Antipsychotic medications cause hypotension?

[alswjdzla]

I had a patient who just came from PACU with continuous epidural infusion. Patient had issues with hypotension and low urine output. We gave NS bolus about 2L but didn't help much and became hypotensive again, still low urine output.

The patient had 4-5 different antipsychotic and antidepressant scheduled at the same time (I can't remember everything but it was Klonopin, Cogentin, Risperdal, and more), and I gave them all together. BTW, he takes them at home as well.

We stopped epidural infusion, patient was still hypotensive. This time, patient is also getting tachycardic (100-110s). H&H okay. Next shift RN comes in and she thinks it's because I gave him all the meds at the same time.

I am just wondering if I shouldn't have given all meds together? Can it cause hypotension?

[NurseCard, ADN]

It's hard to say for sure without knowing what all you gave the

patient at one time. Klonopin alone has a known side effect of

hypotension... but you know, judging by what you are telling us,

it sounds like whatever issue was causing the patient to be

hypotensive, had not yet resolved. Patient needs to continue

to receive more fluid. Giving Klonopin along with Risperdal and

Cogentin is not going to drop a patient's blood pressure that

much, if any at all.

[nrsang97, BSN, RN]

I would think the epidural had more to do with the hypotension than the psych meds. Sounds like they needed more fluid replacement than what they had received.

[Boomer MS, RN]

I would think the epidural had more to do with the hypotension than the psych meds. Sounds like they needed more fluid replacement than what they had received.

I agree with the above, as epidurals are known to cause hypotension and require more fluids. I wonder if you could run this question by an anesthesiologist or an CRNA? As far as giving those meds together, I would doubt it would play a major role but something to consider.