Drug StudyNameGeneral ConsiderationsIndicationMechanism of actionChemical classesAdministration/ Dosage/Relief of symptomsContraindicationsSide effects

Generic name: chlorpromazine

Trade name: ThalitoneAssessment: HistoryAllergy to chlorpromazine; comatose or severely depressed states, bone marrow depression, circulatory collapse, subcortical brain damage, Parkinsons disease, liver damage, breast cancer, arterosclerosis, severe hypotension.

Physical:T, weight; skin color, turgor; reflexes, orientation, IOP, opthalmologic examination; P, BP, orthostatic BP, ECG; R, adventitious sounds; bowel sounds, normal output, liver evaluation, prostates palpation, normal urine output, CBC; urinalysis, thyroid, LFTs , renal function test, EEG.Management of manifestation of psychotic disorder; control of manic phase of manic depressive illness.

Relieve of preoperative restlessness and apprehension.Adjunct in treatment of tetanus.

Acute intermittent prophyria therapy.

Blocks dopamine receptors in the brain, depresses the RAS; anticholinergic, antihistamine and alpha- adrenergic blocking activity may contribute to some of its therapeutic and adverse reactions.Antipsychotic-Dopaminergic blocker

AnxiolyticAntiemticPatient Dosage:100 mg, HS

Tablets- 10,25,50,100,200 mg

Suppository-100 mg-25 mg/Ml.

Full clinical antipsychotic effects may require 6 week to 6 mo of therapy.

Adult:Excessive anxiety, agitation in psychiatric patients; 25 mg IM; may repeat in 1 hr. Increase dosage gradually in inpatient, up to 40 mg every 4-6 hours. Switch to oral dosage asap, 25-50 mg PO tid for out-patient.

PediatricsGenerally not used in children younger than 6 mo.

Psychiatric outpatient: 0.5 mg/kg rectally every 6-8 hours, not to exceed 40 mg/day (up to 5 years) or 75 mg/day (5-a2 years).

Psychiatric inpatient: 50-100 mg/day PO; maximum of 40 mg/day IM for children up to 5 years; maximum of 75 mg/day.Contraindicated with allergy to chlorpromazine, comatose or severely depressed states, bone marrow depression, circulatory collapse, cubcortical brain damage, Parkinsons disease, liver damage, Parkinsons disease, severe hypotension or hypertension.

Use cautiously with respiratory disorder; glaucoma; epilepsy; peptic ulcer, decrease renal function; prostate hypertrophy; breast cancer; exposure to heat, phosphorus insecticides, children with chickenpox.CNS: drowsiness, sedation, seizures, dizziness, syncope, headache, tremor, disturbed sleep, nightmares, restlessness, agitation, increased salivation, sweating, tardive dyskinesia, neuroleptic malignant syndrome

CV: tachycardia, hypotension, hypertension, ECG changes, potentially fatal myocarditis

GI: nausea, vomiting, constipation, abdominal discomfort, dry mouth

GU: urinary abnormalities

Hematologic:Leucopenia, agranulocytosis

Other: fever, weight gain, rash, development of diabetes mellitus.

Nursing Intervention

Do not give by subcutaneous injection; give slowly by deep IM injection into upper quadrant of buttocks.Keep patient recumbent for 30 minutes after injection to avoid orthostatic hypotension.If giving drug via continuous infusion for intractable hiccups, keep patient flat in bed during infusion and monitor BP.Avoid skin contact with parenteral drugs solution to due to possible contact dermatitis.

Collaborative:

Patient of patients guardian should be advised about the possibility of tardive dyskinesia.

Be alert to potential for aspiration because of suppressed cough reflex.Monitor renal function test; discontinue if serum creatinine or BUN becomes abnormal.Monitor CBC; discontinue if WBC count is depressed.