NURS 309: ANTIPSYCHOTICS

Chlorpromazine – Class & Action

A client is prescribed chlorpromazine for psychosis. What is its mechanism of action?

Chlorpromazine – Therapeutic Use

What is chlorpromazine used to treat?

Prevention and treatment of psychotic manifestations such as hallucinations, delusions, paranoia, and agitation in schizophrenia and other psychotic disorders.

Chlorpromazine – Nursing Assessment

What should the nurse assess before and during therapy?

Monitor mental status (hallucinations, delusions, paranoia), vital signs (especially blood pressure for orthostatic hypotension), and ECG for QT prolongation. Assess for extrapyramidal symptoms (EPS) and signs of neuroleptic malignant syndrome (NMS).

Chlorpromazine – Administration

How is chlorpromazine administered?

Oral, IM, or IV depending on severity. Dose is individualized. Use caution with IV/IM due to hypotension risk.

Chlorpromazine – Common Side Effects

What side effects may occur?

Anticholinergic effects (dry mouth, constipation), hypotension, sedation, decreased libido, gynecomastia, erectile dysfunction, and amenorrhea.

Chlorpromazine – Adverse Effects

Which serious adverse effects should be monitored for?

Extrapyramidal symptoms (dystonia, parkinsonism, tardive dyskinesia), neuroleptic malignant syndrome (NMS), hepatotoxicity, QT prolongation, and angle-closure glaucoma.

Chlorpromazine – Drug Interactions

What interactions are important?

Increases effects of antihypertensives and CNS depressants (alcohol, opioids, sedatives), increasing risk of hypotension and sedation.

Chlorpromazine – Contraindications

Who should NOT take chlorpromazine?

Clients with hypersensitivity or allergy to phenothiazines.

Chlorpromazine – Precautions

Who requires caution?

Older adults (especially with glaucoma), clients with cardiovascular disease, liver impairment, or those taking antihypertensives due to increased hypotension risk.

Chlorpromazine – Client Teaching

What should clients be taught?

Avoid driving until effects are known. Change positions slowly to prevent dizziness and falls. Report muscle rigidity, fever, tremors, or abnormal movements immediately. Avoid alcohol and other CNS depressants.

It is a first-generation (typical) antipsychotic that blocks dopamine (D2) receptors in the mesolimbic pathway, reducing hallucinations, delusions, & paranoia.

• It also has anticholinergic, antihistamine, & antiadrenergic effects.

Risperidone – Class & Action

A client is prescribed risperidone for psychosis. What is its mechanism of action?

Risperidone – Therapeutic Use

What is risperidone used to treat?

Schizophrenia, bipolar mania, and irritability associated with autism spectrum disorder. It decreases manifestations of psychosis and mood instability.

Risperidone – Nursing Assessment

What should the nurse assess during therapy?

Monitor for suicidal ideation (especially early in treatment), blood glucose levels for hyperglycemia, mental status changes, weight gain, and signs of EPS or NMS.

Risperidone – Administration

How is risperidone administered?

Oral, IM, or subcutaneous forms depending on indication and formulation. Dosing is individualized.

Risperidone – Common Side Effects

What side effects may occur?

Weight gain, hyperglycemia, hypotension, constipation, dry mouth, nausea, diarrhea, decreased libido, rash, and photosensitivity.

Risperidone – Adverse Effects

Which serious adverse effects require immediate attention?

Extrapyramidal symptoms (EPS), neuroleptic malignant syndrome (NMS), agranulocytosis, Stevens-Johnson syndrome, and cardiac dysrhythmias.

Risperidone – Drug Interactions

What interactions are important?

May reduce effectiveness of Parkinson’s medications. Increased CNS depression when combined with alcohol, antihistamines, opioids, or other CNS depressants.

Risperidone – Contraindications

Who should NOT take risperidone?

Hypersensitivity to risperidone or formulation components; breastfeeding is contraindicated.

Risperidone – Precautions

Who requires caution?

Older adults (except some bipolar use), and clients with renal or hepatic impairment, cardiovascular disease, seizures, diabetes, substance use history, or high fall/aspiration risk.

Risperidone – Client Teaching

What should clients be taught?

Report suicidal thoughts immediately. Use sunscreen and protective clothing due to photosensitivity. Rise slowly to prevent dizziness. Report abnormal movements, fever, or muscle rigidity right away.

It is a second-generation (atypical) antipsychotic that blocks dopamine & serotonin receptors in the CNS, helping reduce psychotic symptoms such as hallucinations, delusions, & paranoia.

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