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aripiprazole

( a-rip-ip-pra,zol )
Abilify

schizophrenia, agitation, bipolar disorder, INTERACTIONS


Pharmacologic class: antipsychot- mania. alcohol: increased sedation. carba-
ic/neuroleptic. Therapeutic class: Data not mazepine: decreased effects of arip-
provided. Pregnancy risk category: C. iprazole. erythromycin, fluoxetine, ke-
INDICATIONS & DOSAGE
toconazole, quinidine, paroxetine: in-
PO adult.: 10-15mg/day, prn dosage may creased effects of aripiprazole, reduce
HOW SUPPLIED be increased to 30 mg/day, after 2wk; dose. famotidine, valproate: decreased
tabs: 2, 5, 10, 15, 20, 30mg. maintenance 15mg/day, periodically re- aripiprazole level. lithium: increased
inj: 9.75mg/1.3ml. assess. EPS. antipsychotics: increased EPS.
orally disintegrated tab: 10, 15mg. IM adult.: 9.75mg as a single dose, may
oral sol: 1mg/ml. CNS depressants: increased sedation.
start with a lower dose. CYP3A4/CYP2D6 inhibitors: increased
bipolar PO adult.: 30mg/day, may reduce
effects of aripiprazole, increase dose.
to 15mg PRN.
PHARMACOKINETICS CYP3A4/CYP2D6 inhibitors: increased
Absorption: unknown. Distribution: pro- effects of aripiprazole, increase dose. be-
tein binding 90%. Metabolism: liver, ex- ADVERSE REACTIONS tel palm, kava: increased EPS. cola tree,
tensively to major active metabolism. Ex- CNS: SEIZURES, NEUROLEPTIC MA- hops, nettle, nutmeg: increased neurolep-
cretion: unknown. LIGNANT SYNDROME, drowsiness, in- tic effect.
somnia, agitation, anxiety, headache, light- CONTRAINDICATIONS & PRECAU-
Route Onset Peak Duration
unknown unknown unknown unknown
headedness, akathisia, asthenia, tremor, TIONS
STROKE, SUICIDAL IDEATION. CV:
■ hypersensitivity, breastfeeding, seizure
TACHYCARDIA, orthostatic hypoten-
sion. EENT: blurred vision, rhinitis. GI: disorders.
■ children, geriatric, renal/cardiac/hepatic
PHARMACODYNAMICS nausea, constipation, vomiting, jaundice,
disease.
decreased excitement, hallucinations, weight gain. SKIN: rash. RESPIRATO-
delusions, paranoia, reoganization of RY: cough.
patterns of thought, speech. Used for
Nursing Diagnosis
Evaluation
■ Knowledge, deficient (teaching).
■ Noncompliance (teaching).
■ Decreased in emotional excitement, hal-
■ Sensory perception, disturbed (uses). lucinations, delusions, paranoia, reorgani-
Assessment
■ Thought processes, disturbed (uses). zation of patterns of thought and speech.
■ Assess mental status before initial ad-
Planning & Implementation
ministration. Check for swallowing of
PO meds, check for hoarding or giv- ■ Administer reduced dose in geriatric.
ing of med to other pts. Monitor I&O ra- Decreased stimulus by dimming lights,
tion, palpate bladder if urinary output is avoiding loud noises. Supervise ambula-
low. Monitor bilirubin, CBC, liver func- tion until patient is stabilized on meds. do
tion tests qmo. Assess affect, orientation, not involve in strenous exercise program
LOC, reflexes, gait, coordination, sleep because fainting is possible, pt should not
pattern disturbances. Monitor BP stand- stand still for a long time. store in tight,
ing and lying, also pulse, respirations, light resistant container.
take q4hr during initial treatment, estab-
lish baseline before starting treatment, re- Patient Teaching
port drops of 30mmHg, watch for ECG
changes. Assess for dizzines, faintness, ■ Advise pt that orthostatic hypotension
palps, tachy on rising. Assess for EPS, in- may occur and to rise from sitting or ly-
cluding akathisia(inability to sit still, no ing position gradually. Avoid hot tubs, hot
patten to movements), tardive dyskine- showers, tub baths, hypotension may ocur.
sia (bizarre movements of the jaw, mouth, Avoid abrupt withdrawal of this product,
tongue, extremities), pseudoparkinsonism EPS may result, product should be with-
(rigidity, tremors, pill rolling, shuffling drawn slowly. Avoid OTC meds unless ap-
gait). Assess for neuroleptic malignant proved by MD because serious product in-
syndrome, hyperthermia, increased CPK, teractions may occur, avoid use with alco-
altered mental status, muscle rigidity. As- hol, CNS depressants, increased drowsi-
sess skin turgor daily. Assess for constipa- ness amy occur. Avoid hazardous activities
tion, urinary retention daily, if these occur, if drowsy or dizzy. Explain importance of
increase bulk and water in diet. compliance with product regimen. Report
impaired vision, tremors, muscle twitch-
ing, urinary retention. Take extra precau-
tions to stay cool in hot weather, that heat
stroke may occur.