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