Risperdone and Lithium Carbonate
Risperdone and Lithium Carbonate
Risperdone and Lithium Carbonate
COLLEGE OF NURSING
DRUG STUDY
Generic / Brand Name Dosage, Timing, & Indication/ Pharmacodynamics Side Effects/ Adverse Reaction Nursing Responsibilities
& Classification (5%) Duration (5%) of Drug (20%) / Contraindication (10%) (Nursing Process Approach) Patient Teaching (20%)
(40%)
Obtain baseline BP Warn patient to avoid
Generic Name: Drug form & Indications: Side Effects / Adverse measurements before activities that require
Dosage Ordered: Schizophrenia Reaction: starting therapy, and alertness until effects
resperidone Parenteral maintenance headache, insomnia, agitation, monitor BP regularly. of drug are known.
therapy for schizophrenia anxiety, pain, parkinsonism, Watch for orthostatic Caution patient or
or bipolar I disorder (as dizziness, fever, hallucination, hypotension, especially caregiver of patient
monotherapy or as mania, impaired concentration, during first dosage taking an opioid with
combination therapy with abnormal thinking and adjustment. a benzodiazepine,
Brand Name: dreaming, tremor, hypoesthesia, Monitor patient for CNS depressant, or
Timing: lithium or valproate)
Monotherapy or fatigue, depression, nervousness, tardive dyskinesia, alcohol to seek
Risperdal combination therapy with tachycardia, chest pain, which may occur after immediate medical
lithium or valproate for 3- orthostatic hypotension, prolonged use. It may attention for
week treatment of acute peripheral edema, syncope, not appear until months dizziness, light-
Duration: manic or mixed episodes HTN, rhinitis, sinusitis, or years later and may headedness, extreme
from bipolar I disorder pharyngitis, abnormal vision, disappear spontaneously sleepiness, slowed or
Classification Name: Irritability, including weight gain or loss, or persist for life, despite difficult breathing, or
aggression, self-injury, hyperglycemia, arthralgia, back stopping drug. unresponsiveness.
Therapeutic class: Other drug forms: and temper tantrums, pain, leg pain, myalgia, dyspnea, Life-threatening Warn patient to rise
Antipsychotics associated with an autistic dry skin, photosensitivity hyperglycemia may slowly, and use other
Pharmacologic class: Injection disorder reactions, toothache, injury. occur in patients taking precautions to avoid
Benzisoxazole Oral Solution atypical antipsychotics. fainting when starting
Tablets Pharmacodynamics: Contraindication: Monitor patients with therapy.
derivatives
Tablets (ODTs) Blocks dopamine, 5-HT2, alpha1 >Contraindicated in patients diabetes regularly. Advise patient that
and alpha2 adrenergic, and H1 hypersensitive to drug. Monitor patient for drug may increase
histaminergic receptors in the >Opioids should only be symptoms of metabolic fall risk due to
brain. prescribed with benzodiazepines syndrome (significant somnolence,
or other CNS depressants to weight gain and orthostatic
patients for whom alternative increased BMI, HTN, hypotension, and
treatment options are inadequate. hyperglycemia, motor and sensory
hypercholesterolemia, instability.
and Advise patient to use
hypertriglyceridemia). caution in hot
Patients experiencing weather to prevent
persistent somnolence heatstroke.
may benefit from Tell patient to take
administering half the drug with or without
daily PO dose b.i.d. food.
Monitor patient for Instruct patient to
weight gain. keep the ODT in the
Complete fall risk blister pack until just
assessments when before taking it. After
initiating treatment and opening the pack,
recurrently for patients patient should
on long-term therapy, dissolve the tablet on
especially for elderly the tongue without
patients and patients cutting or chewing.
with diseases, Tell patient to use dry
conditions, or who are hands to peel apart
taking other drugs that the foil to expose the
could increase fall risk. tablet. Patient
shouldn't attempt to
push tablet through
the foil.
Advise female patient
not to become
pregnant or to
breastfeed for 12
weeks after final IM
injection.
Advise patient to
avoid alcohol during
therapy.
______________________________________________ ______________________________________________
Printed Name and Signature Printed Name and Signature
Clinical Instructor Student
DRUG STUDY
Generic / Brand Name Dosage, Timing, & Indication/ Pharmacodynamics Side Effects/ Adverse Reaction Nursing Responsibilities
& Classification (5%) Duration (5%) of Drug (20%) / Contraindication (10%) (Nursing Process Approach) Patient Teaching (20%)
(40%)
Monitor patient and Tell patient to take
Generic Name: Drug form & Indications: Side Effects / Adverse discontinue drug for drug with plenty of
Dosage Ordered: Acute mania in bipolar Reaction: signs and symptoms of water and after meals
lithium carbonate disorder fatigue, lethargy, coma, seizures, lithium toxicity (ataxia, to minimize GI upset.
Long-term control in tremors, drowsiness, headache, drowsiness, weakness, Explain the
bipolar disorder confusion, restlessness, tremor, vomiting). When importance of having
dizziness, psychomotor drug level is less than 1.5 regular blood tests to
retardation, blackouts, EEG mEq/L, adverse determine drug levels
Brand Name: changes, worsened organic reactions are usually and to monitor
Timing:
mental syndrome, impaired mild. therapy; even slightly
Carbolith, Lithane, speech, ataxia, incoordination. Monitor baseline ECG, high values can be
Lithobid arrhythmias, bradycardia, thyroid studies, renal dangerous.
reversible ECG changes, severe studies, and electrolyte Warn patient and
Duration: bradycardia, hypotension, levels. caregivers to expect
blurred vision, exophthalmos, Check fluid intake and transient nausea,
nystagmus, tinnitus, vomiting, output, especially when large amounts of
Classification Name: anorexia, diarrhea, thirst, nausea, surgery is scheduled. urine, thirst, and
Other drug forms: Pharmacodynamics: metallic taste, dry mouth, Weigh patient daily; discomfort during
Probably alters chemical abdominal pain, flatulence, check for edema or first few days and to
Therapeutic class:
Antimanics Capsules transmitters in the CNS, possibly indigestion, polyuria, renal sudden weight gain. watch for evidence of
Tablets by interfering with ionic pump toxicity with long-term use, Adjust fluid and salt toxicity.
Pharmacologic class:
Tablets (extended mechanisms in brain cells, and glycosuria, decreased ingestion to compensate Instruct patient to
Alkali metals CrCl,albuminuria, urinary
release) may compete with or replace if excessive loss occurs withhold one dose
sodium ions. incontinence, erectile from protracted and call prescriber
dysfunction, leukocytosis, diaphoresis or diarrhea. immediately if signs
transient hyperglycemia, goiter, Under normal and symptoms of
hypothyroidism, hyponatremia., conditions, fluid intake toxicity appear, but
muscle weakness. Skin: pruritus, should be 2½ to 3 L not to stop drug
rash, diminished or absent daily, and patient should abruptly.
sensation, drying and thinning of follow a balanced diet Warn patient to avoid
hair, psoriasis, acne, alopecia, with adequate salt intake. hazardous activities
ankle and Check urine specific that require alertness
wrist edema. gravity and report level and good
below 1.005, which may psychomotor
Contraindication: indicate diabetes coordination until
> Contraindicated if therapy insipidus. CNS effects are
can't be closely monitored. Drug alters glucose known.
>Use extreme caution in patients tolerance in diabetic Tell patient not to
receiving neuromuscular patients. Monitor switch brands or take
blockers and diuretics; in elderly glucose level closely. other prescription or
or debilitated patients; and in Palpate thyroid to check OTC drugs without
patients with thyroid disease, for enlargement. Monitor prescriber's guidance.
seizure disorder, infection, renal weight before and during Advise patient to
or CV disease, severe therapy immediately seek
debilitation or dehydration, or emergency assistance
sodium depletion. if fainting,
>Patients with Brugada lightheadedness,
syndrome (abnormal ECG with abnormal heartbeat,
increased risk of sudden death) or shortness of breath
or with risk factors for this occurs because these
condition shouldn't take lithium. signs and symptoms
are associated with a
potentially life-
threatening heart
disorder known as
Brugada syndrome.
Tell patient to wear
or carry medical
identification at all
times.
______________________________________________ ______________________________________________
Printed Name and Signature Printed Name and Signature
Clinical Instructor Student