Home Drug Guide Propiomazine Hydrochloride

Drug Guide

Generic Name

Propiomazine Hydrochloride

Brand Names Largon

Classification

Therapeutic: Antipsychotic, Sedative

Pharmacological: Phenothiazine derivative

FDA Approved Indications

  • Short-term treatment of insomnia in adults

Mechanism of Action

Propiomazine acts primarily as an antihistamine with sedative properties. It exerts its effects by blocking H1 histamine receptors in the brain, and may have some anticholinergic and sedative effects due to its phenothiazine structure.

Dosage and Administration

Adult: 25-50 mg at bedtime; maximum 100 mg/day

Pediatric: Not typically recommended for children due to safety concerns

Geriatric: Start at lower doses, e.g., 25 mg at bedtime, and adjust carefully due to increased sensitivity

Renal Impairment: Use with caution, consider dose reduction

Hepatic Impairment: Use with caution; liver function may affect metabolism and clearance

Pharmacokinetics

Absorption: Well absorbed after oral administration

Distribution: Widely distributed throughout the body, crosses the blood-brain barrier

Metabolism: Metabolized in the liver, primarily via hepatic enzymes

Excretion: Excreted mainly in urine

Half Life: Approximately 10-12 hours, may be prolonged in elderly or hepatic impairment

Contraindications

  • Severe CNS depression
  • ComA intolerances to phenothiazines

Precautions

  • Use with caution in elderly due to potential for sedation and falls, patient with liver impairment, history of seizure disorders, or history of Parkinson's disease

Adverse Reactions - Common

  • Sedation (Common)
  • Dizziness (Common)
  • Dry mouth (Common)

Adverse Reactions - Serious

  • Extrapyramidal symptoms (Uncommon)
  • Hypotension (Uncommon)
  • QT prolongation, arrhythmias (Rare)

Drug-Drug Interactions

  • Alcohol, CNS depressants (additive sedation), Anticholinergic agents (increased anticholinergic effects)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for excessive sedation, respiratory status, mental status, and involuntary movements

Diagnoses:

  • Risk for falls due to sedation
  • Impaired sleep pattern

Implementation: Use lowest effective dose, advise to avoid alcohol and CNS depressants, assess sleep pattern and side effects

Evaluation: Efficacy in reducing sleep disturbances and monitoring adverse effects

Patient/Family Teaching

  • Take medication exactly as prescribed, preferably before bedtime
  • Avoid alcohol and CNS depressants
  • Report any excessive drowsiness, unusual movements, or cardiovascular symptoms
  • Do not operate heavy machinery until sedative effects are known

Special Considerations

Black Box Warnings:

  • Potential for serious adverse effects including respiratory depression in overdose

Genetic Factors: Metabolism may vary with CYP2D6 polymorphisms

Lab Test Interference: None significant

Overdose Management

Signs/Symptoms: Excess sedation, hallucinations, seizures, respiratory depression, hypotension, extrapyramidal symptoms, arrhythmias

Treatment: Supportive care, activated charcoal if early, IV fluids, monitoring cardiac status, airway management, symptomatic treatment, and measures to control seizures if they occur

Storage and Handling

Storage: Store at room temperature away from light and moisture

Stability: Stable within the expiration date when properly stored

🛡️ 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.