Name: Honey Bee S.

Platolon
Individual Case: Psychosis
DRUG STUDY

GENERIC NAME Recommended, Mechanism of Indication Contraindication Adverse Reaction Nursing Responsibilities
BRAND NAME Dosage, Route of Action
CLASSIFICATION Administration
Generic Name: ORAL SOLUTION, May block To treat Dementia with CNS: Agitation, anxiety, • Be aware that haloperidol shouldn’t
Haloperidol TABLETS postsynaptic psychosis and Lewy bodies, confusion, depression, be used to treat dementia-related
dopamine schizophrenia hypersensitivity dizziness, drowsiness, psychosis in the elderly because of
Brand Name: Adults and receptors in the to haloperidol or dystonia, euphoria, an increased mortality risk.
Haldol, Haldol adolescent limbic system its components, extrapyramidal reactions • Use haloperidol cautiously in
Decanoate Initial: 0.5 to 2 mg and increase Parkinson’s that may be irreversible,
patients with a history of prolonged
every 8 to 12 hr, brain turnover of disease, severe hypothermia, insomnia,
QT interval, patients with
Pharmacologic increased to 3 to 5 dopamine, toxic CNS neuroleptic malignant
uncorrected electrolyte
class: mg every 8 to 12 hr, producing an comatose states syndrome, opisthotonos,
Butyrophenone as needed. antipsychotic or depression Parkinsonism, restlessness, disturbances, and patients receiving
derivative Maximum: 30 mg effect. seizures, slurred speech, Class IA or III antiarrhythmics
daily. somnolence, tremor, vertigo because of an increased risk of
Therapeutic class: prolonged QT interval. Monitor
Antipsychotic Children ages 3 to CV: Cardiac arrest, edema, elderly patients closely because they
12 weighing 15 kg extrasystoles, hypertension, may have an increased risk of
(33 lb) to 40 kg (88 hypersensitivity vasculitis, prolonged QT interval.
lb) orthostatic hypotension, QT- • Be aware that haloperidol
Initial: 0.25 to interval prolongation, concentrations may increase in
0.5 mg daily in ventricular arrhythmias, hepatically impaired patients.
divided doses twice tachycardia, torsades de Monitor closely for adverse
daily or three times pointes reactions.
daily. Increased by
• Dilute oral solution with a beverage,
0.5 mg every 5 to 7 EENT: Blurred vision, dry
such as apple, orange, or tomato
days, as needed. mouth, increased salivation
Maintenance: 0.05 (all drug forms), laryngeal juice or cola.
to 0.15 mg/kg/day edema, laryngospasm, • Give haloperidol decanoate (long-
given in 2 to 3 nystagmus, oculogyric crisis, acting form) by deep I.M. injection
divided doses. stomatitis (oral into gluteal muscle using Ztrack
solution) technique and 21G needle. Don’t
DOSAGE give more than 3 ml per site. Expect
ADJUSTMENT ENDO: Breast discomfort to reach stable plasma level after
For debilitated or and engorgement, third or fourth dose.
elderly patients, galactorrhea, gynecomastia,
initial dosage hyperprolactinemia,
reduced to 0.5 to 2 inappropriate antidiuretic
mg twice daily or hormone secretion
three times daily, as
needed. GI: Acute hepatic failure,
cholestasis, constipation,
elevated liver enzymes,
hepatitis, jaundice, nausea,
vomiting
GU: Decreased or loss of
libido, difficult ejaculation,
impotence, menstrual
irregularities, priapism,
urinary retention
HEME: Agranulocytosis,
anemia, leukocytosis,
leukopenia, neutropenia,
pancytopenia,
thrombocytopenia
MS: Muscle rigidity or
twitching, rhabdomyolysis,
torticollis, trismus
RESP: Bronchospasm,
dyspnea
SKIN: Acneiform skin
reactions, diaphoresis,
exfoliative dermatitis,
photosensitivity, pruritis,
rash, urticaria
Other: Anaphylaxis,
angioedema, heatstroke,
hypersensitivity reactions,
weight gain or loss
• Know that if injection solution has a
slight yellow discoloration this
change doesn’t affect potency.
• Assess patient for fall risks, such
those who are elderly and those
with conditions or diseases or taking
drugs that exacerbate central
nervous system adverse effects such
as motor instability, orthostatic
hypotension, and somnolence. Use
fall precautions in patients at risk.
• Watch for tardive dyskinesia
(potentially irreversible involuntary
movements) in patients receiving
long-term therapy, especially elderly
women who take large doses.
• Monitor CBC, especially if patient
has a low WBC count or history of
drug-induced leukopenia or
neutropenia, often during the first
few months of therapy, as ordered.
If WBC count drops, especially if
neutrophil count drops below
1,000/mm 3, expect haloperidol to
be discontinued. If neutropenia is
significant, also monitor patient for
fever or other symptoms of
infection and provide appropriate
treatment, as prescribed.
• Know that if extrapyramidal
reactions occur during the first few
days of treatment, dosage should be
reduced as prescribed. If symptoms
persist, drug may be discontinued.
Dystonia also may occur during first
few days of treatment, especially in
patients receiving higher doses and
 in males and younger age-groups.
Notify prescriber.
• Avoid stopping haloperidol abruptly
unless severe adverse reactions
occur because withdrawal emergent
dyskinesia may occur.
• Monitor for signs of neuroleptic
malignant syndrome, a rare but
possibly fatal disorder linked to
antipsychotic drugs. Signs include
altered mental status, arrhythmias,
fever, and muscle rigidity.
 GENERIC NAME Recommended, Mechanism of Indication Contraindication Adverse Reaction Nursing Responsibilities
BRAND NAME Dosage, Route of Action
CLASSIFICATION Administration
Generic Name: ADULT Chlorpromazine is This medication is Chlorpromazine CNS: sedation, • Assess patient’s mental
chlorpromazine PO: 30-75 mg/day a member of the used to treat certain should not be given extrapyramidal status (orientation, mood,
divided q6-12hr typical mental/mood if there is a known reactions, tardive behavior) prior to and
Brand Name: initially; maintenance: antipsychotic or disorders (such as hypersensitivity or dyskinesia, periodically throughout
Thorazine usually 200 mg/day neuroleptic drug schizophrenia, acute allergy to neuroleptic malignant therapy.
(up to 800 mg/day in class, also known psychosis, psychotic phenothiazines. The syndrome
Drug Class: some patients; some as first-generation disorders, manic drug should be used
• Monitor blood pressure
Antipsychotics, patients may require antipsychotics phase of bipolar cautiously in CV: hypotension,
(sitting, standing, lying),
Phenothiazine. 1-2 g/day) (FGAs). It disorder, severe patients on tachycardia
pulse, and respiratory rate
produces its behavioral problems antihypertensive
IV/IM: 25 mg initially, antipsychotic in children). medications due to EENT: dry eyes, prior to and frequently
followed PRN with 25- effect by the post- Chlorpromazine the risk of blurred vision, lens during the period of dosage
50 mg after 1-4 hours, synaptic blockade helps you to think developing severe opacity adjustment.
then increased to at the D2 more clearly, feel hypotension. It
maximum of 400 mg receptors in the less nervous, and should not be ENDO: galactorrhea • Observe patient carefully
q4-6hr until patient is mesolimbic take part in administered when administering
controlled; usual pathway. everyday life. concurrently with GI: constipation, dry medication to ensure
dosage 300-800 drugs that depress mouth, ileus, medication is actually taken
mg/day the central nervous anorexia, hepatitis and not hoarded.
system or patients
PEDIATRIC with a poorly GU: urinary retension • Administer oral doses with
<6 months: Safety and controlled seizure food, milk, or a full glass of
efficacy not disorder. SKIN: rashes, water to minimize gastric
established photosensitivity
irritation.
≥6 months: 50-100
• Monitor CBC and liver
mg/day PO/IM; 200
mg/day or more may function tests
be necessary for older
hospitalized patients; • Instruct patient not to skip
for outpatients, may doses or double dose.
administer 0.55 mg/kg
q4-6hr PRN