Many of these agents are used in children, often in combination with other central nervous system (CNS) drugs in an attempt to control symptoms and behavior. Long-term effects of many of these agents are not known, and parents should be informed of this fact.
Of the antipsychotics, chlorpromazine, haloperidol, pimozide, prochlorperazine, risperidone, thioridazine, and trifluoperazine are the only ones with established pediatric regimens. Aripiprazole has doses for children 13 to 17 years of age. The dose is often higher than that required for adults. The child should be monitored carefully for adverse effects and developmental progress.
Lithium does not have a recommended pediatric dose, and the drug should not ordinarily be used in children. If it is used, the dose should be carefully calculated from the child’s age and weight, and the child should be monitored very closely for renal, CNS, cardiovascular, and endocrine function.
The CNS stimulants are often used in children to manage various attention-deficit disorders. Caution should be used with extended-release preparations because they differ markedly in timing and effectiveness. The child should be assessed carefully and challenged periodically for the necessity of continuing the drug.
Older patients may be more susceptible to the adverse effects of these drugs. All doses need to be reduced and patients monitored very closely for toxic effects and to provide safety measures if CNS effects do occur. They should not be used to control behavior with dementia.
Patients with renal impairment should be monitored very closely while taking lithium. Decreased doses may be needed. Because many older patients may also have renal impairment, they need to be screened carefully. They should be urged to maintain hydration and salt intake, which can be a challenge with some older patients.
Prolongation of the QTc interval—associated with use of thioridazine or ziprasidone—may be a concern in elderly patients with coronary disease. Careful screening and monitoring should be done if these drugs are needed for such patients.
psychotherapeutic – a. 治疗精神病的
antipsychotic – a. n. 抗精神病的（药）
chlorpromazine – n. 氯丙嗪
haloperidol – n. 氟哌啶醇
pimozide – n. 匹莫齐特
prochlorperazine -- n. 丙氯拉嗪
risperidone – n. 利培酮
thioridazine – n. 硫利达嗪
trifluoperazine – n. 三氟拉嗪
aripiprazole – n. 阿立哌唑
lithium – n. 锂
stimulant – n. 兴奋剂
prolongation – n. 延长
ziprasidone -- n. 齐拉西酮
1. A client taking lithium carbonate (Lithobid) started complaining of nausea, vomiting, diarrhea, drowsiness, muscle weakness, tremor, blurred vision and ringing in the ears. The lithium level is 2 mEq/L. The nurse interprets this value as:
A. Normal level.
B. Toxic level.
C. Below normal level.
D. Above normal level. 2. A nurse is giving instructions to a client receiving lithium citrate. The nurse tells the client to do which of the following to prevent lithium toxicity:
A. Avoid becoming dehydrated during exercise.
B. Instruct the client to change positions slowly.
C. Restrict salt intake in the diet.
D. Limit fluid intake.
1. B. Toxic level.
The therapeutic drug serum level of lithium is 0.6 to 1.2 mEq/L. 2. A. Avoid becoming dehydrated during exercise.
Lithium toxicity usually occurs during chronic treatment because of reduced drug excretion (dehydration, worsening renal function, concurrent infections, and drug interactions).
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