Home Drug Guide Fluphenazine Hydrochloride

Drug Guide

Generic Name

Fluphenazine Hydrochloride

Brand Names Prolixin, Permitil, Fluphenazine Hcl

Classification

Therapeutic: Antipsychotic (Typical)

Pharmacological: Phenothiazine antipsychotic

FDA Approved Indications

  • Schizophrenia
  • Chronic psychosis

Mechanism of Action

Blocks dopamine D2 receptors in the brain, reducing psychotic symptoms.

Dosage and Administration

Adult: Initial: 2.5 mg to 10 mg daily in divided doses; maintenance doses vary.

Pediatric: Use is generally not recommended; consult specific guidelines.

Geriatric: Start at lower doses due to increased sensitivity; monitor closely.

Renal Impairment: Adjust dose based on clinical response and tolerability.

Hepatic Impairment: Use with caution; no specific adjustments established.

Pharmacokinetics

Absorption: Well-absorbed orally

Distribution: Widely distributed, crosses blood-brain barrier

Metabolism: Primarily hepatic, via CYP450 enzymes

Excretion: Metabolites excreted in urine and feces

Half Life: 15 to 30 hours

Contraindications

  • Hypersensitivity to phenothiazines
  • ComAion, severely depressed CNS

Precautions

  • Use cautiously in Parkinson's disease, history of seizures, blood dyscrasias, cardiovascular disease, pregnancy, and lactation

Adverse Reactions - Common

  • Extrapyramidal symptoms (dystonia, Parkinsonism, akathisia) (Common)
  • Drowsiness, sedation (Common)
  • Dry mouth, blurred vision, urinary retention (Common)

Adverse Reactions - Serious

  • Neuroleptic malignant syndrome (fever, muscle rigidity, autonomic instability) (Rare)
  • Tardive dyskinesia (Less common with long-term use)
  • Cardiac arrhythmias (QT prolongation) (Rare)

Drug-Drug Interactions

  • CNS depressants, anticholinergic agents, other QT-prolonging drugs, drugs affecting CYP450 enzymes

Drug-Food Interactions

  • Alcohol, caffeine

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor mental status, extrapyramidal symptoms, vital signs, cardiac status, and labs (CBC, LFTs)

Diagnoses:

  • Risk for injury, risk for falls, disturbed thought processes

Implementation: Administer as prescribed; observe for side effects; gradual dose titration

Evaluation: Assess for symptom improvement and adverse effects

Patient/Family Teaching

  • Do not operate machinery until oculogically assessed; avoid alcohol; report worsening symptoms or adverse reactions; adhere to follow-up appointments.

Special Considerations

Black Box Warnings:

  • Increased mortality in elderly patients with dementia-related psychosis

Genetic Factors: CYP2D6 poor metabolizers may experience increased plasma levels

Lab Test Interference: May affect liver function tests

Overdose Management

Signs/Symptoms: Serious CNS depression, extrapyramidal symptoms, hypotension, coma

Treatment: Supportive care, gastric lavage, activated charcoal; manage dysrhythmias; administer IV fluids and medications as needed

Storage and Handling

Storage: Store at room temperature, 20°C to 25°C (68°F to 77°F) in a tightly closed container

Stability: Stable under recommended storage conditions for the shelf life specified

🛡️ 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.