Prolixin/Haldol Injections

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    I have recently started work with MR/MH patients and will be giving Prolixin and Haldol injections.

    Any special things I should know about giving these injections? Any tips? I can't find any good websites for administration of these meds...thanks.
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    I hope you will enjoy your new job and find it very rewarding. I have worked with MH patients for 18 years. We gave Haldol and Prolixin injections in the hospital unit when I worked there, but I never gave any Haldol Decanoate or Prolixin Decanoate until I started working outpatient. I assume you are referring to decanoate meds? The first few I gave were challenging, but luckily, the patients I were so accustomed to getting the injection, they were very cooperative. You will need a bigger needle because the medication is in a thick oil. I always use 21gauge 1 1/2 inch needle and a 3cc syringe. The largest dose of Haldol Dec I ever gave was 300mg, so I gave 2 injections (one in each UOQ) of 150mg each. I don't think you can give over 200mg (2cc) in one injection. It is a good idea to draw it up, then change needles because the new needle will be sharper, and also because medication on the outside of the needle can be irritating to the tissue when injected. I always use gluteal (UOQ) because I hate giving shots in the deltoid, and have no experience with other deep muscle sites. Most patients are not equipped with good "targets," and sometimes it is not easy to find the correct site because their "landmarks" aren't as well defined as the ones pictured in textbooks. One doctor I worked with always ordered the Z-track technique, but I was never good at that. The medication goes in very slowly because of the thickness of the solution. Sometimes the medication will ooze back out, and an old nurse told me that leaving a tiny bit of air in the syringe helps prevent the leaking. It is important to rotate sites and be careful not to give it in the same place because after years of injections, they develop scaring. After injection, I hold slight pressure to the site. The old nurse said to massage the site a bit, but I don't. Sometimes decanoate meds are refered to as "depot" meds, I guess because once injected, the med is slowly absorbed over 2-4 weeks unlike regular meds that absorb fast. One last thing, I always cover the site with a band-aid because it just makes me feel better.
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    thanks so much for your information...it really helps. I guess I am also going to be giving Risperdol...Do you know anything about administration of that? Maybe it isn't any different than giving any other IM.

    Thanks...
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    It's ok to get "nursing tips" here, but I think you should check out the policy and procedure manual on your unit for the details on administering meds.
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    if you read the instructions that come with the Risperdal Consta you will do fine. i try to give the injections at an angle and make sure it's room temp so it doesnt hurt as bad. don't change the needle because it it teflon-like coated so the "beads" will flow thru. hope this helps. I LOVE MY PSYCH JOB.
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    augig----good advice about referring to Policy & Procedure Manuals. If there are any. We don't have anything re: injection technique where I work. Do you administer decanoate injections?

    Risperdal Consta---when this med was just getting started, a drug rep gave me a video that was very helpful. Maybe you could get one.

    SuperNurse65: have you had any problem with needles getting clogged or any trouble giving Risperdal Consta?
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    Morgan: I have had a needle clog one time in two years. I mix the solution as the client is standing waiting and give it immediately.
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    augig, that is great advice about referring to the policy and procedure manual, but this place does not have one. It is not a hospital and basically I am teaching myself.
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    oh, and supernurse65, thanks for the advice about not changing the needle on the Risperdal.

    Morgan, I'll check into the video.
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    Re: clogged needles with Risperdal Consta. I have had so many episodes of needles getting clogged giving Risperdal Consta, I contacted the company. The person I talked to admitted that there have been other reports with the needles, and offered to send me a supply from another manufacturer, and I've had better results with them. The problem with needles getting "clogged" only happened with a few of my patients, and the problem probably wasn't with the needles, but with the scar tissue as a result of years of decanoate injections.
    With Risperdal Consta, after mixing it and drawing it up, you have to give it immediately because within 2 minutes, the solution settles out.


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