Chlorpromazine

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Contents

[edit] BRAND NAMES

[edit] STRUCTURE

Chlorpromazine.jpg

[edit] MECHANISM OF ACTION

Chlorpromazine, a phenothiazine derivative classified as a low-potency typical antipsychotic is indicated for the treatment of schizophrenia. The therapeutic effect is thought to be due to blocking of postsysnaptic dopamine D2 receptor subtype in the mesolimbic pathway.
Antagonism of dopamine receptors is also associated with extrapyramidal effects such as akathisia, dystonia and tardive dyskinesia and elevated serum prolactin.
Chlorpromazine has also antiadrenergic, anticholinergic, antihistaminic and antiserotonin activity.
Chlorpromazine acts also as an antiemetic

[edit] INDICATIONS

  • Treatment of schizophrenia
  • To control nausea and vomiting
  • Treatment of agitation and to control the manifestations of the manic type of manic-depressive illness.
  • To control resistant and severe hiccups

[edit] DOSAGE

Medscape link for Chlorpromazine dosage

[edit] CONTRAINDICATIONS

  • Hepatic disease
  • Avoid in elderly due to orthostatic hypotension
  • Avoid in epilepsy (lowers seizure threshold)
  • Avoid in Parkinson’s disease (because of a possible antagonistic effect with dopaminergic agonists used in the treatment of parkinsonism)
  • Avoid in Hypoparathyroidism
  • Avoid in myasthenia gravis (Due to its strong antimuscarinic effects)
  • Avoid in Prostatic hypertrophy (Due to its strong antimuscarinic effects)

[edit] WARNINGS AND PRECAUTIONS

  • Chlorpromazine may impair mental and/or physical abilities. Therefore, caution patients about activities requiring alertness (e.g. operating machinery or vehicles).

[edit] INTERACTIONS

[edit] PREGNANCY AND LACTATION

  • Pregnancy Category C (US)
  • Use in Lactation: Chlorpromazine has been found to be excreted in breast milk in variable amounts, therefore it is not recommended for nursing mothers unless the expected benefits outweigh any potential risk.

[edit] SIDE EFFECTS

  • Sedation
  • Dryness of mucous membranes , Urinary retention.
  • Hypotension
  • Increase LFT (liver function tests). Routine tests are advisable during prolonged therapy.
  • Severe photosensitivity (Avoid exposure in strong sunlight)
  • Weight gain
  • Cardiac effects: Arrhythmias.
  • Agranulocytosis (rare)
  • Leucopenia
  • Elevated prolactin levels: breast enlargement, galactorrhea, impotence in men and irregular menstrual cycles or absence of menstruation in women
  • Contact dermatitis

[edit] RELATED LINKS

Antipsychotics (Typical and Atypical): pharmacology, indications and adverse effects

[edit] BIBLIOGRAPHY

[edit] REFERENCES