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prochlorperazine (Compazine, Stemetil, Novamin, Buccastem)

Tradename: Compazine. Indications: - severe nausea & vomiting (no better than placebo [5]) - NOT effective in preventing vertigo or motion sickness or management of emesis caused by action of drugs on the nodose ganglion - anxiety [6] - schizophrenia [6] Contraindications: - children < 2 years of age Dosage: 1) 5-10 mg IV over at least 2 min 2) 5-10 mg PO/IM TID/QID 3) 25 mg PR every 12 hours 4) pediatrics: a) 0.4 mg/kg/day PO/PR divided TID-QID b) 0.13 mg/kg/dose IM (IV not recommended) Tabs: 5, 10, 25 mg. Elixir: 5 mg/5 mL. Suppositories: 2.5, 5, 25 mg. Injection: 5 mg/mL (2 mL, 10 mL). Sustained-release: (Compazine spansules) - 10 mg PO every 12 hours. - Tabs: 10, 15, 30 mg. Pharmacokinetics: 1) onset of action: a) 30-40 minutes oral b) 60 minutes rectal c) 10-20 minutes IM 2) duration of action: 3-4 hours 3) eliminated primarily by hepatic metabolism & biliary secretion Adverse effects: 1) common (> 10%) - pseudoparkinsonism, akathisia, dystonias, hypotension, pigmentary retinopathy, persistent tardive dyskinesia, constipation, decreased sweating, dizziness, orthostatic hypotension, nasal congestion 2) less common (1-10%) - difficulty urinating, photosensitivity, rash, changes in menstrual cycle, sexual dysfunction, breast pain, weight gain, dizziness, nausea/vomiting, epigastric pain, trembling of fingers 3) uncommon (< 1%) - leukopenia, agranulocytosis, hepatotoxicity, cholestatic jaundice, neuroleptic malignant syndrome, priapism, blue-gray discoloration of skin, impaired temperature regulation, galactorrhea, changes in cornea & lens 4) other - shares toxic potential of other phenothiazines, extrapyramidal reactions common - lowering of seizure threshold - hypersensitivity - anticholinergic effects - dry mouth - mydriasis - decreased GI motility Mechanism of action: -> directly effects the medullary chemoreceptor trigger zone (CTZ) in the area postrema

Interactions

drug interactions drug adverse effects (more general classes)

Related

chemoreceptor trigger zone (CTZ)

General

anti-emetic dopaminergic receptor antagonist phenothiazine

Properties

MISC-INFO: elimination route LIVER KIDNEY pregnancy-category C safety in lactation ?

Database Correlations

PUBCHEM correlations

References

  1. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
  2. AHFS 96 Drug Information, GK McEnvoy et al (ed), American Society of Health-System Pharmacists, Bethesda, MD 1996, pg 2135
  3. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
  4. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  5. Braude D, Soliz T, Crandall C, Hendey G, Andrews J, Weichenthal L. Antiemetics in the ED: a randomized controlled trial comparing 3 common agents. Am J Emerg Med. 2006 Mar;24(2):177-82. PMID: 16490647
  6. Deprecated Reference

Component-of

intravenous anti-emetic combination