BULLDOG MEDICAL

DETAILED EXPLANATION

 

Action: exact mechanism of action unknown; may be mediated through both dopamine type 2 and

              serotonin type 2 antagonism; dopamine system stabilizer.

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Availability: prescription only.

 

Avoid: fast position changes, especially if standing from sitting, due to orthostatic hypotension; 

            hot tubs, hot showers, and bathtubs due to hypotension; abrupt withdrawal due to

            extrapyramidal symptoms; OTC medications for allergies, cold, or cough unless

            approved by provider due to drug interactions; hazardous activities due to dizziness and

            drowsiness; extreme heat due to sensitivity to heat stroke.

 

Black Box Warning: children with depression; suicidal ideation; dementia.

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Class (Chemical): quinolinone.

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Class (Functional): antipsychotic.

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Contraindications: seizure disorders; hypersensitivity; breastfeeding.

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Dose: Agitation: Adult IM: 9.75mg, max 30mg/day

          Bipolar Disorder: Adult PO: 15mg/day, may increase to 30mg/day

          Irritation w/ Autism: Child PO: 2mg/day, may increase to 5mg/day, max 10-15mg/day

          Major Depressive Disorder: Adult PO: 2-5mg/day as adjunct to other antidepressant

          Schizophrenia: Adult PO: 10-15mg/day

          Schizophrenia: 13-17yrs PO: 2mg/day

          Tourette’s Syndrome: Less Than 50kg PO: 2mg/day, increase to 5mg/day

          Tourette’s Syndrome: More Than 50kg PO: 2mg/day, increase to 5mg/day, target

                                                                                     10mg/day after 8 days

 

Interactions: CYP3A4 inhibitors such as ketoconazole and erythromycin, as well as CYP2D6 

                       inhibitors such as quinidine, fluoxetine, and paroxetine, will increase the effects of

                       aripiprazole; CNS depressants and alcohol will increase sedation; other

                       antipsychotics such as lithium will increase extrapyramidal symptoms; famotidine

                       and valproate will decrease levels of aripiprazole; CYP3A4 inducers such as

                       carbamazepine will decrease the effects of aripiprazole; aripiprazole will increase

                       the anti-hypertensive effect of anti-hypertensives; St John’s wort will decrease

                       effects of aripiprazole.

 

Labs: may cause a false positive if screening for amphetamine drug use.

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Off-Label Use: aripiprazole may be used to treat anxiety disorders such as generalized anxiety

                          disorder, obsessive-compulsive disorder, and post-traumatic stress disorder.

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Precautions: geriatric patients; neutropenia; pregnancy; renal, hepatic, or cardiac disease.

 

Report to Provider: impaired vision; muscle twitches; tremors.

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Route: IM; PO.

 

Side Effects: drowsiness; insomnia; agitation; anxiety; headache; seizures; neuroleptic

                      malignant syndrome; light-headedness; akathisia; tremor; suicidal ideation; tardive                          dyskinesia; extrapyramidal symptoms; orthostatic hypotension; tachycardia; chest

                      pain; hypertension; peripheral edema; blurred vision; rhinitis; constipation; nausea;

                      vomiting; weight gain; rash; dry skin; sweating; hyperglycemia; myalgia; cough;

                      dyspnea; hypercholesterolemia; agranulocytosis; anemia; leukemia; death among

                      geriatric patients with dementia and/or hypersensitivity.

 

Uses: mania associated with schizophrenia and bipolar disorder; mixed episodes of bipolar

          disorder; major depressive disorder; irritability associated with autism.

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Reference: Mosby's Nursing Drug Reference