Seroquel

SEROQUEL 1. Name & class of drug – generic and trade name. GENERIC NAME: Quetiapine Fumarate BRAND NAME: Seroquel CLASSIFICATION: CNS agent, psychotherapeutic, atypical, antipsychotic 2. Dose range and routes for adult & geriatric client. PREPARATIONS: PO – (25, 100, 200) mg tablets DOSING: Psychosis – initiate with 25 mg bid, may increase by 25 – 50 mg bid to tid on the second or third day as tolerated to a target dose of 300 – 400 mg/d divided by bid to tid, may adjust dose by 25 – 50 mg bid qd as needed (max. 800 mg/d) Agitation/Dementia – initiate with 25 mg bid, may increase by 25 – 50 mg bid, q 2-7 if needed, (max 200 mg/d) 3. Purpose prescribed. Underline reason your client is prescribed drug. THERAPEUTIC EFFECTS: indicated by a reduction in psychotic behaviour USES: management of psychotic disorders, management of agitation and dementia 4. Major side effects & drug interactions. DRUG INTERACTIONS: Barbiturates, carbamazepine, phenytoin, rifampin, thioridazine may increase clearance of seroquel. • Seroquel may potentiate the cognitive and motor effects of alcohold, enhance the effect of antihypertensive agents, antagonize the effects of levodopa and dopamine agonists. • Ketoconazole, itraconazole, fluconazole, erythromycin may decrease clearance of seroquel HERBAL INTERACTIONS: St. John’s Wort may cause serotonin syndrome SIDE EFFECTS: dizziness, headache, somnolence, asthenia, fever, hypertonia, dysarthria, flu syndrome, weight gain, peripheral edema

5. Nursing Implications & teaching. IMPLICATIONS: • Reassess need for continued Tx periodically • Withhold med and immediately report S & S of tardive dyskinesia or neuroleptic malignant syndrome • Lab tests – periodically monitor liver function, lipid profile, thyroid function, blood glucose, CBC with differential • Monitor ECG periodically, especially in those with known cardio vascular disease • Perform baseline cataract exam when therapy is started and at 6-mo intervals thereafter • Monitor pts with a history of seizures for lowering of the seizure threshold TEACHING: • Exercise caution with potentially dangerous activities requiring alertness, especially during the first week of drug therapy or during dose increments • Make position changes slowly, especially when changing from lying or sitting to standing to avoid dizziness, palpitations, and fainting • Avoid alcohol consumption and activities that may cause overheating and dehydration • Inform Dr immediately if you become pregnant