Quetiapine, olanzapine, aripiprazole, and lurasidone

Quetiapine, olanzapine, aripiprazole, and lurasidone

Drug monograph · NCLEX study reference
Trade names	Seroquel, Zyprexa, Abilify, Latuda
Therapeutic class	Antipsychotic, mood stabilizer
Pharmacologic class	Second-generation (atypical) antipsychotics
Onset / peak / duration	Effect over days to weeks; some have long-acting injectables (olanzapine, aripiprazole).
Half-life / level	Varies; level not routine.
Routes	PO (oral)
High-alert (ISMP)	No
Black box warning	Yes (see Safety)
Antidote / reversal	Supportive care.
Pregnancy / lactation	Use only if clearly needed.

Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and must be verified against current manufacturer labeling before clinical use. This is educational content, not prescribing guidance.

Quetiapine, olanzapine, aripiprazole, and lurasidone (brand names Seroquel, Zyprexa, Abilify, Latuda) — Antipsychotic, mood stabilizer; Second-generation (atypical) antipsychotics.

Identification

• Therapeutic class: Antipsychotic, mood stabilizer.
• Pharmacologic class: Second-generation (atypical) antipsychotics.

Pharmacology

• Mechanism of action: Dopamine and serotonin receptor modulation; aripiprazole is a partial dopamine agonist.
• Onset / peak / duration: Effect over days to weeks; some have long-acting injectables (olanzapine, aripiprazole).
• Half-life / therapeutic level: Varies; level not routine.

Clinical use

• Indications: Schizophrenia, bipolar disorder, adjunct in depression (aripiprazole, quetiapine); lurasidone for bipolar depression.
• Usual dose, route, frequency: PO; quetiapine often at bedtime (sedating); lurasidone with food (at least 350 calories).
• Maximum dose / adjustments: Adjust for hepatic or renal impairment by agent.

Safety

• Contraindications: Hypersensitivity.
• Black box warning: Increased mortality in elderly patients with dementia-related psychosis; antidepressant suicidality warning applies when used adjunctively for depression.
• Interactions: CNS depressants, CYP3A4 interactions (quetiapine, lurasidone, aripiprazole), QT-prolonging drugs; grapefruit (food) for some.
• Pregnancy / lactation: Use only if clearly needed.
• High-alert: No.

Adverse effects

• Common side effects: Sedation (quetiapine, olanzapine), weight gain and metabolic effects (olanzapine notably), akathisia (aripiprazole).
• Serious effects to report: Neuroleptic malignant syndrome, tardive dyskinesia, marked metabolic changes, severe hyperglycemia.
• Antidote / reversal: Supportive care.

Nursing process

• Assessment before administration: Weight, glucose, lipids, movement baseline.
• Interventions during therapy: Routine metabolic monitoring; give lurasidone with food; quetiapine often at night.
• Monitor: Weight, glucose, lipids, movements.
• Evaluation / expected outcome: Reduced psychotic, manic, or depressive symptoms.

Patient teaching

• Patient teaching: Take as directed (lurasidone with food); report stiffness or abnormal movements.
• Notify provider if: High fever with rigidity, involuntary movements, marked thirst or urination.
• Administration tips: Follow food and timing rules per agent.