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To avoid treatment withdrawal and until the correct adherence to the treatment occurs it will be of vital importance to create a therapeutic alliance between patient and nurse through psychosocial approaches to make the bond between them more assertive and provide care holistically for all needs.</p><p id="par0015" class="elsevierStylePara elsevierViewall">These undesirable adverse effects may interfere in the patient's daily life, affecting them socially and provoking changes to their body image. Sedation, which is related to dose and to plasma levels, is regarded as the most negative, and tolerance to it may take several months. Sialorrhea presents in 50% of patients, mainly during sleep, without any absolute tolerance ever being reached. It persists over time and is not reactive to treatment.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Weight increase is a factor to bear in mind as indicated by Villanueva<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> in his study conducted with 76 patients being treated with clozapine. It was confirmed that an increase in body mass index after 18 weeks of 1.83<span class="elsevierStyleHsp" style=""></span>kg/m<span class="elsevierStyleSup">2</span> occurred and after 56 this was 2.67<span class="elsevierStyleHsp" style=""></span>kg/m<span class="elsevierStyleSup">2</span>. Regarding this increase, when there is overweight there is lower risk of continuous weight gain and obesity should therefore not being a limiting factor for initiation of treatment.</p><p id="par0025" class="elsevierStylePara elsevierViewall">It is important to handle the idiosyncrasy of the schizophrenic patient, without losing sight of other considerations which may acquire importance, such as a tobacco habit and caffeine abuse, due to their prevalence.</p><p id="par0030" class="elsevierStylePara elsevierViewall">With regard to smoking we should highlight that the components of tobacco induce CYP1A2 synthesis and UGT (glucuronosyltransferase) synthesis involved in the metabolism of clozapine, as a result of lowering plasma levels.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> This effect appears after 7–12 cigarettes/day and therefore when the tobacco habit ceases the plasma concentrations of the drug increase by 50%. The significance of this data comes from the fact that hospital units which forbid this habit are increasingly more common and dosing must therefore be different on admittance to and discharge from hospital. This dose adjustment would be 1.5 with regard to non smokers.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Regarding caffeine usage for combating the drowsiness associated with treatment with clozapine, in contrast to the expected, it leads to an increase in sedation due to the sudden increase in drug levels.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Although clozapine has been submitted to analytic controls where the risk of agranulocytosis, among other parameters is evaluated, the Spanish Agency for Medication and Healthcare Products recently published a demand that professional send blood tests results of these patients being treated with clozapine, together with another series of modifications aimed at overcoming the barriers to this treatment.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Nurses can enumerate and offer information on the effects of caffeine in the patient being treated with clozapine as well as intervene in their tobacco smoking, whilst simultaneously watching for non-specific early signs of myocarditis (fever, chest pain, dyspnoea, skin rashes, etc.) which require more detailed study due to the potentially serious but reversible nature of the symptoms.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Appropriate follow-up and continuously updated knowledge by nurses help to improve the patient's quality of life, avoiding complications from adverse effects and detecting early life-threatening situations.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Tuñón-Gorgojo L, Estrada-Alarcón N, Muquebil Ali Al Shaban-Rodríguez OW. Potenciación del rol enfermero en el paciente tratado con clozapina. Enferm Clin. 2019;29:201–202.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Addition of filgrastim (Neupogen) por clozapine rechallenge in the case of Parkinson disease patient" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J. Friedman" 1 => "E. Yeboah" 2 => "M. Hmenmenau" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/WNF.0000000000000230" "Revista" => array:6 [ "tituloSerie" => "Clin Neuropharmacol" "fecha" => "2017" "volumen" => "40" "paginaInicial" => "233" "paginaFinal" => "234" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28922288" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "¿Should obesity be a limiting factor for clozapine treatment?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A. Villanueva" 1 => "A. Romero" 2 => "J. Goti" 3 => "E. Fernandez-Egea" 4 => "J. Undurraga" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rpsm.2012.05.005" "Revista" => array:6 [ "tituloSerie" => "Rev Psiquiatr Salud Ment" "fecha" => "2013" "volumen" => "6" "paginaInicial" => "75" "paginaFinal" => "79" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23084801" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effects of a smoking ban on clozapine plasma concentrations in a nonsecure psychiatric unit" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S.H. Gee" 1 => "D.M. Taylor" 2 => "S.S. Shergill" 3 => "R. Flanagan" 4 => "J.H. MacCabr" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/2045125316677027" "Revista" => array:6 [ "tituloSerie" => "Ther Adv Psychopharmacol" "fecha" => "2017" "volumen" => "7" "paginaInicial" => "79" "paginaFinal" => "83" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28255437" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of caffeine-containing versus decaffeinated coffee on serum clozapine concentrations in hospitalised patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "K. Raaska" 1 => "V. Raitasuo" 2 => "J. Laitila" 3 => "P.J. Neuvonen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Basic Clin Pharmacol Toxicol" "fecha" => "2004" "volumen" => "94" "paginaInicial" => "13" "paginaFinal" => "18" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14725610" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Flexibilization in controlling the use of clozapine: a great opportunity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E. Álvarez de Morales" 1 => "O.W. Muquebil Ali Al Shaban" 2 => "J. Fernandez" 3 => "C. 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