Chlorpromazine
Trade name:
Largactil
Class: Antipsychotic,
phenothiazine
Pregnancy: (Category C)
Action: Act by
blocking dopamine receptors. It has significant antiemetic effect,
hypoteinsive, sedative & anticholenergic effect.
Uses:
•
Acute & chronic
psychosis (such as schizophrenia, mania & manic Depression.
•
Preanasthetic.
•
Intractable
hiccoughs. Nausea &
vomiting.
Dose
: by mouth psychomotor agitation,
excitement, and violent or dangerously impulsive behavior initially 25
mg 3 times daily (or 75 mg at night), adjusted according to response, to usual
maintenance dose of 75–300 mg daily
Intractable
hiccup, oral 25–50 mg 3–4 times daily
By deep intramuscular injection,
(for relief of acute symptoms, 25–50 mg every
6–8 hours; Child,
1–5 years 0.5 mg/kg every 6–8 hours (max. 40 mg daily); 6–12 years
0.5 mg/kg every 6–8 hours (max. 75 mg daily)
Induction of hypothermia
(to prevent shivering), by deep intramuscular injection, 25–50 mg every 6–8
hours; Child 1–12 years, initially 0.5–1 mg/kg,
followed by maintenance 0.5 mg/kg every 4–6 hours.
Contraindications:
• Sever depression, coma.
• Bone marrow depression.
• Patients with history of seizures & on anticonvulsant
therapy.
• Hepatic & renal diseases.
• Prostatic hypertrophy.
• Dehydration - glaucoma, measles.
Side effects:
• Depression, dizziness, seizures, gynecomastia. Orthostatic
hypotension, bronchospasm, larlynyospasm
tardive dyskinesia, photosensitivity, leukopnea, aplastic anemia, and
dry mouth.
Nursing
considerations:
• Shouldn’t be used to treat nausea & vomiting in children
less than 6 months of age.
• Should avoid getting solution on hands or clothing (it will
cause dermatitis).
• Solutions with marked discoloration should be discarded.
• Note any history of seizures.
• Take liver & kidney function test periodically.
• Document & rotate injection sites.
• Report side effects immediately.
• Determine age of male patients & assess for prostatic
hypertrophy.
