Generic name:

chlorpromazine
Brand name:
Thorazine
Preparations:
PO 10-25mg 2=4 times daily; may increase every 3-4 days (usual dose is 200ng/day;
up to1g/day)

CLASSIFI-CATION
: Antipsychotics

ACTION:
• Block dopamine receptors in the brain; also alter
dopamine release and turnover.
• Prevention of seizures

INDICATION / USES:
•Acute and chronic psychoses, particularly when accompanied by increased
psychomotor
activity. Nausea and vomiting.
• Also used in the treatment of intractable hiccups.

COMMON ADVERSE EFFECTS:

•CNS: neuroleptic malignant syndrome, sedation, extrapyramidal reactions, tardive
dyskinesia
•CV: hypotension (increased with IM, IV)
•EENT: blurred vision,dry eyes, lens opacities
• GI: constipation, dry mouth, anorexia, hepatitis, ileus
• GU: urinary retention
• Hematologic: agranulocytosis, leukopenia
• Skin: photosensitivity, pigment changes, rashes

CONTRA-INDICATIONS:
• Hypersensitivity.
•Cross-sensitivity may exist among phenothiazines. Should not be used in narrow-
angleglaucoma.
•Should not be used in patients who have CNS depression.

NURSING CONSIDERATIONS:
• Assess mental status prior to and periodically during therapy.

• Monitor BP and pulse prior to and frequently during the period of dosage
adjustment. May
cause QT interval changes on ECG.
• Observe patient carefully when administering medication, to ensure that
medication is
actually taken and not hoarded.
•Monitor I&O ratios and daily eight. Assess patient for signs and symptoms of
dehydration.
• Monitor for development of neurolep
tic malignant syndrome (fever, respiratory distress,tachycardia, seizures,
diaphoresis, hypertension or hypotension, pallor, tiredness, severemuscle
stiffness, loss of bladder control. Report symptoms immediately. May also
causeleukocytosis, elevated liver function tests, elevated CPK.
• Advise patient to take medication as directed. Take missed doses as soon as
remembered,
witih remaining doses evenly spaced through out the day. May require several weeks
to obtaindesired effects. Do not increase dose or discontinue medication without
consulting health careprofessional. Abrupt withdrawal may cause dizziness, nausea,
vomiting, GI upset, trembling, oruncontrolled movements of mouth, tongue or jaw.