VII.

DRUGSTUDY

GENERIC/BRA
ND/CLASSIFIC
ATION
Generic:
Chlorpromazine

BRAND:
Thorazine

CLASSIFICATI
ON:
Antiemetics,
Antipsychotics

MECHANISMOF
ACTION
Alterseffectsof
dopamine(D2)in
CNS.Has
significant
anticholinergic/
alphaadrenergic
blockingactivity.

INDICATION

CONTRAINDICATIO
N

ADVERSEREACTION

DOSAGE

NURSING
RESPONSIBILITY

RATIONALE

Schizophreniaand
psychoses.
Hyperexcitable,
combative,explosive
behaviorinchildren.
Hyperactivechildwith
conductdisorder.
Acutemania.Nausea
andvomiting.
Intractablehiccups.
Preoperative
apprehension.Acute
intermittentporphyria.

Hypersensitivity;
hypersensitivityto
sulfites(injectable)or
benzylalcohol(SR
capsules);cross
sensitivitywithother
phenothiazinesmay
occur;angleclosure
glaucoma;bone
marrowdepression;
severeliver/CV
disease;concurrent
pimozideuse.

CNS:NEUROLEPTIC
MALIGNANT
SYNDROME,sedation,
extrapyramidal
reactions,TD.
EENT:Blurredvision,
dryeyes,lensopacities.
CV:Hypotension(
withIM,IV),
tachycardia.
GI:Constipation,dry
mouth,anorexia,
hepatitis,ileus,
priapism.
GU:Urinaryretention.
Derm:photosensitivity,
pigmentchanges,
rashes.
Endo:Galactorrhea,
amenorrhea.
Hemat:
AGRANULOCYTOSIS
,leukopenia.
Metab:Hyperthermia.
Misc:Allergic
reactions.

Usual:
PO(Adults):
Psychoses:1025
mg24timesdaily;
mayevery34
days
(usualdoseis200
mg/day;upto1
g/day)or30300
mg13timesdaily
asextendedrelease
capsules.

1.Assessmentalstatusprior
toandperiodicallyduring
therapy.

Sothatthenursecan
determinemajororminor
changesafterdrughasbeen
taken.

2.MonitorBPandpulse
priortoandfrequently
duringtheperiodofdosage
adjustment.MaycauseQT
intervalchangesonECG.

Toobserveforanychanges
relevant.

3.Thedrugmaybetaken
withorwithoutfood.

Maybetakenw/mealsto
reduceGIdiscomfort.

4.Observepatientcarefully
whenadministering
medication.

Toensurethatmedicationis
actuallytakenandnot
hoarded.

5.MonitorI&Oratiosand
dailyweight.

Assesspatientforsignsand
symptomsofdehydration.

OffLabelUse:
Vascularheadache.
Bipolardisorder.

IM(Adults):
Severepsychoses:
2550mginitially,
mayberepeatedin
1hr;tomaximum
of400mgevery3
12hrifneeded(up
to1g/day).

Actual:

6.Monitorfordevelopment tobeabletowatchoutfor
ofneurolepticmalignant
anychanges,andreportto
syndrome(fever,respiratory physicianthesechanges
distress,tachycardia,
seizures,diaphoresis,
hypertensionorhypotension,
pallor,tiredness,severe
musclestiffness,lossof
bladdercontrol.Report
symptomsimmediately.May
alsocauseleukocytosis,
elevatedliverfunctiontests,
elevatedCPK.
7.Advisepatienttotake
medicationasdirected.Take

Misseddosesmayrequire