Home Drug Guide Prochlorperazine Maleate

Drug Guide

Generic Name

Prochlorperazine Maleate

Brand Names Compazine, Procomp, Prochlorperazine

Classification

Therapeutic: Antiemetic, Antipsychotic

Pharmacological: Phenothiazine derivative

FDA Approved Indications

  • Nausea and vomiting
  • Psychotic disorders (e.g., schizophrenia)

Mechanism of Action

Blocks dopamine receptors in the brain, particularly in the chemoreceptor trigger zone (CTZ), reducing nausea and psychotic symptoms.

Dosage and Administration

Adult: Typically 5-10 mg three to four times daily, adjusted based on response.

Pediatric: Dose varies; generally 0.15 mg/kg/day divided into 3-4 doses, not to exceed 40 mg/day.

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

Renal Impairment: Use with caution; dose adjustments may be necessary.

Hepatic Impairment: Use with caution; monitor for increased sedation or EPS.

Pharmacokinetics

Absorption: Well absorbed orally.

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

Metabolism: Primarily hepatic via the cytochrome P450 system.

Excretion: Renal and biliary excretion.

Half Life: Approximately 10-19 hours.

Contraindications

  • Comatose states
  • Bone marrow suppression
  • Hypersensitivity to phenothiazines

Precautions

  • Sedation, EPS, anticholinergic effects, hypotension
  • Use cautiously in elderly, Parkinson's disease, cardiac disorders, and in those with a history of seizure disorder

Adverse Reactions - Common

  • Drowsiness, dizziness, dry mouth (Common)
  • Extrapyramidal symptoms (EPS) (Common)
  • Dizziness, orthostatic hypotension (Common)

Adverse Reactions - Serious

  • Tardive dyskinesia (Serious and potentially irreversible)
  • Neuroleptic malignant syndrome (NMS) (Rare)
  • QT prolongation and arrhythmias (Rare)

Drug-Drug Interactions

  • Other CNS depressants, antihypertensives, drugs that prolong QT interval

Drug-Food Interactions

  • Alcohol potentiates sedative effects

Drug-Herb Interactions

  • St. John's Wort may increase risk of CNS side effects

Nursing Implications

Assessment: Monitor for EPS, sedation, blood pressure, baseline ECG in high-risk patients.

Diagnoses:

  • Risk for injury due to sedation or EPS

Implementation: Administer with food to decrease gastrointestinal irritation; monitor for signs of EPS and NMS.

Evaluation: Assess effectiveness in controlling nausea and psychosis; monitor for adverse effects.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Report any involuntary movements, fever, muscle rigidity.
  • Avoid alcohol and CNS depressants.
  • Caution when operating machinery due to sedation.

Special Considerations

Black Box Warnings:

  • Increased risk of death in elderly patients with dementia-related psychosis

Genetic Factors: Slow metabolizers may have increased plasma levels leading to enhanced effects and side effects.

Lab Test Interference: May cause false-positive in some diagnostic tests of catecholamine levels.

Overdose Management

Signs/Symptoms: Sedation, hypotension, EPS, coma.

Treatment: Supportive care, activated charcoal if recent ingestion, monitor vital signs, manage symptoms; possibly use diphenhydramine for EPS.

Storage and Handling

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

Stability: Stable for 2-3 years if stored properly.

🛡️ 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.