Chlorpromazine (Thorazine) Nursing Considerations

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Kara Tarr
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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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Pharmacology Exam III

Concepts Covered:

  • Oncology Disorders
  • Concepts of Pharmacology
  • Medication Administration
  • Nervous System
  • Adulthood Growth and Development
  • Bipolar Disorders
  • Substance Abuse Disorders
  • Depressive Disorders
  • Disorders of Pancreas
  • Intraoperative Nursing
  • Anxiety Disorders
  • Disorders of the Adrenal Gland
  • Central Nervous System Disorders – Brain
  • Hematologic Disorders
  • Respiratory Disorders
  • Cardiac Disorders
  • Immunological Disorders
  • Disorders of the Thyroid & Parathyroid Glands
  • Upper GI Disorders
  • Liver & Gallbladder Disorders
  • Cardiovascular Disorders
  • Urinary System
  • Personality Disorders
  • Psychotic Disorders
  • Peripheral Nervous System Disorders
  • Urinary Disorders
  • Pregnancy Risks
  • Female Reproductive Disorders
  • Neurologic and Cognitive Disorders
  • Noninfectious Respiratory Disorder
  • Learning Pharmacology

Study Plan Lessons

Antineoplastics
Pharmacokinetics
Pharmacodynamics
Parasympathomimetics (Cholinergics) Nursing Considerations
Pain Management for the Older Adult – Live Tutoring Archive
Mood Stabilizers
Methadone (Methadose) Nursing Considerations
MAOIs
Interactive Pharmacology Practice
Insulin Mixing
Insulin Drips
Insulin – Mixtures (70/30)
Insulin – Long Acting (Lantus) Nursing Considerations
Insulin
Glipizide (Glucotrol) Nursing Considerations
Barbiturates
Antidepressants
Antianxiety Meds
Addisons Assessment Nursing Mnemonic (STEROID)
Anticonvulsants
Antianxiety Meds
Barbiturates
MAOIs
Phenobarbital (Luminal) Nursing Considerations
TCAs
Anti Tumor Antibiotics
Alkylating Agents
Sedatives-Hypnotics
Lithium (Lithonate) Nursing Considerations
Pentobarbital (Nembutal) Nursing Considerations
Fluticasone (Flonase) Nursing Considerations
Corticosteroids
Antidiabetic Agents
Sympatholytics (Alpha & Beta Blockers)
Epoetin Alfa
Cyclosporine (Sandimmune) Nursing Considerations
Iodine Nursing Considerations
Levothyroxine (Synthroid)
Propylthiouracil (PTU) Nursing Considerations
Glucagon (GlucaGen) Nursing Considerations
Histamine 2 Receptor Blockers
Histamine 1 Receptor Blockers
Cardiac Glycosides
Calcium Channel Blockers
ACE (angiotensin-converting enzyme) Inhibitors
Metoprolol (Toprol XL) Nursing Considerations
Renin Angiotensin Aldosterone System
Atypical Antipsychotics
Chlorpromazine (Thorazine) Nursing Considerations
Antipsychotics
Haloperidol (Haldol) Nursing Considerations
Atropine (Atropen) Nursing Considerations
Neostigmine (Prostigmin) Nursing Considerations
Parasympatholytics (Anticholinergics) Nursing Considerations
Carbidopa-Levodopa (Sinemet) Nursing Considerations
Autonomic Nervous System (ANS)
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Proton Pump Inhibitors
Ondansetron (Zofran) Nursing Considerations
Insulin – Intermediate Acting (NPH) Nursing Considerations
Insulin – Short Acting (Regular) Nursing Considerations
Insulin – Rapid Acting (Novolog, Humalog) Nursing Considerations
Metformin (Glucophage) Nursing Considerations
Amitriptyline (Elavil) Nursing Considerations
Sertraline (Zoloft) Nursing Considerations
Paroxetine (Paxil) Nursing Considerations
Fluoxetine (Prozac) Nursing Considerations
Escitalopram (Lexapro) Nursing Considerations
SSRIs
Bupropion (Wellbutrin) Nursing Considerations
Antidepressants
Phenytoin (Dilantin) Nursing Considerations
Levetiracetam (Keppra) Nursing Considerations
Lamotrigine (Lamictal) Nursing Considerations
Gabapentin (Neurontin) Nursing Considerations
Carbamazepine (Tegretol) Nursing Considerations
Antianxiety Meds
Buspirone (Buspar) Nursing Considerations
Diazepam (Valium) Nursing Considerations
Midazolam (Versed) Nursing Considerations
Lorazepam (Ativan) Nursing Considerations
Alprazolam (Xanax) Nursing Considerations
Benzodiazepines
Disease Specific Medications
Pharmacology Course Introduction
The SOCK Method – Overview