DRUG STUDY

Name of the Patient : _______Sabrina _____________ Age : __26 y.o____ Sex : __Female__ Name of Student _________Sanguyo, Camille B. ____
Civil Status : _____ Single________Religion : _____ N/A_____ Rm/Bed No. _________________ Area : ____NCMH ___________ Level/ Block : _Level III-B______
Address : _____________________ N/A ______________________ Date Submitted : ________March 08, 2022_______________
Date of Admission : _____________________________ Diagnosis : Factitious Disorder (FD) Rating : ___________________________________________________

MEDICATION Classification/ Action Indications Contraindications Side Effects Adverse Effects Nursing Responsibilities

Generic Name:
Zuclopenthixol Decanoate
Brand Name:
---
Usual Dosage/Frequency:
150 - 300 mg every two to
four weeks
Usual Route:
Intramuscular (IM)
Drug Order:
Zuclopenthixol Decanoate 200
mg weekly injection
Drug Interactions:
Pharmacotherapeutic class:
Thioxanthenes
Clinical class:
Typical Antipsychotic
Action:
Has high affinity for
dopamine D1 and D2
receptors, 1–adrenergic and
5–HT2 receptors.
Dopaminergic blockade
produces neuroleptic activity.
Therapeutic effect:
Decreases psychoses due to
schizophrenia
Pharmacokinetics:
Initial treatment This drug is contraindicated CNS:  Neuroleptic Malignant Before:
and maintenance to patients with:  Dizziness Syndrome
management of acute  Extrapyramidal  Thromboembolism  Verify the doctor’s order
psychotic episodes or  Treatment of dementia symptoms regarding the medication.
exacerbation of  Observe the ten rights of
 Fatigue
psychosis due to  Narrow-angle medication administration.
glaucoma  Sedation
schizophrenia  Assess behavior, appearance,
 Tardive dyskinesia
emotional status, response to
 Weakness environment, speech pattern,
Use cautiously in:  Syncope
thought content.
 Hepatic or renal EENT:  Assess for suicidal tendencies,
impairment especially during early therapy.
 Abnormal vision
Restrict amount of drug available
accommodation
 Electrolyte to patient.
abnormalities, including CV:  Assess weight and BMI initially
hypokalemia, and throughout therapy.
 Arrhythmias
hypomagnesemia  Assess fluid intake and bowel
 Hypotension
function. Increased bulk and
 Concurrent diuretic  Tachycardia fluids in the diet help minimize
therapy or drugs constipation.
affecting QT interval or GI:  Obtain serum potassium, LFT,
cardiovascular disease  Constipation CBC and renal function tests.
and history (increases  Dry mouth  Question for history of allergies
risk of serious  Diarrhea and full medication history;
 Increased risk of CNS Absorption: arrhythmias)  Thirst screen for interactions.
depression with other Slowly absorbed from IM  Vomiting  Educate and verify patient and
CNS depressants sites  Intestinal pathology or SO’s understanding about the
including alcohol, some brain lesions (anti- Derm: medication.
antihistamines, some Distribution: emetic effect may  Photosensitivity  Check the medication three
antidepressants, Enters breast milk mask symptoms) reactions times.
anxiolytics, barbiturates,  Increased sweating  Obtain baseline vital signs.
 History of seizures
benzodiazepines, and Protein binding: Unknown  Obtain baseline I&O.
(may decrease
sedative/hypnotics. Endo:
Metabolism: threshold) During:
 Hyperprolactinemia
 Increases levels and risk Mostly metabolized
(partially by the CYP2D6  Parkinson’s disease  Hyperglycemia
of toxicity with CYP2D6  Maintain patient’s comfort and
enzyme system), metabolites (may cause
inhibitors. GU: safety.
do not have antipsychotic deterioration)
 Decreased libido  Administer the drug:
 Concurrent use of activity  Risk factors/history of  Abnormal urination Zuclopenthixol Decanoate 200
diuretics, lithium, Class Ia stroke mg weekly injection, as ordered
and III antiarrhythmics Elimination: Hemat: by the physician.
including amiodarone, Minimal amounts excreted  Abrupt discontinuation  Anemia  Administer deep in large muscle.
sotalol, and quinidine; unchanged in urine (should be tapered) A test dose may be ordered for
 Granulocytopenia
some antipsychotics first administration.
Half-life:
including thioridazine, Metab:
Unknown After:
some macrolides  Weight change
including erythromycin; Pharmacodynamics:
and some Onset: within 3 days  Assess for hypersensitivity
MS:
fluoroquinolones reaction (chills, fever).
Peak: 3-7 days  Myalgia
including moxifloxacin Duration: 2-4 weeks  Monitor CBC, LFT, hepatic
increases risk of QT enzyme levels, etc.
interval prolongation and  Monitor for onset of akathisia
serious arrhythmias; (restlessness or desire to keep
concurrent use should be moving) and extrapyramidal side
avoided. effects. Reduction in dose or
discontinuation of medication
 Increased risk of may be necessary.
anticholinergic adverse  Monitor for tardive dyskinesia
reactions with other (uncontrolled rhythmic movement
anticholingeric drugs. of mouth, face, and extremities;
lip smacking or puckering; puffing
 Increases risk of of cheeks; uncontrolled chewing;
hypotension with rapid or worm-like movements of
 antihypertensives and tongue). Report immediately;
diuretics. may be irreversible.
 Monitor for development of
 Concurrent use with neuroleptic malignant syndrome
tricyclic antidepressants (fever, respiratory distress,
may result in altered tachycardia, seizures,
metabolism and effects diaphoresis, arrhythmias,
of both. hypertension or hypotension,
pallor, tiredness, severe muscle
 Increased risk of stiffness, loss of bladder control).
extrapyramidal symptoms Report immediately.
with metoclopramide.  Monitor for symptoms related to
hyperprolactinemia (menstrual
 May decrease beneficial
abnormalities, galactorrhea,
effects of levodopa and
sexual dysfunction).
dopamine agonists.
 Monitor for side/adverse effects.
 Evaluate the drug’s desired
therapeutic effect: decreased
symptoms of schizophrenia
(delusions, hallucinations, social
withdrawal, flat, blunt affect).
 Document medication
administration properly as per
institution’s protocol.

Patient/Family Teaching:

 Instruct patient to take

medication as directed, even if
feeling better. Doses should be
taken at the same time each day.
Take missed doses as soon as
remembered, but not if almost
time for next dose. Do not double
dose.
 May cause drowsiness. Caution
patient to avoid driving or other
activities requiring alertness until
response to medication is known.
 Inform patient of possibility of
extrapyramidal symptoms and
tardive dyskinesia. Caution
patient to report these symptoms
immediately to health care
professional.
 Advise patient to notify health
care professional of all Rx or
OTC medications, vitamins, or
herbal products being taken and
to consult with health care
professional before taking other
medications and alcohol,
especially other CNS
depressants.
 Instruct patient to notify health
care professional promptly if sore
throat, fever, unusual bleeding or
bruising, rash, weakness,
tremors, visual disturbances,
dark-colored urine, or clay-
colored stools occur.
 Advise patient to wear sunscreen
and protective clothing to prevent
photosensitivity reactions.
 Instruct patient to avoid sun
exposure and to wear protective
clothing and sunscreen when
outdoors.
 Advise patient to notify health
care professional of medication
regimen before treatment or
surgery.
 Instruct female patient to inform
health care professional if
pregnancy is planned or
suspected or if she is
breastfeeding.
 Emphasize the importance of
 follow-up exams to monitor
progress. Encourage patient
participation in psychotherapy to
improve coping skills

References:
 Vallerand, A. H., Sanoski, C. A., & Deglin, J. H. (2019). Davis’s Drug Guide for Nurses (16th ed.). F.A. Davis Company. 1322-1324.
 Retrieved from: https://www.medicines.org.uk/emc/product/6414/smpc#UNDESIRABLE_EFFECTS