DRUGS

General Considerations It is important to understand that after your manic symptoms abate, you will need to continue taking your medication to prevent relapse. If you miss a dose, take as soon as possible, within 2-3 hours of the scheduled dosing. If it is close to your next scheduled dose, skip the missed dose and continue on your regular dosing schedule, but do not take double doses. Take it after meals or with food to decrease stomach upset. Drink plenty of water or liquid to prevent dehydration, especially from prolonged exposure to hot weather. Contact your physician if you have fever or diarrhea.

Indication

Mechanism of Action Blocks dopamine and 5-HT2 receptors in the brain.

Generic name: risperidone Brand name: Risperdal, Risperdal Consta

Monotherapy or combination therapy with lithium or valproate for 3week treatment of acute manic or mixed episodes from bipolar disorder. - 12-week parental therapy for schizophrenia. - Irritability, including aggression, selfinjury, and tantrums, associated with an autistic disorder. - Tourette Syndrome - ObsessiveCompulsive disorder

Chemical classes of Drugs Anti-psychotic

Administration/ Usual dose Adults: Initial dosing is generally 2mg PO daily. - Adolescents ages 13 to 17: Start treatment with 0.5 mg PO once daily, given as a single daily dose in the morning or evening. Administration: PO - Give drug without regard for meals. - Open package for orally disintegrating tablets immediately before giving be peeling off foil backing with dry hands. Dont push tablets through the foil. IM - Continue oral therapy for the first 3 weeks of IM injection therapy until injections take effect, then stop oral therapy. - To reconstitute IM injection, inject premeasured diluent into vial and shake vigorously for at least 10 seconds. - Refrigerate IM injection kit and protect it from light.

Contraindication

Contraindicated in patients hypersensitive to drug and in breast-feeding women. Use cautiously in patients with prolonged QT interval, CV disease, cerebrovascular disease, dehaydration, hypovolemia, history of seizures, or conditions that could affect metabolism or hemodynamic responses. Use cautiously in patients exposed to extreme heat. Use caution in patients at risk for aspiration pneumonia.

Side Effects and Nursing Interventions with Collaborative Nursing Considerations Monitor patient for tardive dyskinesia, which may occur after prolonged use. It may not appear until months or years later and may disappear spontaneously or persist for life, despite stopping drug. Life-threatening hyperglycemia may occur in patients taking atypical antipsychotics. Monitor patients with diabetes regularly. Periodically reevaluate drugs risks and benefits, especially during prolonged use. Monitor patient for weight gain. Side Effects CNS: akathisia, somnolence, dystonia, headache, insomnia, agitation, anxiety, pain, parkinsonism, neuroleptic malignant syndrome, suicide attempt, dizziness, fever, hallucination, mania, impaired concentration. CV: tachycardia, chest pain, orthostatic hypotension, peripheral edema, syncope, hypertension. EENT: rhinitis, sinusitis, pharyngitis, abnormal vision, ear

Use IM injection cautiously in those with hepatic or renal impairment.

disorder. GI: constipation, nausea, vomiting, dyspepsia, abdominal pain.