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.