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clozapine
Psychosis
| Term | Definition |
|---|---|
| clozapine Route | PO |
| clozapine Action | Drug blocks dopamine receptors, depressing reticular activating system Blocks serotonin and glutamate receptors Anticholinergic, antihistamine, and alpha-adrenergic blocking activity |
| clozapine Use | 1st line therapy for schizophrenia Severe schizophrenia that has not responded to standard meds Reduces risk of recurrent suicidal behavior in patients |
| clozapine Contraindications | History of clozapine-induced agranulocytosis CNS depression history seizure disorders Caution warranted: CVS disease, Narrow-angle glaucoma, DM, Pulmonary disease Pregnancy – especially the 1st trimester Immunosuppression Coma |
| clozapine Adverse Effects | Orthostatic hypotension, tachycardia, ECG changes, increased risk of myocarditis – greatest during 1st month of treatment At risk for MI, pericarditis, cardiomyopathy, mitral insufficiency, HF, pericardial effusion, decrease neutrophils |
| clozapine BBW | Increases the risk seizure activity as dose increases potential risk of fatal agranulocytosis risk of hyperglycemia |
| clozapine Adverse Effects | Severe neutropenia Body may become prone to infections Hyperglycemia and weight gain Extreme cases – ketoacidosis, hyperosmolar coma, death |
| clozapine RN Considerations | Prior to beginning – baseline WBC count and neutrophils Monitor blood glucose for hyperglycemia Gradual tapering over 2-wk period for discontinuation If discontinued abruptly – monitors for s/s acute psychosis Monitor : BP, Lungs , EKG, CBC, Eye ex. |
| clozapine teaching | weekly blood tests, wbc monitoring, 1 wk meds, no driving, no stoping, notify prescriber if increased HR or Preg,Report lethargy, weakness, or flulike symptoms |