CLOZAPINE

Brand Name:
Clozaril

AVAILABLE FORMS:
25mg; 100mg

INDICATIONS:
Schizophrenia

MECHANIS OF ACTION:
Clozapine is an anti-psychotic medication that works by blocking receptors in the brain for several neurotransmitters (chemicals that nerves use to communicate with each other) including dopamine type 4 receptors, serotonin type 2 receptors, norepinephrine receptors, acetylcholine receptors, and histamine receptors. Unlike traditional anti-psychotic agents, such as chlorpromazine (Thorazine) and haloperidol (Haldol) as well as the newer anti-psychotics, risperidone (Risperdal) and olanzapine (Zyprexa), clozapine only weakly blocks dopamine type 2 receptors.

ADVERSE REACTIONS:
CNS: extrapyramidal reactions, tardive dyskinesia, sedation, pseudoparkinsonism, EEG changes, drowsiness, seizures, dizziness, neuroleptic malignant syndrome.
CV: orthostatic hypotension, tachycardia, ECG changes.
EENT: ocular changes, blurred vision, nasal congestion.
GI: dry mouth, constipation, increased appetite.
GU: urine retention, dark urine, menstrual irregularities, inhibited ejaculation.
Hematologic: leukopenia, agranulocytosis, eosinophilia, hemolytic anemia, aplastic anemia, thrombocytopenia.
Hepatic: cholestatic jaundice.
Metabolic: weight pain.
Skin: mild photosensitivity reactions, allergic reactions.
Other: gynecomatia.

EFFECTS ON LAB TEST RESULTS

• May increase liver function test values and eosinophil count. May decrease hemoglobin and WBC, granulocyte and platelet counts.

CONTRAINDICATIONS:
You should not take this medication if you are allergic to clozapine. Clozapine is not for use in psychotic conditions related to dementia. Clozapine may cause heart failure, sudden death, or pneumonia in older adults with dementia-related conditions. You should not take clozapine if you have uncontrolled epilepsy, paralytic ileus or intestinal blockage, an infection caused by clozapine, or if you are also using drugs that weaken your immune system (such as cancer medicine or steroids). Clozapine can pass into breast milk and may harm a nursing baby. You should not use this medication if you are breast-feeding a baby.

NURSING RESPONSIBILITIES:

1. Tell patient that smoking may decrease the effectivity of the drug.
2. Take the regular oral tablet (Clozaril) with a full glass of water. Clozapine can be taken with or without food.
3. Store clozapine at room temperature away from moisture and heat.
4. Clozapine may cause seizures, dizziness, or fainting. Be careful if you drive or do anything that requires you to be awake and alert.
5. Call your doctor at once if you have any serious side effects

CHLOPROMAZINE Hcl ( Zycloran)

INDICATIONS:
For the management of psychotic disorders including management of Schizophrenia and manic depressive illness.

CONTRAINDICATIONS:
Comatose or depressed states due to CNS depressants; blood dyscrasias; bone marrow depression; and liver damage. Hypersensitivity to chlorpromazine. Should be avoided in children or adolescents with symptoms suggestive of Reye’s Syndrome.

ADVERSE EFFECTS:
CNS: Extrapyramidal reactions, dizziness, Tardive Dyskinesia
ANS: Blurred vision, dry mouth, constipation, ileus, nasal stuffiness, photophobia
Cardiovascular: Hypotension, ventricular arrhythmia
Dermatologic: Itching, skin rash, erythema, allergic purpura
GI: Nausea, vomiting, increase or decrease appetite, gastric irritation

WARNING:
The drug may impair the mental and physical ability for operating a motor vehicle or complex hazardous machinery.