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clozapine

Psychosis

TermDefinition
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
Created by: amandalw98
 

 



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