Risperidone

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.

Risperidone (brand name Risperdal) — Antipsychotic; Second-generation (atypical) antipsychotic.

Identification

• Therapeutic class: Antipsychotic.
• Pharmacologic class: Second-generation (atypical) antipsychotic.

Pharmacology

• Mechanism of action: Blocks dopamine D2 and serotonin 5-HT2 receptors.
• Onset / peak / duration: Antipsychotic effect over days to weeks; long-acting injectable available.
• Half-life / therapeutic level: Half-life about 20 hours (with metabolite); level not routine.

Clinical use

• Indications: Schizophrenia, bipolar mania, irritability in autism.
• Usual dose, route, frequency: PO daily or twice daily; ODT and long-acting IM.
• Maximum dose / adjustments: Reduce in renal and hepatic impairment; higher doses raise extrapyramidal risk.

Safety

• Contraindications: Hypersensitivity.
• Black box warning: Increased mortality in elderly patients with dementia-related psychosis.
• Interactions: CNS depressants, dopamine agonists (oppose effect), QT-prolonging drugs, CYP2D6 inhibitors.
• Pregnancy / lactation: Use only if clearly needed; neonatal extrapyramidal and withdrawal risk.
• High-alert: No.

Adverse effects

• Common side effects: Sedation, weight gain, orthostatic hypotension, elevated prolactin (galactorrhea), extrapyramidal symptoms.
• Serious effects to report: Neuroleptic malignant syndrome, tardive dyskinesia, metabolic changes (glucose and lipids), QT prolongation.
• Antidote / reversal: Supportive care; dantrolene and bromocriptine for neuroleptic malignant syndrome.

Nursing process

• Assessment before administration: Baseline weight, glucose, lipids, movement, blood pressure.
• Interventions during therapy: Monitor for movement disorders and metabolic changes; rise slowly.
• Monitor: Movements, weight, glucose, lipids, prolactin symptoms.
• Evaluation / expected outcome: Reduced psychotic or manic symptoms.

Patient teaching

• Patient teaching: Report stiffness, fever, or abnormal movements; metabolic monitoring is routine.
• Notify provider if: High fever with rigidity, involuntary movements, fainting.
• Administration tips: With or without food; consistent timing.