Drug Name Generic Name: Clozapine Brand Name: Clozaril Classification: Dibenzapine derivative

Order 50 mg BID

Action Unknown. Binds selectively to dopaminergic receptors in CNS and may interfere with adrenergic, cholinergic, histaminergic, and serotonergic receptors.

Indication Schizophrenia in severely ill patient unresponsive to other theraphies; to reduce risk of recurrent suicidal behavior in schizophrenia or schizoeffective disorders

Adverse Effect CNS: drowsiness, sedation, dizziness, vertigo, headache, syncope, tremor, disturbed sleep or nightmare, restlessness, hypokinesia, akinesia, agitation, rigidity, akathisia,confusion, fatigue, insomnia, hyperkinesias, weakness, lethargy, ataxia, slyrred speech, depression, myoclonus, anxiety, fever, CV: tachycardia, hypotension, hypertension, chest pain, ECG changes, orthostatic hypotension EENTL: visual disturbances GI: constipation, excessive salivation, dry mouth, n/v,heartburn, diarrhea GU: urinary frequency, urine retention, incontinence abnormal ejaculation, Hematologci:eosinophilia, Metabolic: hyperglycemia, weight

Side Effect CNS: seizure CV: cardiomyopathy, myocarditis, pulmonary embolism, cardiac arrest. Hematologic: leucopenia, agranucytosis, granulocytopenia. Respiratory: respi arrest

Contraindication >Contraindicated in pt s with uncontrolled epilepsy history of clozapineinduced agranolucytosis, wbc count below 3500/mm3 severe cns depression or coma, paralytic ileus, and myelosuppressive d/o. >Also in patient taking other drugs that suppress bone marrow function. >Use cautiously in patients with prostatic hyperplasia or angle-closure glaucoma because drug has potent anticholinergic effect ts.

Nx Responsibility >for the first 6 months of theraphy, monitor patient weekly and dispense no moe than a 1-week supply of the drug. >tell patient about need for weekly blood tests to check for blood-cell deficiency. >Warn patient to avoid hazardous activities that require alertness and good coordination while taking drug. >Drug may cause hyperglycemia. Monitor patients with diabetes regularly. >tell pt about need for weekly blood test to check for bllod-

Musculoskeletal: muscle pain and weakness Skin: rash. sore throat. hypertriglyceridemia.gain. lethargy malaise. hypercholesterolimia. .fever. or other signs of infection.advice him to report flulike symptoms. diaphoresis cell deficiency.

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