Home Drug Guide Prochlorperazine Edisylate

Drug Guide

Generic Name

Prochlorperazine Edisylate

Brand Names Compazine

Classification

Therapeutic: Antiemetic, antipsychotic

Pharmacological: Phenothiazine derivative

FDA Approved Indications

  • Nausea and vomiting
  • Preoperative and postoperative nausea
  • Psychotic disorders
  • Severe anxiety

Mechanism of Action

Prochlorperazine blocks dopamine receptors in the brain's chemoreceptor trigger zone (CTZ), which reduces nausea and vomiting. It also has antipsychotic effects due to dopamine antagonism in the CNS.

Dosage and Administration

Adult: 5-10 mg orally 3-4 times daily as needed; max dose 40 mg/day

Pediatric: Dosing varies by age and weight; typically 0.15-0.33 mg/kg/day divided into 3-4 doses

Geriatric: Start low, monitor closely; typically 5 mg 3-4 times daily, titrate cautiously

Renal Impairment: Use with caution; consider dose adjustment based on severity

Hepatic Impairment: Use with caution; reduce dose as hepatic metabolism may be impaired

Pharmacokinetics

Absorption: Well absorbed from GI tract

Distribution: Widely distributed, crosses blood-brain barrier

Metabolism: Primarily hepatic via CYP enzymes

Excretion: Renal and hepatic routes

Half Life: About 10-12 hours

Contraindications

  • Hypersensitivity to phenothiazines
  • Coma
  • Bone marrow suppression

Precautions

  • History of seizures
  • Children under 2 years old (risk of respiratory depression)
  • Parkinson's disease
  • Prostate hypertrophy
  • Pregnancy Category C; use only if clearly needed

Adverse Reactions - Common

  • Drowsiness (Common)
  • Dizziness (Common)
  • Dry mouth (Common)
  • Blurred vision (Common)
  • Constipation (Common)

Adverse Reactions - Serious

  • Extrapyramidal symptoms (Uncommon)
  • Neuroleptic malignant syndrome (Rare)
  • QT prolongation and arrhythmias (Rare)
  • Blood dyscrasias (Rare)

Drug-Drug Interactions

  • CNS depressants (increase sedation)
  • Other QT-prolonging drugs
  • Lithium (risk of neurotoxicity)
  • Anticholinergic drugs (antagonistic effects)

Drug-Food Interactions

  • Alcohol (enhanced sedation)
  • CNS depressants (additive effects)

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for extrapyramidal symptoms, sedation, blood counts, EKG changes

Diagnoses:

  • Risk for falls due to sedation/dizziness
  • Risk for impaired mobility
  • Impaired skin integrity from anticholinergic side effects

Implementation: Administer with food to reduce GI upset, monitor for adverse effects, avoid alcohol and CNS depressants

Evaluation: Assess nausea relief, monitor side effects, EKG if indicated

Patient/Family Teaching

  • Take medication exactly as prescribed; do not exceed recommended dose
  • May cause drowsiness; avoid driving or operating machinery
  • Avoid alcohol and other CNS depressants
  • Notify provider if signs of abnormal movements, fever, or irregular heartbeat occur
  • Use sunscreen; photosensitivity may occur

Special Considerations

Black Box Warnings:

  • Potential for increased mortality in elderly patients with dementia-related psychosis

Genetic Factors: Consider CYP2D6 polymorphisms affecting metabolism

Lab Test Interference: May affect blood cell counts and ECG readings

Overdose Management

Signs/Symptoms: Extrapyramidal symptoms, sedation, hypotension, seizures, coma

Treatment: Supportive care, activated charcoal if within appropriate timeframe, anti-Parkinsonian drugs for EPS, cardiopulmonary support

Storage and Handling

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

Stability: Stable for recommended shelf life when 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.