View source for Quetiapine, olanzapine, aripiprazole, and lurasidone

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''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.''
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'''Quetiapine, olanzapine, aripiprazole, and lurasidone''' (brand names Seroquel, Zyprexa, Abilify, Latuda) &mdash; 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.

[[Category:Antipsychotics and Mood Stabilizers]]