McKenna's Pharmacology for Nursing, 2e

338

P A R T 4  Drugs acting on the central and peripheral nervous systems

TABLE 22.1

DRUGS IN FOCUS Antipsychotic/neuroleptic drugs (continued)

Common side effects

Drug name

Potency

Usual dosage

Sedation Anticholinergic Hypotension Extrapyramidal

Atypical antipsychotics amisulpride (Solian) High

++

++

+

+

Adult: 400–800 mg/day in two divided doses, adjusted according to response; maximum 1.2 g/day Adult: 10–15 mg/day PO Adult: initially 25 mg PO b.d. to t.d.s.; up to 500 mg/day; available only through the Clozaril Management System, which monitors white blood cell count and compliance issues, only one-week supply given at a time Adult: 5–10 mg/day PO, up to 20 mg/day PO for bipolar mania; available in disintegrating tablets, dose 3 mg/day with severe impairment Adult: initially 25 mg PO b.d., up to 300–400 mg/day; 400–900 mg/day PO (XR) Geriatric, hepatic impairment or hypotensives: reduce dose and titrate very slowly Adult: 1 mg PO b.d. up to 8 mg/day or 25 mg IM once every 2 weeks Paediatric: 10–17 years: 0.5–6 mg/day PO (bipolar disorders) 13–17 years: 1–6 mg/day PO (schizophrenia) Geriatric, renal impaired or hypotensives: 0.5 mg PO b.d. initially, titrate slowly which can be taken without swallowing Adult: 6 mg/day PO; maximum dose 12 mg/day Renal impairment: maximum dose 6 mg/day with moderate impairment, maximum

aripiprazole (Abilify)

Medium +

+

++

+

Low

++++

++

+++

+/–

clozapine (Clopine,

Clozaril)

olanzapine (Zyprexa,

High

++++

++

+++

+

Zyprexa Zydis)

paliperidone (Invega)

Medium +

+

++

++

quetiapine

Medium ++++

++

++

+/–

(Seroquel, Seroquel XR)

risperidone (Risperdal)

High

+++

+

++

++