Exam (elaborations)
Clozaril (clozapine)
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Clozaril (clozapine)
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Clozaril (clozapine)Dose range - ANS-PO: initial dose: 12.5 mg 1-2 times a day
Target dose: 150-500 mg/day
Do not exceed 900 mg/day
Drug classification - ANS--- atypical antipsychotic
Evaluation of medication effectiveness - ANS-- decreased positive symptoms (delusions,
hallucinations) of schizophrenia
- decreased negative symptoms (social withdrawal,
flat, blunted affect) of schizophrenia
Medication/Food interactions - ANS-- increased anticholinergic effect of other drugs
- oral contraceptives and caffeine may increase effect
- increased CNS depression with alcohol, anti-
depressants, antihistamines, opioids, sedative
hypnotics
- using with Lithium increases adverse CNS reactions
including seizures
- no St. John's Wort
Nursing administration (concerns) - ANS-- monitor WBCs and ANC (absolute neutrophil count)
- assess fasting blood glucose
- lowers seizure threshold
- assess respiratory status
- need baseline WBC, and then every 1 week during
treatment and for 4 weeks after
- agranulocytosis can occur 18-24 weeks after initiation
of therapy
Nursing interventions/Client education - ANS-- inform patient /monitor for extrapyramidal
symptoms
- cigarette smoking may decrease clozapine levels
- avoid alcohol and CNS depressants
- notify MD if unexplained palpitations, tachypnea,
chest pain, sore throat, flu-like symptoms
- Notify MD if pregnant or breastfeeding
Pharmacological action - ANS-- binds to dopamine receptors in the CNS
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