GENERIC/BRAND/ CLASSIFICATION Generic: Fluphenazine
BRAND: Prolixin, Fluphenazine Decanoate
CLASSIFICATION: Antipsychotics
Drug Image:
MECHANISM OF INDICATION ACTION Alters the effects of Acute and chronic dopamine in CNS. psychoses. Anticholinergic and alpha-adrenergic blocking activity.
CONTRAINDICATION CONTRAINDICATION
ADVERSE REACTION
DOSAGE
Hypersensitivity; Hypersensitivity; crosssensitivity with other phenothiazines may exist; subcortical brain damage; severe CNS depression; coma; bone marrow depression; liver disease; hypersensitivity hypersensitivity to sesame oil (decanoate salt); some products contain alcohol or tartrazine and should be avoided in clients with known intolerance; concurrent use of drugs that prolong QT interval.
CNS: NEUROLEPTIC MALIGNANT SYNDROME, extrapyramidal reactions, sedation, tardive dyskinesia. dyskinesia. EENT: Blurred vision, dry eyes. CV: Hypertension, hypotension, tachycardia. GI: Anorexia, constipation, druginduced hepatitis, dry mouth, ileus, nausea, weight gain. GU: Urinary retention. Derm: Photosensitivity, pigment changes, rashes. Endo: Galactorrhea. Hemat: AGRANULOCYTOSIS, leukopenia, thrombocytopenia. Misc: Allergic reactions.
Usual: PO (Adults): 0.5 –10 –10 mg/day in divided doses every 6 –8 –8 hr (maximum dose = 40 mg/day). IM (Adults): 12.5 –25 –25 mg initially; may be repeated every 3 wk. Dosage may be slowly ↑ as needed (not to exceed 100 mg/dose).
Actual:
NURSING RESPONSIBILITY Assess patient’s mental status (orientation, mood, behavior) before and periodically throughout therapy. Monitor blood pressure (sitting, standing, lying), ECG, pulse, and respiratory rate before and frequently during the period of dosage adjustment. May cause Qwave and T-wave changes in ECG. Observe patient carefully when administering oral medication to ensure that medication is actually taken and not hoarded. Assess fluid intake and bowel function. Increased bulk and fluids in the diet help minimize constipation. Monitor patient for onset of akathisia (restlessness or desire to keep moving) and extrapyramidal side effects (parkinsonian— (parkinsonian—difficulty speaking or swallowing, loss of balance control, pill rolling, mask-like face,
RATIONALE
shuffling gait, rigidity, tremors; dystonic—muscle spasms, twisting motions, twitching, inability to move eyes, weakness of arms or legs) every 2 mo during therapy and 8 –12 wk after therapy has been discontinued. Reduction in dosage or discontinuation of medication may be necessary. Trihexyphenidyl or diphenhydramine may be used to control these symptoms. Monitor for tardive dyskinesia (uncontrolled rhythmic movement of mouth, face, and extremities; lip smacking or puckering; puffing of cheeks; uncontrolled chewing; rapid or worm-like movements of tongue). Report immediately; may be irreversible. Monitor for development of neuroleptic malignant syndrome (fever, respiratory distress, tachycardia, seizures, diaphoresis, hypertension or hypotension, pallor, tiredness, severe muscle stiffness, loss of bladder control). Report
immediately. Lab Test Considerations: CBC, liver function tests, and ocular examinations should be evaluated periodically during therapy. May cause decreased hematocrit, hemoglobin, leukocytes, granulocytes, and platelets.
May cause elevated bilirubin, AST, ALT, and alkaline phosphatase. Agranulocytosis may occur after 4 –10 wk of therapy with recovery 1 –2 wk after discontinuation. May recur if medication is restarted. Liver function abnormalities may require discontinuation of therapy. May cause false-positive or false-negative pregnancy tests and false-positive urine bilirubin test results.
