Home Drug Guide Promazine Hydrochloride

Drug Guide

Generic Name

Promazine Hydrochloride

Brand Names Sparine

Classification

Therapeutic: Antipsychotic, Major Tranquilizer

Pharmacological: Phenothiazine Derivative

FDA Approved Indications

  • Schizophrenia
  • Relief of severe nausea and vomiting

Mechanism of Action

Promazine Hydrochloride works by antagonizing dopamine receptors in the brain, leading to sedative and antipsychotic effects.

Dosage and Administration

Adult: Initial dose typically 25-50 mg 2-3 times daily, titrated up as needed. Adjust based on response and tolerability.

Pediatric: Use is not well established; dosage should be cautious and based on clinical judgment.

Geriatric: Start at lower doses due to increased sensitivity; monitor for side effects.

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

Hepatic Impairment: Use with caution; close monitoring is advised.

Pharmacokinetics

Absorption: Well absorbed from gastrointestinal tract.

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

Metabolism: Metabolized in the liver.

Excretion: Excreted mainly in the urine.

Half Life: Approximately 10-20 hours.

Contraindications

  • Known hypersensitivity to phenothiazines.
  • Coma.
  • Bone marrow suppression.

Precautions

  • Use cautiously in patients with cardiovascular disorders, CNS depression, or Parkinson's disease.
  • Avoid alcohol and other CNS depressants.

Adverse Reactions - Common

  • Drowsiness, sedation (Common)
  • Dry mouth (Common)
  • Orthostatic hypotension (Common)

Adverse Reactions - Serious

  • Extrapyramidal symptoms (Less common)
  • QT prolongation, arrhythmias (Less common)
  • Blood dyscrasias (Rare)
  • Neuroleptic malignant syndrome (Rare)

Drug-Drug Interactions

  • CNS depressants (e.g., alcohol, sedatives), other antipsychotics, antidepressants, antihypertensives

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor mental status, extrapyramidal symptoms, vital signs, and ECG in at-risk patients.

Diagnoses:

  • Risk for falls related to sedation and orthostatic hypotension.
  • Risk for neuroleptic malignant syndrome.

Implementation: Administer doses as ordered, preferably with food to reduce GI irritation, monitor for side effects.

Evaluation: Assess behavioral response and adverse effects regularly.

Patient/Family Teaching

  • Report any signs of movement disorders, fever, or unusual tiredness.
  • Avoid alcohol and CNS depressants.
  • Caution about orthostatic hypotension, rise slowly from sitting or lying positions.

Special Considerations

Black Box Warnings:

  • Potential for QT prolongation and sudden cardiac death.

Genetic Factors: Consider genetic susceptibility to adverse reactions.

Lab Test Interference: May interfere with liver function tests.

Overdose Management

Signs/Symptoms: Anticholinergic effects, sedation, hypotension, extrapyramidal symptoms, coma.

Treatment: Supportive care, monitor cardiac status, gastric lavage if early, activated charcoal, symptomatic treatment.

Storage and Handling

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

Stability: Stable under proper storage conditions.

🛡️ 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.