Pharmacologic Class: Phenothiazine antipsychotic
ACTIONS AND USES: Prochlorperazine is a phenothiazine, a class of drugs usually prescribed for psychoses. The phenothiazines are the largest group of drugs prescribed for severe nausea and vomiting, and prochlorperazine is the most frequently prescribed antiemetic in its class. Prochlorperazine acts by blocking dopamine receptors in the brain, which inhibits signals to the vomiting center in the medulla. Dopamine
As an antiemetic, it is frequently given by the rectal route, where absorption is rapid. It is also available in tablet, extended-release capsule, and IM formulations.
ADMINISTRATION ALERTS: Administer 2 hours before or after antacids and antidiarrheals. Pregnancy category C.
ADVERSE EFFECTS: Prochlorperazine produces dose-related anticholinergic side effects such as dry mouth, sedation, constipation, orthostatic hypotension, and tachycardia. When used for prolonged periods at higher doses, extrapyramidal symptoms resembling those of Parkinson's disease are a serious concern, especially in older patients.
Contraindications: This drug should not be used in patients with hypersensitivity to phenothiazines, in comatose patients, or in the presence of profound CNS depression. It is also contraindicated in children younger than age 2. Patients with narrow-angle glaucoma, bone marrow suppression, or severe hepatic or cardiac impairment should not take this drug.
INTERACTIONS: Drug-Drug: Prochlorperazine interacts with alcohol and other CNS depressants to cause additive sedation. Antacids and antidiarrheals inhibit the absorption of prochlorperazine. When taken with phenobarbital, metabolism of prochlorperazine is increased. Use with tricyclic antidepressants may produce increased anticholinergic and hypotensive effects.
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