Chlorpromazine (Thorazine) Nursing Considerations

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Outline

Generic Name

Chlorpromazine

Trade Name

Thorazine

Indication

Second line treatment of schizophrenia and psychosis, nausea/vomiting, pre-op
sedation, acute intermittent porphyria, headache, bipolar

Action

Exhibits anticholinergic activity, alters effects of dopamine in CNS

Therapeutic Class

Antipsychotic, antiemetic

Pharmacologic Class

Phenothiazines (dopamine D2 receptor antagonist)

Nursing Considerations

• May cause neuroleptic malignant syndrome, sedation, tardive dyskinesia,
hypotension, agranulocytosis
• Assess mental status prior to and during treatment
• Monitor blood pressure
• Ensure patient is taking medication
• Monitor CBC and liver function tests
• Instruct patient not to skip doses or double dose.

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Transcript

Hey guys, let’s talk about, chlorpromazine also known as Thorazine. This medication comes in a variety of forms, including oral, IV, and rectal suppository. It’s actually been around for a while. As you can see here in this advertisement from 1962, it’s promoting Thorazine as a medication that “quickly puts an end to violent outbursts.”
So remember that the therapeutic class is what the drug does in the body. While the pharmacologic class is the actual chemical effect. The therapeutic class of chlorpromazine is an antipsychotic and also an antiemetic while the pharmacologic class is a phenothiazine or a dopamine D2 receptor antagonist. So how does chlorpromazine work? So it exhibits an anticholinergic which alters the effect of Dopamine in the central nervous system. We use chlorpromazine for schizophrenia and psychosis as a second-line treatment. Also nausea, vomiting, preoperative sedation, in acute intermittent porphyria, which is a group of disorders that result from a buildup of porphyrins that create issues within the nervous system, in the skin, in other organs. And finally, chlorpromazine is used for bipolar disorder.
So antipsychotic medications are known for coming along with some side effects that are times very difficult for patients to deal with. So with chlorpromazine, we see things like sedation, hypotension, dry mouth, and insomnia. So let’s take a look at some nursing considerations for chlorpromazine. Be sure to assess the patient’s mental status prior to and during treatment, CBC, liver function tests, and blood pressure should all be monitored while the patient is taking chlorpromazine. It is important to mention that chlorpromazine may cause neuroleptic malignant syndrome, which is indicated by a high fever, rigidity, and confusion, also tardive dyskinesia, which is characterized by those involuntary, repetitive movements, like sticking the tongue out or smacking of the lips, and also agranulocytosis. Be sure to teach the patient to take the medication exactly as directed, not skipping any doses or even doubling doses. And here’s an interesting fact regarding chlorpromazine. It is actually given to treat patients with intractable hiccups and guys, this actually happened to my friend and this is exactly what they prescribed her and her hiccups went away. That’s it for chlorpromazine or Thorazine. Now go out and be your best self today and as always happy nursing.

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