GENERIC/BRA ND/CLASSIFIC ATION Generic: Chlorpromazi ne

MECHANISM OF ACTION Alters effects of dopamine (D2) in CNS. Has significant anticholinergic/ alphaadrenergic blocking activity.

INDICATION Schizophrenia and psychoses. Hyperexcitable, combative, explosive behavior in children. Hyperactive child with conduct disorder. Acute mania. Nausea and vomiting. Intractable hiccups. Preoperative apprehension. Acute intermittent porphyria. Off-Label Use: Vascular headache. Bipolar disorder.

CONTRAINDICATIO N Hypersensitivity; hypersensitivity to sulfites (injectable) or benzyl alcohol (SR capsules); crosssensitivity with other phenothiazines may occur; angleclosure glaucoma; bone-marrow depression; severe liver/CV disease; concurrent pimozide use.

ADVERSE REACTION CNS: NEUROLEPTIC MALIGNANT SYNDROME, sedation, extrapyramidal reactions, TD. EENT: Blurred vision, dry eyes, lens opacities. CV: Hypotension ( with IM, IV), tachycardia. GI: Constipation, dry mouth, anorexia, hepatitis, ileus, priapism. GU: Urinary retention. Derm: photosensitivity, pigment changes, rashes. Endo: Galactorrhea, amenorrhea. Hemat: AGRANULOCYTOSIS , leukopenia. Metab: Hyperthermia. Misc: Allergic reactions.

DOSAGE Usual: PO (Adults): Psychoses: 10 25 mg 24 times daily; may every 3 4 days (usual dose is 200 mg/day; up to 1 g/day) or 30300 mg 13 times daily as extendedrelease capsules. IM (Adults): Severe psychoses: 25 50 mg initially, may be repeated in 1 hr; to maximum of 400 mg every 312 hr if needed (up to 1 g/day). Actual:

NURSING RESPONSIBILITY 1. Assess mental status prior to and periodically during therapy. 2. Monitor BP and pulse prior to and frequently during the period of dosage adjustment. May cause QT interval changes on ECG. 3. The drug may be taken with or without food. 4. Observe patient carefully when administering medication. 5. Monitor I&O ratios and daily weight. 6. Monitor for development of neuroleptic malignant syndrome (fever, respiratory distress, tachycardia, seizures, diaphoresis, hypertension or hypotension, pallor, tiredness, severe muscle stiffness, loss of bladder control. Report symptoms immediately. May also cause leukocytosis, elevated liver function tests, elevated CPK.

RATIONALE So that the nurse can determine major or minor changes after drug has been taken. To observe for any changes relevant.

BRAND: Thorazine

May be taken w/ meals to reduce GI discomfort. To ensure that medication is actually taken and not hoarded. Assess patient for signs and symptoms of dehydration. to be able to watch out for any changes, and report to physician these changes

CLASSIFICAT ION: Antiemetics, Antipsychotics

Drug Image:

Missed doses may require several weeks to obtain desired effects.