Home Drug Guide Amisulpride

Drug Guide

Generic Name

Amisulpride

Brand Names Barhemsys

Classification

Therapeutic: Antipsychotic, dopamine antagonist

Pharmacological: Selective dopamine D2/D3 receptor antagonist

FDA Approved Indications

  • Prevention of postoperative nausea and vomiting (PONV)

Mechanism of Action

Amisulpride selectively blocks dopamine D2 and D3 receptors in the central nervous system, which reduces nausea and vomiting signals associated with the chemoreceptor trigger zone (CTZ).

Dosage and Administration

Adult: 10 mg IV administered 30 minutes prior to anesthesia, repeat every 8 hours as needed.

Pediatric: Not approved for pediatric use.

Geriatric: Use with caution; start at lower doses due to increased sensitivity in older adults.

Renal Impairment: Adjust dose based on severity of impairment; consult specific guidelines.

Hepatic Impairment: Use with caution; no specific dose adjustment available.

Pharmacokinetics

Absorption: Rapidly absorbed after IV administration.

Distribution: Widely distributed; crosses the blood-brain barrier.

Metabolism: Minimal hepatic metabolism.

Excretion: Primarily excreted unchanged in urine.

Half Life: Approximately 12 hours.

Contraindications

  • Hypersensitivity to amisulpride or other dopamine antagonists.

Precautions

  • Use cautiously in Parkinson’s disease, history of seizures, or QT prolongation.
  • Monitor for extrapyramidal symptoms.
  • Use caution in patients with renal impairment.

Adverse Reactions - Common

  • Drowsiness, dizziness (Common)
  • Dystonia, akathisia (Common)

Adverse Reactions - Serious

  • QT prolongation, torsades de pointes (Serious)
  • Neuroleptic malignant syndrome (Serious)
  • Extrapyramidal symptoms (Serious)

Drug-Drug Interactions

  • Other medications that prolong QT interval (e.g., certain antidepressants, antiarrhythmics)
  • CNS depressants

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of extrapyramidal symptoms, QT prolongation, and allergic reactions.

Diagnoses:

  • Risk for QT prolongation
  • Impaired sensory perception related to adverse effects

Implementation: Administer as scheduled, monitor ECG and vital signs, assess for adverse reactions.

Evaluation: Assess for effectiveness in preventing PONV and monitor for adverse effects.

Patient/Family Teaching

  • Instruct patient to report dizziness, abnormal heartbeat, or signs of allergic reaction promptly.
  • Advise on the importance of hydration and avoiding other QT-prolonging medications.
  • Explain purpose of medication as part of anesthesia plan.

Special Considerations

Black Box Warnings:

  • Prolonged QT interval, which can lead to serious arrhythmias.

Genetic Factors: Genetic variations may affect drug metabolism and response.

Lab Test Interference: No significant interference reported.

Overdose Management

Signs/Symptoms: Severe hypotension, extrapyramidal symptoms, QT prolongation, seizures.

Treatment: Supportive care, cardiac monitoring, activated charcoal if ingestion is recent, magnesium sulfate for QT prolongation, and other supportive measures.

Storage and Handling

Storage: Store at room temperature away from light and moisture.

Stability: Stable in unopened vials; use within manufacturer-specified period after opening.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.