Post by katiearmstrong on Mar 4, 2015 12:15:41 GMT
Ziprasidone
a.) Is the medication a typical/atypical antipsychotic? Is the medication an SSRI/SNRI antidepressant?
Ziprasidone is an atypical antipsychotic.
b.) Common brand names?
Zeldox.
c.) Normal dose range?
Should be started at 40mg BD, but can be titrated up to 80mg BD to a maximum of 160mg total per day if required. This titration should not occur over less than a three-day period, reaching the maximum dose on the third or fourth day of treatment. Powder for injection comes in 20mg.
d.) Common side effects?
CNS akathsia (restlessness or constant need to move), dizziness, dyskinesia (involuntary movement), dystonia (abnormal muscle tone resulting from muscle spasms), extrapyramidal reactions, fatigue, headache, parkinsonism, sedation, somnolence (constant near sleep or sleeping too much), syncope (temporary loss of consciousness from lack of oxygen), tremor, vertigo CV increased QT interval, orthostatic hypotension, palpitations, right bundle branch block, tachycardia Ear tinnitus, ear pain Eye blurred vision, photophobia GI constipation, dry mouth, diarrhea, dyspepsia (indigestion), dysphagia (impaired ability to swallow), flatulence, gastrointestinal discomfort, nausea, salivary hypersecretion, tongue thickening, thirst, vomiting GU dysuria (painful urination), enuresis (night time incontinence), erectile dysfunction, galactorrhoea (milky nipple discharge), urinary incontinence Haematological lymphopenia (abnormally low WBC) Hepatic raised liver enzymes Metabolic increased appetite Musculoskeletal altered gait, asthenia (lack or loss of body strength), muscle cramps, stiffness Psychiatric agitation, anxiety, restlessness, insomnia, panic attacks Respiratory dyspnea (labored breathing or shortness of breath), rhinitis Skin acne, angio-oedema, dermatitis, erythema, urticarial, alopecia Other allergic reaction, pyrexia (increase in temp above normal range), physical and psychological dependence.
e.) Contraindications?
Contraindicated in those who have a hypersensitivity to Ziprasidone or any of its ingredients, those who have experienced a recent myocardial infarction, uncompensated cardiac failure or those with co-morbidities, which could result in an increase in their QT interval.
f.) Special monitoring/Nursing care requirements?
Drug-drug interactions carbamazepine causes lower ziprasidone serum levels, CNS drugs cause antagonised effects of dopamine agonists, ketoconazole has the potential for increased ziprasidone serum levels, lithium has the potential to cause cardiac arrhythmias (caution dispensing together)
Drug-lifestyle interactions alcohol may cause increased effects- discourage use together
Care considerations baseline serum electrolytes should be taken for those at risk of change, lowered potassium and/or magnesium levels should be corrected before starting treatment, BP should be monitored closely, use with caution for those with known cardiovascular disease, observe urinary and bowel function
g.) Education requirements for patients/families/carers?
• Avoid driving and activities that require alertness and good psychomotor co-ordination while taking ziprasidone.
• Move slowly when rising from a laying position or changing positions to avoid orthostatic hypotension.
• Take with food.
• Ice chips, sugarless boiled lollies and chewing gum may relieve dry mouth.
• Avoid alcohol.
• Speak to treating team before ceasing medication.
Action
The action of ziprasidone, as with most psychiatric medications is unknown. It does however, bind to dopaminergic receptors D2 and D3, serotonin and alpha1-adrenergic receptors blocking the uptake or serotonin and noradrenaline.
Uses
Ziprasidone is used in the treatment and maintenance of schizophrenia, psychosis and mania that is associated with bipolar disorder.
Life
If taken orally, the onset is unknown, however, it peaks at 6-8 hours and half-life is generally 3-18 hours with an average of 6-10 hours.
Absorption
Taken without food, absolute bioavailability is 60%. Taken with food, absolute bioavailability can rise to 100%... Must always be taken with food.
a.) Is the medication a typical/atypical antipsychotic? Is the medication an SSRI/SNRI antidepressant?
Ziprasidone is an atypical antipsychotic.
b.) Common brand names?
Zeldox.
c.) Normal dose range?
Should be started at 40mg BD, but can be titrated up to 80mg BD to a maximum of 160mg total per day if required. This titration should not occur over less than a three-day period, reaching the maximum dose on the third or fourth day of treatment. Powder for injection comes in 20mg.
d.) Common side effects?
CNS akathsia (restlessness or constant need to move), dizziness, dyskinesia (involuntary movement), dystonia (abnormal muscle tone resulting from muscle spasms), extrapyramidal reactions, fatigue, headache, parkinsonism, sedation, somnolence (constant near sleep or sleeping too much), syncope (temporary loss of consciousness from lack of oxygen), tremor, vertigo CV increased QT interval, orthostatic hypotension, palpitations, right bundle branch block, tachycardia Ear tinnitus, ear pain Eye blurred vision, photophobia GI constipation, dry mouth, diarrhea, dyspepsia (indigestion), dysphagia (impaired ability to swallow), flatulence, gastrointestinal discomfort, nausea, salivary hypersecretion, tongue thickening, thirst, vomiting GU dysuria (painful urination), enuresis (night time incontinence), erectile dysfunction, galactorrhoea (milky nipple discharge), urinary incontinence Haematological lymphopenia (abnormally low WBC) Hepatic raised liver enzymes Metabolic increased appetite Musculoskeletal altered gait, asthenia (lack or loss of body strength), muscle cramps, stiffness Psychiatric agitation, anxiety, restlessness, insomnia, panic attacks Respiratory dyspnea (labored breathing or shortness of breath), rhinitis Skin acne, angio-oedema, dermatitis, erythema, urticarial, alopecia Other allergic reaction, pyrexia (increase in temp above normal range), physical and psychological dependence.
e.) Contraindications?
Contraindicated in those who have a hypersensitivity to Ziprasidone or any of its ingredients, those who have experienced a recent myocardial infarction, uncompensated cardiac failure or those with co-morbidities, which could result in an increase in their QT interval.
f.) Special monitoring/Nursing care requirements?
Drug-drug interactions carbamazepine causes lower ziprasidone serum levels, CNS drugs cause antagonised effects of dopamine agonists, ketoconazole has the potential for increased ziprasidone serum levels, lithium has the potential to cause cardiac arrhythmias (caution dispensing together)
Drug-lifestyle interactions alcohol may cause increased effects- discourage use together
Care considerations baseline serum electrolytes should be taken for those at risk of change, lowered potassium and/or magnesium levels should be corrected before starting treatment, BP should be monitored closely, use with caution for those with known cardiovascular disease, observe urinary and bowel function
g.) Education requirements for patients/families/carers?
• Avoid driving and activities that require alertness and good psychomotor co-ordination while taking ziprasidone.
• Move slowly when rising from a laying position or changing positions to avoid orthostatic hypotension.
• Take with food.
• Ice chips, sugarless boiled lollies and chewing gum may relieve dry mouth.
• Avoid alcohol.
• Speak to treating team before ceasing medication.
Action
The action of ziprasidone, as with most psychiatric medications is unknown. It does however, bind to dopaminergic receptors D2 and D3, serotonin and alpha1-adrenergic receptors blocking the uptake or serotonin and noradrenaline.
Uses
Ziprasidone is used in the treatment and maintenance of schizophrenia, psychosis and mania that is associated with bipolar disorder.
Life
If taken orally, the onset is unknown, however, it peaks at 6-8 hours and half-life is generally 3-18 hours with an average of 6-10 hours.
Absorption
Taken without food, absolute bioavailability is 60%. Taken with food, absolute bioavailability can rise to 100%... Must always be taken with food.