Clozaril (Clozapine) Flashcards

Drug Classification

• Clozaril is classified as an atypical antipsychotic.

Dose Range

• Initial oral dose: 12.5 mg, administered 1-2 times daily.
• Target dose: between 150-500 mg per day.
• Maximum allowable dose: 900 mg per day.

Pharmacological Action

• Primarily binds to dopamine receptors located in the central nervous system (CNS).

Therapeutic Uses

• Effective for treating schizophrenia that is unresponsive to or intolerant of other antipsychotic therapies.
• Used to reduce suicidal behaviors in patients with schizophrenia.

Side Effects/Adverse Effects

• Potentially severe reactions include neuroleptic malignant syndrome and seizures.
• Risk of cardiac arrest, deep vein thrombosis (DVT), ventricular arrhythmias, and pulmonary embolism.
• Possible blood disorders such as agranulocytosis and leukopenia.

Medication/Food Interactions

• May enhance anticholinergic effects when used with other medications.
• Oral contraceptives and caffeine can amplify clozapine's effects.
• Increased CNS depression when combined with alcohol, antidepressants, antihistamines, opioids, and sedative-hypnotics.
• Co-administration with Lithium can lead to heightened adverse CNS reactions, including seizures.
• St. John's Wort should be avoided.

Nursing Interventions/Client Education

• Monitor for extrapyramidal symptoms and inform patients about these risks.
• Smoking can lower clozapine levels, which may affect efficacy.
• Advise against alcohol and CNS depressants.
• Patients should report symptoms like palpitations, tachypnea, chest pain, sore throat, or flu-like symptoms to their physician.
• Pregnant or breastfeeding patients must notify their healthcare provider.

Nursing Administration Concerns

• Routine monitoring of white blood cells (WBCs) and absolute neutrophil count (ANC) is essential.
• Assessing fasting blood glucose levels is important due to potential metabolic side effects.
• Be aware that clozapine can lower seizure thresholds; assess respiration status regularly.
• Conduct baseline WBC counts, followed by weekly monitoring during treatment and for four weeks post-therapy.
• Agranulocytosis may occur 18-24 weeks after starting treatment.

Evaluation of Medication Effectiveness

• Effectiveness indicated by a decrease in positive schizophrenia symptoms, such as delusions and hallucinations.
• Reduction in negative symptoms, including social withdrawal and blunted affect, is also a marker of effectiveness.