Post by cherryltt on Sept 3, 2015 0:07:29 GMT
Zuclopenthixol Acetate
a) is the medication a typical / atypical antipsychotic?
Zuclopenthixol Acetate is a atypical antipsychotic.
b) common brand names
Clopixol,Acuphase
c) normal dose range
zuclopenthixol acetate injection (Acuphase)– contains medium-chain triglycerides: 50 mg/mL in 1– and 2–mL ampules
d) common side effects
CNS: NEUROLEPTIC MALIGNANT SYNDROME, dizziness, extrapyramidal symptoms, fatigue, sedation, tardive dyskinesia, weakness, syncope
EENT: abnormal vision accommodation
CV: THROMBOEMBOLISM, arrhythmias, hypotension, tachycardia
GI: constipation, dry mouth, diarrhea, thirst, vomiting
Derm: photosensitivity reactions, ↑ sweating
Endo: hyperprolactinemia, hyperglycemia,
GU: ↓ libido, abnormal urination
Hemat: anemia, granulocytopenia
Metabolic: weight change
MS: myalgia
* CAPITALS indicate life-threatening.
Italics indicate most frequent.
e) contraindications
Contraindicated in:
-Treatment of dementia;
-Narrow angle glaucoma;
-Pedi: Safe and effective use in children <18 yr has not been established and is not recommended.
Use Cautiously in:
-Impaired hepatic or renal function;
-Electrolyte abnormalites, including hypokalemia, hypomagnesemia, concurrent diuretic therapy or drugs affecting QT interval or cardiovascular disease/history (↑ risk of serious arrhythmias)
-Intestinal pathology or brain lesions (anti-emetic effect may mask symptoms)
-History of seizures ( may ↓ threshold)
-Parkinson's disease (may cause deterioration)
-Risk factors/history of stroke
-Abrupt discontinuation (should be tapered)
-Geri: Consider age-related decrease in renal, hepatic and cardiovascular function, concurrent disease states and drug therapies in patients >65 yr;
-OB: Infants exposed in the third trimester may exhibit extrapyramidal and withdrawal reactions including agitation, hyertonia, hypotonia, tremor, somnolence, respiratory distress and feeding disorders,
do not use in pregnancy unless expected benefit to the mother outweighs potential fetal risks;
-Lactation: Enters breast milk, safe use has not been established.
f) special monitoring / nursing care requirements
-Assess mental status (orientation, mood, behavior) before and periodically during therapy.
-Observe carefully when administering oral medication to ensure that medication is actually taken and not hoarded.
-Assess weight and BMI initially and throughout therapy.
-Assess fluid intake and bowel function. Increased bulk and fluids in the diet help minimize constipation.
-Monitor for onset of akathisia (restlessness or desire to keep moving) and extrapyramidal side effects
(parkinsonian– difficulty speaking or swallowing, loss of balance control, pill rolling, mask-like face, shuffling gait, rigidity, tremorsdystonic– muscle spasms, twisting motions, twitching, inability to move eyes, weakness of arms or legs)
every 2 mo during therapy and 8–12 wk after therapy has been discontinued. Reduction in dose or discontinuation of medication may be necessary.Benztropine or diphenhydramine may be used to control these symptoms.
-Monitor for tardive dyskinesia (uncontrolled rhythmic movement of mouth, face, and extremities; lip smacking or puckering; puffing of cheeks; uncontrolled chewing; rapid or worm-like movements of tongue). Report immediately; may be irreversible.
-Monitor for development of neuroleptic malignant syndrome (fever, respiratory distress, tachycardia, seizures, diaphoresis, arrhythmias, hypertension or hypotension, pallor, tiredness, severe muscle stiffness, loss of bladder control). Report immediately.
-Monitor for symptoms related to hyperprolactinemia (menstrual abnormalities, galactorrhea, sexual dysfunction).
Lab Test Considerations:
->Monitor CBC and liver function tests every 6 months and periodically as needed during treatment. May cause ↑ AST, ALT, and alkaline phosphatase.
->Monitor blood glucose prior to and periodically during therapy. May cause hyperglycemia.
->Monitor serum prolactin prior to and periodically during therapy. May cause ↑ serum prolactin levels.
g) education requirements for patients / families / carers
-Instruct patient to take as directed. If a dose is missed, omit and take next dose as scheduled. Discontinuation should be gradual.
-Inform patient of possibility of extrapyramidal symptoms and tardive dyskinesia. Caution patient to report these symptoms immediately to health care professional.
-Advise patient to change positions slowly to minimize orthostatic hypotension.
-Medication may cause drowsiness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known.
-Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications.
-Instruct patient to notify health care professional promptly if sore throat, fever, unusual bleeding or bruising, rash, weakness, tremors, visual disturbances, dark-colored urine, or clay-colored stools occur.
-Instruct patient to avoid sun exposure and to wear protective clothing and sunscreen when outdoors.
-Advise patient to notify health care professional of medication regimen before treatment or surgery.
-Advise female patients to notify health care professional if pregnancy is planned or suspected or if breastfeeding or planning to breastfeed.
Reference: Davis's Drug Guide
www.drugguide.com/ddo/view/Davis-Drug-Guide/109856/all/zuclopenthixol
Havard's Nursing Guide To Drug(7th edition)
a) is the medication a typical / atypical antipsychotic?
Zuclopenthixol Acetate is a atypical antipsychotic.
b) common brand names
Clopixol,Acuphase
c) normal dose range
zuclopenthixol acetate injection (Acuphase)– contains medium-chain triglycerides: 50 mg/mL in 1– and 2–mL ampules
d) common side effects
CNS: NEUROLEPTIC MALIGNANT SYNDROME, dizziness, extrapyramidal symptoms, fatigue, sedation, tardive dyskinesia, weakness, syncope
EENT: abnormal vision accommodation
CV: THROMBOEMBOLISM, arrhythmias, hypotension, tachycardia
GI: constipation, dry mouth, diarrhea, thirst, vomiting
Derm: photosensitivity reactions, ↑ sweating
Endo: hyperprolactinemia, hyperglycemia,
GU: ↓ libido, abnormal urination
Hemat: anemia, granulocytopenia
Metabolic: weight change
MS: myalgia
* CAPITALS indicate life-threatening.
Italics indicate most frequent.
e) contraindications
Contraindicated in:
-Treatment of dementia;
-Narrow angle glaucoma;
-Pedi: Safe and effective use in children <18 yr has not been established and is not recommended.
Use Cautiously in:
-Impaired hepatic or renal function;
-Electrolyte abnormalites, including hypokalemia, hypomagnesemia, concurrent diuretic therapy or drugs affecting QT interval or cardiovascular disease/history (↑ risk of serious arrhythmias)
-Intestinal pathology or brain lesions (anti-emetic effect may mask symptoms)
-History of seizures ( may ↓ threshold)
-Parkinson's disease (may cause deterioration)
-Risk factors/history of stroke
-Abrupt discontinuation (should be tapered)
-Geri: Consider age-related decrease in renal, hepatic and cardiovascular function, concurrent disease states and drug therapies in patients >65 yr;
-OB: Infants exposed in the third trimester may exhibit extrapyramidal and withdrawal reactions including agitation, hyertonia, hypotonia, tremor, somnolence, respiratory distress and feeding disorders,
do not use in pregnancy unless expected benefit to the mother outweighs potential fetal risks;
-Lactation: Enters breast milk, safe use has not been established.
f) special monitoring / nursing care requirements
-Assess mental status (orientation, mood, behavior) before and periodically during therapy.
-Observe carefully when administering oral medication to ensure that medication is actually taken and not hoarded.
-Assess weight and BMI initially and throughout therapy.
-Assess fluid intake and bowel function. Increased bulk and fluids in the diet help minimize constipation.
-Monitor for onset of akathisia (restlessness or desire to keep moving) and extrapyramidal side effects
(parkinsonian– difficulty speaking or swallowing, loss of balance control, pill rolling, mask-like face, shuffling gait, rigidity, tremorsdystonic– muscle spasms, twisting motions, twitching, inability to move eyes, weakness of arms or legs)
every 2 mo during therapy and 8–12 wk after therapy has been discontinued. Reduction in dose or discontinuation of medication may be necessary.Benztropine or diphenhydramine may be used to control these symptoms.
-Monitor for tardive dyskinesia (uncontrolled rhythmic movement of mouth, face, and extremities; lip smacking or puckering; puffing of cheeks; uncontrolled chewing; rapid or worm-like movements of tongue). Report immediately; may be irreversible.
-Monitor for development of neuroleptic malignant syndrome (fever, respiratory distress, tachycardia, seizures, diaphoresis, arrhythmias, hypertension or hypotension, pallor, tiredness, severe muscle stiffness, loss of bladder control). Report immediately.
-Monitor for symptoms related to hyperprolactinemia (menstrual abnormalities, galactorrhea, sexual dysfunction).
Lab Test Considerations:
->Monitor CBC and liver function tests every 6 months and periodically as needed during treatment. May cause ↑ AST, ALT, and alkaline phosphatase.
->Monitor blood glucose prior to and periodically during therapy. May cause hyperglycemia.
->Monitor serum prolactin prior to and periodically during therapy. May cause ↑ serum prolactin levels.
g) education requirements for patients / families / carers
-Instruct patient to take as directed. If a dose is missed, omit and take next dose as scheduled. Discontinuation should be gradual.
-Inform patient of possibility of extrapyramidal symptoms and tardive dyskinesia. Caution patient to report these symptoms immediately to health care professional.
-Advise patient to change positions slowly to minimize orthostatic hypotension.
-Medication may cause drowsiness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known.
-Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications.
-Instruct patient to notify health care professional promptly if sore throat, fever, unusual bleeding or bruising, rash, weakness, tremors, visual disturbances, dark-colored urine, or clay-colored stools occur.
-Instruct patient to avoid sun exposure and to wear protective clothing and sunscreen when outdoors.
-Advise patient to notify health care professional of medication regimen before treatment or surgery.
-Advise female patients to notify health care professional if pregnancy is planned or suspected or if breastfeeding or planning to breastfeed.
Reference: Davis's Drug Guide
www.drugguide.com/ddo/view/Davis-Drug-Guide/109856/all/zuclopenthixol
Havard's Nursing Guide To Drug(7th edition)