Dosage, Frequency, Mechanism of Action

Name of Drug Route, Timing Indication Contraindication Adverse Effect Nursing Responsibilities

Nursing Considerations
Generic Name Dosage: Selectively blocks serotonin and To manage psychotic disorders Hypersensitivity to risperidone, CNS: Abnormal coordination, • Use risperidone cautiously in debilitated
Risperidone dopamine receptors in the paliperidone, or its components aggressiveness, patients, elderly patients, and patients with
mesocortical agitation, akathisia, anxiety, hepatic or renal dysfunction or hypotension
Frequency:
tract of the asthenia, confusion, decreased because of their increased
Brand Names sensitivity to the drug. Also use
concentration, depression,
Consta Route: dizziness, risperidone cautiously in patients with a
dream disturbances, drooling, history of seizures; although rare, seizures
Classification Timing: drowsiness, may occur in those with schizophrenia.
Antipsychotic dyskinesia, dystonia, fatigue, fever, warning Be aware that risperidone
headache, hypothermia, insomnia, should not be used to treat elderly
lassitude, malaise, mania, memory patients with dementia-related psychosis
loss, because it increases risk of death in these
nervousness, neuroleptic malignant patients.
syndrome, paresthesia, • Be aware that oral risperidone or another
Parkinsonism, antipsychotic should be continued for 3
restlessness, seizures, shaking of weeks after long-acting I.M. form of
head risperidone is first administered to
repeatedly, somnolence, tardive provide an adequate therapeutic plasma
dyskinesia, tremor, vertigo level until risperidone release from
CV: Atrial fibrillation, bradycardia, injection site has begun. If the patient has
bundle never received oral risperidone, an oral
branch block, cardiopulmonary trial should be prescribed before use of
arrest, chest I.M. form to determine patient’s tolerance
pain, elevated triglyceride levels, of the drug.
firstdegree • Remove I.M. form from refrigerator and
AV block, hypercholesterolemia, allow it to come to room temperature
orthostatic hypotension, before reconstitution. Follow manufacturer’s
palpitations, guidelines for reconstitution, using
QT-interval prolongation, only the diluent supplied in the dose pack.
tachycardia • Give I.M. form using only the needle
EENT: Conjunctivitis, decreased or supplied in the dose pack. Inject entire
increased salivation, dry mouth, ear contents of syringe into the upper outer
pain, quadrant of gluteal area within 2 minutes
epistaxis, nasal congestion, of reconstitution. If drug can’t be given
pharyngitis, right after reconstitution, shake the
retinal artery occlusion, rhinitis, upright vial vigorously back and forth
sinusitis, until particles are resuspended. Discard
taste alteration, vision changes reconstituted drug if not used within
ENDO: Diabetic ketoacidosis 6 hours. Never administer I.M. form
(patients with intravenously.
diabetes), elevated prolactin level, • Monitor for orthostatic hypotension,
galactorrhea, hyperglycemia, especially in patients with cardiac or
hyperprolactinemia, cerebrovascular disease.
hypoglycemia, inappropriate warning Immediately notify prescriber
antidiuretic hormone secretion and expect to stop giving risperidone if
 (SIADH), patient shows evidence of neuroleptic
pituitary adenoma, precocious malignant syndrome (altered mental
puberty status, autonomic instability, hyperpyrexia,
GI: Abdominal pain, anorexia, muscle rigidity), which can be fatal.
constipation, • Monitor patient’s blood glucose and lipid
diarrhea, gastritis, ileus, indigestion, levels as ordered because drug increases
intestinal obstruction, jaundice, the risk of hyperglycemia and hypercholesterolemia.
nausea, • Monitor patient’s CBC, as ordered,
pancreatitis, vomiting because serious adverse hematologic
GU: Amenorrhea, decreased libido, reactions may occur, such as agranulocytosis,
delayed leukopenia, or neutropenia. More
ejaculation, dysmenorrhea, dysuria, frequent monitoring during the first few
glucosuria, hypermenorrhea, months of risperidone therapy is
incontinence, recommended for patients with a history
increased appetite, polyuria, of drug-induced leukopenia or
priapism, neutropenia, or those who have had a
sexual dysfunction, urinary significantly low WBC count in the past.
incontinence or If abnormalities occur during therapy,
retention, UTI monitor patient for fever or other signs of
HEME: Agranulocytosis, anemia, infection, notify prescriber, and expect
leukopenia, drug to be discontinued if severe.
neutropenia, thrombocytopenia patient teaching
MS: Arthralgia; back, buttock, or • Instruct patient to dilute risperidone oral
neck pain; solution with water, coffee, orange juice,
dysarthria; muscle weakness; or low-fat milk, but not with cola or tea.
myalgia • Tell patient prescribed orally disintegrating
RESP: Cough, dyspnea, pulmonary tablets to break open the blister unit with
embolism, sleep apnea, upper dry hands by peeling the foil back to
respiratory expose the tablet. Emphasize the
tract infection importance of not pushing tablet through
SKIN: Alopecia, diaphoresis, dry the foil because this could damage the
skin, tablet. Once patient has removed tablet,
eczema, hyperpigmentation, she should place immediately on her
photosensitivity, tongue, where it will dissolve within
pruritus, rash, seborrhea seconds. Tell patient not to chew orally
Other: Anaphylaxis; angioedema; disintegrating tablet or attempt to spit it
infections; influenza; injection-site out of her mouth.
induration, pain, redness, or • Urge patient to avoid alcohol because of its
swelling; additive CNS effects.
weight gain or loss • Caution diabetic patient to monitor blood
glucose level closely because risperidone
may increase it.

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