Chlorpromazine (Thorazine) Nursing Considerations

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Kara Tarr
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Drug Card Chlorpromazine (Thorazine) (Cheatsheet)
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Outline

Generic Name

Chlorpromazine

Trade Name

Thorazine

Indication

Second line treatment of schizophrenia and psychosis, nausea/vomiting, pre-op
sedation, acute intermittent porphyria, headache, bipolar

Action

Exhibits anticholinergic activity, alters effects of dopamine in CNS

Therapeutic Class

Antipsychotic, antiemetic

Pharmacologic Class

Phenothiazines (dopamine D2 receptor antagonist)

Nursing Considerations

• May cause neuroleptic malignant syndrome, sedation, tardive dyskinesia,
hypotension, agranulocytosis
• Assess mental status prior to and during treatment
• Monitor blood pressure
• Ensure patient is taking medication
• Monitor CBC and liver function tests
• Instruct patient not to skip doses or double dose.

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Transcript

Hey guys, let’s talk about, chlorpromazine also known as Thorazine. This medication comes in a variety of forms, including oral, IV, and rectal suppository. It’s actually been around for a while. As you can see here in this advertisement from 1962, it’s promoting Thorazine as a medication that “quickly puts an end to violent outbursts.”
So remember that the therapeutic class is what the drug does in the body. While the pharmacologic class is the actual chemical effect. The therapeutic class of chlorpromazine is an antipsychotic and also an antiemetic while the pharmacologic class is a phenothiazine or a dopamine D2 receptor antagonist. So how does chlorpromazine work? So it exhibits an anticholinergic which alters the effect of Dopamine in the central nervous system. We use chlorpromazine for schizophrenia and psychosis as a second-line treatment. Also nausea, vomiting, preoperative sedation, in acute intermittent porphyria, which is a group of disorders that result from a buildup of porphyrins that create issues within the nervous system, in the skin, in other organs. And finally, chlorpromazine is used for bipolar disorder.
So antipsychotic medications are known for coming along with some side effects that are times very difficult for patients to deal with. So with chlorpromazine, we see things like sedation, hypotension, dry mouth, and insomnia. So let’s take a look at some nursing considerations for chlorpromazine. Be sure to assess the patient’s mental status prior to and during treatment, CBC, liver function tests, and blood pressure should all be monitored while the patient is taking chlorpromazine. It is important to mention that chlorpromazine may cause neuroleptic malignant syndrome, which is indicated by a high fever, rigidity, and confusion, also tardive dyskinesia, which is characterized by those involuntary, repetitive movements, like sticking the tongue out or smacking of the lips, and also agranulocytosis. Be sure to teach the patient to take the medication exactly as directed, not skipping any doses or even doubling doses. And here’s an interesting fact regarding chlorpromazine. It is actually given to treat patients with intractable hiccups and guys, this actually happened to my friend and this is exactly what they prescribed her and her hiccups went away. That’s it for chlorpromazine or Thorazine. Now go out and be your best self today and as always happy nursing.

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Mental Health Prep

Concepts Covered:

  • Studying
  • Substance Abuse Disorders
  • Anxiety Disorders
  • Central Nervous System Disorders – Brain
  • Cognitive Disorders
  • Eating Disorders
  • Medication Administration
  • Depressive Disorders
  • Personality Disorders
  • Psychotic Disorders
  • Trauma-Stress Disorders
  • Bipolar Disorders
  • Developmental Considerations
  • Concepts of Mental Health
  • Health & Stress
  • Psychological Emergencies
  • Somatoform Disorders
  • Communication

Study Plan Lessons

08.01 Psychological Review for CCRN Review
Addiction – Behavioral Problems Nursing Mnemonic (The 5 D’s)
Albumin Lab Values
Alcohol Withdrawal (Addiction)
Alcohol Withdrawal Case Study (45 min)
Alcoholism – Outcomes Nursing Mnemonic (BAD)
Alprazolam (Xanax) Nursing Considerations
Altered Mental Status- Delirium and Dementia for Progressive Care Certified Nurse (PCCN)
Alzheimer – Diagnosis Nursing Mnemonic (The 5 A’s)
Ammonia (NH3) Lab Values
Anorexia – Signs and Symptoms Nursing Mnemonic (ANOREXIA)
Antianxiety Meds
Antianxiety Meds
Antidepressants
Antidepressants
Antipsychotics
Antipsychotics
Anxiety
Anxiety Disorders (PTSD, Anxiety, Panic Attack) for Certified Emergency Nursing (CEN)
Atypical Antipsychotics
Benzodiazepines
Benzodiazepines Nursing Mnemonic (Donuts and TLC)
Blood Urea Nitrogen (BUN) Lab Values
Bulimia – Signs and Symptoms 1 Nursing Mnemonic (BULIMIA)
Bulimia – Signs and Symptoms 2 Nursing Mnemonic (WASHED)
Buspirone (Buspar) Nursing Considerations
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Carbamazepine (Tegretol) Nursing Considerations
Chloride-Cl (Hyperchloremia, Hypochloremia)
Chlorpromazine (Thorazine) Nursing Considerations
Cholesterol (Chol) Lab Values
Cognitive Impairment Disorders
Creatinine (Cr) Lab Values
Day in the Life of a Hospice, Palliative Care Nurse
Day in the Life of a Mental Health Nurse
Defense Mechanisms
Defense Mechanisms
Dementia Nursing Mnemonic (DEMENTIA)
Depression
Depression Assessment Nursing Mnemonic (SIGNS)
Depression Concept Map
Diazepam (Valium) Nursing Considerations
Disruptive Behaviors, Aggression, Violence for Progressive Care Certified Nurse (PCCN)
Dissociative Disorders
Divalproex (Depakote) Nursing Considerations
Eating Disorders (Anorexia Nervosa, Bulimia Nervosa)
Encephalopathy Case Study (45 min)
End of Life for Progressive Care Certified Nurse (PCCN)
End-of-Life and Palliative Care (Organ and Tissue Donation, Advance Directives, Care Withholding, Family Presence) for Certified Emergency Nursing (CEN)
Escitalopram (Lexapro) Nursing Considerations
Fluoxetine (Prozac) Nursing Considerations
Generalized Anxiety Disorder
Glomerular Filtration Rate (GFR)
Grief and Loss
Grief and Loss
Haloperidol (Haldol) Nursing Considerations
Handling Death and Dying
Head to Toe Nursing Assessment (Physical Exam)
Homicidal and Suicidal Ideation for Certified Emergency Nursing (CEN)
Hypochondriasis (Hypochondriac)
Lamotrigine (Lamictal) Nursing Considerations
Lithium (Lithonate) Nursing Considerations
Lithium Lab Values
Liver Function Tests
Lorazepam (Ativan) Nursing Considerations
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Manic Attack – Signs and Symptoms Nursing Mnemonic (DIG FAST)
MAO Inhibitors Nursing Mnemonic (TIPS)
MAOIs
Meds for Alzheimers
Mental Health Course Introduction
Metabolic Alkalosis
Methadone (Methadose) Nursing Considerations
Midazolam (Versed) Nursing Considerations
Mood Disorders (Bipolar, Depression) for Certified Emergency Nursing (CEN)
Mood Disorders (Bipolar)
Mood Stabilizers
Mood Stabilizers
Nurse-Patient Relationship
Nursing Care Plan (NCP) for Alcohol Withdrawal Syndrome / Delirium Tremens
Nursing Care Plan (NCP) for Alzheimer’s Disease
Nursing Care Plan (NCP) for Anxiety
Nursing Care Plan (NCP) for Depression
Nursing Care Plan (NCP) for Dissociative Disorders
Nursing Care Plan (NCP) for Eating Disorders (Anorexia Nervosa, Bulimia Nervosa, Binge-Eating Disorder)
Nursing Care Plan (NCP) for Mood Disorders (Major Depressive Disorder, Bipolar Disorder)
Nursing Care Plan (NCP) for Paranoid Disorders
Nursing Care Plan (NCP) for Personality Disorders
Nursing Care Plan (NCP) for Post-Traumatic Stress Disorder (PTSD)
Nursing Care Plan (NCP) for Schizophrenia
Nursing Care Plan (NCP) for Somatic Symptom Disorder (SSD)
Nursing Care Plan (NCP) for Suicidal Behavior Disorder
Nursing Case Study for (PTSD) Post Traumatic Stress Disorder
Nursing Case Study for Bipolar Disorder
Nursing Case Study for Mania (Manic Syndrome)
Olanzapine (Zyprexa) Nursing Considerations
Oxycodone (OxyContin) Nursing Considerations
Palliative Care for Progressive Care Certified Nurse (PCCN)
Paranoid Disorders
Paroxetine (Paxil) Nursing Considerations
Personality Disorders
Phases of Nurse-Client Relationship
Phosphorus-Phos
Post-Traumatic Stress Disorder (PTSD)
Postmortem Care
Potassium-K (Hyperkalemia, Hypokalemia)
Psychological Disorders (Anxiety, Depression) for Progressive Care Certified Nurse (PCCN)
Quetiapine (Seroquel) Nursing Considerations
Schizophrenia
Schizophrenia Case Study (45 min)
Self Concept
Senile Dementia – Assess for Changes Nursing Mnemonic (JAMCO)
Sertraline (Zoloft) Nursing Considerations
Sodium-Na (Hypernatremia, Hyponatremia)
Somatoform
Somatoform Disorder Case Study (30 min)
SSRI’s Nursing Mnemonic (Effective For Sadness, Panic, and Compulsions)
SSRIs
Substance Abuse (Alcohol, Drug Withdrawal) for Progressive Care Certified Nurse (PCCN)
Substance Abuse (Chronic Alcohol Abuse, Chronic Drug Abuse) for Progressive Care Certified Nurse (PCCN)
Substance Abuse (Drug-Seeking Behavior) for Progressive Care Certified Nurse (PCCN)
Suicidal Behavior
TCAs
Therapeutic Communication
Therapeutic Drug Levels (Digoxin, Lithium, Theophylline, Phenytoin)
Thought Disorders (Psychosis, Schizophrenia) for Certified Emergency Nursing (CEN)
Total Bilirubin (T. Billi) Lab Values
Types of Schizophrenia
Urinalysis (UA)
Vitamin B12 Lab Values