Post by zwilliams on Mar 6, 2015 10:43:24 GMT
Clozapine.docx (139.73 KB)
If possible open attachement for full test and image. If unavailable text below. Thanks, Zoe
Clozapine –
Clozapine is an atypical antipsychotic drug. Given to those suffering from schizophrenia but also in some cases those who are not responding to or have higher intolerances to commonly used antipsychotic medications. It displayes both a sedative effect and a antipsychotic effect lessening the positive and negative side effects found with certain conditions.
Common brand names that are used for Clozapine are Clopine, Clozaril
The normal dosing range for Clozapine are typically between 200-450mg a day in split doses, if no response if found at this range medication is not often continued.
The beginning dose is 12.5mg either once or twice a day increasing to 25mg on the second day and if going well it well move to 50mg the following day this will be continually increased so that a range of about 300mg can be reached in 2-3 weeks of commencing the drug, as long as no adverse effects have presented.
Common side effects found with Clozapine use are Leucopenia or a decreased WBC, decreased neutropenia, eosinophilia, leucocytosis.
Also experienced side effects are fatigue, drowsiness, sedation, dizziness, blurred vision, headaches, tremors, rigidity, extrapyramidal symptoms, seizures, convulsions or myoclonic jerks.
Some more common adverse reactions are tachycardia, ECG alterations, constipation, hypersalivation, nausea, vomiting, dry mouth, elevated liver enzymes, excess sweating, temperature regulation, weight gain, urinary incontinence and retention, hypertension and postural hypotension and also syncope.
Contradictions to use of clozapine are found in people suffering from various conditions such as a paralytic illus, epilepsy, hepatic failure, severe hepatic disease, progressive hepatic disease, anorexia, jaundice, renal disease, cardiac disease such as myocarditis, bone marrow disease, central nervous system depression, circulatory collapse, alcoholism, toxic psychosis such as drug intoxication, those with a history of drug induced granulocytopenia and drug induced agranulocytosis and finally those with a sensitivity to compounds included in clozapine
Special monitoring or care requirements that are required with Clozapine include a full physical examiniation, a history check for cardiomyopathy, myocarditis and cardiac failure. FBE, blood group, troponin levels, BSL and lipid profile is needed, an ECG and a mental health assessment are all required before a patient starts Clozapine alone with consent from the patient.
Once commenced all observations both physical and neurological need to be within normal limits following which they will need to monitored for the 6 hours after commencement. In the 48 hrs after commencement a blood sample, assessment of physical and mental state, review of blood results by a medical officer with a new prescription to be then written, results sent to pharmacy on a blood count form, following this more medication provided by pharmacy and a blood count form sent to a clozapine co-ordinator.
The WBC and neutrophil counts along with physical assessments need to be performed before writing any prescription, this is done weekly for the first18 weeks then every 28 days after the 18 week period pervading the individual stays within the green range.
White blood count and Neutrophil range:
See Attachment -
Education requirements for patients and familys:
Side effects to look out for
Correct dosage for individual.
Regular monitoring that will be needed
Clozapine cannot just be stopped without medical monitoring
Missing doses need to reported to medical officers ASAP.
If possible open attachement for full test and image. If unavailable text below. Thanks, Zoe
Clozapine –
Clozapine is an atypical antipsychotic drug. Given to those suffering from schizophrenia but also in some cases those who are not responding to or have higher intolerances to commonly used antipsychotic medications. It displayes both a sedative effect and a antipsychotic effect lessening the positive and negative side effects found with certain conditions.
Common brand names that are used for Clozapine are Clopine, Clozaril
The normal dosing range for Clozapine are typically between 200-450mg a day in split doses, if no response if found at this range medication is not often continued.
The beginning dose is 12.5mg either once or twice a day increasing to 25mg on the second day and if going well it well move to 50mg the following day this will be continually increased so that a range of about 300mg can be reached in 2-3 weeks of commencing the drug, as long as no adverse effects have presented.
Common side effects found with Clozapine use are Leucopenia or a decreased WBC, decreased neutropenia, eosinophilia, leucocytosis.
Also experienced side effects are fatigue, drowsiness, sedation, dizziness, blurred vision, headaches, tremors, rigidity, extrapyramidal symptoms, seizures, convulsions or myoclonic jerks.
Some more common adverse reactions are tachycardia, ECG alterations, constipation, hypersalivation, nausea, vomiting, dry mouth, elevated liver enzymes, excess sweating, temperature regulation, weight gain, urinary incontinence and retention, hypertension and postural hypotension and also syncope.
Contradictions to use of clozapine are found in people suffering from various conditions such as a paralytic illus, epilepsy, hepatic failure, severe hepatic disease, progressive hepatic disease, anorexia, jaundice, renal disease, cardiac disease such as myocarditis, bone marrow disease, central nervous system depression, circulatory collapse, alcoholism, toxic psychosis such as drug intoxication, those with a history of drug induced granulocytopenia and drug induced agranulocytosis and finally those with a sensitivity to compounds included in clozapine
Special monitoring or care requirements that are required with Clozapine include a full physical examiniation, a history check for cardiomyopathy, myocarditis and cardiac failure. FBE, blood group, troponin levels, BSL and lipid profile is needed, an ECG and a mental health assessment are all required before a patient starts Clozapine alone with consent from the patient.
Once commenced all observations both physical and neurological need to be within normal limits following which they will need to monitored for the 6 hours after commencement. In the 48 hrs after commencement a blood sample, assessment of physical and mental state, review of blood results by a medical officer with a new prescription to be then written, results sent to pharmacy on a blood count form, following this more medication provided by pharmacy and a blood count form sent to a clozapine co-ordinator.
The WBC and neutrophil counts along with physical assessments need to be performed before writing any prescription, this is done weekly for the first18 weeks then every 28 days after the 18 week period pervading the individual stays within the green range.
White blood count and Neutrophil range:
See Attachment -
Education requirements for patients and familys:
Side effects to look out for
Correct dosage for individual.
Regular monitoring that will be needed
Clozapine cannot just be stopped without medical monitoring
Missing doses need to reported to medical officers ASAP.