Drug Name

Classificatio
n

Action

Indication

Contraindicatio
n

Side Effect

Nursing Consideration

Chlorpromazine
(Thorazine)

Antipsychoti
cs,
Antiemetics

Chlorpromazine is a
neuroleptic that acts
by blocking the
postsynaptic
dopamine receptor in
the mesolimbic
dopaminergic system
and inhibits the
release of
hypothalamic
andhypophyseal
hormones. It has
antiemetic, serotoninblocking, and weak
antihistaminic propert
ies and slight
ganglion-blocking
activity.
Onset:
15 min (IM); 30-60
min (oral).
Absorption:
Readily but
sometimes erratically
absorbed from the GI
tract (oral);
peak plasma
concentrations after
2-4 hr.

Chlorpromazine
is used virtually
in all types of
psychoses. It can
be combined
with other antipsychotics.
Chlorpromazine
is also used to
control anxiety or
agitation
in certain patient
s,to relieve a
wide range of
drug or disease
induced
vomiting, and in
severehiccups.
Chlorpromazine
is also used in
the treatment of
tetanus in
combination
withother drugs.
Acute and
chronic
psychoses,
particularly when
accompanied by

Hypersensitivit
y.
Crosssensitivity may
exist among
phenothiazines.
Should not be
used in narrowangle
glaucoma.
Should not be
used in patients
who have CNS
depression.
Coma
bone-marrow
suppression
phaeochromo
cytoma
lactation.

Blurred vision;
constipation;
dizziness;
drowsiness; dry
mouth; light
sensitivity;
nasalcongestion.S
evere allergic
reactions (rash;
hives; itching;
difficulty
breathing;
tightness inthe
chest or throat;
swelling of the
mouth, face, lips,
or tongue);
changes
in breasts;changes
in menstrual
period;
changes in vision;
chest pain; chills;
confusion;
difficultyswallowi
ng; difficulty
urinating;
drooling; extreme
tiredness; fever;

1. Assess mental status prior

to and periodically during
therapy.R: So that the nurse
can determine major or
minor changes after
drug has been taken.
2. Monitor BP and pulse
prior to and frequently
during the period of
dosage adjustment.May
cause QT interval changes
on ECG.R: to observe for
any changes relevant.
3. The drug may be taken
with or without food.R:
May be taken w/ meals
to reduce GI discomfort.
4. Observe patient carefully
when administering
medication.R: to ensure that
medication is actually taken
and not hoarded.
5. Monitor I&O ratios and
daily weight.R: Assess
patient for signs and
symptoms of dehydration.
6. Monitor for development
of neuroleptic
malignant syndrome (fever,

Distribution:
Widely distributed;
crosses the bloodbrain barrier and
placenta; enters breast
milk.
Metabolism:
Extensively hepatic
by hydroxylation and
conjugation with
glucuronic acid, Noxidation, oxidation
of a sulfur atom and
dealkylation.
Excretion:
Urine and faeces (as
active and inactive
metabolites); 30 hr
(elimination halflife). Block
dopamine receptors
in the brain; also alter
dopamine release
and turnover.
Prevention of
seizures

increased
psychomotor acti
vity. Nausea and
vomiting.
Also used in
the treatment
of intractable
hiccups.

inability
to moveeyes;
involuntary
movements of the
face, mouth,
tongue, or jaw;
jitteriness; lip
smackingor
puckering; masklike face; muscle
spasms of the
face, neck, or
back; prolonged
or painful
erection; puffing
of cheeks; rigid
muscles; seizures;
shuffling walk;
skindiscoloration;
sleeplessness;
sore throat; stiff
arms or
legs; tremors of
hands; twitching
or twisting
movements;
weakness of arms
or legs; yellowing
of the skin

respiratorydistress,
tachycardia, seizures,
diaphoresis, hypertension
or hypotension, pallor,
tiredness,severe muscle
stiffness, loss of bladder
control. Report symptoms
immediately. May alsocause
leukocytosis, elevated liver
function tests, elevated
CPK.R: to be able to watch
out for any changes, and
report to physician these
changes
7. Advise patient to
take medication as directed.
Take missed doses as soon
asremembered, with
remaining doses evenly
spaced through out the
day.R: Missed doses may
require several weeks to
obtain desired effects.
8. Do not increase dose or
discontinue medication
without consulting health
care professional.R: Abrupt
withdrawal may cause
dizziness, nausea, vomiting,

or eyes.

GI upset, trembling,
or uncontrolled movements
of mouth, tongue or jaw.
9. Instruct patient to report
significant changes in
neurological status, such as
seizures,extreme lethargy,
slurred speech,
disorientation or ataxia.R:
To report to the physician
and to be able to do some
precautions.
10. Monitor kidney and
liver function of the
patient.R: Observe for signs
of hepatic toxicity. Monitor
laboratory blood work such
as platelets,PT, PTT, and
liver enzymes
11. Monitor cardiovascular
status of the patient.R: To be
able to observe for
hypertensive crisis and signs
of impending stroke or
M.I.:severe headache,
dizziness, paresthesias, brad
ycardia,
tachycardia, nausea/vomitin
g,diaphoresis.

12. Watch out for

somnolence, coma,
hypotension and
extrapyramidal
symptoms,agitation and
restlessness, convulsions,
fever, autonomic reactions
such as dry mouth andileus,
EKG changes and cardiac
arrhythmias.