SEROQUEL

1. Name & class of drug – generic and trade name.

GENERIC NAME: Quetiapine Fumarate

BRAND NAME: Seroquel
CLASSIFICATION: CNS agent, psychotherapeutic, atypical, antipsychotic

2. Dose range and routes for adult & geriatric client.

PREPARATIONS: PO – (25, 100, 200) mg tablets

DOSING: Psychosis – initiate with 25 mg bid, may increase by 25 – 50 mg bid to tid on the second or third day as tolerated to
a target dose of 300 – 400 mg/d divided by bid to tid, may adjust dose by 25 – 50 mg bid qd as needed (max. 800 mg/d)
Agitation/Dementia – initiate with 25 mg bid, may increase by 25 – 50 mg bid, q 2-7 if needed, (max 200 mg/d)

3. Purpose prescribed. Underline reason your client is prescribed drug.

THERAPEUTIC EFFECTS: indicated by a reduction in psychotic behaviour

USES: management of psychotic disorders, management of agitation and dementia

4. Major side effects & drug interactions.

DRUG INTERACTIONS: Barbiturates, carbamazepine, phenytoin, rifampin, thioridazine may increase clearance of seroquel.
• Seroquel may potentiate the cognitive and motor effects of alcohold, enhance the effect of antihypertensive agents,
antagonize the effects of levodopa and dopamine agonists.
• Ketoconazole, itraconazole, fluconazole, erythromycin may decrease clearance of seroquel

HERBAL INTERACTIONS: St. John’s Wort may cause serotonin syndrome

SIDE EFFECTS: dizziness, headache, somnolence, asthenia, fever, hypertonia, dysarthria, flu syndrome, weight gain,
peripheral edema
5. Nursing Implications & teaching.

IMPLICATIONS:
• Reassess need for continued Tx periodically
• Withhold med and immediately report S & S of tardive dyskinesia or neuroleptic malignant syndrome
• Lab tests – periodically monitor liver function, lipid profile, thyroid function, blood glucose, CBC with differential
• Monitor ECG periodically, especially in those with known cardio vascular disease
• Perform baseline cataract exam when therapy is started and at 6-mo intervals thereafter
• Monitor pts with a history of seizures for lowering of the seizure threshold

TEACHING:
• Exercise caution with potentially dangerous activities requiring alertness, especially during the first week of drug
therapy or during dose increments
• Make position changes slowly, especially when changing from lying or sitting to standing to avoid dizziness,
palpitations, and fainting
• Avoid alcohol consumption and activities that may cause overheating and dehydration
• Inform Dr immediately if you become pregnant