior
ADEs of Seroquel
Drowsiness, dizziness, EPS, weight gain, anticholinergic effects
ADEs of Clozaril
Drowsiness, dizziness, NMS, agranulocytosis, GI symptoms
List Common Long-Acting Antipsychotic Drugs
Fluphenazine Decanoate Haloperidol Decanoate
ADEs and SEs of Long-Acting Antipsychotic Drugs
Fluphenazine Decanoate = Same as phenothiazines Haloperidol decanoate = same as Haloperidol
Nursing Considerations for Long-acting antipsychotics
Haldol given every 4 wks -Prolixin given every 7-28 days -Requires several months to reach therapeutic levels
List Nonphenothiazines
Haloperidol Thiothixene HCL Pimozide
Nursing Considerations for Atypical Antipsychotics
Monitor WBC weekly for 6 months, biweekly thereafter Obtain baseline VS and ECG Change positions slowly Monitor for EPS and NMS Seroquel: Monitor Lipids, esp. for obese, diabetic or HTN clients
ADEs of Risperdal (atypical antipsychotic)
NMS, EPS, dizziness, GI symptoms
List Common Atypical Antipsychotic Drugs
Olanzapine Quetiapine Risperidone Aripiprazole Clozapine Ziprasidone
Indications for use of Atypical Antipsychotic Drugs
Treat positive and negative symptoms of schizophrenia w/o EPS For clients who have not had success with other antipsychotics Fewer Side Effects Clozapine: Good efficacy w/ clients who have been treatment resistant
ADES of Zyprexa
drowsiness, dizziness, EPS, agitation