Risperidone is a second generation antipsychotic used to treat schizophrenia and bipolar mania. It works by decreasing excitation in the brain and reducing functional impairment and paranoia while increasing appropriate socialization. Common side effects include dizziness, extrapyramidal reactions, weight gain, and fatigue. Risperidone has a rapid absorption rate and is primarily excreted in the urine with a prolonged half-life in cases of hepatic or renal dysfunction. Nurses play an important role in ensuring patient safety by educating patients about risperidone's use, risks, and interactions and by questioning any potentially erroneous medication orders.

1. Jeremy Sanders
MSNE 5356 Section 3N, Advanced Pharmacology
April 3, 2016

2. Risperidone
 Treatment of schizophrenia and
bipolar mania
 2nd generation antipsychotic

3. Reelin expression deficit
- Chromosome 22
Serotonin transporter (5-HT-T) either short allele or
long allele
- Reuptake of serotonin moderates serotonin
response to stress
 Mood Alterations (depression/mania)
- Neurochemical dysregulation
- Neuroendocrine dysregulation

4.  Decreased excitation
 Decreased functional impairment
 Decreased paranoia (fear & mistrust)
 Increased appropriate socialization
 Decreased risk-taking behavior
- promiscuity
- drug abuse
- reckless driving
 Calm demeanor

5.  Levedopa- decrease antiparkinsonian effects
 Paxil, Prozac, Tegretol- cytochrome adjustment
 Additive hypotension with acute ETOH,
antihypertensives, nitrates ingestion
 Additive central nervous system (CNS) depression
with other CNS depressants
 Enzyme inducers> increase metabolism, decrease
effectiveness
 Clozapine decreases metabolism increasing
risperidone effects

6.  Neuroleptic malignant syndrome
 Aggressive behavior
 Dizziness
 Extrapyramidal reactions
 Cough
 Constipation, diarrhea, dry mouth, nausea
 Itching/skin rash
 Weight Gain

7.  Fatigue, impaired temperature regulation,
nervousness, tardive dyskinesia (TD)
 Dyspnea
 Arrhythmias, orthostatic hypotension
 Abdominal pain, anorexia, dyspepsia, increased
salivation, vomiting
 Difficulty urinating, polyuria
 Dry skin, increased pigmentation, increased
sweating, photosensitivity, seborrhea

8.  Rapid absorption (70% after
administration of tablets,
solution or orally disintegrating)
 Excreted primarily in urine
 Effective half-life 24 hours
 Prolonged half-life with hepatic
or renal dysfunction

9.  Phenytoin and other enzyme inducers
- Increase metabolism of risperidone

10. Electronic Health Record (EHR)
- Warning detectors for duplicate medications
- Drug-drug interactions
- Prevention of drug abuse from doctor shopping
Nurses question prescribers to decrease medication
errors
- Decrease patient harm from med errors
- Improve patient outcomes

11.  Educate patients/caregivers in home health
- Adverse reactions/side effects
- Drug interactions
 Nurses spearhead movement- nurses as patient
advocates (no exceptions)
- Question potential erroneous medication orders
 Patient safety increased through open and honest
communication across disciplines