Home Drug Guide Chlorprothixene

Drug Guide

Generic Name

Chlorprothixene

Brand Names Taractan

Classification

Therapeutic: Antipsychotic, typical

Pharmacological: Thioxanthene derivative

FDA Approved Indications

  • Schizophrenia
  • Manic-depressive illness, related psychoses

Mechanism of Action

Chlorprothixene acts by blocking dopamine D2 receptors in the brain, which helps to alleviate psychotic symptoms. It may also have antihistaminic, anticholinergic, and alpha-adrenergic blocking properties.

Dosage and Administration

Adult: Typically 25-50 mg 3-4 times daily, adjustable based on response and tolerability.

Pediatric: Use is not well established; dosage should be determined by a pediatric psychiatrist.

Geriatric: Lower starting doses are recommended due to increased sensitivity and risk of side effects.

Renal Impairment: Adjust doses cautiously; no specific guidelines, monitor closely.

Hepatic Impairment: Use with caution; dose adjustments may be necessary, monitor liver function.

Pharmacokinetics

Absorption: Well absorbed from the gastrointestinal tract.

Distribution: Widely distributed; crosses the blood-brain barrier.

Metabolism: Metabolized extensively in the liver.

Excretion: Primarily excreted in urine and feces.

Half Life: Approximately 4-8 hours.

Contraindications

  • Hypersensitivity to chlorprothixene or other thioxanthene derivatives.
  • Coma or CNS depression.

Precautions

  • Use with caution in elderly patients, patients with cardiovascular disease, and in those with a history of seizures.
  • Pregnancy category C; can be used if the potential benefit justifies risks.
  • Lactation: Consider benefits vs. risks; may pass into breast milk.

Adverse Reactions - Common

  • Drowsiness, sedation (Frequent)
  • Dry mouth (Frequent)
  • Blurred vision (Occasional)
  • Constipation (Occasional)

Adverse Reactions - Serious

  • Extrapyramidal symptoms (Uncommon)
  • Agranulocytosis (Rare)
  • QT prolongation / cardiac arrhythmias (Rare)
  • Neuroleptic malignant syndrome (Rare)

Drug-Drug Interactions

  • CNS depressants (enhances sedation)
  • Other antipsychotics (risk of increased side effects)
  • CNS-stimulants (may counteract sedative effects)

Drug-Food Interactions

  • Alcohol (enhanced sedative effects)

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor mental status, neurological status, and for extrapyramidal symptoms. Check baseline ECG if needed.

Diagnoses:

  • Risk for falls due to sedation or orthostatic hypotension
  • Impaired physical mobility related to extrapyramidal symptoms

Implementation: Administer with food to decrease GI upset. Educate about side effects and safety precautions.

Evaluation: Assess effectiveness in symptom control and monitor for adverse effects.

Patient/Family Teaching

  • Do not operate heavy machinery until you know how the drug affects you.
  • Avoid alcohol and other CNS depressants.
  • Report any signs of unusual movements, fever, or muscle rigidity.
  • Take medication exactly as prescribed.

Special Considerations

Black Box Warnings:

  • Increased mortality in elderly patients with dementia-related psychosis; avoid use in this population

Genetic Factors: CYP2D6 poor metabolizers may have increased plasma levels.

Lab Test Interference: May cause false-positive urinary catecholamine screening.

Overdose Management

Signs/Symptoms: Drowsiness, agitation, hallucinations, seizures, extravasation, coma, hypotension, QT prolongation.

Treatment: Supportive care, gastric lavage, activated charcoal if recent ingestion, cardiac monitoring. Specific antidote not available.

Storage and Handling

Storage: Store at room temperature, away from light and moisture.

Stability: Stable under normal storage conditions for shelf life specified by manufacturer.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.