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Mental Health Medications > Chlorpromazine > Flashcards

Chlorpromazine Flashcards

1
Q

What pharmacologic class of drugs does Chlorpromazine belong to?

A

Phenothiazine

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2
Q

Broadly speaking what is its mechanism of action?

A

D2 dopamine receptor antagonist

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3
Q

What is it used to treat?

A

Positive symptoms of schizophrenia

Controls manic symptoms in schizoaffective disorder

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4
Q

Time of onset?

A

Oral - 30 to 60 mins

IV/IM - minutes

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5
Q

Peak period?

A

Oral - 2-4 hours

IV/IM - 15-20 mins

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6
Q

Duration?

A

30 hours

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7
Q

What cautions should be exercised with sustained release forms of the drug?

A

Do not crush or open

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8
Q

Is it safe to stop using the drug suddenly?

A

No, it must be withdrawn over 2 to 3 weeks

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9
Q

What are the withdrawal effects if the drug is stopped suddenly?

A 
Nausea
Vomiting
Dizziness
Tremors
Dyskinesia
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10
Q

When is it appropriate to use an IV form of the drug?

A

Only during surgery or for severe hiccups

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11
Q

What are common adverse effects of Chlorpromazine?

A 
Dizziness
Drowsiness
Orthostatic hypotension
EPS
Constipation
Photosensitivity
Urinary Retention
Sedation
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12
Q

In which patient groups do EPS more commonly occur?

A

Elderly, female and paediatric patients who are dehydrated.

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13
Q

For which symptoms should patients taking the drug who are exposed to higher temperatures be more closely monitored for?

A

Neuroleptic malignant syndrome

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14
Q

What is the Black Box Warning for this drug?

A

Elderly patients with dementia related psychosis at increased risk of death

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15
Q

When is Chlorpromazine contra-indicated?

A 
During alcohol withdrawal
If patient is in a comatose state
CNS Depression
Hypothyroidism
Phaeochromocytoma
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16
Q

If a patient has what conditions should chlorpromazine be used with caution?

A

Subcortical brain damage
Bone marrow depression
Reye’s syndrome
Diabetes

17
Q

What type of drugs is it not safe to use Chlorpromazine with?

A

Sedative medications such as Phenobarbital

18
Q

What adverse physiological effect can result from concurrent use of chlorpromazine and tricyclic anti-depressants?

A

Elevated blood pressure

19
Q

What can happen with concurrent use of Chlorpromazine and antiseizure meds?

A

It can lower the seizure threshold

20
Q

What tests can this drug effect?

A

Liver function tests
False positive - amylase, 5 hydroxyindole acetic acid, porphobilinogens, urobilinogen and urine bilirubin.
False positive or negative pregnancy tests

21
Q

What can happen with concurrent use of the drug with either Kava or St John’s Wort?

A

Increased risk and severity of dystonia

22
Q

What is dystonia?

A

Neurological movement disorder syndrome
Sustained or repetitive muscle contractions
Twisting and repetitive movements or abnormal fixed postures.
Resemble a tremor

23
Q

Is there a treatment for overdose?

A

No

Patients are treated symptomatically

24
Q

According to the BNF what group of Phenothiazines does Chlorpromazine Hydrochloride belong to?

A

Group 1

25
Q

For schizophrenia/psychoses/anxiety what is the initial dose recommended by the BNF for oral administration?

A

25mg TID
OR
75mg nochte

26
Q

What is the max daily dose recommended by BNF for schizophrenia/psychoses/anxiety?

A

1g daily

27
Q

What adjustment should be made for elderly/debilitated patients being treated for psychoses/schizophrenia/anxiety?

A

Use a third to half of adult dose

28
Q

How is the drug administered in the treatment of acute symptoms of psychoses

A

Deep IM

29
Q

When would you use Chlorpromazine to control nausea and vomiting?

A

In terminal illness where other drugs have failed or are not available

30
Q

One of the side effects of Chlorpromazine is an Oculogyric crises. What is this?

A

Dystonic reaction characterized by a prolonged involuntary upward deviation of the eyes.

31
Q

What precautions must be taken when administering Chlorpromazine intramuscularly?

A

Patient should remain supine

Monitor Blood Pressure for 30 minutes post treatment

Mental Health Medications (12 decks)

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